Almost a year out from treatments but no catscan

Chris Ptown

Hi Friends! I have another appointment with the surgeon that originally found my cancer and who has been doing the digital rectal exams for me for the past six months or more. He will give me another DRE in January but I am concerned that I am not having a catscan. I lost my job in April and now have no insurance but the surgeon in Hyannis, MA still sees me and gives me the DRE's. They said I can pay what I can, when I can. My question to all of you is shouldn't I be having a catscan? I contacted the doctors where i had my treatment last year and since I no longer have Blue Cross they can't see me anymore. That means I can't see my radiation doctor or oncologist.

mp327

Hi Chris--
I'm very sorry to hear you lost your job and that your insurance coverage is no longer in effect. Have you had any post-treatment scans?--I can't remember.

In looking at the NCCN guidelines for follow-up, CT scans are only recommended in cases of T3-T4 tumors and only annually for the first 3 years. What must be done without question is to continue having DRE's and anoscopes every 3-6 months for 5 years post-treatment. It sounds like you are getting DRE's on a regular basis, but you did not mention getting anoscopes.

I believe in the follow-up phase that the most important doctor to see is the colorectal doctor for the above-mentioned exams. I haven't seen my radiation oncologist for some time now. My medical oncologist continues to see me every six months for a post-scan appt. I seem to be one of the few whose doctor continues with scanning for some time, as I am over 4 years out of treatment. However, if you are getting the all clear on your exams, scans may be overkill, I just don't know.

I am adding on a couple more thoughts here, Chris. First of all, I can totally appreciate how reassuring clear scans can be and why you might want to have one. I think all of us would get scanned frequently for peace of mind if it weren't for the cost and the risks of more radiation exposure. If you feel the need for that peace of mind, ask your doctor about getting one and then call the facility where it would be performed and ask them what they would charge you as a self-pay patient. Some hospitals/facilities will negotiate a reasonable fee for someone who has no insurance. Obviously, payment up front would be required. It wouldn't hurt to ask and that way you can decide what you want to do or are able to do, based on finances.

Just be sure to keep getting those regular DRE's and ask about getting anoscopes.

Marynb

Chris
Hi. I just want to tell that I have not had scans either and I am being treated at top rated hospital, and I have insurance and the ability to pay, etc. I was also concerned about not having scans and was told that research shows that the harm of the scans outweighs the benefit. The dre's and scope should be enough to spot any problems. Also, if you become symptomatic another scan could be done.

Take care.

Chris Ptown

mp327 said:

Hi Chris--
I'm very sorry to hear you lost your job and that your insurance coverage is no longer in effect. Have you had any post-treatment scans?--I can't remember.

In looking at the NCCN guidelines for follow-up, CT scans are only recommended in cases of T3-T4 tumors and only annually for the first 3 years. What must be done without question is to continue having DRE's and anoscopes every 3-6 months for 5 years post-treatment. It sounds like you are getting DRE's on a regular basis, but you did not mention getting anoscopes.

I believe in the follow-up phase that the most important doctor to see is the colorectal doctor for the above-mentioned exams. I haven't seen my radiation oncologist for some time now. My medical oncologist continues to see me every six months for a post-scan appt. I seem to be one of the few whose doctor continues with scanning for some time, as I am over 4 years out of treatment. However, if you are getting the all clear on your exams, scans may be overkill, I just don't know.

I am adding on a couple more thoughts here, Chris. First of all, I can totally appreciate how reassuring clear scans can be and why you might want to have one. I think all of us would get scanned frequently for peace of mind if it weren't for the cost and the risks of more radiation exposure. If you feel the need for that peace of mind, ask your doctor about getting one and then call the facility where it would be performed and ask them what they would charge you as a self-pay patient. Some hospitals/facilities will negotiate a reasonable fee for someone who has no insurance. Obviously, payment up front would be required. It wouldn't hurt to ask and that way you can decide what you want to do or are able to do, based on finances.

Just be sure to keep getting those regular DRE's and ask about getting anoscopes.

thanks again mp327!
i will ask my doctor about the anoscope! thanks again so much!

Chris Ptown

Marynb said:

Chris
Hi. I just want to tell that I have not had scans either and I am being treated at top rated hospital, and I have insurance and the ability to pay, etc. I was also concerned about not having scans and was told that research shows that the harm of the scans outweighs the benefit. The dre's and scope should be enough to spot any problems. Also, if you become symptomatic another scan could be done.

Take care.

Thank you Marynb
That makes me feel a little better, thank you very much!