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Question About Scans After Treatment
I have ten more rad treatments and 2 more chemo treatments left to go. As far as I know anyway. ( NPC, T-3,TN-2,M0)
( treatment plan was 35 rads 12 chemo)
I talked with my rad Doctor this morning and asked him if he would be doing a scan after my last treatment to see how things worked out.
He said that the first scan would probably be in about 3 months after treatment.
He said he would be seeing me monthly to monitor my side effects.
Is this what you folks have experienced after treatment ? A scan delay. ?
I was hoping that he would at least scope me or scan me to give me an idea if the tumor has shrunk according to plan.
Thanks for any replies,
Dennis 
Comments
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to delay or not delay
Hi Dennis
It’s normal to delay the first scan until a few months after the last treatment. The region gets a lot of inflammation from the radiation and chemo, and the scans will show a bunch of abnormalities (false positive) that would be very difficult to distinguish between reoccurrence, residual or inflammatory.
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My med onc had me scaned (CT)
My med onc had me scaned (CT) at 6 weeks post treatment and I will have a PET scan at 12 weeks post treatment. He believes in early scans. Most others here have them after another 6 weeks. I see my med onc once per week. Saw my ENT 8 weeks post and will see my Rad onc after PET.
Just one guy's schedule.
J.
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Scans
After my husband completed 35 radiation and 3 chemo treatments for laryngeal cancer, they did a PET/CT scan less than 6 weeks after he completed his treatment. The scan said NED. WRONG. 2 months later he had trouble with breathing and the ENT said he needed another biopsy and trak. We were then referred to Emory Winship Cancer Center to a H&N specialist. The cancer was back, but according to the specialist it never went away. The PET/CT scan was wrong. The specialist said the PET/CT was done too early after completion of radiation. He then had surgery and a PET/CT every 3 months after that. Then a year later when he was going to have the procedure for a TEP, a tumor was discovered at the cervical of his esophagus. He underwent another 35 radiation and 7 chemo treatments. This time the PET/CT was done 3 months after treatment was completed and he was NED even with an endoscopy. But three months later the cancer had recurred at the cervical of his esophagus and has spread to his right lung.
The PET/SC done three months after completing the radiation and chemo did light up but they were putting that down to the radiation side effects. Did mention that the possibility remained that not all the cancer cells were gone, covering themselves to the possibility that the cancer was still there. No way to really know because a PET/CT scan will not pick up any cancer that is tiny -- nothing will.
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Healing takes Tme
Irradiated tissues take a long time to heal so it is not surprising that your oncologist is waiting. I had BOT with left cervical lymph nodes, 33 rads, 8 chemo treatments and while the ENT that found the tumor originally scoped my throat at 3 weeks post treatment (clear scope!) it was not until 3 months later that I had my first post treatment PET/CT.
Healing tissues will take up a lot of the FRG molecule so you WILL get false positives. My 3 month showed a couple of lymph nodes that at first were thought to be scar tissue but the tumor board recommended surgery. Pathology was positive for weak, inactive remnant disease.
Surgical healing has been long too, so much so that the next scan at 8 months post still showed issues and resulted in another surgery, though fortunately pathology was negative for all the nodes removed.
Talk with your Oncologist and relay your concerns, no one is more anxious than a patient finished with treatments wanting to know if it is 'gone'!
Peter
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