How often do you get imaging done for nasopharyngeal cancers?

Ag123

Hi everyone! 
hope all is well. I haven't posted for a while. I hope everyone is doing well. My dad has been doing great. 

 

I'm curious how often is CT scan normally ordered for nasophangeal cancer 3-5 years post treatment if you don't have symptoms? it's been about 4.5 years since dad's last treatment and it seems like they started to do head & neck CTs only once a year for a few years now.

They do chest CTs to monitor his nodules more frequently.

 

If youre wondering why I'm asking this, it's cause his insurance rejected his H&N CT (scheduled 9 months after his last scan) and we have to appeal. 

So I'm just curious!

 

thanks

motorcycleguy

Ag123

I was NPC, and I met with my Oncologist, twice a year, and also my ENT Specialist twice a year.

I'm two years out .. and it's happening once a year each, now. So, what your Dad is experiencing sounds typical. The good news, is he is way past the 2 year mark, and I've heard the chances of recurrence are reduced. So, he will likely be good going forward.

I personally haven't had any issues with insurance. In the end, although I would recommend he follow his Doctors' advice, he's in charge of his own schedule, and it's up to him, if he wanted to go every other year.

I hope he continues to have great tests - going forward!

MG

Logan51

hhmmm

I'm 12 years and 4 months out from NPC, so...back in the day, I had a PET/CT done 3 months after, then 1,2,3,4 year anniversaries. CTs are cheap compared to PET Scans, so I think your Dad's Insurance is peculiar. If the Dr. orders it, then they should cover it- the Insurance people are not Doctors. Are you in the US? I've heard of "social medicine" countries in Europe that allow only one PET Scan- the one before tx, which surprised me, and that's why I ask.

 

wbcgaruss

I Believe this Is

Sort of normal procedure for a lot of insurance.
I remember being turned down, well actually they turned down the doctor and the nurse said something like "they always do this, or often do this (insurance turns down test request) we just resubmit it".
So have your docs resubmit for it and it will probably be approved.
Take Care-God Bless-Russ

Ag123

motorcycleguy said:

Ag123

I was NPC, and I met with my Oncologist, twice a year, and also my ENT Specialist twice a year.

I'm two years out .. and it's happening once a year each, now. So, what your Dad is experiencing sounds typical. The good news, is he is way past the 2 year mark, and I've heard the chances of recurrence are reduced. So, he will likely be good going forward.

I personally haven't had any issues with insurance. In the end, although I would recommend he follow his Doctors' advice, he's in charge of his own schedule, and it's up to him, if he wanted to go every other year.

I hope he continues to have great tests - going forward!

MG

That does sound like a

That does sound like a reasonable frequency to me as well. For my dad, it's been about one CT scan for head and neck annually and once for chest every 6-8 months to monitor benign appearing nodules. He sees his oncologist (now the PA) twice yearly, and surgeon For scope twice yearly as well.
I've no clue if it's their protocol but the scans always seem like a decision the PA makes intuitively. 

That's great that you passed the two year mark! If I remember correctly I think 1.5 years in is when they started doing less frequent testings for my dad. this is when he also started to see a PA on behalf of the oncologist. 

Dealing with insurance is always a headache. They approved it for the lungs but not the head and neck scan. Can't figure out why. when I called they told me the provider must've made a mistake when they submitted the order. who knows!

He's also going to see the surgeons for the scope (which he also does every 6 months) so hopefully we can get his second opinion on that while we're waiting for the approval.  

Ag123

Logan51 said:

hhmmm

I'm 12 years and 4 months out from NPC, so...back in the day, I had a PET/CT done 3 months after, then 1,2,3,4 year anniversaries. CTs are cheap compared to PET Scans, so I think your Dad's Insurance is peculiar. If the Dr. orders it, then they should cover it- the Insurance people are not Doctors. Are you in the US? I've heard of "social medicine" countries in Europe that allow only one PET Scan- the one before tx, which surprised me, and that's why I ask.

 

Interesting!

They only did PET/CT 6 months and 1.5 year post-treatment for my dad!

For him, after the PETs they did chest CTs basically every 6 months. They focused on his lungs more so they would do H&N CTs once a year only as it seemed stable. He got scoped twice yearly and physical assesments/ follow-ups twice a year per team (two appointments with his oncologist or the PA and two appointments with cancer surgeon). He also did two random EBV tests (well not random per se. one was during treatment and the other 2 years after it ended). 

 

His insurance has always been like this. -.- I still remember when they rejected second round of chemo. His oncologist called them himself in front of us to convince them that he needed it. 

12 years is awesome! Do you ever need to do any screening? 

oh and he lives in the US Btw. his center is Sylvester cancer center from Universitu of Miami. 

Ag123

wbcgaruss said:

I Believe this Is

Sort of normal procedure for a lot of insurance.
I remember being turned down, well actually they turned down the doctor and the nurse said something like "they always do this, or often do this (insurance turns down test request) we just resubmit it".
So have your docs resubmit for it and it will probably be approved.
Take Care-God Bless-Russ

Yup

Sounds exactly like our experience as well unfortunately. I'll contact the office also- if they can speed up the process, why not! 

 

thanks!