The problem with CT scans

LaundryQueen
LaundryQueen Member Posts: 676
in Ovarian Cancer #1
Has anyone considered that the recurrence rate of ovarian cancer might possibly be related to how the condition is followed by doing frequent CT scans?

I read somewhere that (in Germany) once a woman has had breast cancer, she NEVER gets another mammogram. I think she gets an MRI or ultrasound but not ionizing radiation to the breasts.

This info came from a link on the teal journal web site.

http://www.cancernetwork.com/cancer-genetics/content/article/10165/1776919

Does anyone know why MRIs are not done to follow up after chemo?

Comments

  • mopar
    mopar Member Posts: 1,972 Member
    #2
    I HAVE QUESTIONS, TOO
    One day I asked the CT technician, 'how much radiation am I getting with this scan'? He said, 'the equivalent of 70 xrays'. I about fell of the table. I also get triple contrast with each CT - that is, oral, enema AND IV. So, I've always had concerns, considering I've done this at least 2-4 times a year since 1999. The thinking seems to be that the CT is a better diagnostic tool, and if there is evidence of disease, it is followed with PET scan. At least, that's how it worked for me and my 2 bouts with OVCA.

    I also heard through this board that the CT cannot detect anything smaller than 1cm - is this true?

    Well, I do attribute a portion of my destroyed thyroid to the CT scans. And the enormous amount of radiation does concern me. For the physician, I think they see it as a 'small price to pay, low risk' for the peace of mind it may bring. I don't know. Sounds like a coin toss to me.

    Monika
  • anicca
    anicca Member Posts: 334 Member
    #3
    Yes.
    I feel completely crazy saying this, but I had an abdominal CT two years before my diagnosis, and when I went to get the DVD of the scan (part of my documentation submitted to the gyn/onc to be seen by him), it occurred to me that maybe the radiation from that scan is what triggered my tumor. My dad always told me that radiation damage is cumulative (not bad for someone born in 1910, huh) and to avoid any unnecessary x-rays, and I have done so. That CT scan is the only time my abdomen was ever exposed.
  • Rookerbird
    Rookerbird Member Posts: 100
    #4
    mopar said:

    I HAVE QUESTIONS, TOO
    One day I asked the CT technician, 'how much radiation am I getting with this scan'? He said, 'the equivalent of 70 xrays'. I about fell of the table. I also get triple contrast with each CT - that is, oral, enema AND IV. So, I've always had concerns, considering I've done this at least 2-4 times a year since 1999. The thinking seems to be that the CT is a better diagnostic tool, and if there is evidence of disease, it is followed with PET scan. At least, that's how it worked for me and my 2 bouts with OVCA.

    I also heard through this board that the CT cannot detect anything smaller than 1cm - is this true?

    Well, I do attribute a portion of my destroyed thyroid to the CT scans. And the enormous amount of radiation does concern me. For the physician, I think they see it as a 'small price to pay, low risk' for the peace of mind it may bring. I don't know. Sounds like a coin toss to me.

    Monika

    What a CT Can Detect
    No idea why CTs are the diagnostic tool of choice instead of MRIs. I want to find out, though...

    I am about to head to the hospital for a follow-up CT for my first 3 Doxil infusions, so I happen to have my November CT report with me. There were areas noted smaller than 1 cm (7mm x 5mm, 7mm, etc.) and some nice big ones too (4.5 cm diameter, 2.5 cm diameter).

    If I recall correctly, there are several women on the board who have CTs this week. Hoping for positive results for one and all!
  • kikz
    kikz Member Posts: 1,345 Member
    #5
    anicca said:

    Yes.
    I feel completely crazy saying this, but I had an abdominal CT two years before my diagnosis, and when I went to get the DVD of the scan (part of my documentation submitted to the gyn/onc to be seen by him), it occurred to me that maybe the radiation from that scan is what triggered my tumor. My dad always told me that radiation damage is cumulative (not bad for someone born in 1910, huh) and to avoid any unnecessary x-rays, and I have done so. That CT scan is the only time my abdomen was ever exposed.

    CT scans
    I've had 5 or 6 CT scans since 3/16/2010. The first one determined I had ov/ca and the last one was after the final chemo infusion. I ended up in the ER 4 times in between and I believe I had a CT scan each time. I remember feeling so sick as I was wheeled down to radiology and thinking this must be some kind of cruel joke. But of course no one was laughing. It seems that things that help us can also ultimately hurt us. I read on the Tylenol label that taking more than the recommended dose can cause liver damage. Good grief!

    Karen
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834
    #6
    My CT scans have picked up
    My CT scans have picked up "something" that was sized at 2 mm. My doctor said that is smaller than a BB and he was surprised that the radiologist could even see it on the scan. But he did.....twice.

    Whatever it is, it has not grown, moved or shrunk in the last year. And it's still too small to identify. The head of a pin is about 2mm. I don't know if anything that small would show up better on a PT scan, or an MRI, but if it's so small they can't tell what it is, I don't know how much benefit another test would be.

    There are 10mm in one cm, so I'm pretty sure a CT scan can detect things before they get as big as a centimeter.


    Carlene
  • LaundryQueen
    LaundryQueen Member Posts: 676
    #7
    Hissy_Fitz said:

    My CT scans have picked up
    My CT scans have picked up "something" that was sized at 2 mm. My doctor said that is smaller than a BB and he was surprised that the radiologist could even see it on the scan. But he did.....twice.

    Whatever it is, it has not grown, moved or shrunk in the last year. And it's still too small to identify. The head of a pin is about 2mm. I don't know if anything that small would show up better on a PT scan, or an MRI, but if it's so small they can't tell what it is, I don't know how much benefit another test would be.

    There are 10mm in one cm, so I'm pretty sure a CT scan can detect things before they get as big as a centimeter.


    Carlene

    Psammoma body
    I don't know if I spelled it correctly but my pathology report identified a couple of psammoma bodies--calcified cancer. Wikipedia has a picture of one. The doctor said it was a healing response to cancer.
  • kayandok
    kayandok Member Posts: 1,202 Member
    #8
    MRI
    scans are to look inside of a particular tumor, from what I understand. I had an MRI initially, after the internal ultrasound detected ovarian tumors. The doctor determined that the cysts were 50/50 chance of being cancer, and scheduled surgery. My dx was stage 3C. If they had done a PET/CT at that point, everything would have lit up as cancer, and I am still baffled as to why they did that. (I have only had PET/CT or a CT's for scan follow up since that time.)

    I know that my doctor is always dragging his feet about doing scans, and I usually put the pressure on him to do them. I agree that the radiation is not good, but wanting to know the condition of my body, outweighs that fact and I choose to get a scan, usually.

    I think that comparing breast cancer treatment to ovarian cancer treatment is apples and oranges too, because of the way that they spread.

    My two cents today,
    k
  • kayandok
    kayandok Member Posts: 1,202 Member
    #9
    Hissy_Fitz said:

    My CT scans have picked up
    My CT scans have picked up "something" that was sized at 2 mm. My doctor said that is smaller than a BB and he was surprised that the radiologist could even see it on the scan. But he did.....twice.

    Whatever it is, it has not grown, moved or shrunk in the last year. And it's still too small to identify. The head of a pin is about 2mm. I don't know if anything that small would show up better on a PT scan, or an MRI, but if it's so small they can't tell what it is, I don't know how much benefit another test would be.

    There are 10mm in one cm, so I'm pretty sure a CT scan can detect things before they get as big as a centimeter.


    Carlene

    Carlene,
    the CT scans are not all the same at each hospital. It seems that the old machines can only detect tumors that are 2 or 3 cm. And the newest latest CT machines (including the one that goes with the PET scan) can detect down to the mm, but the doc has the option of setting the grid and field to whatever grid and range he decides. This is a good thing or scary thing, depending on your doctor's philosphy of treating cancer recurrence.

    This is another area that we can take charge of our own treatment, by finding out about the CT machine and what grid it is set on. And also a good argument for going to a learning/reputable hospital for treatment (they tend to always have the latest technology).

    That being said, Carlene, your hospital's CT scan seems to be a good one, and your doctor is doing his job, it seems.

    kathleen
  • LaundryQueen
    LaundryQueen Member Posts: 676
    #10
    kayandok said:

    MRI
    scans are to look inside of a particular tumor, from what I understand. I had an MRI initially, after the internal ultrasound detected ovarian tumors. The doctor determined that the cysts were 50/50 chance of being cancer, and scheduled surgery. My dx was stage 3C. If they had done a PET/CT at that point, everything would have lit up as cancer, and I am still baffled as to why they did that. (I have only had PET/CT or a CT's for scan follow up since that time.)

    I know that my doctor is always dragging his feet about doing scans, and I usually put the pressure on him to do them. I agree that the radiation is not good, but wanting to know the condition of my body, outweighs that fact and I choose to get a scan, usually.

    I think that comparing breast cancer treatment to ovarian cancer treatment is apples and oranges too, because of the way that they spread.

    My two cents today,
    k

    Adhesions
    Does anyone know if adhesions can be detected by CT &/or MRI. The comment about breast cancer & avoiding radiation was more in the interest of preventing new cancers not metastasis. There is an expression that you can cut an apple off the tree but the tree is still capable of making a new apple. Maybe not the best analogy, but the idea is to change the environment that spawned a malignancy. I think that is why there is a lot of interest in looking into gene therapy & vaccine therapy.

    I spoke to the oncology nurse who said it was OK if I had MRIs instead of CTs & there were other women who chose that option also.
  • Kaleena
    Kaleena Member Posts: 2,088 Member
    #11
    LaundryQueen said:

    Adhesions
    Does anyone know if adhesions can be detected by CT &/or MRI. The comment about breast cancer & avoiding radiation was more in the interest of preventing new cancers not metastasis. There is an expression that you can cut an apple off the tree but the tree is still capable of making a new apple. Maybe not the best analogy, but the idea is to change the environment that spawned a malignancy. I think that is why there is a lot of interest in looking into gene therapy & vaccine therapy.

    I spoke to the oncology nurse who said it was OK if I had MRIs instead of CTs & there were other women who chose that option also.

    All I know is that I have
    All I know is that I have had many CT scans since 2005. In 2009, my "new" doctor reviewed my CT scan done in July and indicated I had a recurrence. Although my radiation oncologist said that the spot was there since 2005 as he has seen it on the CT scans and it was believed to be scar tissue. So I was sent for a PET/CT which showed a decrease in size and negative. Not convinced, they sent me for an MRI - also negative. All within a three week period. I did, however, have a positive biopsy.

    Ultimately, I had surgery in 2010 to remove the small tumor (it was negative), although one of my lmphy nodes removed had a microscopic cell in it. No treatment, just watch. Since then, I have had two PET scans (just PET), all good. I was to get another one in six months (which is now), but the nurse practioner doesn't want to schedule it. I was too stressed about having too many, but now stressed because I think it is a good idea to have them.

    CT Scans - with or without detects changes and can see scar tissue and surgical changes
    CT/PET Scans - with or without contrast - detects changes and can see active cancer
    PET Scan - can see active cancer - has to be over a certain number though
    MRI - can view area from all angles and determine size, etc.


    Some hospitals do the scans different. My one hospital only did CT/PET Scans whereas my new hospital can do just a PET scan (they only put isotops in your iv - nothing to drink).

    It would seem to me that the best option would be either CT/PET or PET scans on patients who have been diagnosed or treated for cancer. However, most insurance companies do not allow PET scans or there is a limit.

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