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  • Alexandra
    Alexandra Member Posts: 1,308
    #22
    bosberg said:

    Opinions welcomed

    Today my dr called me. He has gone ahead and ordered me an MRI. I asked him if I could have a CT scan instead to better identify any cancererous tissues and he said that MRI would be safer for me due to it not needing radiation vs the ct so they do mri's.

    My question is this: if it were you, would you try to get in at the clinic you want to go to for a second opinion at this point, before an mri and ask for a ct scan? Would you get the mri and then go for the second opinion? I am not sure if the mri does not show cancer clearly why pay for it if I can get a ct somewhere else?

    Again, at this point I am dealing with a gyn. dr only and not a gyn/onc. I am not sure if I can get in w/ a gyn/onc w/out further proof or maybe they would take me w/ all my symptoms thus far. Have any of you had any problems originally getting w/ a gyn/onc. ?

    What questions did you ask before going w/ the one you did or were you just 'assigned' a gyn/onc at what ever hospital/clinic you were at?

    Thank you for your opinion

    Opinion

    I recently had a conversation with GYN-ONC (Dr. Les Levine @ Princess Margaret Hospital) about CT vs. MRI. In terms of radiation an abdominal/pelvic CT is the equivalent of 400 X-Ray's and yes, it is more harmful than MRI; but one CT scan is not Chernobyl and not gonna kill you. In his opinion CT is a better diagnostic tool for abdominal issues. They limit it for very young patients or for someone with existing bone marrow defficiencies.

    My regular ONC at Odette Cancer Center does not do regular CT scans, she only monitors CA-125. Ovarian patients at Princess Margaret get regular (every 3 months) CT scans for several years as part of their follow-up. There is really no rule on how often to get CT scan. Back in April I asked my GP for a CT scan. 2 weeks ago I had another CT scan ordered by the doctor running a drug trial. It came back positive for several new peritoneal nodes while my CA125 stays normal.

    I am in Toronto, Canada and we don't have much choice selecting oncologists. It's one of the side effects of the free healthcare. We pretty much have to stick with the one we got referred to. I believe that in the USA you can shop around within your network as long as your insurance covers it.

  • mamajc
    mamajc Member Posts: 22
    #23
    Alexandra said:

    Opinion

    I recently had a conversation with GYN-ONC (Dr. Les Levine @ Princess Margaret Hospital) about CT vs. MRI. In terms of radiation an abdominal/pelvic CT is the equivalent of 400 X-Ray's and yes, it is more harmful than MRI; but one CT scan is not Chernobyl and not gonna kill you. In his opinion CT is a better diagnostic tool for abdominal issues. They limit it for very young patients or for someone with existing bone marrow defficiencies.

    My regular ONC at Odette Cancer Center does not do regular CT scans, she only monitors CA-125. Ovarian patients at Princess Margaret get regular (every 3 months) CT scans for several years as part of their follow-up. There is really no rule on how often to get CT scan. Back in April I asked my GP for a CT scan. 2 weeks ago I had another CT scan ordered by the doctor running a drug trial. It came back positive for several new peritoneal nodes while my CA125 stays normal.

    I am in Toronto, Canada and we don't have much choice selecting oncologists. It's one of the side effects of the free healthcare. We pretty much have to stick with the one we got referred to. I believe that in the USA you can shop around within your network as long as your insurance covers it.

    Get a Second Opinion

    I don't understand why your doctor is ordering a MRI for you. If you look online for diagnostic tests for ovarian cancer (American Cancer Society), MRIs are rarely used. It doesn't make sense; what specifically is he looking for?

    Could it be that your health insurance is refusing to authorize a catscan? Maybe it would be a good idea to review your policy. I would also find out if you need a referral to a specialist like a gynecological oncologist. I would also find out who is in network for your insurance and then google reviews about them. If you live in a city, you may be able to find a list of "Best Doctor's ". 

    Joan

     

  • bosberg
    bosberg Member Posts: 19
    #24
    Thank you

    He is trying to determine if what's on my ovary could be cancerous.

    I also have fibroids in my uterus and I don't know if that is also a concern or not.  The radiologist that read my ultrasound recommended next step as mri for me to determine a closer look. My dr  tells me he doubts I would be cancerous since my he4 and caa125 came back low and wanted more of a wait and see approach. That scares me.   I asked him what the next step is  and that I was not comfortable w/ waiting to see if the tumors grow more or go away on their own (afterall they've not gone away in the  past 16 months and in fact, are bigger now, why wait anymore?)   and he said he could order a mri if I was concerned. Of course I am concerned!  So I at that point brought up ct scans instead. He said no, he's ordering the mri. He said they are as good as ct scan for this type thing which contradicts what I'm reading here and elsewhere on the internet and told him that. He then said this is the way they do it at this facility and it was non negotiable. 

    I am pretty sure insurance is not preventing him from ordering a ct scan. 

    I think rather than have the mri, I should start my request at a clinic w/ a gyn/onc. and see if they would order a ct scan for me.

    Wish me luck.

    I find the health care in my area very frustrating.   I've gone in over the course of 2 yrs w/ symptoms and been told I feel this way for various reasons. It became undeniabley clear it's not from  stress, depression or any of the other various things they told me it is when I started having unusual bleeding and unexplainable pain  which is in the end, what is causing the gyno to take a deeper look.  

  • bosberg
    bosberg Member Posts: 19
    #25
    bosberg said:

    Thank you

    He is trying to determine if what's on my ovary could be cancerous.

    I also have fibroids in my uterus and I don't know if that is also a concern or not.  The radiologist that read my ultrasound recommended next step as mri for me to determine a closer look. My dr  tells me he doubts I would be cancerous since my he4 and caa125 came back low and wanted more of a wait and see approach. That scares me.   I asked him what the next step is  and that I was not comfortable w/ waiting to see if the tumors grow more or go away on their own (afterall they've not gone away in the  past 16 months and in fact, are bigger now, why wait anymore?)   and he said he could order a mri if I was concerned. Of course I am concerned!  So I at that point brought up ct scans instead. He said no, he's ordering the mri. He said they are as good as ct scan for this type thing which contradicts what I'm reading here and elsewhere on the internet and told him that. He then said this is the way they do it at this facility and it was non negotiable. 

    I am pretty sure insurance is not preventing him from ordering a ct scan. 

    I think rather than have the mri, I should start my request at a clinic w/ a gyn/onc. and see if they would order a ct scan for me.

    Wish me luck.

    I find the health care in my area very frustrating.   I've gone in over the course of 2 yrs w/ symptoms and been told I feel this way for various reasons. It became undeniabley clear it's not from  stress, depression or any of the other various things they told me it is when I started having unusual bleeding and unexplainable pain  which is in the end, what is causing the gyno to take a deeper look.  

    I can get a second opinion at

    I can get a second opinion at the other clinic but I can't get in w/ a gyn/onc until I am for sure diagnosed w/ cancer. Until then, I am put w/ a regular gyno.

    So I do understand why this is their policy but they said they to would have their gyno do the initial surgery and send for biopsy. If positive at that point go to a gyn/onc.

    So, I'm disappointed b/c I had hoped a gyn/onc would be the one to do the surgery/ biopsy and see what it looks like in there. I guess since my numbers were low, they all think my mass is most likely benign.

    Regardless, I have set up an apt. w/ the other clinic to get the second opinion on it all.  I am still on the fence on having the mri. It is Wed. now and I have one day to decide if I should get it or wait. If I wait maybe the next dr would order one or order a ct scan. Or maybe tell me non of it's neccessary. Not sure what to think. I just feel if a mri doesn't show beginning stages of cancer then why do it, I would think if anything, I would be in the beginning stages.. confused.. 

     

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