PET Scan for Bone Mets

I've had bone mets since 8/2001, never had a PET scan, but if I understand correctly they use radioactive glucose. It has a very short half life; meaning its out of the body in minutes so I'm sure they can safely repeat scan in a few weeks. Probably will want another one in 6-12 weeks. Are they going to radiate mets? That's how I had mine treated and seemed to stop growth for about 3 years now am back on taxotere, carboplatinum, herceptin and zometa. Best wishes and God bless.
hummingbyrd

Applications in Oncology: Tumor-therapy Monitoring

Evaluating therapeutic efficacy

PET is useful in a variety of therapy-monitoring applications, including distinguishing between radiation necrosis and recurrence; determining the resectability of a recurrence; and evaluating response to chemotherapy or radiation therapy.

This is because effective therapy leads to rapid reductions in the glucose uptake levels of tumors. PET tracers can easily reveal this drop in metabolic activity and show - sometimes within minutes or hours - whether a patient is responding positively to a particular course of treatment. With this information, physicians can quickly modify less effective therapy, thereby improving patient outcomes and reducing the cost of ineffective treatment.

Furthermore, PET has demonstrated efficacy for monitoring therapeutic response in a wide range of cancers, including breast, lung, ovarian, head, neck, and thyroid cancers, as well as melanoma and lymphoma.

Can cancer patients be evaluated annually with Pet scanning?

A PET scan is a diagnostic test (ordered to answer a specific question) as opposed to a screening test (ordered to try rule out a particular condition). PET scans are used in combination with other radiology procedures (MRI, CT, X-rays) to help make a diagnosis or follow a patient that has undergone treatment. They are not used as screening tests for cancer.

A good screening test needs to be safe, specific (positive only for the particular condition being screened), and make a difference in survival because it allows for early initiation of treatment. There are a number of reasons for a PET scan to have increased activity, not just cancer. If a PET scan was used to screen for cancer and increased activity was found, this may lead to undue anxiety and further unnecessary evaluations and procedures that could be harmful to the patient. Furthermore, PET scans are not helpful in all types of cancer. Thus it is not feasible to do a PET scan on everyone annually for cancer screening. Below are the indications for FDG-PET scans (both Medicare approved and non-Medicare approved). Typically a PET scan costs between US $ 1500 to 2500. We frequently encounter patients who pay from their own pockets to get a scan when their insurance company has denied. In future, the indications for PET scans are going to increase and the cost of getting a scan would decrease."

Medicare approved indications for FDG PET scan

PET IndicationsReason for Procedure1. Breast Cancer* Staging and restaging locoregional or metastatic recurrent disease * Monitoring tumor response to treatment for locally advanced and metastatic disease2. Lung Cancer (SPN)* To determine if the lung nodule if benign or malignant3. Lung Cancer (non-small cell)* Initial preoperative staging; lung cancer, non-small cell * Re-staging; lung cancer, non-small cell to determine recurrent and/ or distant disease after surgery, radiation therapy or chemotherapy4. Colorectal Cancer* Preoperative staging in high risk patients * Re-staging; colorectal cancer * Localize recurrent disease when CEA is elevated or rising5. Melanoma* Whole body staging in high risk patients * Restaging to evaluate recurrent and/ or distant sites of disease6. Lymphoma (Hodgkin's and non-Hodgkin's)* Diagnosis; lymphoma * Initial staging; lymphoma * Re-staging; lymphoma7. Head & Neck Cancer (excluding CNS and thyroid)* Preoperative evaluation of regional nodal and distant metastasis * Assess presence of residual/ recurrent tumor8. Esophageal Cancer* Pre-surgical staging to evaluate regional nodal and distant metastasis * Restaging to evaluate recurrent and/ or distant disease9. Refractory Seizures* Metabolic brain imaging for pre-surgical evaluation of refractory seizures10. Myocardial Viability* Metabolic assessment for myocardial viability following inconclusive SPECT *

Primary or initial diagnosis prior to revascularizationNon Medicare approved indications
1. Alzheimer's disease
Evaluate early memory loss/ cognitive decline
Differentiate Alzheimer's from other types of dementia
2. Ovarian Cancer
Localize recurrent disease when tumor marker is elevated or rising
3. Thyroid Cancer
Localize recurrent disease when thyroglobulin is rising and I - 131 scan is negative
4. Evaluation of Infection and inflammation
Prosthesis infection, osteomyelitis
Evaluation of FUO
5. Hepatocellular cancer
6. Brain cancer
7. Pancreatic cancer