PET - pros and cons

taraHK · February 2005

In April, it will be 2 yrs since my surgery (dx with Stage III rectal cancer Dec 02, chemoradiation, surgery April 03, chemo finishing Aug 03). I've been NED since the surgery (yea). This 2 yr anniversary is a "biggie" for me, as I have heard that most recurrences happen within the first 2 years -- and it has developed into a big emotional milestone for me. I am already scheduled to have a CT scan in April. Today, my surgeon discussed with me the possibility of having a PET scan as well. She has some concern about the "over sensitivity" of the PET (false positives, etc.). But, I also know it can pick things up the CT cannot. My insurance will cover, so the $$ (which is huge) blessedly is not a factor. I'm leaning towards having the PET but I'd really welcome any views on this topic....
With all best wishes,
Tara

FRANTIC · February 2005

Hi Tara. The petscans are very good. I am having my 4th one on 2/28 which is Monday. They are accurate but if they light up with hot spots it does not necessarily mean the cancer is back it could be an inflammation. So far with all the major surgery I have had the petscans have been clear. I also had radiation and chemo etc. I sent you an E-mail. I will let you all know of my results on MOnday. As I am going to take my first trip on Thursday to Florida to visit my niece for 5 days. I am hoping for the best news on MOnday. On a lighter note I am going to try anf bribe the technician if he sees any hot spots on the scan.!
Any test is nerve racking. I am scared to death right now. Your friend Fran (FRANTIC)

kerry · February 2005

Hi Tara,

My doctor also told me that the PET scans come back with many false positives, however I insisted on one and it found my recurrance of cancer. I'm so thankful too because it caught it early and I have been able to resolve it in short time. I know it's a scary decision to make and I also know the 2 yr anniversary is a biggie - I didn't quite make it - was 2 months short.

My thought is to check everything and catch it early.

Kerry

shmurciakova · February 2005

IMO - If I were you I would not waste the time/money on a PET scan. It is more of a diagnostic tool and it cannot "pick up" more than a CT scan. It can only accurately detect cancerous nodules that are 1cm in size or larger. They would be seen on a CT scan as small as perhaps even 3mm. At any rate, the PET scan usually is used to verify that something seen on a CT scan is cancer. If nothing is seen on the CT, then there is not any reason to do a PET. Are you following me?
I had 2 nodules show up on my right lung last February on a CT - one 3mm and one 5mm. I had a PET scan done and it came back negative but we did not know if this was because they really were not cancer, or it the nodules were just too small. In other words the test was inconclusive. Then in August I had another CT - the nodules had doubled in size but the PET still came back negative. Finally in October when the nodules were around 1cm in size, the PET finally came back positive. Do not waste your time and energy on a test that you do not need....If your CT is clear then just don't worry about it!
Take care, Susan.

CAMaura · February 2005

Hi there, Gosh you pose a tricky question. All I hear are differing opinions about the PET. My oncologist doesn't like them - too many false positives. But my sister in law (stage IV lung cancer) said that they showed things for her. I do not know how to help you other than to offer the thought of finding the doc with whom you have the most gut-renching trust in - and see what he says. The other thought is just to have it and then make sure tht it is read really well and that follow up to the PET confirms what was found. I didn't know that most recurrences come within two years. I am in my chemo regimen; it isn't going too well, but reading about recurrences makes me wsnt to try to get through it. Well, I probably haven't helped too much; I guess I leave you with "get a few more opinions from oncologists". Good Luck. Maura

scouty · February 2005

Hi Tara!!!!

Congrats on the 2 year mark. Scout sends puppy kisses!!!!

I will offer this up. I know that there are diffent CT scan machines with some having better identifying levels. I had CT scans at one hospital that saw nothing in my lungs and liver and then had CT scans on what the comprehensive cancer center called "the million dollar system" that found 3 tumors on my liver and 1 on my lung. Biopsies confirmed them. Apparently CT scans are only as good as the machine that runs them is. The newer and more expensive, the better it is. I suspect that same is true for PETs but am not sure.

Lisa P.

taraHK · February 2005

I really want to thank you all for your responses -- very helpful. These are tough issues! and I so value the advice of those who have been and are going through similar experiences - you are a gold mine.
Tara

Moesimo · February 2005

taraHK said:
I really want to thank you all for your responses -- very helpful. These are tough issues! and I so value the advice of those who have been and are going through similar experiences - you are a gold mine.
Tara

I recently had a pet scan before my surgery. There was an area of concern that was questionably larger on my cat scan. I work in a radiology dept., so my scans are checked by many docs. I had my surgery at a different hospital, so those docs. also checked my films. They weren't convinced that the area was bigger. It was in the presacral space in my pelvis. My pet scan was done at a different place that does only pet scans. It came back as positive, but the surgeon who wasn't sure he was going to get to the area involved was able to remove the whole area questionable and it came back as scar tissue. I would still want follow up with more pet scans.

Maureen

johnom · February 2005

Dear Tara,
I agree with Kerry. I would get the PET because it is more accurat than a CT scan, especially if the money is not a problem. I'm waiting to hear about a spot on my lung that was picked up recently that didn't exist last summer. Nonetheless, it may well be nothing. I feel like it's worth it to have every speck checked out.

Good luck on your 2nd anniversary!

PET - pros and cons

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