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CT Scan Useless

Annabelle41415's picture
Annabelle41415
Posts: 6715
Joined: Feb 2009

I've read on other message boards that CT scans vs. PET scans are useless and that they wouldn't put any stock in what the CT scan says and the only reason that the doctors order CT scans instead of PET scans is because the insurance companies usually won't pay for the PET but they will for the CT. If the CT scan is so useless, why do they have you go through that if it isn't reliable and you could have cancer elsewhere and it would cost more money in the long run to just do all the treatment at one time if they could do a PET scan first?

I'm just feeling very nervous about what I have read and now don't believe my CT scan, however, my radiation oncologist told me that everything was clear.

How can one scan be so widely used and insurance is so ignorant (oh wait - just answered my own question - yeah - greed and the bottom line).

Just feeling lost and scared.

Kim

tootsie1's picture
tootsie1
Posts: 5065
Joined: Feb 2008

Yeah, I hate reading things like that and then wondering...

*Hugs*
Gail

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Well, you can put that thought to rest, Kim :)

CT Scans and PET scans are looking for totally different things and reading totally different information.

CT Scans - focus on one area. IE: Then have to aim the scan/camera at one area and it is not a body image. They may be taking a CT scan of your lungs, or liver... and the resulting image is sort of like a 3D image of that part of the body, done in layers (vs an xray that is just a flat image)

PET Scans - are also a 3D image, but are on the molecular level. They are not taking pictures of your skeleton, etc., but with the help of the small dose of radioactive glucose, they are looking for fast dividing cells that could indicate cancer activity.

Bone Scans - use a radioactive substance as well, and like the PET scan, they are looking for fast dividing cells on or in the bones (not elsewhere in the body, just in the bones)

XRay - takes a flat picture of wherever the camera is pointed at, but can not detect anything at the molecular level. With an xray, you get an image of bones and organs... and possible "dark" areas that may indicate a mass or some sort of problem. But an xray can not tell you if you have cancer.

Ok... so the doctor has the above tools at their disposal and they will use them to find what they are looking for... and obviously using them with regards to expense so they are not using them unnecessarily. For instance, a PET scan can vary in price but is in the ballpark of $4000 - $6000/scan. With a combination of other tests (IE: Blood work) and depending if you are on chemo or have finished (and if so, for how long), a CAT scan may be more appropriate. I'm not exactly sure how much a CAT scan is but it is way cheaper than a PET scan. And xray, obviously is the cheapest, but it also produces an image that doesn't give the kind of detail an oncologist is looking for.

Why would you not assume that they would want to use a PET scan? Well, let's take my lungs as an example. If we had done a PET scan only, then there would have been 2 spots that lit up the scan and one could assume that I had 2 cancer lesions. But in fact, by doing a CAT scan, there were actually 7 lesions... 5 of them were under 5mm and were not big enough to light up the PET scan. In that case, the CAT scan actually gave more accurate information than the PET scan did... the PET scan notified the oncologist that there was cancer activity, but the CAT scan showed exactly where and what we should be worried about.

So, do not fret ... when your onc orders a particular scan, it is for different reasons and they go hand in hand with what the other non-scan tests have told him/her.

Hugggggs,

Cheryl

dixchi's picture
dixchi
Posts: 438
Joined: Jun 2008

There is also the PET/CT scan which is a combination of the two and is supposed
to be the latest in scanning techniques, it is done at the same appointment while
on the table, Not having the oncologist and surgeon in the same medical group
created some issues around this....my oncologist ordered just a CT scan the second
time and my surgeon wants me to have a PET/CT scan which I will have April 6.

Barbara

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Yes, you are correct, Barbara! Actually, when I get a PET scan done (have only had two of them so far), it is the machine that does a PET and CAT combined... with the same machine. I didn't realize some only get PET scans now, vs the combination.

But it's true... same principal applies. The PET will do the whole body scan whereas, while you are in the machine, they also can take a CAT of a particular area(s).

Hehehe Phil.... thanks for the compliment! With all the stuff that is thrown at us, I swear we all can put the title Dr. before our names . Sometimes personal experience is worth way more than all the studying and classes in the world ;)

The Cancer Agency I go to is also a teaching facility for up and coming oncologists and researchers. Sometimes I shudder at the oncologists in training. You can tell when you meet some of them that they are going to be great oncologists with fabulous patient manner... others, I want to tell them to go into research or some branch where they are not dealing with people face to face ;) Sometimes, I seriously think I know a lot more than they do... and that is just not right! They are the ones that are studying and by the time they are doing their student practicum, they should already know the basics and I, as a patient, should not be having to correct them! Luckyily, I can just ignore them and what they say and just wait until my onc comes in with the real news :)

Huggggggs,

Cheryl

Annabelle41415's picture
Annabelle41415
Posts: 6715
Joined: Feb 2009

TY Cheryl for that explanation, that makes me feel so much better. Guess I read too many different boards and get myself all worked up. It just didn't make sense to me that they would do a test if it really wasn't worth any information.

Kim

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

unless it's from Cheryl. Great explanation Cheryl. My CT scans sure seem to find stuff all the time. I have one tonight after work. Can't wait.
-p

dixchi's picture
dixchi
Posts: 438
Joined: Jun 2008

just a minor correction......don't know if any oncs are just doing PET scans
but there are probably many who do only CT scans.....I know University Hospital
here is the only one to have the PET/CT scan machine; the previous place
I had some early scans does not have this new machine.
Barbara

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Barbara... there's actually a reason there aren't that many PET scan machines around, besides the expense of them (hugely expensive!). The radioactive "isotope" that is given to the patient via IV has a very short life. So the nuclear facility where these isotopes are created have to be within a distance that the isotopes can be delivered in a certain period of time, otherwise they become useless.

We have one such facility out by our University, which a friend of mine used to work for and he explained this to me. Our Cancer Agency in Vancouver is close enough that they could have one of these PET scan machines on the premises and use it... the other one was out at the University Hospital.

So that could also be why your University Hospital has a PET/CAT scan machine... the university my have one of these isotope facilities on the grounds or close by.

Ms. Trivia
Cheryl

polarprincess
Posts: 210
Joined: Aug 2008

i didn't have time to read through the other replies first , but i do know that at mayo clinic they kind of scoffed at pet scans.. also on the NCCN website for follow up for at least my stage..it says pet scans are not routinely recommended althought CT scans are, at leats once a year so i think that says something..

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

I'd have a problem with a facility that "scoffed" at PET scans. If it weren't for the PET scan, there would be no way they would have found the cancer in my right adrenal gland. Colon cancer rarely spreads to the adrenal glands (I just happened to be one of those rare, let's not follow the usual pattern type people).

The first clue we got was, 1 1/2 months after I had finished chemo, my CEA was "slightly" elevated (normal for me is 1.5... and it read as a 6.0). My onc ordered a CAT scan but there was absolutely nothing in the colon or surrounding area. The next CEA reading it was elevated even more, so a PET scan was ordered... and it was the PET scan that revealed the malignant growth on the right adrenal and 2 lit spots in the lungs.

If my onc scoffed at the idea of a PET scan, I might be in big trouble because no one would have thought to do a scan on my adrenal glands since there is no reason to suspect colon cancer would spread to them, if you go by the "norm" when it comes to spreading. But cancer is cancer and it can technically spread anywhere... it's just that the common pattern is to spread to the liver and then to the lungs. Even that I wasn't normal... my liver is fine. But it did spread to my lungs and the adrenal gland.

I'm glad my onc doesn't scoff at anything. She is very thorough and doesn't leave any stone unturned and not only do I appreciate that, it is why I have so much confidence in her.

Hugggggs,

Cheryl

Annabelle41415's picture
Annabelle41415
Posts: 6715
Joined: Feb 2009

Hope all goes well with your scan. Let us know.

Kim

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