PET/CT verses CT post chemo

[Cabisbee]

My husband went in today to get a post chemo follow-up scan. He had his one year colonoscopy at the end of July and they removed 2 more precancerous adenomas, but his previous site was clear, as was the rest of his colon. He finished chemo in May and this is the first scan he has had since then to check for re-occurrence or any mets. We were told he would be getting a PET/CT and when he showed up they had scheduled him for a regular CT. I spoke with our oncologists nurse and she said the oncologist wrote in her notes that she wanted a regular CT. I am very uncomfortable with this discrepancy and the doctor is out of town until Monday, which is when we see her to get the results anyway. So what is typical for those of you who have been at this point. I was under the impression that a PET/CT is more sensitive and am extremely uncomfortable relying on a regular CT at this point. If it is clear, he won't be getting anymore scans for a while. Am I over-reacting or should he have gotten the PET/CT instead? I'm a nurse, but this is not my field of expertise. He was rather advance stage 3 with peritoneal adhesion, not great surgical margins and I am rather anxious about this now.

[Coppercent]

At the point where your husband is at I was getting CT scans.

[NWgirl]

I was stage 3c with 27 lymph nodes affected. For the first year I had quarterly CT scans, then the 2nd year 6 month CT scans. It wasn't until mid way through the 2nd year that some very small spots showed up on the CT - but they were so small I think the oncologist said they wouldn't light up on a PET anyway so we'd just have to wait and watch.

So from my personal experiences, the CT's were what I had for the first two years. At the end of 2 years post chemo my oncologist ordered a PET for two reasons. #1 - It had been so long since my last PET and #2 - to check the spots in my lungs (which did end up lighting up).

I know you want to be ultra aggressive with your follow ups but one of the frustrating realities of watching for a recurrence is the wait and see aspect. Definitely discuss your concerns with your oncologist. This has just been my personal experience.

[nkoske]

NCCN recommends contrast enhanced CTs. They do not recommend the use of PET/CT.

It's my understanding that contrast CTs can show more than PET/CT. Typically the CT that goes along with the PET is not contrast enhanced and potentially not as high of a resolution as it's just use to give an anatomical frame of reference for the PET.

I had two >1cm lymph nodes that were cancerous that didn't show up on the PET. So I don't put a ton of faith in the PET catching small things when I'd like them to be caught.

[ANDRETEXAS]

I am finishing my chemo today, a the oncologist is having blood work and a CT scan done on me in two weeks as a starting point. He said CT's should be enough to start, and if I wanted a Pet scan later, it could be arrranged. I would guess we would combine the blood work results and the CT scan to develop future scans.

[Cabisbee]

Had the doctor explained ahead of time why she wanted to have just a CT this time, I would have been more comfortable. It's just unsettling to go in expecting one thing and get another when you can't verify with the doctor that it is what she wants for sure. It does make me feel better that you all have been getting regular CTs, too. My mothers law died from stage 4 breast cancer a year and a half ago and they always did PET/CT on her so I just was unsure about it. Thank you for replying!

[annalexandria]

My own experience was a little different so I will share it. For me the CTs were almost useless, as they failed to pick up growth in the intestines and peritoneum until it was very advanced. It was only through use of the PET/CT (which was something I had to fight for btw) that further spread was detected before it got too advanced. This allowed it to be addressed surgically. I think with localized mets (rather than the more typical lungs/liver) the PET is a more effective choice. I think without it I probably would not have made it to NED a few years ago.
Good luck to your husband!

[KWT]

I've only had one pet. Mostly ct scans

[midlifemom]

I had a conversation with my onc just yesterday about CT vs PET/CT. The info I got agrees with what nkoske stated about contrast CTs being the preferred choice. I was also told that I wouldn't get my second follow up CT (post chemo) for one year because studies did not show significant results for 6 month follow up vs one year. Make me somewhat nervous to wait that long so I may bring it up again.

[ziggymonster]

I agree a contrast enhanced CT should be fine. I was a year out from chemo...2 weeks ago..the contrast enhanced CT found a 2 cm spot on my liver.....then my onc said to do a PET CT which confirmed the spot but nothing else. Finally my liver surgeon wanted a contrast enhanced MRI which also agreed with the CT done.

[PaulC]

I just finished 12 rounds of FOLFOX after DX in January.

My onc. ordered a CT w/contrast. I'm having that on Tuesday. I've had 4 CATs and 1 PET since all this started.

I would have been concerned also though, if I showed up expecting a PET and got a CAT instead.

Good luck to your husband and you also!

[singingholly]

Guidelines say CT with contrast. Even because on liver PET is not the best scan and liver is a frequent site of recurrence... CT is the best exam to do first while MRI and PET are used to better understand the nature of the lesions that CT may have indicated.

[sbrainbolt]

I have only had CT/w contrast since diagnosis and post chemo. I had one every six months for the first 2 years and have recently graduated to once a year follow up scans. I have NEVER had a PET scan. I asked my onc (MD Anderson) and was told that PET is not the scan of choice when finding something less than 1cm.

[JDinNC]

I've only had PET scans..total of 4 so far...since July 2013. My oncologist feels they are more accurate. My next one will be in Feb. 2015, if I continue to be NED.....I'll have the next scan a year later....which I feel is way too long to wait for a stage 4 patient.

[justin case]

I've had 4 PET/CT scans. The last 3 showed nothing. My last CT showed nodules in my lungs, also ruled nothing. The nodules in my lungs showed up on the PET/CT also, but they did not light up. I decided to go with another CT with contrast, tomorrow, as nothing has shown up in my blood work. I truly am more confident in the PET, but the cost is prohibitive at this time. CT's are half the cost. It's not an issue when you know you have reached your max out of pocket for the year, but when it is just monitoring, I am going with the CT.As an aside, if this one is good, or unchanged, I would surely like to be rid of my oncologist, no matter how much I like her. (Yes Kenny, she is almost as foxy as my wife)
regards,
Michael