GI Surgeon wants chest added back to my ct scan

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CRguy
Posts: 9286
Joined: Sun Feb 10, 2008 6:00 pm

Re: GI Surgeon wants chest added back to my ct scan

Postby CRguy » Tue Sep 12, 2017 12:21 pm

Yes DE is correct : chest abdomen pelvis is what I've had and they consider required for rectal primaries.

The reason I was adamant is that my lung met was initially missed on a CT after resection BUTT picked up later on a survey xray, as I had opted for CT / abdominal ultrasound + thoracic xrays, offset every 6 months to keep lots of "eyes" on my imaging results.

And yes, sometimes the Canadian system can be a little UNwieldy and protocol heavy :twisted:
BUTT the good news is there are more eyes looking, as in
" you miss more for NOT looking, than not knowing ! "

Hoping all your results are good !!
Cheers
CR
Caregiver x 3
Stage IV A rectal cancer/lung met
10 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

DarknessEmbraced
Posts: 2832
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: GI Surgeon wants chest added back to my ct scan

Postby DarknessEmbraced » Tue Sep 12, 2017 12:29 pm

Thanks CR! I don't understand why the protocol is to take chest off of the scans if the first year ct scans are normal? I get scans once a year. I have to see the doctor filling in for my family doctor to discuss adding chest to my ct scans and getting the prednisone and Benadryl I need for scans so I won't have anaphylaxis when they inject the ct contrast. I talked to the ct department and asked if chest had been added beforehand and they said no. They told me that they would have to know a few days in advance of my scans so the radiologist can approve having chest added. I don't know why the radiologist would have to approve it?
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

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LeonW
Posts: 306
Joined: Sun May 03, 2015 4:59 pm
Location: Amsterdam, Netherlands

Re: GI Surgeon wants chest added back to my ct scan

Postby LeonW » Tue Sep 12, 2017 1:56 pm

Obvious: CAP=chest abdomen pelvis. Thanks DE/CR for clarifying.
DE wrote: . . . why the protocol is to take chest off of the scans if the first year ct scans are normal?

I'm on 6-mos scans now (stage IV - approaching 4 yrs since surgery):
- abdomen/pelvis each scan
- chest added every other one (=annual)
Dec 2012 - Dx CC; MM @ 65yrs, 2 unresect liver mets, CEA 41.8
Jan 2013 - colectomy @ spleen (IVa T3N1bM1a) 2/26 nodes, MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, mets shrink from #3
Sept - nuclear liver scan, 2x failed Portal Vein embolization
Oct 2013 - R liver resect 28 hosp days (liver failure, bad delirium, emboli, encephalopathy) all cancer gone, pCR
2014/15 - recovery; benign polyp Apr '15
Apr 2016 - new house/town/life
clean CTs and 1.3/1.4 CEAs: 4x2014, 4x2015/16, May2017, next Nov 2017

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susie0915
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Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: GI Surgeon wants chest added back to my ct scan

Postby susie0915 » Tue Sep 12, 2017 2:47 pm

I just noticed that the scan my oncologist ordered for October is only for abdomen and pelvis. I see a pulmonologist for lung scarring and inflammation. I'm being monitored for auto immune disorder. At my yearly scan, she added the chest when I had my cancer scan. That's when the 4mm lung nodule was found, so the pulmonologist ordered a repeat chest scan in 3 months. That showed no change. At my last oncology visit the Dr. ordered a 6 month scan. I assumed it was chest, abdomen, and pelvis. After reading these threads I checked and it's just abdomen and pelvis. I sent her an email to ask if chest should be added due to nodule. After the chest scan in July, my pulmonologist said would repeat chest in 6 months. So I guess we'll see. I guess I assumed chest was always included. Both doctors are at the same hospital so maybe they coordinate.
58 yr old mother of 3 Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks of chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. 3 1/2 weeks in hospital,early ileo rev since
surgery to repair blockage. c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc thinks scar tissue
monitored for autoimmune disorder/interstitial lung disease
7/17 no change lung nodule
10/17 Clear CT

JJH
Posts: 164
Joined: Mon Apr 24, 2017 7:26 am
Location: Europe

Re: GI Surgeon wants chest added back to my ct scan

Postby JJH » Sun Sep 17, 2017 12:09 am

Will your CT scan cover the neck region? When was the last time you had your thyroid cysts examined by ultrasound?

My CT scans cover neck to pelvis because of my thyroid problem.
DX 2012: Stage IIc
Locations: upper-rectum T4b + mid-sigmoid T4b
Surgery: Open LAR + temp ileo
TX: chemo/rad (28 days) + Xelox (3 cycles)
Ileo reversal
5 years surveillance
7/3/2017: Final 5-year report -
"complete remission ... cured'

DarknessEmbraced
Posts: 2832
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: GI Surgeon wants chest added back to my ct scan

Postby DarknessEmbraced » Wed Sep 20, 2017 4:36 pm

My ct doesn't cover the neck area because my endocrinologist told me that I no longer need a biopsy. During the second thyroid ultrasound the technician said the radiologist said it looked like a collection of cysts and not a nodule. I assume that's why I won't need a thyroid biopsy. I see my endocrinologist November 1st which is her first available appointment. I will find out more then. :)
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

SurvivorsSpouse
Posts: 73
Joined: Sun Nov 22, 2015 12:38 pm

Re: GI Surgeon wants chest added back to my ct scan

Postby SurvivorsSpouse » Thu Sep 21, 2017 9:30 am

DarknessEmbraced wrote:My ct doesn't cover the neck area because my endocrinologist told me that I no longer need a biopsy. During the second thyroid ultrasound the technician said the radiologist said it looked like a collection of cysts and not a nodule. I assume that's why I won't need a thyroid biopsy. I see my endocrinologist November 1st which is her first available appointment. I will find out more then. :)

I have read that thyroid issues can cause elevated CEA because of liver clearance. Another potential solution to the increased CEA.

DarknessEmbraced
Posts: 2832
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: GI Surgeon wants chest added back to my ct scan

Postby DarknessEmbraced » Thu Sep 21, 2017 10:32 am

Thanks SurvivorsSpouse. My hypothyroidism is being well controlled on synthroid but it's a possibility.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

JJH
Posts: 164
Joined: Mon Apr 24, 2017 7:26 am
Location: Europe

Re: GI Surgeon wants chest added back to my ct scan

Postby JJH » Thu Sep 21, 2017 1:30 pm

DarknessEmbraced wrote:...All of my doctors are aware of all of my medications...

It's good that your doctors know about all of your medications, since the doctors would then be able to check if there are any interactions between your medications that might cause liver problems or an elevated CEA.
DX 2012: Stage IIc
Locations: upper-rectum T4b + mid-sigmoid T4b
Surgery: Open LAR + temp ileo
TX: chemo/rad (28 days) + Xelox (3 cycles)
Ileo reversal
5 years surveillance
7/3/2017: Final 5-year report -
"complete remission ... cured'


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