Imaging tests (or scans) are ways to create pictures of the organs and tissues inside the body. I had a CT scan with contrast two days ago at my “home” hospital. PET and PET-CT scans have risks. “The message for survivors is one of reassurance,” Dr. Chang said. In one study, more than 2,500 people from several European countries who had had surgery to treat colorectal cancer were randomly assigned to receive either high- or low-intensity surveillance testing. The study, called COLOFUL, was led by Peer Wille-Jørgensen, D.M.Sc., of the Danish Colorectal Cancer Group. The first group I had did the scans every 6 months for the first three years. Like other X-ray imaging exams, CT scans expose you briefly to a small, targeted amount of ionizing radiation. Also, due to the volume of comments we receive, not all comments will be posted. Asked by Claire Myers, Rockledge, Florida. If one is taking the medical oncology board exam, the answer is bone-only metastatic breast cancer that is being treated with hormones or that has been treated with chemotherapy and is now quiet should be followed with regular questioning of the patient about symptoms, physical examination and some blood tests to assess bone turnover, liver and renal function. On average, patients who were initially treated for advanced stage colorectal cancer received more tests. Many patients also demand them. Seven or eight years is not unusual. But cancer care guidelines generally do not recommend a PET scan be used as a first-line test for determining if the cancer … So, you’re probably not missing that window of opportunity” by doing surveillance tests once a year, he said. Today I found out that the Mayo Clinic wants to do a CT scan and an MRI of my brain. There is no recommended limit on how many computed tomography (CT) scans you can have. The goal of follow-up testing, or surveillance, of people who have been treated for cancer is to improve patient survival by detecting and treating a recurrence early. That will put him in year 3. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Do Frequent Follow-Up Tests Benefit Colorectal Cancer Survivors? “Multiple factors, such as the aggressiveness of surgical resection at an individual facility, might influence these outcomes other than surveillance frequency,” she wrote. Have I drunk enough to cause liver cirrhosis? In practice, many doctors do CT scans of the body and pelvis every few months; others do nuclear medicine tests such as PET scans or bone scans. The emphasis during follow-up should be not only on recurrence detection, but on the entire survivorship experience, he added. “We noticed that there was tremendous variation in the number of [follow-up] tests patients received” and that the facility where patients received their follow-up strongly influenced the number of tests, explained the lead investigator, George J. Chang, M.D., of the University of Texas MD Anderson Cancer Center. Whenever I go to see doctors other than my oncologist, they want to know about when and how often additional testing and/or scans are performed. ( 6 ) Other studies have calculated that the risk of a single CT scan causing cancer … That aspect of follow-up shouldn’t change, said Dr. Guidelines may recommend imaging tests every 3, 6, or 12 months after surgery… The American Society of Radiology holds that individuals can receive a cumulative maximum dose of 100 mSv for normal diagnostic imaging scans … Polite. However, current medical guidelines differ on the recommended surveillance tests and how often they should be performed. To make CT scans safer, providers use X-ray shields to protect sensitive areas and adjust doses to minimize the risk for younger patients. CNN Privacy Statement.The information contained on this page does not and is not intended to convey medical advice. Based on their findings, Dr. Chang and his colleagues agreed with the surveillance recommendations of the National Institute for Health and Care Excellence in the United Kingdom: In the first 3 years following initial surgery, people who have been treated for colorectal cancer should receive CEA testing every 6 months in addition to two CT scans. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. This may lead to more tests and procedures, including follow-up scans, and even biopsies and surgery. After 5 years, they are typically done about once a year. Polite. When the researchers characterized each facility as one that performed high- or low-intensity surveillance, they found that patients who were treated at low-intensity surveillance facilities received an average of 1.6 imaging tests and 1.6 CEA tests in 3 years. Overall survival was also unaffected by the intensity of surveillance. But cancer … The other study was a retrospective cohort study, funded partly by NCI, of more than 8,500 people who had been treated for colorectal cancer in the United States and who were registered in the National Cancer Database—a collection of clinical oncology data gathered from multiple hospitals. This will mean that I will have 2 CT scans … There is … For example, she noted, the COLOFUL trial investigators modified the design of their study to increase enrollment and aid trial completion. Comments are moderated by CNN, in accordance with the CNN Comment Policy below, and may not appear on this blog until they have been reviewed and deemed appropriate for posting. Conditions Expert This encompasses monitoring people who have undergone cancer treatment for toxicities from their treatment, counseling them about leading a healthy lifestyle, and providing them with appropriate resources for psychosocial support and management of financial toxicity when needed. Physicians will often perform a follow-up PET scan on people undergoing treatment for cancer. But results from both studies, published May 22 in JAMA, showed that more frequent tests did not change the rate of detection of recurrence or death due to cancer. Having PET and PET-CT scans can add to your stress as a cancer survivor. Although these new studies are important, they do have limitations, Dr. Sanoff pointed out. These tests include chest CT scan or X-ray. CEA every 3 months for the first year, then every 6 months … Follow-up tests can be a psychological and financial burden on patients. by NCI Staff, Complementary & Alternative Medicine (CAM), Coping with Your Feelings During Advanced Cancer, Emotional Support for Young People with Cancer, Young People Facing End-of-Life Care Decisions, Late Effects of Childhood Cancer Treatment, Tech Transfer & Small Business Partnerships, Frederick National Laboratory for Cancer Research, Milestones in Cancer Research and Discovery, Step 1: Application Development & Submission, Researchers Testing “Packaged” CAR T Cells for Retinoblastoma, Study Confirms HPV Vaccine Prevents Cervical Cancer, NCI Priorities in Reducing Global Cancer Burden, U.S. Department of Health and Human Services. “They don’t have to get a CT scan at every follow-up visit.”. In an attempt to quantify cancer risks from CT scans, the National Research Council in 2006 calculated that every 10 mSv of radiation exposure increases the lifetime risk of cancer by 0.1 percent. Physicians tend to "over-image" with costly radiologic and nuclear medicine tests. Undergoing follow-up testing for cancer recurrence more than once a year may not benefit people who have been treated for colorectal cancer, results from two new studies show. Please consult a physician or medical professional for personal medical advice or treatment. The 5-year overall survival rate was about 74% for participants tested at both high- and low-intensity facilities. What determines how often to get CT scans after chemo for Ovarian Cancer? I have metastatic breast cancer, so far in bones only. Before your scan … Biosimilars for Cancer Emerge as Patents on Widely Used Biological Drugs Expire, Approval Expanded for Venetoclax in Chronic Lymphocytic Leukemia, If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. Play it safe by asking the following questions next time a doctor prescribes a CT scan … Also, PET, and especially PET-CT scans… Can a nerve stimulator stop my back pain? Therefore, cancer patients should be checked according to the needs of the disease. Before your next CT scan. Your question actually speaks directly to one of the controversies in medicine today regarding medical costs in the United States. What makes CT scans more of a threat than even X-rays has to do with the way they deliver radiation. Dr. Chang’s study compared the outcomes of patients who got tested at a high- or low-intensity facility, rather than comparing the outcomes of patients who received high-intensity or low-intensity testing, Dr. Sanoff noted. Abdominal and pelvic CT scans raise the risk for cancer more than brain scans, and the risk is far greater in younger patients, especially children. The same researchers also noted huge variability in how much radiation patients get, with some patients … He will then we believe go on to yearly PET scans … And colorectal cancer that spreads quickly between yearly surveillance tests is not likely to respond to available treatments anyway, he explained. You are solely responsible for your own comments, the consequences of posting those comments, and the consequences of any reliance by you on the comments of others. Both of the new studies aimed to determine whether increased surveillance improved outcomes of colorectal cancer, but they took different approaches. 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