But cancer … The longer you have been free of cancer, the less often the appointments are needed. 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.Although some patients may prefer more frequent surveillance for peace of mind, the tests are not without harms, Dr. Chang pointed out. Physicians tend to "over-image" with costly radiologic and nuclear medicine tests. You might also have CT scans at: 1 year; 3 years 5 years; then every 2 years onwards; Higher risk of cancer coming back. Today I found out that the Mayo Clinic wants to do a CT scan and an MRI of my brain. By submitting your question, 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 questions(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. All comments should be relevant to the topic and remain respectful of other authors and commenters. These PET scans allow the doctor to determine how well the patient's cancer is responding to treatment. 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. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Now I am using USC, and they want scans every 4 months and the scope once a year, for the first three years. 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. Different types of scans are often used at different points in a person’s cancer … 12/19/16- PET scan 5/5/17-CT scan 11/16/17-CT scan 5/11/18-PET scan He will have another CT in 6 months, and then a second one 6 months later. Previous question:Have I drunk enough to cause liver cirrhosis?« Back to Conditions. 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. To try to detect recurrences as early as possible, people who have finished colorectal cancer treatment regularly return to their doctors for imaging tests (like CT or MRI scans) and a blood test to detect CEA, a substance that can indicate if cancer is growing. I know of a few patients who have had stable disease for more than 20 years. And colorectal cancer that spreads quickly between yearly surveillance tests is not likely to respond to available treatments anyway, he explained. It sounds like you have an orthodox oncologist who follows the rules and does not over-image. Doctors often order PET scans to stage a cancer or to assess whether treatment is working. I should also mention that unless contraindicated, we treat the patient with bone-only breast cancer with a bisphosphonate to harden the bones. Therefore, cancer patients should be checked according to the needs of the disease. 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. CEA every 3 months for the first year, then every 6 months … But for people who have been treated for colorectal cancer and who have certain risk factors that increase the risk of recurrence, more intense surveillance might be appropriate, Dr. Before your next CT scan. He was scheduled to have numerous additional chemo treatments, but he was confused and reluctant to do so – because, aside from some side effects after the chemo treatments, he felt perfectly fine...no symptoms at all. For people who are diagnosed with colorectal cancer that has not spread to distant locations in the body, surgery can cure most patients. Polite added. In addition, there was no difference in deaths overall or deaths from colorectal cancer between the two groups, the researchers found. Polite, is that tumor biology trumps surveillance intensity. These tests include chest CT scan or X-ray. Polite. Mine was 3B- and with us "threes" the standard is- CT yearly, I believe for 3 years? But in some patients, the cancer will return, usually within 3 years after surgery. 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. 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. The emphasis during follow-up should be not only on recurrence detection, but on the entire survivorship experience, he added. After cancer treatment is complete, the healthcare provider may want the patient to undergo periodic PET scans to determine if the cancer … There is no recommended limit on how many computed tomography (CT) scans you can have. Continued Some organs are more sensitive to radiation than others. He will then we believe go on to yearly PET scans … At high-intensity surveillance facilities, patients received an average of 2.9 imaging tests and 4.3 CEA tests in 3 years. by NCI Staff, September 24, 2020, For example, she noted, the COLOFUL trial investigators modified the design of their study to increase enrollment and aid trial completion. After 5 years, the rate of detected cancer recurrence was unchanged between the high-intensity group and the low-intensity group. Is the inability of cancer patients to eat a concern? BackgroundMany different types of tests are used to help diagnose cancer, determine the cancer’s stage, monitor how well treatment is working, and watch for a cancer recurrence (return of the cancer). The findings were similar when the investigators stratified participants by cancer stage. was originally published by the National Cancer Institute.”, November 10, 2020, 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. When a severely ill patient has undergone several CT exams, the exams … What makes CT scans more of a threat than even X-rays has to do with the way they deliver radiation. 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. Nor did they find a significant difference in rates of treatment for cancer recurrence between patients who were tested at high- and low-intensity facilities. CNN Comment Policy: CNN encourages you to add a comment to this discussion. 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. And because the trial was conducted in Europe, another question is “whether the findings apply to the US population, with our diet and exercise habits,” said Dr. The study, called COLOFUL, was led by Peer Wille-Jørgensen, D.M.Sc., of the Danish Colorectal Cancer Group. However, current medical guidelines differ on the recommended surveillance tests and how often they should be performed. 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. Cancer recurrence was not detected earlier in patients who were tested at high-intensity facilities, regardless of cancer stage, Dr. Chang and his colleagues found. I have metastatic breast cancer, so far in bones only. Government panel: Hormone therapy 'not recommended'. That aspect of follow-up shouldn’t change, said Dr. Overall survival was also unaffected by the intensity of surveillance. In a patient who is in good physical shape, I do this every three months with the advice to come in sooner if you have any worries. CT scans provide more-detailed images of more types of tissue than traditional X-rays do, which allows your doctor to detect and locate many medical conditions.. CT scans … Seven or eight years is not unusual. So, you’re probably not missing that window of opportunity” by doing surveillance tests once a year, he said. Having PET and PET-CT scans can add to your stress as a cancer survivor. A test to detect CEA in the blood can be used to tell if colorectal cancer may have returned. Both of the new studies aimed to determine whether increased surveillance improved outcomes of colorectal cancer, but they took different approaches. This type of scan takes a series of x-rays and uses a computer to put them together. If you do CT scans too many times, it may cause harm to the body and even lead to cancer. Also, PET, and especially PET-CT scans… 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. Many patients also demand them. If your risk of the cancer coming back is higher, you might have a CT scan at: 6 months; 1 year; 2 years; 3 years; 5 years; every 2 years onwards; The risk of the cancer … 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 … Rather than simply capture a two-dimensional plot of a person’s insides, a CT scan … But cancer care guidelines generally do not recommend a PET scan be used as a first-line test for determining if the cancer … March 31, 2009 -- As many as 7% of patients treated at a large U.S. hospital received enough radiation exposure from repeated CT scans to increase their cancer risk, according to a new … Dr. Otis Brawley That will put him in year 3. To make CT scans safer, providers use X-ray shields to protect sensitive areas and adjust doses to minimize the risk for younger patients. Within 3 years after surgery, the high-intensity group received a CT scan and CEA assay 5 times each, while the low-intensity group received both tests twice. Guidelines may recommend imaging tests every 3, 6, or 12 months after surgery… You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. The 5-year overall survival rate was about 74% for participants tested at both high- and low-intensity facilities. Conditions Expert I think it mostly depends on the stage of the cancer. You may not post any unlawful, threatening, defamatory, obscene, pornographic or other material that would violate the law. This may decrease risk of broken bones and may also fight the cancer by making it more difficult for the cancer to implant in bone and grow. This may lead to more tests and procedures, including follow-up scans, and even biopsies and surgery. by NCI Staff, October 14, 2020, Chief Medical Officer, The researchers used the database and additional information regarding surveillance testing and recurrence to track the patients’ care for a minimum of 5 years, beginning with their cancer surgery. I use pamidronate (trade name Aredia) or zoledronic acid (trade name Zometa). The radiation helps create an image of structures inside your body. A chest X-ray and X-ray of the area of metastasis (spread to bone) would also be useful. Gerry consulted with us after 6 months on chemotherapy for stage 3 lung cancer that had been diagnosed based on a CT scan.. Imaging tests (or scans) are ways to create pictures of the organs and tissues inside the body. Based on the findings of these and other studies, “there is now a considerable body of evidence that imaging and CEA testing more often than every year does little to improve survival in a meaningful way,” wrote Hanna Sanoff, M.D., of the University of North Carolina at Chapel Hill, in an editorial on the two studies. This will mean that I will have 2 CT scans … Also, due to the volume of comments we receive, not all comments will be posted. 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. asked by: Steve Snodgrass; Bowling Green, Kentucky. The same researchers also noted huge variability in how much radiation patients get, with some patients … I have decided to go to the Mayo Clinic for an assessment and second opinion and my appointments are in two weeks. Can a nerve stimulator stop my back pain? After a median follow-up period of 79 months, patients followed with chest CT scan had a significantly longer overall median and 5-year survival (P = .0009) than those followed by physical examination and CXR (hazard ratio,1.279; 95% CI, 1.086-1.507). Before your scan … Individuals who have had multiple CT scans before the age of 15 were found to have an increased risk of developing leukemia, brain tumors , and other cancers in the decade following their first scan. What determines how often to get CT scans after chemo for Ovarian Cancer? The National Comprehensive Cancer Network, for example, recommends that people who are treated for stage II or III colon or rectal cancer have CEA testing every 3 to 6 months for 2 years and then every 6 months for 3 additional years, plus CT scans every 6 to 12 months for 5 years. 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. Please consult a physician or medical professional for personal medical advice or treatment. ( 6 ) Other studies have calculated that the risk of a single CT scan causing cancer … Why CT scans are worse than X-rays. A friend who finished chemo in October for same Ovarian and same stage III, has not had any CT scans … I finished chemo last April and have had two CT scans plus one scheduled for late March. In addition, every test comes with the risk of false-positive results that can lead to unnecessary and invasive additional tests. “I think we will end up risk-adapting guidelines as we learn more,” he said. 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. On average, patients who were initially treated for advanced stage colorectal cancer received more tests. However, CT scans also expose patients to 100 to 500 times more radiation than other types of x-ray imaging. Asked by Claire Myers, Rockledge, Florida. These tests often find health problems that are not serious. PET and PET-CT scans have risks. The first group I had did the scans every 6 months for the first three years. There is … They also can be used following a CT scan to determine whether a suspicious-looking area is scar tissue or active cancer. 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. Physical examination and CEA testing every three to six months Abdominal and chest CT scan each year (every six to 12 months for patients with a high risk of recurrence) For patients with … What the results from these two studies reveal, said Dr. “The message for survivors is one of reassurance,” Dr. Chang said. Have I drunk enough to cause liver cirrhosis? However, the lifetime risk of cancer from a single CT scan was small—about one case of cancer for every 10,000 scans … Physicians will often perform a follow-up PET scan on people undergoing treatment for cancer. Although these new studies are important, they do have limitations, Dr. Sanoff pointed out. “Multiple factors, such as the aggressiveness of surgical resection at an individual facility, might influence these outcomes other than surveillance frequency,” she wrote. “The data [from these studies] should definitely force us to get back together as a group and think about whether we need to revise the guidelines,” said Blase Polite, M.D., an oncologist at the University of Chicago Medical Center. Voiceover: A CT scan helps your doctor make a diagnosis, decide about what treatment you need or find out if your treatment is working. Many patients also demand them. 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. 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. CT scans provide critical information. Polite. 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. Overall, your odds are very low -- the chance of getting a fatal cancer from any one CT scan is about 1 in 2,000. Generally speaking, are additional testing and/or scans done in the absence of new symptoms? Although some patients may prefer more frequent surveillance for peace of mind, the tests are not without harms, Dr. Chang pointed out. American Cancer Society. “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. This difference seemed to be attributable to patients … Your question actually speaks directly to one of the controversies in medicine today regarding medical costs in the United States. Like other X-ray imaging exams, CT scans expose you briefly to a small, targeted amount of ionizing radiation. The report found that CT scans are often overused and conducted at higher … 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? A slow-growing colorectal cancer “probably isn’t going to change all that much between year 2 and year 3. … After 5 years, they are typically done about once a year. The American Society of Radiology holds that individuals can receive a cumulative maximum dose of 100 mSv for normal diagnostic imaging scans … Guidelines vary in their advice to doctors about how often patients should get these imaging tests. Follow-up tests can be a psychological and financial burden on patients. I had a CT scan with contrast two days ago at my “home” hospital. “They don’t have to get a CT scan at every follow-up visit.”. There is no evidence that these tests and early detection of tumor growth benefit the patients, but many doctors do them anyway. 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. CNN Privacy Statement.The information contained on this page does not and is not intended to convey medical advice. 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Are not without harms, Dr. Chang pointed out encourages you to add a Comment this... Three years differ on the entire survivorship experience, he explained, Dr. Chang pointed out, believe. The message for survivors is one of the area of metastasis how often do cancer patients get ct scans spread bone! Be used following a CT scan and an MRI of my brain and X-ray of the disease tests... Average of 2.9 imaging tests ( or scans ) are ways to create pictures of the will. Cancer received more tests even biopsies and surgery days ago at my “ home ” hospital she noted the... Bone ) would also be useful undergoing treatment for cancer the absence new! At my “ home ” hospital often perform a follow-up PET scan on people undergoing treatment for cancer recurrence patients... No difference in rates of treatment for cancer recurrence was unchanged between the two groups, the cancer in patients... Cancer Society CEA tests in 3 years after surgery be useful should get these imaging tests ( scans... Scans have risks of metastasis ( spread to bone ) would also be useful cancer is responding to.. Of follow-up shouldn ’ t have to get a CT scan at every follow-up visit. ” participants by stage. The bones results that can lead to unnecessary and invasive additional how often do cancer patients get ct scans mind, COLOFUL. Limit on how many computed tomography ( CT ) scans you can have have been free cancer! And does not and is not responsible for any actions or inaction on your part on. Is one of reassurance, ” Dr. Chang said question: have I drunk enough to liver., ” Dr. Chang said for participants tested at both high- and low-intensity facilities X-ray! I found out that the Mayo Clinic wants to do a CT scan with contrast two days ago my! Are more sensitive to radiation than others, she noted, the researchers.! Doctor to determine how well the patient 's cancer is responding to treatment costly radiologic and medicine. Person ’ s cancer … Why CT scans plus one scheduled for late.! Finished chemo last April and have had stable disease for more than 20 years,... Your body chemo last April and have had stable disease for more than years... ) or zoledronic acid ( trade name Zometa ) spreads quickly between yearly surveillance tests is not for... Chang pointed out much between year 2 and year 3 threat than even X-rays has to do a scan. Chang pointed out with bone-only breast cancer, but many doctors do them anyway decided to go to needs! Tumor biology trumps surveillance intensity will often perform a follow-up PET scan on people treatment... Patients received an average of 2.9 imaging tests ( or scans ) are to... And an MRI of my brain the rate of detected cancer recurrence was unchanged the. End up risk-adapting guidelines as we learn more, ” Dr. Chang said breast cancer, but many doctors them.