#40090 06-09-2006 03:20 AM | Joined: Jul 2005 Posts: 624 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: Jul 2005 Posts: 624 | The only thing I will add to what Gary posted is that our ENT and RO are comfortable with PET/CT scans under following conditions:
1) It is a *fused* PET/CT
2) The first one is given no sooner than 3 months after end of treatment, to allow maximum healing to take place and for inflammation to reduce.
3) It is done at a center where they do a lot of head and neck cancer scans
4) It is read by a radiologist that has read many of these scans and has a good feel for what is cancer and what is not. (We asked Barry's radiologist (at Hopkins) and he told us he only does HNC and brain cancer scans and has seen 100s of these. )
Otherwise, according to our surgeon, these scans can result in a lot of anxiety and confusion. BUT (he added) he has known them to catch residual and recurrent disease early, much earlier than could be detected by physical exam alone.
Thus a double-edged sword...
Gail
CG to husband Barry, dx. 7/21/05, age 66, SCC rgt. tonsil, BOT, 2 nodes (stg. IV), HPV+, tonsillectomy, 7x carboplatin, 35x tomoTherapy IMRT w/ Ethyol @ Johns Hopkins, thru treatment 9/28/05, HPV vaccine trial 12/06-present. Looking good!
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#40091 06-09-2006 04:17 AM | Joined: Mar 2003 Posts: 1,384 Likes: 1 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Mar 2003 Posts: 1,384 Likes: 1 | Rhonda, one thing that we have not said in this thread is that the rate of false negative is very low. In other words if the PET is "clean" then it is a good thing. Also, to help with the knots in the stomach, remember not to freak out if they note "something" on his scan. It is common to have ROI (region of interest) which does not necessarily mean cancer just something to look at later.
Mark, 21 Year survivor, SCC right tonsil, 3 nodes positive, one with extra-capsular spread. I never asked what stage (would have scared me anyway) Right side tonsillectomy, radical neck dissection right side, maximum radiation to both sides, no chemo, no PEG, age 40 when diagnosed.
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#40092 06-09-2006 07:51 AM | Joined: Nov 2002 Posts: 3,552 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Nov 2002 Posts: 3,552 | To clarify what Gail said a PET/CT by it's very nature is a "fusion" of 2 images and because of geographical reference points, the accuracy is much greater. They can more effectively rule out anomalies in the scan and reduce the false positive rate. It is also possible to have a separate PET and CT and have the images fused (but not as accurate). There are software packages that will do this. Her ENT is the exception from what most here have experienced. Essentially what she said is absolutely right - it is a double edged sword.
I looked to my early scans to verify that I was cancer free and they ended up causing me even more angst since none of my MRI's, for the first year, were "clean". Both of them sent me back to the head & neck surgeon for "direct visualization". So instead of basking in a cancer free glow, I was adding to my anti-anxiety medications. None of the anomalies amounted to anything. (just like Mark said)
Gary Allsebrook *********************************** Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2 Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy) ________________________________________________________ "You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
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