Hi All, I'm three weeks out of treatment and my rad oncologist said I cant get a PET scan done until three months post treatment. But he also tells me to go see my ENT surgeon. I don�t understand the point of doing that if he has no films to look at yet. I know he can feel for the tumor, which has all but disappeared, but can he determine if surgery is needed without seeing a PET scan? I wouldn�t mind so much if it wasn�t so difficult to get to him. I live in central Jersey and he is in Manhattan, NY. I was referred to him by a doctor in Jersey who said he�s one of the best in the country for this type of surgery. It doesn�t pay to drive into Manhattan, and the other alternative is two trains and a walk of a few blocks. (Which I don�t know if I�m up to at this time). I�m even thinking of getting a different ENT that�s closer to me. So is it really necessary to see my ENT Surgeon at this point, or should I wait until I have the PET scan done?

Hi Mike

Grats getting through the treatment and I hope you have turned a corner in your recovery phase.

My wife went through the same thing, where she went to see the ENT doctor around 3 weeks post treatment, followed by a separate meeting with her RO two weeks later!

I was told this is because the ENT doc is essentially in charge of the cancer side of things, whereast the RO is in charge of managing the side effects to the treatment side of things.

The visual scope that the ENT doctors do is very important as they are able to see visually if there is anything malicious going on post-tx, as a PET scan within 3 months of treatment will NOT be able to distinguish between scar tissue & malignant cells.

So, in short - absolutely go see your ENT doctor and get him/her to have a look inside. The good news is that after that meeting, you probably won't be back to see the doc for a good 2 months time if all looks good!

I recommend still seeing the ENT who has been treating you all along until after the clear scan, and several all clears being they already treated you, know you, have all your records, and can take action quickly. Another doctor of hospital can refuse to see/treat you, and most don't like handling another doctor's or hospital's work, which has happened to me. If it's a major CCC they choose you, you don't choose them, and often they ask to send All your paperwork, scans just to decide for a consultation.

You can always add a local doctor in the future, but still keep the CCC, and even ask your treatment hospital for a recommendation after explaining your situation, and probably know someone where you live. I understand the travel time involved, and travel to myself to Manhattan to two different treatment hospitals, MT. Sinai and Beth Israel, from Staten Island, but I do have local doctors to go to where I live, which is best of both worlds.

The ENT does a visual and palpable exam of the mouth, throat and neck, and a fiber optic largynoscope. If anything is suspicious further action can be taken,if warranted, in addition too, an MRI or CT, FNAB can always be performed, and some doctors even do PET scan between 6-8 weeks, instead of waiting 12 weeks, to see if there are any changes in-spite of false positives.

After the first scan, there is no set protocol when any other scans are to be performed, minus any suspicion, and most rely on Physical exam, scopes, and scans depend on the doctor, and hospital policy.

Good luck, and hope this helps.

Mike you should see someone regularly - scan or no scan. Your dr can scope you, see how things are healing and check out any problems you may have, I'm seen at a cancer center here in toronto so they tag team me. I see one - either my RO or SO every three months and in between if I have a concern I call my SO because I like him better and trust him. But they were seeing me almost monthly up to my first clear scan. A scope is a valuable tool a scan is good but a good ENT and RO can spot an area of concern just by scoping and doing a visual.