Michael -- I agree with much of what you said, particularly the comparison views over time. I had one of those new-fangled Body Scans a few years ago, and it showed some tiny nodules in my lungs. I had CT Lung scans every 6 months for 2 years, so that they could rule out anything nasty, and it was the comparisons that enabled them to do this.

My ENT/Surgeon and my RO do a real thorough examination of my neck, oral cavity, throat and tongue every time I see them. My MO does a more cursory check, but also does CXR every other visit, and blood work every visit. Now that I am past one year, I see each one every 3 months, but I stagger them so that I never go more than 6 weeks between visits. Last year, I never went more than 4 weeks between visits.

Both my RO and Surgeon say that they can tell more by their physical exams than they can through PET/CT, again due to the false positive issue and knowing my particular case and the tissue changes that I experienced due to radiation and neck dissection. Predictably, it was the MO who ordered the PET scans.

They are one piece of the puzzle, but only that. BTW, the PET can discern masses equal to or somewhat smaller than 1 cm (10 mm). However, it is the metabolic activity that it detects, rather than the size of the lesion, that is the good news/bad news of the PET scan. Good news because cancer cells have increased metabolic activity, bad news because so do non-cancerous cells that are involved in infection, scar tissue etc.