Okay so I clearly have an issue with my RO. I had an appointment with my SO three weeks ago and followed up with my plastics guy the next day, but my RO is my primary. I had a check up with him and all is clear thankfully, but some of you may remember before I started treatment they did a chest CT on me... that showed "insignificant spots" now I was later told... that everyone has them, r/t environment etc... and it was called insignificant spots for a reason... makes sense but I was concerned because my original chest CT was clear... was later told that it likely wasn't likely the spots were there, but only one radiologist reported it because - it is a cancer hospital and they have to report everything where as the other ct was taken at a local hospital. I was okay with this.
However today I asked my RO (I had a clear head CT with clear lung passages etc in AUG but they didn't do a chest CT) if they only do CTs if there is an issue, he said yes... exposure to radiation yada yada yada... okay so that's fine. I guess... he said they prefer to look and feel to make sure everything is okay... I get scoped every three months etc... So I said to him well should you not do another chest CT to make sure everything is clear.. he said well it's either in your chest or it's not. If its there there's no point in doing a chest CT because there's nothing we can do.
WTF??? seriously?
I mean... okay I know it would be grave, however, if something is there in the early stages is it NOT MORE TREATABLE at that stage than if you are presenting symptoms and issues? Hello? Early detection? I've about had enough of this guy.
HMPH! Thanks for letting me sound off.

Hi Cheryl, CT scan uses X-Rays (much higher exposure than your standard Chest X-Ray) and presents higher radiation risks and that too when you have been treated heavily using IMRT. Frequent CT scan is not advisable just for nothing (as your doctor said, you may have or may not have)!

Nothing to be upset about. Even if you want to check your chest, get X-Ray. It may not have too much resolution but it does serve the purpose.

Refer to comparisons of effective radiation dose here: http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray#part5

For my dad, both his RO and SO have always recommended Head-Neck MRI over CT (since he does not have any other medical condition prohibiting MRI) and for chest he has had 3 X-Rays in last 3 years. They also tend to avoid PET scan as much as possible primarily due to the fact that PET is usually in combination with CT and Radio-isotope use and ofcourse the cost - even though we are ready to bear it but they do not want to overburden us.

Even with low risk for normal patients, it presents significant risk to cancer patients in remission.

Thanks... I know believe me I don't want to be exposed to any more radiation that I need, however a chest xray only picks up tumors in the late stages. I wasn't asking for lots of scans... I wanted one to ensure my chest was clear... Then follow up xrays would be fine... he just infuriates me when he says... it may or may not be there - and if it's there at this point it doesn't make a difference. as in... so it's there too late you're gonna die... essentially. That peeves me off. He only does ct's when you are symptomatic... are you kidding me. I follow up chest ct post treatment should be offered. Then only given if symptomatic. However usually by the time you have symptoms it's advanced... what's the matter with catching it in the early stage? or better yet... knowing if there is something they should keep an eye on...? UGH! this guy make me crazy. I do get where you're coming from Eshwar... I agree.. too much is bad. But I'm really not a person who runs to the dr. about stuff all the time. If I have an issue I give it time to resolve itself, then if nothing changes I go see someone. I'm not an alarmist believe me. I just feel that once everything is done a final ct should be done to say... okay clear. or not. Also I have trust issues with this guy. I guess. I really think I need to change... Im sure he's good at what he does and I don't need a hand holder, but I do need someone who is ahead of the game not behind it. I guess the words are proactive instead of reactive?

I'm so sorry Cheryl- I can only imagine the frustration! I'm a bit ignorant with how things work in Canada- are you able to get a second opinion?
I hope so.

One of my RO's said after all the treatment exposure I have had (~70grays) that I really shouldn't worry about the CT diagnostic follow up exposure.

I know CT scanners have come a long way and radiation induced cancers and not very well understood.

Interestingly, the daily Tomotherapy setup CT scans added less than a told of 2gray.

Thanks. I'm clear.. He said I was - I'm just frustrated because - well I think I just need a new RO - I do not need hand holding. But I do need a dr. Who is po active and not reactive, and that I have confidence in. After this conversation, it makes me wonder that if I do suffer a recurrence - will I get the best care from him. ? Ugh. I'm gonna call the hospital. And see if my care can be transferred to some one else! Thanks guys! hugs!

I have at least one "insignificant lung mark"as well. I get a Chest X Ray Annually. You need to do two things:

1) Speak to the Patient Rep at your CancerCare and ask for a referral to a different RO
2) Ask you GP to schedule an annual chest X Ray.

Good luck - Glad to hear all is going well.

(your R.O. sounds like a ditz!!)

Donna

That is extremely maddening and frustrating! I had issues with my RO too. She was extremely bright but zero empathy and social skills. Absolutely terrible bedside manner. Sometimes the more brilliant the doctor the worse they are with social interaction. Being a RO is the equivilant of a rocket scientist. Look at all the sophisticated equipment-- there is a lot involved. They tend to be super nerdy and not great with patients... not all of them of course--- but I've heard this same complaint from others. Mine was one of the rudest most insensitive individuals I've ever met. Completely callus and inappropriate.

Definitely get a second opinion on your situation- see if you can see a partner or something. I switched Drs. within the same hosiptal and have been so much happier.

That's what I'm going to do. Actually - I'm sure he's brilliant - and I'm sure with regards to treatment he did what he had to do - despite the amount of treatment etc... I'm doing well and feel great. And he did it well - but for follow up care... I think I need someone a little more pro active that way if something comes up... He's on it before its a big problem. Hope you all have a wonderful day! many blessings to you

Cheryl

Two major studies reported in the Washington Post and the Wall Street Journal and even USA Today document that X-rays do NOT detect cancer in the lungs as well as a CT scan and even the CT scan is not so hot. Moreover there was no survival rate increase for even smokers who had chest X rays every year. It's from the national Cancer Institute
[quote]Routine chest X-rays do not prevent lung cancer deaths, not even in smokers or former smokers, according to a big government study challenging a once common type of screening.

In the study of more than 150,000 older Americans, those who had four annual chest X-ray screenings were just as likely to die of lung cancer as participants who didn�t have those tests. [/quote]
Here's the article
screening with chest X-rays doesn�t save lives,
Charm