| Joined: Apr 2013 Posts: 21 Member | OP Member Joined: Apr 2013 Posts: 21 | My first follow up scan after treatment will be the first week in August and I will have blood work and a CT scan. I noticed others have a PET/CT. Just wondering which is preferred and why.
T1 N2b M0 IVa HPV+ right tonsil 58 non smoker Noticed enlarged lymph node right side 2-2013 CT scan 2-18-2013, FNA 2-21-2013 Neg, Excised 1 node and bio tonsil SCC 3-19-2013. MD Anderson 4-1-2013 8 teeth removed 4-12-2013 Start treat 4-29-2013 66 GY IMRT Comp treat 6-7-2013 8-15-2013 NED | | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) Joined: Jun 2007 Posts: 10,507 Likes: 7 | Steve, not everyone gets a PET scan. They are very expensive. Ive heard a PET can cost several thousand dollars while a CT is only a couple hundred. I think in other countries the CT is more common.
Ive had both done and my doc said for my follow up a CT w/ contrast is enough for my situation. ChristineSCC 6/15/07 L chk & by L molar both Stag I, age44 2x cispltn-35 IMRT end 9/27/07 -65 lbs in 2 mo, no caregvr Clear PET 1/08 4/4/08 recur L chk Stag I surg 4/16/08 clr marg 215 HBO dives 3/09 teeth out, trismus 7/2/09 recur, Stg IV 8/24/09 trach, ND, mandiblctmy 3wks medicly inducd coma 2 mo xtended hospital stay, ICU & burn unit PICC line IV antibx 8 mo 10/4/10, 2/14/11 reconst surg OC 3x in 3 years very happy to be alive | | | | Joined: Jan 2013 Posts: 1,291 Likes: 1 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jan 2013 Posts: 1,291 Likes: 1 | Hi Steve, Welcome to OCF. I can not articulate the technical merits of either other than to say a PET/CT is both a CT and a PET scan, two scans. So I would venture to say having both types of scans to review the progress is better in the hands of those who know how to read each.
My understanding of the CT done during PET/CT is not as clear and useful as the standalone CT. Someone mentioned the reason why but that eludes me now.
Best for your scans. I am due end of this month too for first set.
don
Don Male, 57 - Great health except C Dec '12 DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes 1 tooth out Jan '13 2nd tooth out Tumor Board -induction TPF (3 cycles), seq CRT 4-6/2013 CRT 70gr 2x35, weekly carbo150 ended 5/29,6/4 All the details, join at http://beatdown.cognacom.com | | | | Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 1 | As mentioned, cost is one factor. A CT is easier to read, and doesn't need specialized training like a PET, no specialized diet, fasting, so is the most often utilized scsn. I had about 11 PET/CT scans, some costing $6,000. It also depends what the doctor wants to view, area, to indicate which diagnostic test to use, sometimes multiple ones. CT is also good to highlight bone involvement, MRI for vessels, nerve line involvement, and a PET/ CT for distance metastases, and lymph nodes. I also had an MRI's followed by a PET/CT due to tooth filling scatter. I read that the most accurate is the PET/CT, down to as small as 5mm, then the MRI, followed by CT. PET also has a high rate of false positives. Some say it's 90% accurate at 8 weeks, 3 months is the most often taken, 4 months is better, and at a year is 100% accurate. I had most scans done at 3 months, and two at 5 months, 8 months post treatment for various reasons, and that's long waiting.
I'm also have a scheduled for a PET/CT in August, without CT contrast, due to the kidneys. At first my ENT was scheduling a CT, but I needed the nephrologist's clearance, and in between my RO, who specialises in HNC, said I need to get a PET/CT, and that is what I'm having. Personally, I would rather have a PET/CT, and If needed, another test to follow to highlight the area they want to view, as Don mentioned, I don't think it as good in a PET vs stand alone CT.
Good luck with your scan.
10/09 T1N2bM0 Tonsil 11/09 Taxo Cisp 5-FU, 6 Months Hosp 01/11 35 IMRT 70Gy 7 Wks 06/11 30 HBO 08/11 RND PNI 06/12 SND PNI LVI 08/12 RND Pec Flap IORT 12 Gy 10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux 10/13 SND 10/13 TBO/Angiograph 10/13 RND Carotid Remove IORT 10Gy PNI 12/13 25 Protons 50Gy 6 Wks Carbo 11/14 All Teeth Extract 30 HBO 03/15 Sequestromy Buccal Flap ORN 09/16 Mandibulectomy Fib Flap Sternotomy 04/17 Regraft hypergranulation Donor Site 06/17 Heart Attack Stent 02/19 Finally Cancer Free Took 10 yrs
| | | | Joined: Sep 2012 Posts: 381 "OCF Canuck" Platinum Member (300+ posts) | "OCF Canuck" Platinum Member (300+ posts) Joined: Sep 2012 Posts: 381 | Steve, I asked my doc about this as I had a false positive on nodes for my pre-surgery PET. My neck was like a Christmas tree on the PET, but none of the nodes came back positive at surgery.
He said he prefers the CT with contrast as all my scopes are coming back clear, but offered the PET if I wanted it. I was actually more worried about another false positive, so I'm going to stick with the CT.
Tina Diag: Aug. 13/12 T3N0M0 50% + glossectomy and bilateral radical neck dissection, removal of nodes zones I - V Surgery October 11/12 Chemo/rad on hold due to clear margins and nodes Sept 21/13 clear CT with anomaly thought to be the artery, being watched closely. Dec 16/13 - anomaly confirmed artery, all clear nickname: "get 'r done" Plans: kick cancer's butt
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | I was treated at Moffitt a CCC and I only had 1 PET and that was pre Tx. Post Tx I had 3 CT's and that was because I had spots on my lungs so I had one every 3 months post Tx until they were gone.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: Jan 2013 Posts: 1,291 Likes: 1 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jan 2013 Posts: 1,291 Likes: 1 | David, Don't mean to pull this thread OT but what's the story on spots on lungs? I have a couple small and low SUV spots which after a lot of hemming and hawing was never fully diagnosed, just in wait and watch mode. don
Don Male, 57 - Great health except C Dec '12 DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes 1 tooth out Jan '13 2nd tooth out Tumor Board -induction TPF (3 cycles), seq CRT 4-6/2013 CRT 70gr 2x35, weekly carbo150 ended 5/29,6/4 All the details, join at http://beatdown.cognacom.com | | | | Joined: Apr 2013 Posts: 21 Member | OP Member Joined: Apr 2013 Posts: 21 | Thanks everyone it is nice to get the feed back. I am going to a CCC (M.D.Anderson) and trust that they know what they are doing. At the same time the more I understand and am informed about some of these issues the better I feel about what's going on to be able to self advocate when needed.
T1 N2b M0 IVa HPV+ right tonsil 58 non smoker Noticed enlarged lymph node right side 2-2013 CT scan 2-18-2013, FNA 2-21-2013 Neg, Excised 1 node and bio tonsil SCC 3-19-2013. MD Anderson 4-1-2013 8 teeth removed 4-12-2013 Start treat 4-29-2013 66 GY IMRT Comp treat 6-7-2013 8-15-2013 NED | | | | Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 1 | MD Anderson is the number one cancer center in the country, according to U.S. News Report Best Hospitals 2013. I would say you are in good hands.
10/09 T1N2bM0 Tonsil 11/09 Taxo Cisp 5-FU, 6 Months Hosp 01/11 35 IMRT 70Gy 7 Wks 06/11 30 HBO 08/11 RND PNI 06/12 SND PNI LVI 08/12 RND Pec Flap IORT 12 Gy 10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux 10/13 SND 10/13 TBO/Angiograph 10/13 RND Carotid Remove IORT 10Gy PNI 12/13 25 Protons 50Gy 6 Wks Carbo 11/14 All Teeth Extract 30 HBO 03/15 Sequestromy Buccal Flap ORN 09/16 Mandibulectomy Fib Flap Sternotomy 04/17 Regraft hypergranulation Donor Site 06/17 Heart Attack Stent 02/19 Finally Cancer Free Took 10 yrs
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Don,
The 1st post Tx scan report came back showing 2 spots in the upper part of one lung (I forget which side) with the verbiage "areas that cannot be excluded." My RO who during Tx had already shared with me that if my cancer spread to my lungs or brain I was dead, told me and my wife "don't worry". Yeah right, so he agreed to schedule another scan in 3 months. THREE LONG MONTHS and another scan and this time the first set of spots were "resolved" but there were new spots in the lower part of the same lung which the same verbiage "areas that cannot be excluded." RO again said "don't worry." Yeah right so he agreed to do another scan in 3 months. THREE LONG MONTHS and finally I got an all clear. RO surmised spots must have been inflammation from the Tx.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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