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#174644 11-29-2013 04:30 AM
Joined: Oct 2011
Posts: 225
samkl Offline OP
"OCF Down Under"
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"OCF Down Under"
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Joined: Oct 2011
Posts: 225
I know I tend to go on a bit about this, but my brother, who is now 2+ years post treatment, hasn't had a scan since 3 months post treatment. He's had good visual/scope reports every three months, but how does the ENT know things aren't happening eg. in the lungs? I keep reading signatures with mention of scans every few months, but his ENT is anti the idea, saying the outcome would be the same regardless of the scan result (I'd ask questions at this point but I'm not in the consults and my brother would be too freaked to ask). Isn't it better to know if there is a metastasis sooner rather than later?

I think the NCCN guidelines say only scan as indicated, so why do so many of you have regular scans? I'm asking because he feels something is amiss - he's just back out work (in the last week or so), which is cause for celebration, but cancer never lets you let your breath out, I find, so just as things start looking up ....


Brother 49yo DX 22/6/11 Tonsil SCC HPV+ Stage IV T4N1(?)M0. Carbo/docetaxel (Taxotere)19/7, 11/8 (with E-tux), 1/9; E-tux 11/8, 25/8, 15/9, 30/9, 14/10, 28/10; IMRT X 35 (70gy tumour;63gy nodes;56gy gen area) 19/9-4/11/11. Clear PET scan 1/2/12. 1 and 2 year post treatment checks good.
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Here in the US, scans are more common. I believe the first one is done about 3 or 4 months post rads and then at 6 months, 1 year, 1 1/2 years and 2 years then it goes to either 9 months or yearly.

Im 4 years out since my last round of OC and I get scoped once a years and chest xrays yearly but thats it. I only get the chest xrays as a tiny spot appeared a couple years back on my one lung.

Im not sure why we get scanned more than patients in other countries???? Medical conditions and routines are different in other countries.


Christine
SCC 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 smile
Joined: Jul 2012
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Patient Advocate (old timer, 2000 posts)
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There is no general consensus when any scan should be done post treatment. It depends on the doctor, and hospital. NCCN guidelines say a post treatment scan should be done 3-6 months, minus any cancer signs or suspicions, and even that is only for T3, T4 disease, and only in certain head and neck cancers like oropharyngeal, not even oral cancer is mentioned.

All my doctors at several CCC do a PET/CT at 3-6 months post treatment, and 6 months thereafter. I'm sure the time between increases thereafter, but I never made it to that point. What guideline this is from, I don't know, maybe it was an old NCCN guideline, but seems many follow this or similar. Some doctors don't believe it post treatment scanning or want to subject the patient to more radiation with no added benefit.

There are other guidelines, ENT's, MO, RO follow, that are followed, and NCCN guidelines list similar too. Like the first year is every 1-3 months, where ENT's they do a palpable, visual exam, and maybe a flex scope. Some say the visual, and palpable exam is just as good ad any scan, but also read in other abstracts a PET/CT is like 28%, don't quote exact figures, in finding cancer than a palpable exam. A chest x-ray should be done yearly, as well as TSH levels for thyroid dysfunction, which may increase as time goes by.

A patient can also be vigilant in doing their own observations, exams. I found all my nodal cancers (8) in the cervical neck, then confirmed by FNA, PET, except my last one, which is probably due to a pec flap, and was told before, scanning is the only way now to probably detect cancer, and was.

Good luck.


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







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