San Diego oncs

nash

San Diego oncs

nash

A question for those of you in the San Diego area--do any of you have oncs who give annual scans to check for mets in the absence of symptoms?

I realize that this approach to the detection of mets is not the current ASCO recommendation, but I was wondering if anyone out there has an "old school" onc who does routine scans.

BMD

Not me but you already know that. I just thought I would bump your question.

formygirls

Hi,

I am in SD and my onc only gives scans in response to symptons. I am in still in active tx but she is not a fan of PET scans and prefers to do MRI's when symptons are present. I also went for a second opinion at the Moores cancer center in LaJolla and he seemed to want to do scans regularly.

nash

Thanks, formy--I sent you a PM.

(and thanks for the bump, BMD)

jeanne46

Have had three oncs in the SD area. None did scans after initial DX and TX. The only reason I was scanned again many years later was a rule/out prior to implant changeout. Unfortunately I never got the new implant. Scans showed recurrence. I really had no obvious symptoms prior to that.



Jeanne

Anonymous

My onc does not do any blood work or scans unless you have symptoms.  How does anyone know if they have mets if you do not have scans when you are diagnosed?

nash

Thanks for the input, Jeanne. I'm sorry to hear of your mets, but glad that they found them. Where are the mets, and do you have any symptoms now that you're a couple years out from their diagnosis?

Melissa--mets are found either through happenstance (like in Jeanne's case, above), through symptoms which prompt scanning, or through rising tumor markers. Tumor markers aren't accurate for everyone, which is why many oncs don't use them for their Stage 1 through 3 patients (they usually are more useful for Stage IV patients to monitor treatment). 

So that's the dilema. The medical community has decided that it's not cost effective to scan everyone on a regular basis, b/c they've decided the practice doesn't result in increased overall survival. The theory is that the mets will eventually become apparent through symptoms, and that it doesn't matter when you start treating them.

HOWEVER, I know of many women who didn't know of their bone mets until they fractured parts of their spine. I know of other women who found liver mets by accident when they were small and not numerous, and were able to have them zapped with radioablation, which wouldn't work if they were wide spread. Same thing for brain mets--although that's obviously a very late stage place to have mets, it's sure easier to deal with one or two small spots than numerous and/or large ones. So taking those situations in mind, it makes sense to me (and a lot of other bc women I know) to catch the mets earlier than later.

My Stage IV bc mom passed away 3 months ago, and I'm was so used to her being monitored that it freaks me out to just go on my merry way (although my onc pulls tumor markers. However, I don't know how useful they'd be in my case--they were normal when I still had the primary tumor in me). I also lost my dad, my grandfather, my uncle and my father-in-law to cancer, so we have this pathetic family history of dying of cancer. I have small children, and I'd like to be able to have an idea of what's going on in  my body so I can have an idea if I'll be around for them. Without mets, shouldn't be a problem. With mets, who knows if I'll see them get out of high school.

There are a few old school oncs who scan annually just to get an overview of things, and I sure would like to find one of them and transfer my care!