Do i need scans after chemo is finished, P.A. says NO!!

I had neoadjuvant chemo, (am done) and am waiting to hear when my CT scan the doc ordered is..also the B.S. has already said she will probably order an MRI before the surgery...I know personally I will feel better..did you tell your doc how anxious you are?

Deb

I was told the same thing, no scans unless symptons.  I have to say that I'm not so sure I buy that because with we Triple Negs, our cancer is so aggressive that couldn't it come back and we just don't feel it?  I say push for brain MRI and bone scan an PET/CT may somepoint may be 6 months after treatment.  

Each doc seems to have his own ideas, but the general concensus seems to be "wait till there's a reason to scan."  My onc (who I do love dearly) told me that most patients "just seem to know" when there is progression & that's when she'll scan.  Of course dh & I thought that was insane (altho now I realize just how correct she was!) and she went ahead & ordered my scans when she saw how uncomfortable/nervous we were when she told us there is no real schedule that is followed.  This was just a couple of wks after surgery (and before rads) and there was a place that lit up... since it WAS so soon after sx, it was attributed to that but they decided to rescan in 4 mos just to be sure.  Like Maire said, what's impt is to follow up on any symptoms ~ the info from the scans is impt, but our own input is just as impt. 

What your doctors don't want to tell you, because they don't want you to yell at THEM, is that insurance won't pay for scans unless there are symptoms.  I believe that's the primary reason doctors don't order routine, post chemo scans.  And, I can see their reasoning.  Insurance has to make a profit, and scans are expensive, and have not been proven to increase life expectancy in mets.  You think there's a health care crisis now?  Imagine what the costs would do if doctors ordered routine scans every three to six months for every cancer survivor.

That said, you can always fake symptoms.  Get a cough that just won't go away, an ache in your rib, a pain on your right side under your ribs, a recurring morning headache.  If you report symptoms, the doctor has a responsibility to present the test to the insurance company for certification.

The other reason to not be too aggressive with routine scans is radiation load.  It doesn't go away, at least very slowly, from your body.  And radiation is also a risk factor in developing cancer.  It's a balance.

My cancer came back.  I finally got a CT scan and bone scan after my tumor markers went up over a 6 month period.  I switched to a new oncologist after getting a second opinion.  My first oncologist said that my insurance company would not approve a PET/CT.  I didn't have any symptoms and my new oncologist said that the tumor (as well as lymph nodes) that showed as cancerous probably were there and growing for at least five months prior to finally getting a PET/CT scan.  She told me that she prefers to do a base PET/CT scan initially and then have them done routinely after that every six months or so along with monitoring my tumor markers every couple months.  She had no problems getting the insurance company to approve the PET/CT.  I also had an MRI of my head even though I was having no symptoms.  My initial oncologist said he didn't feel it was necessary.  He only did a CT of my Chest and abodmen and a bone scan.  No CT of my pelvis or MRI of my head.  In my opinion, I feel better when they are pro active and don't wait for me to have some sort of symptom.  I wasn't even told that my tumor markers had been going up until he saw that they had gone up for the third time.  I'm much happier with my current oncologist who is a "leave no stone unturned" type.  I believe there are different doctors for different personalities.  If you are more comfortable with the less intrusive approach then maybe no scans are a better way to go for you.  If you need a doctor that's more pro active then by all means, find one that is that way. 

I can't help but wonder if it would have helped if I had PET/CT scans on a regular basis along with monitoring the tumor markers and maybe having a PET/CT when the markers first started to go up, especially with my history of Triple Negative, vascular involvement, and positive nodes. You need to be your own advocate and don't be afraid to ask for a PET/CT if you want it.  If your doctor is not willing then maybe you may want to consider a second opinion.

BorninWA

So sorry about your news. How many nodes involvment did you have the first time? You wrote, you had vascular invasion. How did you know that? Did they tell you in the path report the first time?

I say "Yes!" you need scans to follow up as Tri-Negs! I was CT scanned at the end of treatment and was clear. Just 1 yr later I had another scan (Scheduled) and already had extensive tumor spots all over my liver, but no physical symptoms to report.. Can't help wondering if I'd be in a better place today if I'd been scanned at 6 months instead!

Skigrl- I had blood work done every 3 months, but nothing showed up and my liver is still functioning well despite the cancer- good news for me right now.

kellyless,

You are so lucky your doctor will be aggressive with your follow up.  I've seen many ladies just be put out to pasture after treatment...like you say the "not doing anything" after so many months of battling this disease does not feel right. I hope you find radiation gentle for you and congrad's with finishing chemo.

Flalady

Ha ha, in California, wirh HMO's, we only get a referral to Dr. Krevorkian after treatment, certainly no scans.  But oh well.

Hugs, Shirlann

I finished my last round of chemo three weeks ago...And my Onc is going to schedule a PET Scan, she wants a new test before I start my reconstruction.  I meet with the Radiation Onc about 2 weeks ago and he said that radiation was to risky for me and wouldn't make much of a difference since i had a Bilateral Mast...

Has anybody ever been told the same thing?  I'm a little nervous about not getting radiation, but I am glad that I am getting another PET SCAN just to make sure everything is good.

Shonda