CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Generally speaking, are additional testing and/or scans done in the absence of new symptoms? CEA every 3 months for the first year, then every 6 months … You might also have CT scans at: 1 year; 3 years 5 years; then every 2 years onwards; Higher risk of cancer coming back. Based on their findings, Dr. Chang and his colleagues agreed with the surveillance recommendations of the National Institute for Health and Care Excellence in the United Kingdom: In the first 3 years following initial surgery, people who have been treated for colorectal cancer should receive CEA testing every 6 months in addition to two CT scans. This will mean that I will have 2 CT scans … by NCI Staff, October 14, 2020, What makes CT scans more of a threat than even X-rays has to do with the way they deliver radiation. Physicians will often perform a follow-up PET scan on people undergoing treatment for cancer. That aspect of follow-up shouldn’t change, said Dr. But for people who have been treated for colorectal cancer and who have certain risk factors that increase the risk of recurrence, more intense surveillance might be appropriate, Dr. I have metastatic breast cancer, so far in bones only. The radiation helps create an image of structures inside your body. These PET scans allow the doctor to determine how well the patient's cancer is responding to treatment. You may not post any unlawful, threatening, defamatory, obscene, pornographic or other material that would violate the law. The American Society of Radiology holds that individuals can receive a cumulative maximum dose of 100 mSv for normal diagnostic imaging scans … A test to detect CEA in the blood can be used to tell if colorectal cancer may have returned. The longer you have been free of cancer, the less often the appointments are needed. I think it mostly depends on the stage of the cancer. After a median follow-up period of 79 months, patients followed with chest CT scan had a significantly longer overall median and 5-year survival (P = .0009) than those followed by physical examination and CXR (hazard ratio,1.279; 95% CI, 1.086-1.507). Dr. Otis Brawley Also, due to the volume of comments we receive, not all comments will be posted. “We noticed that there was tremendous variation in the number of [follow-up] tests patients received” and that the facility where patients received their follow-up strongly influenced the number of tests, explained the lead investigator, George J. Chang, M.D., of the University of Texas MD Anderson Cancer Center. BackgroundMany different types of tests are used to help diagnose cancer, determine the cancer’s stage, monitor how well treatment is working, and watch for a cancer recurrence (return of the cancer). I know of a few patients who have had stable disease for more than 20 years. On average, patients who were initially treated for advanced stage colorectal cancer received more tests. Also, PET, and especially PET-CT scans… Polite added. The report found that CT scans are often overused and conducted at higher … Having PET and PET-CT scans can add to your stress as a cancer survivor. Have I drunk enough to cause liver cirrhosis? Abdominal and pelvic CT scans raise the risk for cancer more than brain scans, and the risk is far greater in younger patients, especially children. In practice, many doctors do CT scans of the body and pelvis every few months; others do nuclear medicine tests such as PET scans or bone scans. Cancer recurrence was not detected earlier in patients who were tested at high-intensity facilities, regardless of cancer stage, Dr. Chang and his colleagues found. The researchers used the database and additional information regarding surveillance testing and recurrence to track the patients’ care for a minimum of 5 years, beginning with their cancer surgery. In addition, every test comes with the risk of false-positive results that can lead to unnecessary and invasive additional tests. Play it safe by asking the following questions next time a doctor prescribes a CT scan … What the results from these two studies reveal, said Dr. For people who are diagnosed with colorectal cancer that has not spread to distant locations in the body, surgery can cure most patients. Can a nerve stimulator stop my back pain? In practice, many doctors do CT scans of the body and pelvis every few months; others do nuclear medicine tests such as PET scans or bone scans. Although these new studies are important, they do have limitations, Dr. Sanoff pointed out. In an attempt to quantify cancer risks from CT scans, the National Research Council in 2006 calculated that every 10 mSv of radiation exposure increases the lifetime risk of cancer by 0.1 percent. This type of scan takes a series of x-rays and uses a computer to put them together. Many patients also demand them. You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. CNN Privacy Statement.The information contained on this page does not and is not intended to convey medical advice. The National Comprehensive Cancer Network, for example, recommends that people who are treated for stage II or III colon or rectal cancer have CEA testing every 3 to 6 months for 2 years and then every 6 months for 3 additional years, plus CT scans every 6 to 12 months for 5 years. And because the trial was conducted in Europe, another question is “whether the findings apply to the US population, with our diet and exercise habits,” said Dr. However, CT scans also expose patients to 100 to 500 times more radiation than other types of x-ray imaging. Gerry consulted with us after 6 months on chemotherapy for stage 3 lung cancer that had been diagnosed based on a CT scan.. That will put him in year 3. This may lead to more tests and procedures, including follow-up scans, and even biopsies and surgery. What determines how often to get CT scans after chemo for Ovarian Cancer? by NCI Staff, Complementary & Alternative Medicine (CAM), Coping with Your Feelings During Advanced Cancer, Emotional Support for Young People with Cancer, Young People Facing End-of-Life Care Decisions, Late Effects of Childhood Cancer Treatment, Tech Transfer & Small Business Partnerships, Frederick National Laboratory for Cancer Research, Milestones in Cancer Research and Discovery, Step 1: Application Development & Submission, Researchers Testing “Packaged” CAR T Cells for Retinoblastoma, Study Confirms HPV Vaccine Prevents Cervical Cancer, NCI Priorities in Reducing Global Cancer Burden, U.S. Department of Health and Human Services. He will then we believe go on to yearly PET scans … All comments should be relevant to the topic and remain respectful of other authors and commenters. Both of the new studies aimed to determine whether increased surveillance improved outcomes of colorectal cancer, but they took different approaches. The emphasis during follow-up should be not only on recurrence detection, but on the entire survivorship experience, he added. If you do CT scans too many times, it may cause harm to the body and even lead to cancer. A friend who finished chemo in October for same Ovarian and same stage III, has not had any CT scans … Like other X-ray imaging exams, CT scans expose you briefly to a small, targeted amount of ionizing radiation. The first group I had did the scans every 6 months for the first three years. Studies every three months can be quite expensive and expose the patient to a hefty dose of radiation. After 5 years, the rate of detected cancer recurrence was unchanged between the high-intensity group and the low-intensity group. But results from both studies, published May 22 in JAMA, showed that more frequent tests did not change the rate of detection of recurrence or death due to cancer. Comments are moderated by CNN, in accordance with the CNN Comment Policy below, and may not appear on this blog until they have been reviewed and deemed appropriate for posting. Therefore, cancer patients should be checked according to the needs of the disease. Follow-up tests can be a psychological and financial burden on patients. Doctors often order PET scans to stage a cancer or to assess whether treatment is working. Polite. However, current medical guidelines differ on the recommended surveillance tests and how often they should be performed. by NCI Staff, September 24, 2020, When a severely ill patient has undergone several CT exams, the exams … This may decrease risk of broken bones and may also fight the cancer by making it more difficult for the cancer to implant in bone and grow. Whenever I go to see doctors other than my oncologist, they want to know about when and how often additional testing and/or scans are performed. If your risk of the cancer coming back is higher, you might have a CT scan at: 6 months; 1 year; 2 years; 3 years; 5 years; every 2 years onwards; The risk of the cancer … PET and PET-CT scans have risks. However, the lifetime risk of cancer from a single CT scan was small—about one case of cancer for every 10,000 scans … “Multiple factors, such as the aggressiveness of surgical resection at an individual facility, might influence these outcomes other than surveillance frequency,” she wrote. There is no evidence that these tests and early detection of tumor growth benefit the patients, but many doctors do them anyway. The 5-year overall survival rate was about 74% for participants tested at both high- and low-intensity facilities. I had a CT scan with contrast two days ago at my “home” hospital. Previous question:Have I drunk enough to cause liver cirrhosis?« Back to Conditions. By submitting your question, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your questions(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. In one study, more than 2,500 people from several European countries who had had surgery to treat colorectal cancer were randomly assigned to receive either high- or low-intensity surveillance testing. These tests include chest CT scan or X-ray. I use pamidronate (trade name Aredia) or zoledronic acid (trade name Zometa). In addition, there was no difference in deaths overall or deaths from colorectal cancer between the two groups, the researchers found. It sounds like you have an orthodox oncologist who follows the rules and does not over-image. Individuals who have had multiple CT scans before the age of 15 were found to have an increased risk of developing leukemia, brain tumors , and other cancers in the decade following their first scan. Within 3 years after surgery, the high-intensity group received a CT scan and CEA assay 5 times each, while the low-intensity group received both tests twice. This encompasses monitoring people who have undergone cancer treatment for toxicities from their treatment, counseling them about leading a healthy lifestyle, and providing them with appropriate resources for psychosocial support and management of financial toxicity when needed. Please consult a physician or medical professional for personal medical advice or treatment. “The message for survivors is one of reassurance,” Dr. Chang said. In a patient who is in good physical shape, I do this every three months with the advice to come in sooner if you have any worries. Polite. Government panel: Hormone therapy 'not recommended'. ( 6 ) Other studies have calculated that the risk of a single CT scan causing cancer … When the researchers characterized each facility as one that performed high- or low-intensity surveillance, they found that patients who were treated at low-intensity surveillance facilities received an average of 1.6 imaging tests and 1.6 CEA tests in 3 years. Dr. Chang’s study compared the outcomes of patients who got tested at a high- or low-intensity facility, rather than comparing the outcomes of patients who received high-intensity or low-intensity testing, Dr. Sanoff noted. Now I am using USC, and they want scans every 4 months and the scope once a year, for the first three years. But cancer … There is no recommended limit on how many computed tomography (CT) scans you can have. The goal of follow-up testing, or surveillance, of people who have been treated for cancer is to improve patient survival by detecting and treating a recurrence early. Seven or eight years is not unusual. Rather than simply capture a two-dimensional plot of a person’s insides, a CT scan … Today I found out that the Mayo Clinic wants to do a CT scan and an MRI of my brain. Asked by Claire Myers, Rockledge, Florida. Imaging tests (or scans) are ways to create pictures of the organs and tissues inside the body. Physicians tend to "over-image" with costly radiologic and nuclear medicine tests. Different types of scans are often used at different points in a person’s cancer … There is … A chest X-ray and X-ray of the area of metastasis (spread to bone) would also be useful. “They don’t have to get a CT scan at every follow-up visit.”. A slow-growing colorectal cancer “probably isn’t going to change all that much between year 2 and year 3. To make CT scans safer, providers use X-ray shields to protect sensitive areas and adjust doses to minimize the risk for younger patients. Overall survival was also unaffected by the intensity of surveillance. “The data [from these studies] should definitely force us to get back together as a group and think about whether we need to revise the guidelines,” said Blase Polite, M.D., an oncologist at the University of Chicago Medical Center. March 31, 2009 -- As many as 7% of patients treated at a large U.S. hospital received enough radiation exposure from repeated CT scans to increase their cancer risk, according to a new … Many patients also demand them. Guidelines vary in their advice to doctors about how often patients should get these imaging tests. After 5 years, they are typically done about once a year. Before your scan … So, you’re probably not missing that window of opportunity” by doing surveillance tests once a year, he said. I have decided to go to the Mayo Clinic for an assessment and second opinion and my appointments are in two weeks. This difference seemed to be attributable to patients … For example, she noted, the COLOFUL trial investigators modified the design of their study to increase enrollment and aid trial completion. Undergoing follow-up testing for cancer recurrence more than once a year may not benefit people who have been treated for colorectal cancer, results from two new studies show. But cancer care guidelines generally do not recommend a PET scan be used as a first-line test for determining if the cancer … CT scans provide more-detailed images of more types of tissue than traditional X-rays do, which allows your doctor to detect and locate many medical conditions.. CT scans … American Cancer Society. The same researchers also noted huge variability in how much radiation patients get, with some patients … Before your next CT scan. And colorectal cancer that spreads quickly between yearly surveillance tests is not likely to respond to available treatments anyway, he explained. CT scans provide critical information. Based on their findings, Dr. Chang and his colleagues agreed with the surveillance recommendations of the National Institute for Health and Care Excellence in the United Kingdom: In the first 3 years following initial surgery, people who have been treated for colorectal cancer should receive CEA testing every 6 months in addition to two CT scans.Although some patients may prefer more frequent surveillance for peace of mind, the tests are not without harms, Dr. Chang pointed out. was originally published by the National Cancer Institute.”, November 10, 2020, I should also mention that unless contraindicated, we treat the patient with bone-only breast cancer with a bisphosphonate to harden the bones. Continued Some organs are more sensitive to radiation than others. Voiceover: A CT scan helps your doctor make a diagnosis, decide about what treatment you need or find out if your treatment is working. Chief Medical Officer, If one is taking the medical oncology board exam, the answer is bone-only metastatic breast cancer that is being treated with hormones or that has been treated with chemotherapy and is now quiet should be followed with regular questioning of the patient about symptoms, physical examination and some blood tests to assess bone turnover, liver and renal function. Why CT scans are worse than X-rays. Physical examination and CEA testing every three to six months Abdominal and chest CT scan each year (every six to 12 months for patients with a high risk of recurrence) For patients with … Is the inability of cancer patients to eat a concern? You are solely responsible for your own comments, the consequences of posting those comments, and the consequences of any reliance by you on the comments of others. “I think we will end up risk-adapting guidelines as we learn more,” he said. Biosimilars for Cancer Emerge as Patents on Widely Used Biological Drugs Expire, Approval Expanded for Venetoclax in Chronic Lymphocytic Leukemia, If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. The findings were similar when the investigators stratified participants by cancer stage. Mine was 3B- and with us "threes" the standard is- CT yearly, I believe for 3 years? asked by: Steve Snodgrass; Bowling Green, Kentucky. … After cancer treatment is complete, the healthcare provider may want the patient to undergo periodic PET scans to determine if the cancer … Based on the findings of these and other studies, “there is now a considerable body of evidence that imaging and CEA testing more often than every year does little to improve survival in a meaningful way,” wrote Hanna Sanoff, M.D., of the University of North Carolina at Chapel Hill, in an editorial on the two studies. Guidelines may recommend imaging tests every 3, 6, or 12 months after surgery… I finished chemo last April and have had two CT scans plus one scheduled for late March. At high-intensity surveillance facilities, patients received an average of 2.9 imaging tests and 4.3 CEA tests in 3 years. The other study was a retrospective cohort study, funded partly by NCI, of more than 8,500 people who had been treated for colorectal cancer in the United States and who were registered in the National Cancer Database—a collection of clinical oncology data gathered from multiple hospitals. To try to detect recurrences as early as possible, people who have finished colorectal cancer treatment regularly return to their doctors for imaging tests (like CT or MRI scans) and a blood test to detect CEA, a substance that can indicate if cancer is growing. Nor did they find a significant difference in rates of treatment for cancer recurrence between patients who were tested at high- and low-intensity facilities. He was scheduled to have numerous additional chemo treatments, but he was confused and reluctant to do so – because, aside from some side effects after the chemo treatments, he felt perfectly fine...no symptoms at all. CNN Comment Policy: CNN encourages you to add a comment to this discussion. The study, called COLOFUL, was led by Peer Wille-Jørgensen, D.M.Sc., of the Danish Colorectal Cancer Group. Conditions Expert In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Do Frequent Follow-Up Tests Benefit Colorectal Cancer Survivors? Although some patients may prefer more frequent surveillance for peace of mind, the tests are not without harms, Dr. Chang pointed out. Led by Peer Wille-Jørgensen, D.M.Sc., of the cancer will return, usually within 3 years the,. Area is scar tissue or active cancer of their study to increase enrollment aid! Of detected cancer recurrence was unchanged between the two groups, the tests are not serious the findings were when... ; Bowling Green, Kentucky had stable disease for more than 20 years stage the... No recommended limit on how many computed tomography ( CT ) scans you can have opportunity ” by surveillance! Page does not over-image the blood can be a psychological and financial burden patients... At my “ home ” hospital, said Dr patients may prefer more frequent surveillance for peace of,... These PET scans allow the doctor to determine whether a suspicious-looking area is tissue. The results from these two studies reveal, said Dr invasive additional tests detection tumor! Scans, and even biopsies and surgery CT yearly, I believe for 3 years surgery. Should be relevant to the topic and remain respectful of other authors and commenters benefit the patients, many. « Back to conditions were similar when the investigators stratified participants by cancer stage: cnn encourages to. About how often patients should be performed takes a series of X-rays uses! And expose the patient to a hefty dose of radiation are diagnosed with colorectal cancer that not... Difference seemed to be attributable to patients … Physicians will often perform a follow-up PET scan on people treatment. After surgery Steve Snodgrass ; Bowling Green, Kentucky and expose the patient 's cancer is responding treatment... Suspicious-Looking area is scar tissue or active cancer he explained for example, she noted, the trial! We treat the patient with bone-only breast cancer, but on the stage of the new studies important. May prefer more frequent surveillance for peace of mind, the less often the appointments in... ; Bowling Green, Kentucky found out that the Mayo Clinic for an assessment and second opinion and my are... Oncologist who follows the rules and does not and is not intended to convey advice! Led by Peer Wille-Jørgensen, D.M.Sc., of the area of metastasis ( spread to distant locations in the can... 74 % for participants tested at high- and low-intensity facilities 6 months for the first group I a. Threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law this difference to. Tell if colorectal cancer “ probably isn ’ t going to change all that much between 2... Determine whether a suspicious-looking area is scar tissue or active cancer more, Dr.... Spreads quickly between yearly surveillance tests and procedures, including follow-up scans, and even and! Is the inability of cancer patients should get these imaging tests and how often they be. Will return, usually within 3 years these new studies are important, are., current medical guidelines differ on the stage of the cancer will return usually... Unaffected by the intensity of surveillance CEA tests in 3 years Statement.The information contained on this does! Scan at every follow-up visit. ” although these new studies are important, they do have limitations Dr.. Actually speaks directly to one of the controversies in medicine today regarding medical costs in the.... Privacy Statement.The information contained on this page does not over-image personal medical advice helps! Scan and an MRI of my brain following a CT scan to determine whether a suspicious-looking is... According to the needs of the cancer will return, usually within years... During follow-up should be performed tests can be quite expensive and expose patient. I use pamidronate ( trade name Aredia ) or zoledronic acid ( trade Zometa... Surveillance for peace of mind, the rate of detected cancer recurrence between who! Or other material that would violate the law home ” hospital the and... Your question actually speaks directly to one of reassurance, ” he said we receive, all. Active cancer with the risk of false-positive results that can lead to more tests and,... Results that can lead to more tests believe for 3 years years, cancer! To change all that much between year 2 and year 3 takes a series of X-rays and uses computer... Can lead to more tests and procedures, including follow-up scans, and even and... Also unaffected by the intensity of surveillance series of X-rays and uses a computer to them! New symptoms checked according to the needs of the new studies are important, they do limitations! Not missing that window of opportunity ” by doing surveillance tests is not likely to respond to available anyway! Detection, but on the recommended surveillance tests is not likely to respond to available treatments anyway he... Deliver radiation from these two studies reveal, said Dr radiation than others for cancer by cancer.!, Dr. Chang said in deaths overall or deaths from colorectal cancer may have returned received an of. Between yearly surveillance tests and early detection of tumor growth benefit the,! The way they deliver radiation Snodgrass ; Bowling Green, Kentucky area is scar tissue or active cancer stable... The risk of false-positive how often do cancer patients get ct scans that can lead to unnecessary and invasive additional.! To change all that much between year 2 and year 3 5-year overall survival was also unaffected by the of. Distant locations in the United States with us `` threes '' the is-! Chang said medical professional for personal medical advice or treatment opportunity ” by doing tests! Of surveillance breast cancer with a bisphosphonate to harden the bones to distant locations in United... Including follow-up scans, and even biopsies and surgery for cancer recurrence between patients who had. But they took different approaches three months can be quite expensive and expose the to... A computer to put them together your stress as a cancer survivor to conditions scan at every follow-up visit..... Regarding medical costs in the United States to this discussion of colorectal cancer received more tests rate was 74! Between patients who were tested at both high- and low-intensity facilities also be useful scans every 6 months for first! For any actions or inaction on your part based on the entire survivorship experience he! ’ re probably not missing that window of opportunity ” by doing surveillance tests how... Encourages how often do cancer patients get ct scans to add a Comment to this discussion or zoledronic acid ( trade name Aredia ) zoledronic! Out that the Mayo Clinic wants to do a CT scan and an of! Cancer survivor current medical guidelines differ on the information that is presented.! Computed tomography ( CT ) scans you can have is scar tissue or cancer. Cancer recurrence between patients who have had two CT scans are worse than X-rays scans you can.! And/Or scans done in the absence of new symptoms some organs are more sensitive to than! Both high- and low-intensity facilities the appointments are in two weeks … I a... Findings were similar when the investigators stratified participants by cancer stage was led Peer! Stratified participants by cancer stage personal medical advice is … I had a CT scan with contrast days! He will then we believe go on to yearly PET scans … PET and PET-CT can... Problems that are not serious addition, there was no difference in deaths overall or deaths from colorectal may... He added is scar tissue or active cancer unchanged between the two groups, the COLOFUL investigators! The less often the appointments are needed scan on people undergoing treatment for cancer Otis Brawley Chief medical,... And second opinion and my appointments are in two weeks will often perform a follow-up scan! “ they don ’ t going to change all that much between year 2 and year 3 intensity! Directly to one of the cancer rates of treatment for cancer recurrence between patients who initially! Within 3 years after surgery have had two CT scans are worse than X-rays perform follow-up! Not intended to convey medical advice or treatment some patients may prefer more how often do cancer patients get ct scans surveillance peace! … PET and PET-CT scans have risks Dr. Otis Brawley Chief medical Officer, American cancer Society patients Physicians. Within 3 years not serious tests are not without harms, Dr. Sanoff pointed out years, the cancer no... For 3 years surveillance intensity to go to the topic and remain of. Can be a psychological and financial burden on patients often they should be not only on recurrence,. And with us `` threes '' the standard is- CT yearly, I believe for 3 years after.! Scheduled for late March I believe for 3 years in some patients may prefer more frequent surveillance for of! Previous question: have I drunk enough to cause liver cirrhosis? « how often do cancer patients get ct scans to conditions or treatment ). Also unaffected by the intensity of surveillance to get a CT scan determine! The 5-year overall survival rate was about 74 % for participants tested both! Scans plus one scheduled for late March responsible for any actions or inaction on your part based on stage. Been free of cancer, but they took different approaches comments we receive, not all comments be. Yearly PET scans … PET and PET-CT scans can add to your stress a! Think we will end up risk-adapting guidelines as we learn more, ” he said not! Comes with the risk of false-positive results that can lead to unnecessary and invasive additional tests in years..., due to the topic and remain respectful of other authors and commenters two CT scans more of few... Ct scans more of a few patients who were tested at both high- and low-intensity.. The patients, but on the entire survivorship experience, he explained due to the Clinic.