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I'm wondering which scan is better in regards to detecting recurrence of OvCa.
I'm stage III-C diagnosed in Jan 2009. Finished with chemo. And getting CT scans every 3 months. Also testing for CA-125 every six weeks or so.
Since I am already getting the CT every 3 months, is there reason or advantage to ask for a PET as well? I'm confused as to which is best.
PET scans are rather expensive. I believe they are done more when a CT scan is inconclusive and not just as a routine test.
Also depends on docs and insurance. I have had way more PETS (4 in a year) and only 1 CT and the only reason I had the CT was because the insurance insisted on it before approving a PET, which wasted a month of my valuable time. My docs have all prefered PETS. I do too.
But if your cancer is stable, your CA 125 is stable, and you have no reason to suspect recurrence, then stick with your current monitoring plan. I assume your doc would order a PET if there were some reason to do so.
Jeanie
My Doctors told me I don't need one right now. They said they use them if you have symptoms and there is something on a CAT scan that is not clear or if the CA125 is rising,and you have new symptoms but nothing is seen on the CAT. They said it can show very small cancer activity. So my question to them was, why not do one instead of the CAT and their response was that new studies show that doing chemo if the PET shows very tiny new activity will not necessarily increase survival. If a PET was always used we may get chemo more frequently than we need. It makes us sick,our hair falls out and it is toxic to our bodies. I have seen differing opinions on this site about this. Some women get PET Scans all the time so I can see why you would wonder as I do. This is just the explaination I was given. I know I always have a million questions when I go in for an appt. This site is so helpful. I hope this helps.
Ansophie (Anne)
Kennebec, I also have a question. I wrote on this site last night about the fact that My Gyn/Onc may not do a CAT in Nov or at my next appt in Feb 2010. I had my debulking in Dec 2008 and my last chemo in April 2009.My scan post chemo was clean and my August one was clean,but I do seem to remember that She said we would do CATs every 3 mos for 2 yrs. How long will you rec'v scans every 3 mos. I did only speak to her nurse,but she said she had spoken to the Doctor and said as long as I am symptom free she may wait awhile to do another. I hate the scans,but they do give me peace of mind when they are clean. I was just wondering if you knew how long the 3 mo schedule would go.
Thank You,
Anne
Ansophie, I am on a clinical trial so my checkups are scheduled by the trial protocol.
My actual chemo was finished in early July and I continue with the trial drug Avastin or placebo for another 16 sessions, 3 weeks apart. The last session will be in June 2010.
Currently I get the CA-125 (and complete blood count) every 6 weeks. I get a CT every 3 months.
After the treatment is done in June 2010 I will get CA-125 test every 3 months for 2 years. Then every 6 months for 3 years.
As for the CTs at the end of treatment in June 2009 the protocol says that a CT will be done "if physician feels there is a possibility of cancer regrowth". Since this is a study and they want info, I'm guessing they will be liberal with the CT, especially if there is any change at all in the CA-125.
I don't know if this schedule is standard for all ovarian patients.
I am glad to say that last week's CT showed no change from the previous and my CA-125 yesterday was 37. It's been hovering at 42 or so since April. This reading of 37 seems good to me, altho it is high in comparison to some I've read here. But I do not know how accurate the CA-125 tests are and this particular test was taken at a different facility than the previous ones. So perhaps it is closer to 42 than it appears. Still...it has not gone up, so I am happy about that.
I hope this answers your questions.
You don't need CT's and PET's - way too much radiation unless something critical has to be checked.
A PET will show more detail. I only had one once in 9 years - to reconfirm what a CT showed after chemo for a recurrence was complete. Turns out the CT reading was correct.
If your CA-125 readings work for you, then a CT scan is more than enough. My doctor always tells me that the blood test, plus how I feel and what I tell him is sufficient during checkups. He'll do a CT scan if something is suspected. I have gotten CT's to reconfirm a recurrence after a rise in my CA-125, and I get CT's to monitor chemo results after it has been completed. I've been on several chemos for the past 11 months and when we suspect one has stopped working, he'll do a CT scan to see what is going on (I've had 3 during that time).
I'm also IIIC and have been fighting for just about 9 years now. This routine has worked well for me, but I understand everyone has a different situation.
It is my understanding that the CAT scans only certain trageted areas but the PET scans the whold body. I had one PET and it proved inaccurate for seeing cancel cells. I have had four CATs with good results.
I asked about this just yesterday at my onc's office and was told that for ovac the CT scan is the best initial test (sometimes if something is questionable another type of test can be ordered though). Some oncs in my office won't even look at PET scans if the patient has transferred to them because they just don't tell enough for ovac. I was told about the breast MRI scan, too, so I questioned if I could have an MRI so my breasts and abdomen could be scanned at one time, and we went through the different scan options and how the CT scan really is the best for ovac.
My Dr. has me doing only MRI's from now on - I did have 38 rounds of radiation this year, so he said enough radiation. I don't know which is more accurate - CT, MRI or PET. I would be curious to know.
If one has a concern about the radiation (too much of it) from Cat scans, or the high cost/reliability of Pet scans-only (not talking about the PET/CT scan), utilization of the (non-radiation) combination unenhanced/enhanced MRI may be a good alternative (doing an unenhanced MRI first, followed by an enhanced MRI).
From first-hand experience, I had physicians from two medical centers (who had all the latest high-tech toys) expressed their amazement on how accurate our physicians at Penn State Hershey Medical Center were with the combination unenhanced/enhanced MRI for metastasis. Experience counts!
I had MRI couple days before debaulking surgery and it showed NOTHING.m I had two 4 cm tumors and dozens of smaller ones thruout pert. cavitiy when they opened me up.
My worry about CT scan is that I can never drink contrast without vomiting. So I am not sure how accurate of reading they are getting on me. i do get IV contrast during test, but what could be missing without the other drink?
I explained situation to onc and asked for PET scan. He said PET is better with CT than alone? He said we would wait for CT scan.
Yes, he meant a PET/CT combined. But you don't have to drink the contrast for the CT part of the PET/CT.
Jeanie
Thanks, everyone. That pretty much answers my question.
It's interesting to read everyone's experiences! We have about as many as members of the site. Mine has been that PET/CT is superior to either PET alone or CT alone. But combined, it's superior. We receive less radiation exposure to PET/CT vs. the CT.
CA-125 is not a reliable method of detection in my situation as in recurrence, that number was well below what's considered "normal". Each person is unique.
Laurel
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