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My oncologist is planning on doing a CT Scan to check for additional cancer cells after I finish chemo, would a PET Scan be a better indicator?
When asking why, I really didn't get a good answer.
As a note, Colon Cancer, Stage 3 A. Had surgery, removed 12" plus nearby lymph nodes and now going through chemo, half way point. Would a PET Scan be something my Colon Cancer doctor would do and not my Oncologist?
Location: East of Seattle since 1992, 615' Elevation, Zone 8b - originally from SF Bay Area
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My experience is with bladder cancer that moved to my prostrate, and resulted in kidney damage. Now 4 years later I still get an annual CT and MRI. I only had the PET once, and that was to look at the kidneys, ordered by my Nephrologist. It was weird because I could see them working on a little screen right above me as I laid there. It's been the MRI that my Oncologist orders to check for additional cancer cells. I regularly see my regular physician, Nephrologist, Oncologist, and next week the Urologist that did my surgery. I wouldn't second guess my providers, as long as you keep them informed and ask questions they should do what's needed. I find that my various doctors will be in touch with each other. For example when my regular doctor wanted to up my meds for Type 2 Diabetes, he checked with the Nephrologist to make sure it wouldn't affect my kidneys.
Good luck to you, I hope your chemo is not too hard on you.
Presumably you already know that a simple x-ray is good to see bones, but doesn't visualize soft tissue very well, and that a CT takes many x-rays from many different angles and then a computer enhances those images to give "3D" images, including soft tissues...
A PET scan takes advantage of the fact that cancer cells are multiplying and metabolizing faster than normal cells, so they take up and use glucose more rapidly. The pt is given a solution of glucose with a radioactive "dye" attached. That will show up as darker tissue on x-rays or a CT.--Usually the PET dye is given and then a CT performed...Usually plain PET scans (dye + simple x-ray) are not done. Usually the PET/CT is ordered and we lazily call it a "PET scan."
Without knowing the details of your case, I can't comment on whether the CT or the PET/CT should be ordered, but the latter would certainly give more detailed info, including more sensitivity in finding mets, and the cost/time/effort/dangers are not very much different than the plain CT....
Press the doc for a good explanation. I should think the oncologist is the guy in charge, and would be the one to order it. Your "colon ca doc" is presumably the surgeon-- just a mechanic. (I was an internist. I used to kid the surgeons, telling them that I went to school so I didn't have work with my hands anymore.)
I have CT scans as part of the ongoing surveillance for the possible return of the colon cancer I was diagnosed with in June 2022. It was a 2A, no lymph node involvement, and was entirely removed along with around 12 inches of colon ( caecum, ascending colon and enough transverse colon to get a wide margin past the tumor, located in the hepatic flexure.) Fortunately after further testing involving genetics of the tumor, residual circulating tumor DNA ( none detected) and low tumor markers, I didn't need chemo.
The CT scans, for chest,,abdominal and pelvic areas, are done with and without contrast, and also involve drinking barium beforehand to visualize the GI tract ( I guess that is standard.). I am thinking CTs are done for routine surveillance, and maybe PET scans are done when there is more suspicion that a tumor might be present, as in finding a circulating tumor marker elevated, or symptoms? I've never had a PET scan, though the oncology group I go to has a PET scan facility ( it's in a trailer truck they drive from office to office as they need it)
I haven't seen the surgeon who did my colon resection since the post-op visit a week or so after the surgery. The oncologist I see orders the scans, and the orders are sent to the Imaging center of my choice ( they asked me where I had, or preferred to have this done). The oncologist apparently informs the Imaging Center of the date(s) he wants these done, and they call me to schedule the scans.
At least this is the way it works here, though the process might vary with the medical practices. I'm hazarding a guess, OP, that if the oncologist is treating you, your cancer-related care/testing would be coordinated by the oncologist's staff, but it's a question you might ask him/her.
PET scan has better sensitivity & specificity for finding distant Mets than CT https://www.ncbi.nlm.nih.gov/pmc/art...s%20(Table%202). which is why it's probably the better choice for follow up for the pt in the OP here.
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