• I would like a PET or body scan done,my oncologist says "No,they wait for symptoms of metastatic cancer first."

    Asked by Irishsurvivor on Sunday, February 12, 2012

    I would like a PET or body scan done,my oncologist says "No,they wait for symptoms of metastatic cancer first."

    Why don't they do PET or body scans to see if my breast cancer has gone somewhere else? Has anyone else had their oncologist tell them this. What are the statistics of finding false positives on these scans compared to finding cancer that should be treated?

    16 Answers from the Community

    16 answers
    • Staci1219's Avatar

      Hey there my mom is a breast cancer survivor and they did regular PET scans throughout her treatment but every doctor is different. I can look up statistics for you, if you need anything please let me know, feel free to view my journey if you want..I talk about my mom's journey.

      almost 7 years ago
    • fkalb's Avatar

      I believe pet scans should be done regardless... i would suggest finding a different doctor.

      almost 7 years ago
    • MamasLibrary's Avatar

      I've had 2 PETS, one I had to fight with a resident to get it and then my Dr approved no issues, while the 1st was approved contingent that I wouldn't get scared if anything came back "lit up". Id say nothing that gives you peace of mind you are entitled to, it's not hurting anyone for you to get a scan. If they continue to say no I agree, a new Dr is in order.

      almost 7 years ago
    • ibcword's Avatar
      ibcword (Best Answer!)

      My Dr also said to wait for symptoms and that there is no proof you live one day longer by getting tests done periodically vs. waiting for symptoms. I disagree however and plan to fight for a more proactive approach. I was stage 3c by the time initial symptoms appeared and am afraid of how advanced it will be next time. IBC grows too fast and I am not comfortable with waiting.

      almost 7 years ago
    • GregP_WN's Avatar

      The first pet I had showed a pre cancerous tumor in my colon, without it, It never would have been found, I had lymph nodes in my neck that they new about, but they gave me the pet to see where else in my body it was. My opinion is if I am worried, I'm going to have one.

      almost 7 years ago
    • leepenn's Avatar

      I think there has to be a balance between the risks and benefits of the scans. A PET is nearly always accompanied by a CT, which means full body irradiation with X-rays. The PET also involves the injection of a radioactive compound. MRIs involve the injection of the MRI contrast agents. And so on.

      The research is suggesting exactly what IBCWORD has written, that people don't live longer when they have regular scans versus scans when symptoms appear.

      I would prefer to minimize my exposure to radiation as exposure to radiation is a known risk factor for cancer. If I had a worrisome symptom, however, I would push hard for appropriate tests to be sure that the symptom was well understood and appropriate action taken to address it, whether it turned out to be cancer or another problem.

      Above all else, you should be able to get a full explanation from your oncologist - why they are suggesting that patients wait until symptoms appear before undergoing the scans. If your oncologist is not taking the time to explain that clearly, then I think a new oncologist might be called for.

      I don't know if that helps, but there are my two cents....

      Best wishes,

      almost 7 years ago
    • Cindy's Avatar

      My oncologist wants me to get PET/CT scans once a year and a different type of scan between PET/CT scans. He said that I would not have any symptoms if my cancer reoccurs somewhere else. I had ovarian cancer and there is no good preventative tests for it.

      almost 7 years ago
    • leepenn's Avatar

      I'm sure that the oncologists' recommendations depend greatly upon the details of the cancer etc....

      almost 7 years ago
    • IKickedIt's Avatar

      I was a very ignorant yet obedient cancer patient. Unlike my normal self who is very inquisitive and needs semblance and control, I didn't do research online and listened to advice from experienced friends, but really depended on doctors...and we visited and talked to every doctor friend we have. I found wonderful doctors (fortunately, I live near Philadelphia and have access to the outstanding medical facilities) and had a very successful journey, thank goodness.

      Prior surgery and following chemo, I had several CT scans, but they waited until after my chemo to do a PET. I have chemo brain so I don't remember if I asked exactly why I wasn't getting a PET during treatment.

      I am wondering whether it had to due with the type of cancer. I had colon cancer which did not break completely through the wall of the colon, but a few lymph nodes were involved so I had to have chemo. From the very start, all our doctors were optimistic that this was curable. Perhaps they didn't want to expose me to the PET scan since it wasn't going to make a difference...I had to have chemo anyway. The CT scans indicated that the cancer hadn't metastasized the neighboring organs so maybe that goes along with your doctor's diagnosis.

      almost 7 years ago
    • nancyjac's Avatar

      "No,they wait for symptoms of metastatic cancer first." My question would be who are "they"? PET/CT are pretty expensive and most insurance companies will only cover them if they are medically necessary.

      almost 7 years ago
    • saltermd's Avatar

      I wanted to carefully weigh in on this matter, as it EXTREMELY controversial.

      The current NCCN Guidelines (considered by most to be THE evidence-based practice guidelines) strongly discourage routine use of PET-CT in this setting. This is the "standard-of-care." Doctors may choose to deviate from this standard for a variety of reasons, including preserving patient satisfaction, retaining their patients (out of fear they will leave to seek the test elsewhere), or in the worst scenario, for profit.

      Many for-profit oncologists own their PET machines or share in the profits from PET scanning. They know that patients want these sophisticated tests, and they also know the guidelines discourage their use. However, when a patient wants a test and he insurance company will reimburse for the study, the doctor really has no "dis-incentive" to order it. The patient gets their scan and the doctor makes money. How do they get around the insurance companies ? Usually by suggesting the patient is "symptomatic" in the medical chart to get the study covered. Technically, this is fraud, and the physician is risking litigation if the symptoms supporting the order were fabricated. It's a slippery slope.

      The reasons the guidelines do not suggest routine use of PET go beyond financial considerations alone, but admittedly money is part of the equation. If PET scans were cheap and involved no radiation exposure risk, everyone would get them routinely. The tougher part of the argument has to do with the fact that early detection of metastatic breast cancer technically does not prolong survival - only early detection of early-stage breast cancer has data to back that claim. Until studies can prove that lives are saved by finding stage IV (by definition, incurable) breast cancer earlier, I doubt these guidelines will be modified. And since insurers base coverage for services on evidence-based guidelines, most PET scanning would be declined for reimbursement in this setting.

      In understand patients' frustration, and the sense that their doctors are not providing what they need. The good docs - the ones that follow the expert guidelines and don't risk fraudulent testing (which could result in criminal charges and jail time in some instances...try cheating Medicare and see what happens !) are the ones patients get so mad at. The ones ordering the PET scans are either making money (and dishonestly, I might add) or are ignorant of the current guidelines and are risking fraud claims.

      Hope that doesn't muddy the water to much.


      almost 7 years ago
    • ConnieB's Avatar

      I had a PET scan when diagnosed. When I asked my Oncologist about having repeat PET scans to find out if cancer had returned, he said no. Not sure why, but would feel better with a PET scan on a regular basis.

      about 6 years ago
    • ConnieB's Avatar

      I was told the same thing.

      almost 6 years ago
    • mishkat's Avatar

      I had 3b adenocarcinoma. Was given a PET prior to lobectomy, which was clear except for the dx'd R lung. 2 nodes closest to tumor showed uptake and so I did chemo and then radiation. Completed tx in July 2012 and have had clear chest CTs since then. I, too, asked about PET scans and my dr said no because of radiation exposure, I have no symptoms and because sometimes scar tissue and other conditions "light up", potentially leading to unnecessary anxiety/testing/procedures. I do still want one, however. My cancer was an incidental finding and I worry that if there is a next time, it won't be caught until it's too late. But I'm also trying to balance this with being calm, rational and practical about my life post-cancer tx.

      about 5 years ago
    • twinkledawnn's Avatar

      Sorry for the late reply, but I just found this. I hope you are in good health. To answer your question regarding PET scan. They don't order them because they are expensive. American medicine is interested in $$ and not saving lives. This is the simplest reason and it is true no matter how much double talk you here from people in the system.

      almost 3 years ago
    • LJJ's Avatar

      I had Stage 1 breast cancer and after surgery and radiation treatments, I spoke with my oncologist about testing going forward. She indicated that I should only have my yearly mammogram. I did have a PET scan early on before surgery and a CAT scan etc. I asked about MRI's and she started talking about what insurance would cover. I told her that she was talking about insurance and not medicine. Conclusion was that I would have a mammogram and six months later an MRI which I will have to pay for. Doctors often negotiate lower cash prices for their patients and that's what will happen for me. It's worth peace of mind. You can always ask what the cash price is for testing...it is much lower than the price charged to insurance. Asking doesn't hurt.

      almost 2 years ago

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