I'm approaching a year out from a low grade non-invasive diagnosis. The urologist set me up for a CT scan in a month. Generally I'm all for the testing, but CT scans do give you a fair bit of radiation which has its own risk and this is supposed to be with and without the dye. What's the risk/benefit trade off with the CT scan? Worth the increased radiation? I think I'm at fairly low risk for progression, but it's certainly not zero.
I probably wouldn't have blinked at this in the past, but I've recently read in the WSJ about the overuse of CT scans.
I'll bring this up with my urologist, but this forum has its own collective wisdom which I value.
Yes! I totally understand your concern. After kidney cancer the Dr. kept wanting me to have CT scans (I was high risk for recurrence, etc.). Long story short, I did a fair bit of reading. It's quite late here right now and I've got to get to bed, but will try to post one of the articles I read in the morning.
I found an interesting article when I was researching the effects of CT scans. Don't know if you will find this helpful....but the latter part gives some suggestions to reduce the the negative effects. The full article can be found on-line. I have attached the file here....don't know if it will work as I'm new to this forum.
I realize that this author is speaking about a specific brand of supplements, however, there is enough information to at least set you in the right direction.
Lots to think about.
CT scans still leave me feeling very uncomfortable and I try my best to avoid them, although I know that sometimes they are the lesser of two evils.
The CT scans I was having for my kidney (with and without dye) are said to be the equivalent in radiation to 500 chest x-rays! That doesn't thrill me.
That is truly a difficult question and something that many of US wrestle with.
I have had 4 pelvic/abdominal CT's in just under 4 years (due again in Oct), and I guess that would be 8 scans since it is repeated each time to add the contrast. Except for the first one that was prior to my TURBT which showed the tumor location, all of them have been clear. I have told my doctor that the radiation concerns me, but I have also read that the CT scan is better for looking for mets than an MRI, so I let him do what gives him the best chance of spotting any irregularity. Since I did have an invasive "rare" tumor, and since there isn't much data on its behavior post removal, I have gritted my teeth and had the scans.
Last time I asked the CT tech if the machine is calibrated to match a patient's weight and body mass since I had read about cases of excessive radiation doses. I also found it interesting that they don't use any shields anywhere else on my body. When I asked about that, he replied that they have discovered that since radiation bounces all over the room, it might stay in the body longer if a lead shield is blocking its immediate exit. Who really knows? I do know that if there were to be suspicious lymph nodes or distant mets, I would want them found as early as possible. Those first five years are supposed to be the most critical for recurrence, but again, that's a general theory based on existing data and only as good as the data collected.
Since radiation is supposed to be cumulative over one's lifetime, I no longer let the dentist take yearly teeth xrays, and I stretched my mammogram out to 18 months last time so it was between my scan cycle. As with many things, it is a calculated risk and one each person much decide whether they are willing to take. Hopefully for the majority of us, the benefits do outweigh the risks.
I do think personally, even if I had been non-invasive, I would probably want a one-year CT scan done just in case anything might have been missed or understaged. After that, probably not depending on what happens over the second year and if the cystos are clean.
My doctor explained checking for mets this way: cancer cells are like toothpaste... once it's out of the tube, you can't put it back in. I want to know if there is any toothpaste where it doesn't belong!
Talk to you doctor about the level of confidence the CT scan may provide for him, and together decide if it is appropriate for you.
Best wishes... Catherine
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TURBT 1/21/10 at age 55
Dx: T2aN0M0 Primary Bladder Adenocarcinoma
Partial Cystectomy 2/25/10
Vanderbilt Medical Center
I have been paranoid about CT scans for other issues particularly when they have seemed like "fishing expeditions" (the doctor says he doesn't really know what the problem is so he wants to do a CT). HOWEVER, with my bladder cancer, my uro is relatively conservative with his recommendations. A CT scan is about the only way to check for occurences in the upper tract...which I DO NOT WANT. Therefore,
in the case of keeping an eye on my bladder cancer, I agree to them.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society