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Can someone help clarify the right sequence of staging tests?

Forums General Melanoma Community Can someone help clarify the right sequence of staging tests?

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      I’m a bit confused and wanted to get help from this community to understand the right sequence of tests that are done when Staging melanoma.

      My dad had WLE a month ago, results came back 2.1mm no ulceration. Yesterday he had further excision to widen the margins, plus an SLNB where 2 lymph nodes were removed from the groin area to be examined. When reviewing his files, one of the doctors spotted something on his lungs x-ray and suggested PET scan to examine further if it’s a metastasis. We asked his onco-dermatologist but they’re saying it’s too early for a PET scan, plus the wait times for it are long and won’t be feasible while he’s hospitalised. They said he may “light up everywhere” if a PET scan is done now – what does this mean, does anyone know?

      They are likely to book him for a CT at least, but I’m not sure if that’s enough or whether we should be pushing for a PET scan (or go private for it).

      Are there any risks in performing PET / CT right after SNLB that make the scans unreliable? Curious what is the best sequence of tests and what others have done.

      Thank you so much for any info you have!

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          That seems like a lot of contradictory statements certainly. I am not certain where you are. In the US a PET scan is often used when cancer is diagnosed but insurance companies don’t like them because they cost twice as much as a CT so only only some people get them routinely. My very good oncologist doesn’t really care and only cares if something new shows up (I am NED). Usually a brain MRI and a full body CT are considered more valuable. I have never heard of any risks per se although it might be uncomfortable depending on the surgical site. However, because of the use of certain dyes with either the CT or PET and the interaction with a SNLB surgical site it is possible the injections would not be compatible. Is there a waiting list? Can this not be done during hospitalization? I’m a little confused.
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