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Oncologist vs Radiologist Opinion

Forums General Melanoma Community Oncologist vs Radiologist Opinion

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      Hi all, new to melanoma and so thankful for this message board. 

      Do radiology reports usually differ from oncologists interruptions?  Trying to have peace of mind and direction when they differ?  

      I am currently healing from a sepsis blood infection which caused many abscesses on my liver and spleen likely a result from a recent melanoma wide excision preformed by a plastic surgeon for stage 1a.   

      Decided to consult with a experienced medical/surgical melanoma oncologist who is part of a well known melanoma center to do a follow up contrast CT Scan suggested by ER doctor.  Found it interesting when asked if I had prior cancer and you mention early stage melanoma the ER doctors freak out and automatically think spread.  

      Just had the follow scan and the melanoma specialist showed me the scans and his opinion was less concerning than the radiology report.  Just received the radiology report and it states in regard to the liver  “findings are concerning for metastasis”.  Radiologist suggested PET or tissue sample can be considered if clinically warranted.  Thinking liver metastasis would show on a constrast CT Scan.  

      My melanoma oncologist feels these two concerning spots are inflammation from the residual liver infection healing.  And wants another follow up CT Scan or if insurance approves a PET Scan in a month to check infection is resolved/liver functions are normal.  I’m sure the oncologist would have told me he was concerned and ordered additional testing sooner rather than later.  Right?  

      Hope for some insight.  Thank you 


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          I can’t give you a definitive answer but I had something not too dissimilar recently but the radiologist report was less concerning than the Onc interpretation.  When I spoke with the Onc he said the radiologist will not know your full medical history and will just being examining a scan for what it shows without knowing anything else that’s happening with you.

          i would go with the Inc interpretation – they have a pretty good ability to read scans anyway and know your full history.  However it sounds like you should probably have a follow up scan at some stage to be sure

          best wishes



            Yes, they can differ, at least in my experience. It’s the radiologist’s job to call out everything that they see in the scans. It’s the oncologist’s job to interpret and guide treatment. As we know, not every shadow is active cancer. I would go with the oncologist’s interpretation in this case, especially if they are an experienced melanoma specialist. 

            You could also get another opinion if you are still unsure. 


                Thank you for the insight and comments, greatly appreciative.  


                Yes, in general, a radiologist is going to call out every single thing they can see and paint it in the most serious light.   This is because they want the referring specialist to review everything and make the final interpretation.  A radiologist doesn't want to be in a position of not mentioning something that may appear minor or of stating it is of minimal concern, only to find out a year later that it was a serious matter and didn't get the serious consideration due to their report.

                So the radiology report is going to often be much more concerning just from a reading and review perspective.  The oncologist's job is to review the report and the images and put them in the context of your overall situation and all the other information they know about you.  If you trust your oncologist I would trust his/her interpretation of the radiology report.


                  To put this in perspective, about a year ago I had a lump on my on my arm not far from my original WLE. My PCP referred me for an ultrasound and the radiologist’s report came back “likely sebaceous cyst.” I wish that he/she had been more of an alarmist, but they didn’t know my history. In retrospect, I wish that I had run to the original surgical oncologist for his opinion. He knew my history and had the knowledge and experience to better interpret the results. 

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