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questions on standard practice for routine scans for stage 3b melanoma
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questions on standard practice for routine scans for stage 3b melanoma

› Forums › General Melanoma Community › questions on standard practice for routine scans for stage 3b melanoma

  • Post
    • May 6, 2011 at 4:40 pm
    jtheisen29
    Participant

       

       

      I was just wondering if my sister is getting the most out of her oncologist and if her scans for her stage are normal. Sara has stage 3b diagnosed Sept 09 and did the 1 year of interferon which she finished this past Feb. She was having routine 3 month scans which included MRI's and CT's however she only had 1 PET scan right after diagnosis as well as only 1 brain MRI.  At her last visit when she finished her interferon the oncologist told her he would be moving the scans to every 6 months. He told us that repeated use of the scans every 3 months could pose long term risks. My sisters primary was 3mm and ulcerated and had a mitosis of 15/mm and she had microscopic involvement in the sentnial lymph node. We just want to make sure that we are being proactive and as aggressive as we can be. 

      1. My first question, is it standard to not give a PET scan for routine scans and use it just for a baseline? And rather have MRI's and CT's?

      2. Is it standard to move scans to every 6 months when she hasn't even been NED for 2 years yet?

      We are looking into switching oncologist and going to University of Wisconsin Madison Comprehensive Cancer Center, but would like to know if this would be the same course of action that most dr's take for stage 3… any insight would be greatly appreciated!!

      Thanks so much,
      Jessica (Twin sister diagnosed with stage 3b) 
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    • Replies
        • May 6, 2011 at 5:00 pm
        Janner
        Participant

          When it comes to scans, there ARE no standards.  Each cancer center uses different recommendations.  You'll find some who do scans at 3 months, some at 6 months or yearly, other do NO scans unless you are symptomatic.  Scans (especially PET) do have a lot of radiation and that can be a consideration over the long haul.  Statistically, scans haven't been shown to increase overall survival.  If your sister went to U Mich or other places close to that, she wouldn't be having scans at all.  That is actually considered ok, too.  You will get a bunch of different responses on who gets what when, and that should be the key.  There is NO standard.  You just need to work out with the oncologist what they are willing to do, what insurance is willing to pay for (this can be an important consideration, too) and what your sister can live with. 

          Best wishes,

          Janner

          • May 6, 2011 at 5:00 pm
          Janner
          Participant

            When it comes to scans, there ARE no standards.  Each cancer center uses different recommendations.  You'll find some who do scans at 3 months, some at 6 months or yearly, other do NO scans unless you are symptomatic.  Scans (especially PET) do have a lot of radiation and that can be a consideration over the long haul.  Statistically, scans haven't been shown to increase overall survival.  If your sister went to U Mich or other places close to that, she wouldn't be having scans at all.  That is actually considered ok, too.  You will get a bunch of different responses on who gets what when, and that should be the key.  There is NO standard.  You just need to work out with the oncologist what they are willing to do, what insurance is willing to pay for (this can be an important consideration, too) and what your sister can live with. 

            Best wishes,

            Janner

            • May 6, 2011 at 7:38 pm
            KatyWI
            Participant

              I had a roughly analagous scan schedule during the years following my IIIa diagnosis; I think moving the scans out to 6 months is perfectly fine at this point.  I did every 3 mos for a year, every 6 mos for the second year, and annually up to 5 years.  It started out as CT scans, and eventually he moved me to just chest Xrays and bloodwork.  This was just a local oncologist though, not a mm specialist.

              I do now go to UW, and I love it; if you need to move you'll be well cared for there.

              KatyWI

              • May 6, 2011 at 7:38 pm
              KatyWI
              Participant

                I had a roughly analagous scan schedule during the years following my IIIa diagnosis; I think moving the scans out to 6 months is perfectly fine at this point.  I did every 3 mos for a year, every 6 mos for the second year, and annually up to 5 years.  It started out as CT scans, and eventually he moved me to just chest Xrays and bloodwork.  This was just a local oncologist though, not a mm specialist.

                I do now go to UW, and I love it; if you need to move you'll be well cared for there.

                KatyWI

                • May 6, 2011 at 10:55 pm
                nicoli
                Participant

                  Hi,

                  I was diagnosed 3b December 2009. Scalp melanoma. Brain MRI and PET at diagnosis and every 3 months for the first year. Now I am at every 6 months for PET scans for the same reason your onc gave you…too much radiation. I have had local recurrances and they can be an indicator of mets in another area so I have PETs when that happens.

                  I too am kinda nervous about scans so far apart but I also know radiation can cause more cancer.

                  Like I told my onc when I did biochemo………"I don't wanna die from cancer but I SURE don't wanna die from the treatment".

                  Nicki

                  • May 6, 2011 at 10:55 pm
                  nicoli
                  Participant

                    Hi,

                    I was diagnosed 3b December 2009. Scalp melanoma. Brain MRI and PET at diagnosis and every 3 months for the first year. Now I am at every 6 months for PET scans for the same reason your onc gave you…too much radiation. I have had local recurrances and they can be an indicator of mets in another area so I have PETs when that happens.

                    I too am kinda nervous about scans so far apart but I also know radiation can cause more cancer.

                    Like I told my onc when I did biochemo………"I don't wanna die from cancer but I SURE don't wanna die from the treatment".

                    Nicki

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