› Forums › General Melanoma Community › Seeking advise on scan types and schedules
- This topic has 9 replies, 7 voices, and was last updated 4 years, 3 months ago by
BillB.
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- December 29, 2019 at 2:21 am
Hi Everyone,I hope everyone is having a good time during these holidays. It is our first Christmas and New Years since my husband was diagnosed with melanoma in June. For everyone who has just recently been diagnosed or has received bad news in the last few weeks, please know that I am praying that you get the strength to continue to deal with the anxieties and fear that melanoma brings. My husband had his parotid gland(salivary gland)removed and a CLND (completion lymph node dissection) at the end of July after which he had 6 weeks of radiotherapy. I am still waiting to get confirmation whether he is Stage 3b or 3c. He began his one year biweekly adjuvant Nivo immunotherapy at the same time he began his radiotherapy. He has not gotten any scan since his surgery on July 23rd, so we have been pushing the doctors to schedule one. His oncologist wants to wait until March in order to give the immunotherapy a chance to do its job (in case the surgeon did not remove all of the melanoma when he took out the tumor!) However, since 2 lymph node involvement was discovered during the CLND, we feel the sooner he gets a scan, the sooner we can confirm whether there has been any metastasis and change his treatment if so needed. We managed to get his radiologist to schedule a full body CT scan on January 8th, (5 and 1/2 months after his tumor removal). According to what I have read in these posts, it seems most people get scans about 3 months after surgery and continue to do so for approximately the 1st year after surgery. I am also very confused as to what type of scans he should be getting as PET scans, CT scans, and ultrasound scans have all been mentioned in these posts.
So the advise I am seeking is:
1. Should my husband get scans done this coming January or in March?
2. What type of scans should we be requesting?Again, thank you very much for taking the time to read this post, and I truly wish everyone a safe and healthy New Year.
Sincerely,
Affected
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- December 30, 2019 at 12:27 am
I’m not sure on the rationale for the imgaing time frame your husband was given but I can tell you that my scans have been CT (body), MRI (head), and ultrasound of the head, neck, and upper torso every 3 months for the past two years while engaged in treatment and even after. I have never had a PET scan but I know many people here have. I’m hopeful that after his next round of scans that the frequency decreases to every 6 months.-
- December 30, 2019 at 12:28 am
I meant after THIS round of scans coming up for me, not “his” next round of scans. Sorry if that sounded confusing, -
- December 30, 2019 at 1:15 pm
Thank you soooo sooo much Tex for your reply, especially during this holiday period. I’m in hospital at the moment with my husband. He has a very bad rash all over his body. Began 6 days ago. We’re still waiting to see the oncologist, but the nurse who has already seen him thinks he won’t be able to get his scheduled biweekly nivo treatment tomorrow. She’s grading the rash as a grade 3 Adverse Event. When you say you were getting the CT scans while engaged in treatment, did that treatment include nivo or any other immunotherapy? Could it be that the doctor doesn’t want to schedule scans until my husband has had more Nivo treatments? So far he has had 5 biweekly infusions of Nivo. He began in mid October. Did you ever have a rash? I’m scared that if they give him oral steroids, that that may exclude him from the one melanoma trial here in Ireland which is joint treatment with nivo and NKTR-214. Was not having had steroids a prerequisite for the trial your on? I’m so sorry for all these questions. 2 friends passed away just this month from cancer. My phone is about to go. Thank you so much for your reply.
Sincerely, Affected -
- December 30, 2019 at 2:39 pm
So, if your husband is 5 treatments into biweekly would put things at 2 and a half months, and it is pretty common when on trial to scan at the 12 week (3 month) mark and many oncologist follow this schedule with stage 4 patients. When it comes to adjuvant patients it isn’t as clear as to a schedule of scans and what type of scans. For example during the MSLT-2 trial and the German trial which looked at observation of lymph nodes vs complete resection they used ultra sound to monitor lymph basin. Checkmate 238 comparing Ipi to Nivo in adjuvant setting did ct scan every 3 months and Mri of brain as well but this was in clinical trial setting and data recording of progression and the exact time of progression is what they were focused on. Here is a link to checkmate 238 and two are of interest would be the assessment section and second area would be side effects. There was another Pd-1 trial of just Pembro as well called keynote-054 and again you can look at assessment section for trial design of scan type and frequency. https://www.nejm.org/doi/full/10.1056/NEJMoa1709030 https://www.nejm.org/doi/full/10.1056/NEJMoa1802357
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- December 30, 2019 at 2:58 am
Dear Affected,My schedule has been similar to Tex’s. CT every three months (Plus MRI of my leg where my tumour has been) and Brain MRI every year. if i had a bad CT scan then that would mean a brain MRIimmediately. That schedule is lighter than Tex’s but means the annual brain MRI is more stressful.
i have read some of your earlier posts and how your doctors have been proactive in putting your husband on immunotherapy. however, i would be inclined for more regular scans. Its true that you need to give immunotherapy time to work, but its probably good to scan to check so that if there is a spread then it can be caught early and a new plan developed if needed. I hope your doctors are melanoma specialists as three months does seem kind of standard.
I would not stress over this but three monthly scans seems standard. After a year of almost clear scans my oncologist is letting me go to four minths!
Good luck, :Mark
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- December 30, 2019 at 3:01 pm
My schedule for scans are typically quarterly for Ct scans and yearly for the Brain MRI. I will likely starting making the transition to every 6 months this coming year. I’m not as big of a stickler on schedules though as I regularly push things off if I feel like it. I think my next scan is actually 5 months from the one before. MY oncologist really lets me dictate my own treatment plan. -
- December 30, 2019 at 4:30 pm
My dad’s scan cycle after original petscan was every three months. Then after his last surgery it was changed up to CT scans and brain MRI every 8 weeks.
Originally, we were confused because he went from pet to CT/MRI, but after a bit of research from blogs like this those are standard more than Pet.
W -
- December 30, 2019 at 4:30 pm
My dad’s scan cycle after original petscan was every three months. Then after his last surgery it was changed up to CT scans and brain MRI every 8 weeks.
Originally, we were confused because he went from pet to CT/MRI, but after a bit of research from blogs like this those are standard more than Pet.
W -
- December 30, 2019 at 10:24 pm
Hi, I had parotid removed and 4 affected nodes. Completed 1 month radiation 48 gy. I have been on a 3 month schedule of CT’s one to the neck and then one for the chest abdomen etc in the second scan. Both scans with contrast. Yearly MRIs to the head.
Bill
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