If a doctor says no scans are planned, that usually means no
ROUTINE
scans are planned simply because it has been a year since
the last
one. Most doctors are going to do quarterly physical exams
and blood
work. Many times cancer that has spread is going to affect
the organ
it has spread to and show in the blood work. And the
physical exam
can find swelling in the lymph nodes and/or liver, hear lung
problems,
and get a feel for the patient's overall health. If the
blood work or
physical exam shows a problem, then scans and/or biopsies
are ordered
to get a better look.
For example, once my blood work showed a slight elevation of
alkaline
phosphatase (sp?), and the very next day, I was in the lab
having a
bone scan because elevated alkaline phosphatase can indicate
bone
mets. Fortunately, the scan showed everything was OK, and
on my next
blood test, everything was normal.
Doctors who follow this philosophy point to studies that
show no
increase in survival rates with routine scans. Others are
concerned
about the stress of waiting for results for the patient,
wise use of
medical resources that may be limited in some communities,
and/or the
possibility that overuse of scans may itself be risky
because so many
of them rely on radiation. We do have folks on our list
whose mets
were discovered on routine scans, who feel they are an
important part
of follow-up care.
If your doctor doesn't use routine scans, it is especially
important
to let your doctor know about any aches and pains that might
be
symptoms of mets.
There will be a pathology report after your surgery that
will give
additional information.
Many people who are initially concerned that their doctors
don't
routinely scan, find that they have quite enough tests,
thank you, in
practice. Sometimes it seemed to me that if my little
toenail hurt,
the doc was ordering an MRI. 
One concern I have is increasingly tight insurance policies
about
scans. My insurance now requires preapproval of scans for
outpatients. If that policy had been in effect when I was
in
treatment, I don't know how long it would have taken to get
that
preapproval, which would have been a terrible source of
anxiety.
I hope all goes well with your surgery.
Phyllis in Concord, NC
Diagnosed in 1998, Her2neu pos, ER neg
AC, MRM (16 pos lymph nodes), Taxol, Rads completed Jan. 15,
1999
Now well and doing fine
On 1/14/07, Ruth Coates <racoates btc-bci.com> wrote:
> <>Ok, so here's a newbie question...if you don't
have more scans and
> tests, how do you know if you have any mets elsewhere?
Initially, I had
> clear scans, no mets elsewhere in the body, but grossly
positive nodes
> which says that cells could have gotten away. No one
has said anything
> to me about future tests or scans, only about blood
counts right now.
> I'm an RN, but knowing about medicine isn't always
living it. I am
> thinking that I'll feel something (ie. pain, fatigue,
something not
> right, whatever) one day and not know if it's something
to bother my Dr
> about or just me. <>
>
> I'm having bilateral MRM Wednesday and am so afraid
that they will miss
> something or not get enough tissue to have clear
margins. I have had 2
> previous surgeries that did not get clear margins. I
have a new
> surgeon, one who believes in my diagnosis, so that's a
plus! I still
> have a very large red area on my RT Breast, and it is
still painful
> (achy). I'll be glad to get rid of it!
>
> Mainly this is just a down time, and anticipation is
more often worse
> than the reality of the situation. Just wish the tears
would go away
> for awhile.
>
> Ruth
>
>
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>
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