I have stage IV prostate cancer with a spot on my lung being the only known spread of my cancer. After my chemo regimen, my CT and bone scans have been clean for a year now. And my blood work is perfect at the moment. I am on Zytiga and getting a Lupron shot quarterly.
My doc still wants to do full bone and CT scans every 3 months even though my PSA and testosterone are zero or very low. And have been for a year now.
Is this normal or a bit overkill? I am worried about the radiation but also my novice perception of wasted resources.
Thoughts?
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Wildfun44
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I will visit with my oncologist in more detail next appointment. I have had a lot of radiation in my life (multiple full body and targeted radiation treatments, tons of CT and bone scans, xrays, etc), chemo twice, three types of cancer, etc. I am just trying to dial things back a bit if the blood work shows nothing is happening. Thanks for the feedback
doctors love ordering scans and there may be a bit of “defensive” medicine going into that so I suggest telling the doctor you just don’t want to unless there is a real good reason. Ultimately we all make our own decisions.
Yeah, I was thinking the same. I have a friend who has worked in hospitals for years and said there is a lot of "defensive" testing done that is unlikely needed. But he also said there is a lot of money to be made with CT and other scans. He said they opened up a new wing just to fit in more CT type machines because they were such cash cows. I have a feeling that if I was in Europe they wouldn't scan me at all until my blood work showed that I might have a reoccurrence.
Yep, they biopsied me through my chest to get to the spot/growth on my lung. But chemo (Aug 22 to Jan 23) and ADT seems to have knocked it back. All my scans have been clean for over a year along with my very low PSA scores. I know it is early but curious if others had experiences like mine with testing.
I would ask for everyone 6 months... every 3 months seems overly conservative treatment protocol, particularly since you seem to be responding well to treatment. Time is limited and I certainly wouldn't want to used it getting scans if not completely necessary.
I am in a similar situation and have thought of a couple reasons for getting scans again 3 months after my last one when previous to that it was almost 1 year. My PSA is very low so I suspect they are monitoring for NEPC and also there was a spot on my T6 that showed on the last CT but the bone scan could not corroborate. If these scans, tomorrow and Friday, look clear and they say to do them again in 3 months I'll wany to know why.
Sounds absolutely pointless and a waste of money. Never have a test unless you have thought through each potential outcome and know how you will respond to each.
I don’t know your age but the key question, if therapy is suggested, to ask your doctor is what difference treatment will make to overall “all cause” mortality - not just from cancer. And furthermore what is the trade off in terms of quality of life with side effects.
Some oncologists prefer to manage based on what they can see vs bio markers. That was my situation. I cannot say if that approach would apply given your numbers are so low.
This is your 3rd trip around the block. He may just want to keep a close watch on it. Compromise at 6 months if he doesn't have a good reason in your mind but ask him.
Yep. 3 different cancers and 3rd time on prostate cancer. I've had my share! I'll see if that is part of why my oncologist is so overly aggressive here.
I get a PSMA or Choline 11 scan every three months, but that might be because I have a history of always having very low or undetectable PSA. My regular MO would not recommend such frequent scans, but my other doc, Dr. Kwon, recommends it.
And, it has paid off. I had no tumors at one point and the scans revealed new tumors.
This is not advice, just my experience. I was diagnosed in April 2020 and my scans went from quarterly to semi-annually to annually now based on good scans and low testosterone and PSA. YMMV.
It is a bit aggressive but I would rather have an aggressive oncologist than not. Ask him his reasoning on your next visit. Kwon does choline scan every 6 months and a PSMA scan every 6 months. There is a 3 month gap between choline and PSMA.
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