What!! you say you don't trust me?? I should have figured you guys to be a tough crowd(-; Well, I guess that is a good sign. Those who make claims should be smarter than the average Bear and I make no claims for that. I'm even told there are folks who go to retreats where they sit in caves with Radon gas for “health” benefits?!
In an additional nod to the contrarian for warnings on CT overuse, here is a paper that dismisses the concern – you read - you decide but as you read this paper I hope you are comparing it to the other warning opinions while keeping in mind that our CLL community, by definition, is less capable at repairing damaged DNA and NONE OF THESE PAPERS, PRO OR CON, DISCUSSES CT USE IN THE SPECIFIC CONTEXT OF CLINICAL TRIAL DATA ACQUISITION WHERE FREQUENT CT SCANS ARE REQUIRED. <usnews.com/science/articles... <tinyurl.com/k54soyg>
As I previously posted, there is support IN SOME CASES for scanning with some CLL/SLL patients given specific clinical signs and presence of markers on tested blood. The scan in question is the FDG-PET and not the CT scan. I mistakenly inserted a commentary to the Falchi et al paper instead of the full paper (thanks Chris Dwyer who caught that) so here it is. <bloodjournal.hematologylibr... It should be noted that findings indicated patients with aggressive (HAC) CLL and RS (Richter's) both had high SUV uptake. SUV refers to a cancer cell's metabolic rate to bring in more or less radioactive sugar that the patient gets through an IV. Rapidly growing tumor cells (RS & HAC) use much more than what slower growing CLL cells would do in indolent (HIC) CLL. The paper clearly states that tissue biopsy is preferred for diagnosis of RS. It is the utility of the FDG-PET in selecting the best tissue for biopsy. This is not something best left up to the general Onc who knows less than the average Bear about CLL and RS. Because nodes that are transformed to RS are often internal and FNA (Fine Needle Aspiration) too often gives false negatives, the FDG-PET can select the most promising tissue mass to do a core biopsy. The message I take is that CTs won't be useful but in the presence of histological evidence and clinical observations an FDG-PET is most appropriate provided you don't put the cart before the horse.
In spite of radon cave frequenters, currently there are US States that are adopting CT radiation regulations over concerns for potential harm from overuse. If you are treated in the US just click this link and see if your state is or has enacted legislation. If you are outside the US click and compare to your Country's policy. <advisory.com/research/imagi... or <tinyurl.com/prwk92f>
Confused? Not swayed yet? The issue is complex and I want to give you both sides so you can choose your own path based on information though I have never let objectivity get in the way of my opinion. My opinion is that the voices of caution have won the argument and we as individual patients and as a community impacted by CT technology can change the scanning culture to make it safer while retaining its benefits. Tomorrow, the medical authorities weigh in. Stay tuned.
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Richter Transformation - Update
