CT lung cancer screening

Posted by joelars @joelars, Sun, Jul 7 11:39pm

I listened to a discussion concerning cancer screening. It was the opinion of the oncologists that doctors continue screenings late into the patients life where the risks of radiation exposure outweigh any benefits because the patient doesn’t have enough years, statistically, to live. Does anyone know about what age is the right age to discontinue cancer screenings?

@joelars– Good morning. What an excellent question. Unfortunately there is no excellent answer. It depends on a lot of different things, from my experience. It depends mostly on what your doctor thinks, what he's been taught and how much emphasis he believes economics should play.
The second important things is they type of cancer you have. Although I have NSCLC I also have a sub category called Multi-nodule Adenocarcinoma of the lung, or MAC. (https://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.e20041). Since I have to be followed pretty closely, because I have had numerous lesions over a period of 22 years, I've also needed many many CT scans. What was available at first was high dosage CT's. Now it's low dose. An intern once told me that because of the amount of the cost of CT scans people shouldn't have them for more than 5 years. Now he just happened to be following my Oncologist who was seeing me for the first time. It was also 10 years after my first tumor. He should have kept his mouth shut.
If you have advanced, metastatic cancer than I think that is a different question.
Another thing to keep in mind is that scans aren't 100% perfect in either what they capture or how they effect people. Some changes in tissues can happen, but it's very slight.
There are so many variable that it boils down to what is best for your quality of life–how do you want to feel for the rest of your life. Because of my 4 lung cancers I have lost a lot of lung tissue and some loss from both of my radiations (SBRT's). So my quality of life has changed do to the lack of oxygen that helps feed my ability to move and breathe. Yes I am hindered in some of the things that I want to do, so I do them slower.

We are people, not statistics, which I continuously tell my radiologist. lol Risks, after a time, become secondary in the situation that you cited. I would think that if I had less time to live because of advanced, metastatic cancer then my choice would be whether to stop treatments altogether and not worry about CT scans. So what do you think? Does the CT scan pose enough problems at that stage to worry about?
https://www.health.harvard.edu/cancer/radiation-risk-from-medical-imaging

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@merpreb

@joelars– Good morning. What an excellent question. Unfortunately there is no excellent answer. It depends on a lot of different things, from my experience. It depends mostly on what your doctor thinks, what he's been taught and how much emphasis he believes economics should play.
The second important things is they type of cancer you have. Although I have NSCLC I also have a sub category called Multi-nodule Adenocarcinoma of the lung, or MAC. (https://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.e20041). Since I have to be followed pretty closely, because I have had numerous lesions over a period of 22 years, I've also needed many many CT scans. What was available at first was high dosage CT's. Now it's low dose. An intern once told me that because of the amount of the cost of CT scans people shouldn't have them for more than 5 years. Now he just happened to be following my Oncologist who was seeing me for the first time. It was also 10 years after my first tumor. He should have kept his mouth shut.
If you have advanced, metastatic cancer than I think that is a different question.
Another thing to keep in mind is that scans aren't 100% perfect in either what they capture or how they effect people. Some changes in tissues can happen, but it's very slight.
There are so many variable that it boils down to what is best for your quality of life–how do you want to feel for the rest of your life. Because of my 4 lung cancers I have lost a lot of lung tissue and some loss from both of my radiations (SBRT's). So my quality of life has changed do to the lack of oxygen that helps feed my ability to move and breathe. Yes I am hindered in some of the things that I want to do, so I do them slower.

We are people, not statistics, which I continuously tell my radiologist. lol Risks, after a time, become secondary in the situation that you cited. I would think that if I had less time to live because of advanced, metastatic cancer then my choice would be whether to stop treatments altogether and not worry about CT scans. So what do you think? Does the CT scan pose enough problems at that stage to worry about?
https://www.health.harvard.edu/cancer/radiation-risk-from-medical-imaging

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Thank you for your thorough response. The discussion I referred to, that prompted the question, was limited to patients who may be at advanced risk (ex-smokers) but have never had cancer, and were elderly. So the logic was why expose people to radiation when there life span was so limited. Does that change your response?

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@joelars

Thank you for your thorough response. The discussion I referred to, that prompted the question, was limited to patients who may be at advanced risk (ex-smokers) but have never had cancer, and were elderly. So the logic was why expose people to radiation when there life span was so limited. Does that change your response?

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I am 82 and an ex smoker. I have a small nodule on my right lung. It’s been checked by ct scan every six months for about 10 years. No change. I stopped about two years ago. I hope to live to 100 but have no worry about the nodule. Life is uncertain. Who knows? We are all different. After a number of major surgeries I could probably light up the city with my X-rays ct scans and MRIs. If you feel it is necessary probably should do it. Let your body tell you and have peace.

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thanks for your response. Can I ask how long you smoked? I'm afraid that I quit too late (51) I'm now 65. So far nothing has shown up except 2x I had pneumonia.

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@jo54

I am 82 and an ex smoker. I have a small nodule on my right lung. It’s been checked by ct scan every six months for about 10 years. No change. I stopped about two years ago. I hope to live to 100 but have no worry about the nodule. Life is uncertain. Who knows? We are all different. After a number of major surgeries I could probably light up the city with my X-rays ct scans and MRIs. If you feel it is necessary probably should do it. Let your body tell you and have peace.

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@to54- I'm not at that stage yet. I have one nodule in my lower left lobe that is 9mm. It is being watched and because it's being scanned once every 3-6 months it'll be easier to get rid of. I'll know tomorrow. And you are right, you have to let your body tell you when to let go. But I am not there. Was it an easy step for you to stop the scans?

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To All- It's getting very difficult to follow conversations with so many posts now. Please don't forget to put a person's @username before your comment. It will really help, me at least. lol Thank you

Liked by bluelagoon

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@joelars

thanks for your response. Can I ask how long you smoked? I'm afraid that I quit too late (51) I'm now 65. So far nothing has shown up except 2x I had pneumonia.

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@joelars– Thirty-five years. I smoke very heavily. I was diagnosed at 51yrs and am now 72 years of age. Please don't jump the gun and think that something will happen. Have you seen a pulmonologist to see if you have COPD and to treat it?

Liked by auntieoakley

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@merpreb

@to54- I'm not at that stage yet. I have one nodule in my lower left lobe that is 9mm. It is being watched and because it's being scanned once every 3-6 months it'll be easier to get rid of. I'll know tomorrow. And you are right, you have to let your body tell you when to let go. But I am not there. Was it an easy step for you to stop the scans?

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I smoked for almost 40 years. I quit about 25 years ago. I don’t use oxygen but every time I am in hospital they put me on it. There’s some things I cannot explain. I have gone through the bronchitis, colds, inability to breathe, chest pain, chest expanding, nostrils flaring, trips to ER, choking and coughing. I realized suddenly that I have not had a cold in over a year. My oxygen readings are over 94 and I feel free. I still cannot walk a distance and stay in when humidity is high. I am careful and some days are better than others. I was ready for oxygen 24/7 but I was given a gift and i am grateful. I know there is no cure but I am convinced that taking care of yourself helps. Prayer is an answer for me. God gave me this body and after many years I have learned to respect it. 💞

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@merpreb

@joelars– Thirty-five years. I smoke very heavily. I was diagnosed at 51yrs and am now 72 years of age. Please don't jump the gun and think that something will happen. Have you seen a pulmonologist to see if you have COPD and to treat it?

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When I quit 14 years ago I saw a pulmonologist and was diagnosed with COPD. My response was to work-out daily, including yoga, weights and running, (actually slow jogs) every other day. I'm not really on anything.albuterol occasionally. the doc didn't seem to have an answer. He also wasn't very concerned and hasn't seen me in years. He thinks I'm doing fine.I would like to get a thorough work-up at mayo.However, I don't think they will have anything to offer someone who functions as well as I do.

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@merpreb

To All- It's getting very difficult to follow conversations with so many posts now. Please don't forget to put a person's @username before your comment. It will really help, me at least. lol Thank you

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@merpreb @colleenyoung I agree that it gets confusing when there's a post without a directon, but I'm pretty sure I've done that myself.
I know when I post by hitting "reply" on your message I expect it to know that it's you whom I'm replying but that doesn't seem like the case! When all the user comments were coming up when they made changes awhile back do you recall if this came up? At the time I hadn't used it enough to have questions like that!

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@joelars

When I quit 14 years ago I saw a pulmonologist and was diagnosed with COPD. My response was to work-out daily, including yoga, weights and running, (actually slow jogs) every other day. I'm not really on anything.albuterol occasionally. the doc didn't seem to have an answer. He also wasn't very concerned and hasn't seen me in years. He thinks I'm doing fine.I would like to get a thorough work-up at mayo.However, I don't think they will have anything to offer someone who functions as well as I do.

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@joelars– You are one lucky person! I envy you. Because of the lung tissue that I've lost due to lung cancer I do use an inhaler. There's a new one out that replaces QVAR and Spiriva called Trelegy. I only need to inhales a day, first thing in the AM! Even if there is nothing new that they might have for you, if it's been a while, I'd go for the check-up. If I've answered this post before I apologize. Have you called Mayo yet?

Liked by auntieoakley

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@merpreb I haven't called yet. I'm waiting for the results of the test I take this week. You may remember I had pneumonia in March In my follow=up chest x-ray a few weeks later they found a small "infiltrate" My doctor scheduled a 2nd x-ray. I put it off. I'm scheduled this week. In part I put it off because I don't think it was realistic to find a completely clean x-ray that soon after pneumonia should be expected? . A small patch of dead infectious material should be expected? Assuming this x-ray is clean I will schedule the Mayo exam. My concern is going to doctors they tend to find things. The findings may demoralize my arduous work-outs and runs. The fact that I can do so much physically I believe has saved my life. I don't want anything to interfere with that. So unless they can really help me improve my athletic performances and I don't believe they can, what is the point of letting them test me just to report problems?

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@joelars– Yes I do remember that you had pneumonia and am glad that you recovered. I'm still confused because you said that you did want a work-up. Instead of another Xray, I'm wondering why not a CT scan. What do you mean by demoralizing a workout? Do you mean that it would ruin your mindset?

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@joelars

@merpreb I haven't called yet. I'm waiting for the results of the test I take this week. You may remember I had pneumonia in March In my follow=up chest x-ray a few weeks later they found a small "infiltrate" My doctor scheduled a 2nd x-ray. I put it off. I'm scheduled this week. In part I put it off because I don't think it was realistic to find a completely clean x-ray that soon after pneumonia should be expected? . A small patch of dead infectious material should be expected? Assuming this x-ray is clean I will schedule the Mayo exam. My concern is going to doctors they tend to find things. The findings may demoralize my arduous work-outs and runs. The fact that I can do so much physically I believe has saved my life. I don't want anything to interfere with that. So unless they can really help me improve my athletic performances and I don't believe they can, what is the point of letting them test me just to report problems?

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Trust me, all that working out will stand for something even if they find something. My husband was always very physically fit. When he was diagnosed with bone cancer he was able to tolerate the hard treatments, and still continue to do well. He is in his 70s, and still way ahead of most with his disease, we attribute much of that to workouts, marathons, etc. even though he has been unable to do continue it after diagnosis. Walking is his friend now.

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@merpreb

@joelars– Yes I do remember that you had pneumonia and am glad that you recovered. I'm still confused because you said that you did want a work-up. Instead of another Xray, I'm wondering why not a CT scan. What do you mean by demoralizing a workout? Do you mean that it would ruin your mindset?

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@merpreb, I'm ambivalent about a work-up because I feel the docs are good at finding problems but not in providing remedies. So if I just get a poor diagnosis and no medical solution it would dampen my desire to continue with the high intensity work-outs that I put myself through. On the other hand, maybe they have something new that can help me with my exercise program making it a little easier.

The x-ray is my primary doc's suggestion. I'm guessing the x-ray is just a follow-up from the pneumonia and not a cancer screening. The cancer screening question I asked earlier was prompted by a medical program I was listening to. It had nothing to do with my x-ray (although I'm guessing that an x-ray would pick up a tumor?)

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