Declining CT scan - straight to treatment plan
Discussion
I was diagnosed with follicular lymphoma from an excisional biopsy, in order t fully understand the extent of the spread I needed a CT scan with contrast to show if I had any other enlarged nodes that were not obvious to look or feel, and about 5 more were discovered that could not have been discovered without a scan of some sort.
fish butty said:
Has anyone declined a CT scan (with contrast) on the basis of radiation exposure - was there any pushback? The medical issue has already been diagnosed by what's considered the gold standard method according to what I've read online
Which part of the body & have you have other CTs already? You may have been diagnosed but can you be sure they found everything?Mr Pointy said:
Which part of the body & have you have other CTs already? You may have been diagnosed but can you be sure they found everything?
It's an airway scar causing the airway to close up. Doctor wants to do a full chest and throat scan but they've seen the scarring on scope. If it's anything more than a scar they will notice that during surgery? Just questioning if the CT is completely necessary given the radiationsimon_harris said:
the amount of "extra" radiation you are getting is tiny anyway, without question worth the amount of additional information it will give to your diagnosis.
Actually it isn't if you look it up. A chest CT is equivalent to 3.6 years of background radiation & comes with a 1 in 2500 lifetime additional risk of a fatal cancer. It's not negligible.Hi I am a thoracic surgeon with an interest in the airway. While most diagnoses can be made with a scope ( namely bronchoscopy in your situation) CT scan is a useful adjunct, especially if surgery to cut out the scar is contemplated or looking for causes of the scarring not evident on biopsy. Radiation doses for CT chest are smaller these days but you are right to be concerned, however, I would think the risks are very small compared to the benefits of the information the CT scan may provide, even if it is negative.
Mr Pointy said:
simon_harris said:
the amount of "extra" radiation you are getting is tiny anyway, without question worth the amount of additional information it will give to your diagnosis.
Actually it isn't if you look it up. A chest CT is equivalent to 3.6 years of background radiation & comes with a 1 in 2500 lifetime additional risk of a fatal cancer. It's not negligible.Mr Pointy said:
simon_harris said:
the amount of "extra" radiation you are getting is tiny anyway, without question worth the amount of additional information it will give to your diagnosis.
Actually it isn't if you look it up. A chest CT is equivalent to 3.6 years of background radiation & comes with a 1 in 2500 lifetime additional risk of a fatal cancer. It's not negligible.It will be fine, the additional risk is negligible. If you’re really concerned, ask about equivalent dose to the organs being targeted.
Edited by ChevronB19 on Tuesday 7th July 13:27
Not to be underestimated but if it helps achieve better diagnosis/treatment or surgical planning then you have to think about pros and cons.
A CT chest is less radiation than a yearly exposure to radon if you live in Cornwall.
Meaning, in terms of radiation if you live in Cornwall you are getting the same amount of extra radiation as CT chest every year.
A CT chest is less radiation than a yearly exposure to radon if you live in Cornwall.
Meaning, in terms of radiation if you live in Cornwall you are getting the same amount of extra radiation as CT chest every year.
CrgT16 said:
Not to be underestimated but if it helps achieve better diagnosis/treatment or surgical planning then you have to think about pros and cons.
A CT chest is less radiation than a yearly exposure to radon if you live in Cornwall.
Meaning, in terms of radiation if you live in Cornwall you are getting the same amount of extra radiation as CT chest every year.
True, but there is a difference between effective dose and equivalent dose.A CT chest is less radiation than a yearly exposure to radon if you live in Cornwall.
Meaning, in terms of radiation if you live in Cornwall you are getting the same amount of extra radiation as CT chest every year.
A one off CT is not a major risk to most people.
For some, genetically predisposed to certain cancers, it is.
The radiation dose is significant, but so is the level of information gained.
Ask if they can do an MRI instead if you are worried.
Not as useful for calcification and scarring, but not currently thought to be harmful.
You're the patient.
Your treatment is your decision, guided (non-directively) by the medics.
You have every right to voice your concerns.
For some, genetically predisposed to certain cancers, it is.
The radiation dose is significant, but so is the level of information gained.
Ask if they can do an MRI instead if you are worried.
Not as useful for calcification and scarring, but not currently thought to be harmful.
You're the patient.
Your treatment is your decision, guided (non-directively) by the medics.
You have every right to voice your concerns.
look at it this way - you have someone who is going to operating on your throat and by not having this scan you are depriving them of useful additional information about how that op might go, if they find nothing extra then great they know what they are dealing with is what they have already seen, if the problem is deeper then they know about it before they go in and it might even change what or how they plan to do it. Not having the information raises the possibility that they open you up and find something they don't expect and is more complicated to deal with than planned.
for me it is a no brainer and I say that as someone who had (multiple) CT and PET scans with actual cancer.
for me it is a no brainer and I say that as someone who had (multiple) CT and PET scans with actual cancer.
Also consider that airway narroiwng will often require repeated operations with the attendant risks of each operation. There's also the suggestion that repeated anaesthetic exposure will increase your lifetime risk of dementia.
Basing a decision on an isolated statistic is often not helpful in Medicine. But as stated above, discuss it with your specialist
Basing a decision on an isolated statistic is often not helpful in Medicine. But as stated above, discuss it with your specialist
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