Frequency of scans after surgery?
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In case anyone else happens upon this thread with a similar question:
After we applied a bit of pressure re: shifting the scans to a quarterly schedule rather than the semi-annual calendar our oncologist initially recommended, he went ahead and ordered the scans. He did warn us though that insurance would probably not cover them. Much to our pleasant surprise, insurance approval came through almost immediately. It sometimes pays to be pushy!
Thank you so much for your prompt and informed reply, Mary. As always, you are a wealth of knowledge.
-Hannah
Hi Hannah,
This is a topic of some debate. The NCCB guidelines, which some U.S. doctors and insurers follow, suggest scans every six months in the first few years after surgery. The European ESMO guidelines for cholangiocarcinoma (which you can find through an internet search) recommend scans and bloodwork every three months in the first two years, every six months during years 2-5, and annually thereafter. A few U.S. hospitals have information posted on their websites that seems more consistent with ESMO than NCCB.
I was able to persuade my oncologist to follow the ESMO recommendation. So far my insurance has paid for the scans. My case has been described as high risk. The risk of recurrence is generally high for cholangiocarcinoma so it is fair to say we are all at high risk.
Why is it important to have more frequent scans? There are no studies I am aware of looking at this question. The radiation and/or contrast agents involved in scans do introduce some risks to patients. My own belief as a patient is that the earlier a recurrence is spotted, the better. There may be better treatment options if recurrence is caught early or I may be in a stronger position to withstand treatment.
My impression from postings on the discussion board is more doctors are recommending scans every three months in the first two years after resection, rather than every six months, although we see both.
I hope this is helpful. Regards, Mary
Hi everyone –
As some of you know my mom had a successful (R0, lymph-negative) surgery in late February this year after 6 cycles of gem-cis. She then followed up with another 4 cycles and had a clear scan in late August.
My question now is what the standard should be for follow-up scans? Her oncologist wants to do scans every 6 months for the time being, but I worry whether this is sufficient. My mom does not express the CA-19-9 marker that many rely on as an early indicator, so scans are our only tool. I’ve read comments on this board indicating that some people get CT scans as often as every 3 months, and digging through the medical literature I’ve seen similar recommendations. Of course we’re anxious about catching any recurrence as early as possible.
I’m sure my mom’s doctor worries about the amount of radiation my mom accrued in the past 15 months – perhaps that plays into the decision as well?
Any insights on this issue? Are there people out there on 3-month or 6-month scan schedules, or has anyone read any recent literature on this that I might use as ammunition or for reassurance?
Thanks so much-
Hannah
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