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Important Info I want to share.... Important Info I want to share....

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  #1  
Unread 06-23-2005, 07:57 AM
Important Info I want to share....

Hi Ladies~

I wanted to share the following important information (see report below) for any of you who may be facing what may be the possible recurrence of OvCa.
My sister was recently DX'd with recurrent OvCa and her lesions were only detected via a COMBINATION PET/CT SCAN. It never showed up in a CT Scan alone:

Hopkins Study Finds Combined PET-CT Better At Detecting Ovarian Cancer Spread

Hopkins radiologists have found that a combination of positron emission tomography (PET) and computed tomography (CT) detects cancer spread better than PET alone. In a study to be presented at the Radiological Society of North America (Abstract #1458, 10:57 AM, CST, Thursday, December 5, Room S502AB), researchers reported that overall, PET-CT improves the ability to distinguish cancerous from normal tissue and locate metastases, where they have spread.

<Admin snipped whole article to comply with copyright laws. Link added to the whole article>

http://www.hopkinsmedicine.org/press...er/021203A.htm
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  #2  
Unread 06-23-2005, 08:28 AM
Important Info I want to share....

Thanks for sharing this information. I am a little confused as to its implications though. Am I correct to assume that in this combined technology the CT is not done with contrast? It is stated that "routine contrast enhanced CT was able to find disease in three of the five false negatives produced by PET-CT." Would this mean that CT with contrast is a better diagnostic tool? My follow-up program includes a CT with contrast 4-6 months after surgery (it is scheduled for this Monday), and I was hoping to obtain peace of mind (for a short time anyway) if all comes back ok. Now I'm not so sure.
  #3  
Unread 06-23-2005, 09:15 AM
This is what I know....

Hi Grayhair~

What I do know is that my sister did have the CT Scan with contrast...while it did show a recurrence...it DID NOT show the precise number of lesions.
What I am saying is the CT scan with contrast only showed 2 lesions while the PET/CT scan showed all 5 that were actually present. Thus, the CT scan alone was not able to pick up "all that was going on" internally.

My sister was trying to obtain a detrmination as to whether or not she would be a candidate for second surgery. That determination could only be made after having a PET/CT scan. I am not able to find the most current report (the one I posted was from 2002, I believe), however, there is another report (more current) stating that whenever there is a probability of recurrence, a CT scan alone is not the gold standard in diagnosis.

I hope this doesn't come across as too confusing and that I was able to clarify matters.

My prayers are with you!

's
Heni
PS Please feel free to email me at any time for any help I may be able to extend. I am a research "freak" and have compiled an entire folder on my sister's OvCa.
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  #4  
Unread 06-23-2005, 11:12 AM
Important Info I want to share....

Hi Heni,
I understand what you are saying and thank you for this clarification. I am curious if others out there have had CT 's with contrast as their followup to surgery, and, if so, why is this being used if it is not "the gold standard." My surgery was done at a top notch hospital, well-respected gyn. onc., etc. and now I am wondering what's up with this. Do I go on Monday for the scheduled CT, or do I pose the question to my doctor?
  #5  
Unread 06-23-2005, 11:38 AM
Important Info I want to share....

Hi Heni,

Thank you for sharing this information. However, I do think that all doctors look at things differently. When I had my recurrance, the cat scan (which I always do without contrast due to possible allergic reaction) was all that my oncologist/gynecologist said was needed. The radiologists report said that a pet scan might also be needed but my doctor did not. I did question my doctor on this and his response was that for ovarian cancer it is not needed.
Oh well, who knows......as long as we all remain healthy.

Rosalie
  #6  
Unread 06-23-2005, 12:21 PM
Important Info I want to share....

I can only speak to my sister's experinces and the invaluable time lost for her when the CT scan (not in combination with the PET scan) was not accurate.

If the new doctor which I brought my sister to at Hopkins did not order the PET/CT scan, they had no way of knowing how many lesions "grew" just following the completion of her chemo.

I, myself, saw and read the radiologist's reports from both types of scans. The CT scan alone was inaccurate. We now know the PET/CT scan WAS ACCURATE, as following her second surgery, the doctor did find the exact number of lesions as was reported in the PET/CT scan.

According to the doctor at Hopkins, often times lesions are missed in a CT scan alone, especially in recurrences.

I just thought I would pass along the research and what I have learned myself through all of this.
  #7  
Unread 06-23-2005, 12:29 PM
This is for grayhair....

This is for grayhair>>>>>>

I am not a physician...as I said before...I just wanted to pass along the research and what I have learned myself through this entire ordeal with my sister.

As Rosalie stated, every doctor has their own views and opinions which can differ from Dr to Dr.
It wouldn't hurt to inquire about it...if it were me...I would.

I am very proactive and it sounds like you are as well.

For example, if we would have listened to another well respected cancer facility (top 5 in the country), my sister would NOT have had her second surgery last week. According to her new Dr at Hopkins, having the second surgery was her only hope. As he put it to me, different doctors and different minds have varying thresholds of risk tolerance.

I'm just passing along what has been told directly to me.
  #8  
Unread 06-23-2005, 12:47 PM
Important Info I want to share....

Here are a few articles on studies of combined PET/CT imaging. It appears that all of the studies are pretty small, and that one of the main purposes of the PET/CT in ovca is to evaluate women who are having a second cytoreduction

This is all pretty new - a few years ago it wasn't clear that PETS were useful at all in ovarian cancer, so I don't think there is a new standard of care yet.


http://ctep.cancer.gov/resources/gcig/news032805e.html

http://www.pslgroup.com/dg/24bad6.htm

http://radiology.rsnajnls.org/cgi/co...ract/233/2/433

Dorrie
  #9  
Unread 06-23-2005, 02:07 PM
Important Info I want to share....

As always with recurrent ovarian cancer there are no clear answers.
Many oncologists would prefer to restart chemo later, rather than sooner. Especially if the recurrence occurs within one year of completing the standard of taxol and carbo and the patient has no symptoms, but only a rising ca 125. They would prefer to wait until the regrowth is at least large enough to show on a CT scan, or a ca 125 tops out at 100 or symptoms occur.
Some oncologists are more aggressive. And they are the ones ordering Pet/CT scans, opting for redebulkings when masses are spotted and treating ca 125s less than 100.
I'd like to think it depends somewhat on the general physical condition of the patient and how well they have tolerated the toxiciites of chemo.
But we all are responsible for clearly letting our doctors know how aggressive we wish them to be. And that involves keeping up to date on all advances with this cancer and not depending totally on our health care providers.
In January I had my ca 125 pop up to 20 with a clean CT. They repeated my ca 125 in three weeks and it was back to 9. If it had been higher I would have insisted on a CT/PT scan.
JMHO
oxoxo karenann
  #10  
Unread 06-23-2005, 02:26 PM
Important Info I want to share....

Karenann is so right. We need to be as informed as possible and an active member of our health team.
This fourm is just one avenue to use to collect info.
I think after a period of time ovca survivors/families should be awarded some type of advanced degree for our continuing education.

Cindy
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