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National Cancer Institute study makes case for more aggressive use of CT scans for all cancer patients

Posted by on November 19, 2010 in RCC News & Research - 4 Comments

A new study from the National Cancer Institute found that the rate of lung cancer death can be significantly lowered if doctors screen smokers with CT scans instead of using x-rays.  The reason?  X-rays don’t detect tumors in the lungs early enough – but high tech CT scans can find the growths at an early stage.

The study made a lot of news, but the findings didn’t surprise me. I just wish that the medical community would expand their findings to other areas – mainly screening for current cancer patients.

When my husband was diagnosed with kidney cancer at the age of 40, our community hospital did an x-ray to be sure that the cancer hadn’t spread to his lungs.  We were euphoric to get the news that his lungs were clear.  In the early stages of diagnosis, we were still in the panic phase and listened and believed whatever the doctors told us.  Three weeks after his surgery, a radical nephrectomy to remove his entire kidney along with the tumor that had overtaken it, I had done a little more research.  What I learned was that lung x-rays are notoriously unreliable in finding tumors in the lungs – whether it’s lung cancer or some other metastatic cancer.

I went back to our doctor, the urologist who had performed the surgery, and said that I felt that we needed a CT scan instead.  He confidently waived me away.  Silly woman.  An x-ray is fine.  CT scans use too much radiation – and the contrast is hard on the kidney (which was significant since my husband was now operating on one kidney).

One thing you should know about me is that I’m a lobbyist.  I spend my working hours arguing.  I’m pretty good at it – even sometimes to my detriment.  And I wasn’t convinced that our doctor was right.  I told my husband we needed to get a second opinion.  He agreed – after all, when you get a cancer diagnosis, getting a second opinion is just common sense.

The second doctor we went to agreed with the first doctor.  I should point out – fairly or unfairly, he too was a urologist. He said x-rays every six months would be a reasonable scanning regime for someone with my husband’s diagnosis and prognosis.  I reminded him that Chris’s tumor was large and of an aggressive grade.  He assured me that the chances of his cancer coming back were low.  I was, at first relieved.  But the nagging in the back of my mind wouldn’t go away.   Everything I was reading and everything I was being told from the patient community said that we needed a CT scan.

Almost by accident, I set up an appointment for a third opinion.  I had been chatting with a friend who was on the board at another hospital and I mentioned my concern.  Within a few minutes, I was confirming an appointment the next day with a new doctor – this time an oncologist.

I wasn’t relieved when the third doctor agreed with me.  I wish that an x-ray would have been sufficient.  I wish that the first two doctors were right and that my husband didn’t have metastatic cancer in his lungs.  But they were wrong. He did.  We discovered this when we received the results from his first CT scan of the lungs. He’d probably had it the entire time, and it was just never caught because the doctors failed to do a CT scan.

I hope that this study for the NCI will be used more broadly.  I hope that fewer patients will go through what we went through.  I have no idea how long it would have been before they would have found the cancer in Chris’s lungs.  I can tell you that nine months after the initial CT scan found the tumors – an x-ray we had during treatment looking for fluid buildup still showed no signs of tumors in his lungs.

If we can agree to scan smokers for potential lung cancer, shouldn’t we also make it standard to use the same technology to scan current cancer patients for potential metastasis?

  • Jeff

    Like you husband I had my kidney removed 3 years ago and while I have had regular CT Scans the scans have been without contrast because of the concern about potential damage to my one good kidney.
    Recently on a webcast from the Kidney Cancer Canada group I heard one doctor state that a CT Scan without contrast was no better than an ultrasound. My question is just how much damage would I be risking to my kidney if I request that my CT Scans be with contrast?
    Any reply would be appreciated.

  • Dena_Battle

    Jeff,
    I always get my scans with contrast, and I’ve been doing so for two years — every three months. To me, the danger of doing the scans without the contrast, and failing to pick up disease progression, far outweighs the risk to the kidney. After every scan, I drink tons of water to flush the system and kidney.

  • Jeff

    Like you husband I had my kidney removed 3 years ago and while I have had regular CT Scans the scans have been without contrast because of the concern about potential damage to my one good kidney.
    Recently on a webcast from the Kidney Cancer Canada group I heard one doctor state that a CT Scan without contrast was no better than an ultrasound. My question is just how much damage would I be risking to my kidney if I request that my CT Scans be with contrast?
    Any reply would be appreciated.

  • Chris Battle

    Jeff,
    I always get my scans with contrast, and I’ve been doing so for two years — every three months. To me, the danger of doing the scans without the contrast, and failing to pick up disease progression, far outweighs the risk to the kidney. After every scan, I drink tons of water to flush the system and kidney.

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