Recently diagnosed with TC

[Az09]

Hi,
I was recently diagnosed with TC on left testes after my orchiectomy. Doctor said its Seminoma. I had no tumour markers in my blood. Besides that i dont have much details about my condition. Doctor advised me to go have a CAT scan of the whole body for further treatment(or to see if i need further treatment). My question is i read alot about CAT scans how they can be extremely dangerous in terms of radiation and harmful. Im worried about that fact and i dont know what to do. Is it possible to opt for MRI instead of CAT scan. Is it going to show same kind of results. Please help

[Az09]

anyone ? im really freaked out about this having CT/CAT scan.

[Mike]

You absolutely need to have a CT scan for proper staging. As of yet, MRI really isn't an alternative. There is a study in the UK looking at the equivalence of MRI to CT but they are using radiologists that are highly familiar with retroperitoneal lymph node imaging via MRI. In the general population, MRI would not be recommended. The benefit of a CT scan for staging far outweighs the theoretical risk for a secondary cancer 20 or 30 years down the road. Depending where you are in the world will also dictate the radiation levels used. The US typically has higher doses than those in the UK, Europe and Australia. You can ask for a facility that has low-dose CT technology and you can work with your doctor to make sure you are following proper protocols and not scanning too frequently when monitoring for reoccurrence. However, not having a scan at the beginning for staging and for monitoring really is unacceptable and unadvisable. For more information on low-dose CT and questions you can ask you can check out www.dialitdown.org

[Az09]

I am in canada. Im not sure if we have low dose CT scanners or not

[Mike]

I am not that familiar with the dose levels used in Canada but there are questions that you can ask on this page http://dialitdown.org/did-you/ that will give you a better idea. Many times the scanners are the same but the software have been updated to allow for lower doses. Princes Margaret Hospital in Toronto did publish a study on low-dose CT use specifically in testicular cancer patients so the process/technology it not new in Canada.

When I was diagnosed in 2006, I was to receive 16 CT scans in 5 years, These scans were with and without contrast and had a delayed phase or essentially 2.5 times the radiation I would have received if they just did one scan with contrast. This frequency of scanning isn't recommended anymore as CT check ups are much less frequent. I can not stress enough that you need to have a scan for proper staging and proper follow up. I am fairly well versed on radiation exposure from CT scans and have lectured on it on an international level without being laughed off the stage by the radiologist and medical physicists. I personally would not be so concerned with radiation exposure that I would go without the needed scans for proper diagnosis and monitoring, even if low-dose technology wasn't available in my area.

[eodtech2001]

I have to concur with Mike. The benefit of a CT/PETSCAN far out weighs the risk. I will give you an example of risk versus need. I was exposed to vastly larger amounts of radiation "military grade" with my career in the military. I have received more than 10x the normal amount the normal person is exposed to in a life time. Radon, Sun, xray etc...
So for you to worry about 20 to 30 years down the road of what could happen from a CT scan is the least of your concerns. You run a higher risk of dying from a car accident than you do from exposure to a CT scan.

[eodtech2001]

Not to mention if you dont get a proper staging then you may not be around to worry about the CT scan in 20 to 30 yrs. Worry about saving your life now and deal with the fall out later. No pun intended

[JeskiM69]

I 100% agree with Mike and Eodtech on this. You NEED to get the CT/PET scan done.

- Matt

[Az09]

I got a date for my CAT scan after 21 days. Do you guys think its a bit long wait? should i be worried and ask my dr to try to refer me somewhere else ?

[Az09]

any one have any feedback?

[Mike]

How long has it been since the orchiectomy? 21 days seems like a bit of a long time to me but I think things can be a bit slower in Canada. The thing would be that if the CT chows spread then how much longer are you going to have to wait to start treatments? To me 21 days would be unacceptable but again, I am not familiar with your system waiting times.

[Az09]

my orchiectomy was on oct 7th. results came on 27th october. so almost after a month. now CT scan is on 21st nov. and appntment with oncologist on nov12th

[Az09]

I dont know if they are a bit relaxed about me because my cancer was confined in testicle ( visually) ?

[Mike]

I personally would not be happy to wait until the 21st for a CT scan. Ideally, I would want to make a decision and start chemotherapy, if needed, within a month or so of my orchiectomy. However, I am not sure if you are able to do anything to sped things up. Having the CT later is obviously better than not having it at all.

[ColdCanadian]

Hello to another Canadian. Our system can be slow but it does work. I waited just shy of a month for my results and have a good idea what's going through your head right now. As for CT dosage in Canada, I think it depends on where you are. Locally our hospital equipment was updated a couple of years ago and the dosage is now much lower than it used to be. (and the scans are much faster) I can't say I enjoy the scans but I do enjoy the peace of mind from the reports after. As far as testicular cancer goes, you picked the right kind. Wishing you the best in the ugly situation you've found yourself in.
Greg