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When to get CT Scan and Chest Xray?

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  • When to get CT Scan and Chest Xray?

    Hello everyone,

    My son-in-law Shane, diagnosed last week with suspicious mass. Suspect 2cm tumor Feb 5.
    Feb 7 Urologist visit. radical orchiectomy was scheduled and tumor markers ordered.
    Feb 8 Tumor markers AFP 7.0 , bHCG 239, LDH 389
    Feb 13 radical orchiectomy (today)
    February 21 will be followup to discuss pathology.

    I asked the urologist when ct scans and chest x-ray will be ordered. He told me he will order them on the 21st when tumor pathology results will be discussed.

    Is this the right Protocol? I was disappointed to wait until next week to order ct and chest x-rays. I was hoping to get all 3 results at one for staging results, tumor pathology, ct scans, chest xray and blood markers.

    My theory is that before the urologist refers him to oncology for surveillance or further treatment, he wants to have radiology done late as possibly to have most current results?

    what do you all think?

    I am sorry if I didn't provide enough info appreciate any replies or feedback.
    My Brother's Advocate
    Left I/O DEC 2 non-seminoma Embryonal Carcinoma stage 1 survaillance

  • #2
    There's no reason whatsoever why he shouldn't have already ordered the imaging needed, such that it can be reviewed on Feb 21st.

    2cm solid mass, and HCG at 239, it's clear this is cancer and that imaging is going to be needed. I'd call his office and push for him to order the scans now so that he can get them done while waiting for the pathology results to come in. (read that as engage "*****/ahole mode" if you have to - they'll order the scans just to get you to go away, lol) My workup scans were ordered at the same time as my initial urology consult, before I had the orchiectomy.
    Young Adult Cancer Survivorship by Steve Pake
    April is Testicular Cancer Awareness Month!
    www.stevepake.com
    Feb 2011, Stage IIB, 4xEP, RPLND, PTSD
    My Survivorship Thread | All of my Blogs
    C
    ONTACT ME ANYTIME!

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    • #3
      Imaging doesn't depend on pathology results - it needs to be done reguardless. So I am in agreement with Steve, the sooner you have imaging, the sooner staging can be completed and a post-orchiectomy treatment plan can be formulated.

      My DR also ordered my imaging immediately after my ultrasound. I actually had it and my tumor markers drawn the same day since the ultrasound result nearly guaranteed cancer.
      6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
      6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
      7/7/15: bHCG 56, AFP 42, LDH 322
      7/13/15: begin 4xEP, end 9/18/15
      10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
      10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
      4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
      4/20/16: RPLND @ IU - teratoma only!
      9/27/18: all clears up to this date!

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      • #4
        Originally posted by biwi View Post
        My DR also ordered my imaging immediately after my ultrasound. I actually had it and my tumor markers drawn the same day since the ultrasound result nearly guaranteed cancer.
        Now that I think about it, I think my wife actually ordered my initial scans as soon as there was a positive U/S result (she's a neurologist). I either had it done the same day, or the next day, but it was all really fast. There's zero reason to wait to do scans.
        Young Adult Cancer Survivorship by Steve Pake
        April is Testicular Cancer Awareness Month!
        www.stevepake.com
        Feb 2011, Stage IIB, 4xEP, RPLND, PTSD
        My Survivorship Thread | All of my Blogs
        C
        ONTACT ME ANYTIME!

        Comment


        • #5
          Thanks....you have confirmed my annoyance. I totally want staging to be completed asap. I just wasnt sure why he would insist to wait untill pathology came back to clinically diagnose the nodes and chest.
          My Brother's Advocate
          Left I/O DEC 2 non-seminoma Embryonal Carcinoma stage 1 survaillance

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          • #6
            I agree with the guys above. Chest X-ray to check the lungs, CT scans usually tell the entire story. Should get them ASAP since it could be 2 weeks before an open appointment. Sometimes even more.

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            • #7
              Well....i called an oncologist and confirmed that they will want imaging prior to his visit (hopefully next week).
              However...shane had complications today and was re-admitted for internal bleeding ( surgical clamp broke) not to sure what actual problem was as i was at work today. But this new surgery will setback his recovery from 2 weeks to 8 weeks. I hope to visit with shane soon(tomorow) make sure to let him know that it will all be ok. This young couple distraught and it breaks my heart.
              My Brother's Advocate
              Left I/O DEC 2 non-seminoma Embryonal Carcinoma stage 1 survaillance

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