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Petct scan after chemo

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  • Petct scan after chemo

    Hi, my husband is 5 weeks out of chemo now. His dr. Wants him to do another petct next week, even though his first one prechemo was fine, and our last dr visit he told us we wouldnt need to do another pet just the ct. Is it normal to do another pet for a stage 1a that showed no issues pre chemo? (We did chemo as a precaution since he has embryonal mixed)
    Crystal wife to Jonny (30) diagnosed

    1/28/2015: got sick after dirt bike riding, right testicle swelling
    5/2015: saw a dr who said it was torsion but since the swelling "went down" we shouldn't worry
    02/2017: swelling increased tremendously no longer "went down"
    07/24/2017: had realistic dream telling him it was cancer, went to ER, was told it was never torsion and the tumor was cancer
    Afp: 4759
    Hcg: <1
    Ldh: 258
    07/28/2017: right orchiectomy ct scans all clear
    08/04/2017: nonseminoma stage 1 no invasion 40% ec 60% yolk
    08/28/2017: pet-ct and brain ct due to headaches
    Afp: 11.8
    Hcg: <2
    Ldh: 138
    09/06/2017: pet and brain clear
    09/18/2017 afp down to 2.9! Stage 1a
    10/02/2017 1xbep starts

  • #2
    hi there,

    most of the doctors recommend CT instead of PET CT for TC - as non-seminoma can give teratoma mets (and vice versa). Teratoma is not seen by PET CT. Therefore normally most of the times they recommend CT-s even though PET CT is more sensitive for Non-seminoma only...

    Timing should be ok - close to 3 months after the last one.

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    • #3
      a nice article on this:

      https://link.springer.com/chapter/10...-470-5385-4_87

      " In non-seminomatous germ cell tumors of the testis, however, FDG-PET should be used with caution, as it cannot differentiate between mature teratoma and fibrosis"

      However, I realise you would have PET CT (PET + CT) and not FDG- PET so it might be absolutely OK...

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      • #4
        Not to confuse you more: just ask the radiologist and the oncologist if they think they can see any potential teratoma with the current plan. By now I think PET CT is superior to FDG-PET in this (and every) regard so any - unlikely- teratoma would be visible.

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        • #5
          It is my understanding that PET has no real role in nonseminomas compared to just a CT scan. Also, it seem that having another scan this soon may be an over abundance of caution. I would ask my doctor why they want to use PRT over just a CT of the abdomen and what they are expecting to find or confirm or are of suspicion. Sure, it would be nice to know that the scans are clean but after BEPx1 for stage Ia do they really suspect anything is there?

          Mike
          Oct. 2005 felt lump but waited over 7 months.
          06.15.06 "You have Cancer"
          06.26.06 Left I/O
          06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
          06.30.06 It's Official - Stage I Seminoma
          Surveillance...
          Founded the Testicular Cancer Society
          6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

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          • #6
            I would consider the advice from both Mike & Sanis. Having a CT Scan would be the preferred way to take a look if Oncologist is insistent.
            Son Grant
            dx 12/21/16 at age 17

            BEP x3
            Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
            2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
            Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.
            Grant is enjoying his senior year in High School Cancer Free!

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