March 20, 2007
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From Dr. H
I know that a lot of you were concerned about the lack of a PET scan. Here is Dr. H's response to the question "should we pay for a PET scan ourselves?"
Evie,
I got your message passed to be by Jill. The reason that I opted not to fight the insurance company further for the PET scan is the possibility of a false positive result. Radiation is going to continue to work for weeks beyond the last radiation fraction, and in talking to Dr. P, he recommends not doing a PET scan for 8-12 weeks after the last fraction of radiation. The insurance companies take a more conservative approach by stretching this out to 120 days or just over 17 weeks. If we were to do the scan now, there is a high likelihood that it would demonstrate uptake in the areas treated with RT. We are looking for residual disease that survived the chemo/RT. I would like to do the CT scan so that we have a baseline scan to compare to the original one you had in November. Ultimately, I will be using CT scans to follow your response to treatment, as we will be more interested in assessing changes in size of any suspicious areas, rather than looking for complete resolution on PET scan as a determination of response to therapy. I believe that we can use the PET scan intermittently to validate our response to therapy. I don't feel compelled to use it up front and would rather reserve it for when I know we are going to get a good, unbiased scan. I believe that the RT may cloud the issue and give us false positive results. I am interested in seeing anatomically what is different now that you have gone through definitive RT with chemotherapy, comparing the pretreatment scan with a scan 4-5 months later (now). I would specifically be looking for decrease in size and number of nodes. Please let your mother know that getting a PET scan now will not have anything to do with or impact on your survival. In my mind, the PET scan is not worth the hassle. We can get plenty of information from the CT scan and utilize the PET scan later after we have done some chemotherapy, specifically to validate the findings on CT scan. I hope that this makes sense. I don't write good e-mails because I am so long winded. Let me know if you have any other questions.
Comments (10)
Well, that makes sense. At the very least, you know that if he felt that you really needed the PET scan, then he would have appealed it to the insurance company.
Heh. Tell him being long-winded is a good thing!
Makes sense to me! I'm all for getting the best results from these tests that you can!
His letter makes sense, so I guess it's one thing that you no longer need to worry about!
I feel his email is pretty informative too. Hope it eases your mind a little too.
It sounds like he has a good plan for you Evie. I thought his email was great.
What a blessing to have a doctor that communicates so well and seems to have the situation in hand. What he's saying makes sense too.
That is very reassuring!
I am so relieved to hear his reasoning for not fighting the insurance company. {{Evie}} What a great Dr. to take the time to really explain to you his thinking and approach to your care.
Makes you just want to hug the doctor for caring enough to explain his position and relieve your concerns....and your mom's, and ours, etc.
Sounds like a good plan.
This makes sense. It's great to have a medical team that is so accessible.
Comments are closed.