Follow-Up Tests Schedule - 1270682

Mon, 08/03/2015 - 14:27

My history is as follows:

Nov 14 - diagnosed with urothelial carcinoma, tumor removed from ureter, stage 4 because in 2 of 21 lymph nodes.
No need to remove ureter, kidney or bladder.
Jan-Apr 15 - did four rounds of cisplatin and gemzar.
Jun 15 - cystoscopy and cytology clear.
Jul 15 - CT scan of chest and abdomen clear.
Oct 15 - scheduled for scan of just chest (I think oncologist thinks it may metastasize to lungs).
Dec 15 - scheduled for another cystoscopy and cytology; and I think maybe scan of abdomen.

My concerns are as follows, and I'd appreciate your opinion.
1) I know some patients get cystoscopy and cytology every 3 months. My urologist has me on a 6-month schedule.
2) Next CT scan will be in 6 months; but chest scan in 3 months. There was a nodule that showed up on my pre-chemo scan - one in lung and one in liver. Scan in June showed no change.
3) First and only colonoscopy was 7 years ago - polyps removed that were not pre-cancerous (at that time told to follow-up in 10 years). I asked my oncologist if he thought I should have another colonoscopy now, and he said I could wait another 3 years.
4) I am a year behind on pap smear and mammogram. Planning on get those taken care of as soon as possible.
5) And in my free time, I may get to the dentist! (that's my attempt at humor :-) )

Thank you so much!
Marie Harvey

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Hi Marie,

Great results on your recent CT scans!

Worry tends to be the name of the game with cancer, but if you're getting checked by your doctors in the interim and reporting any new symptoms promptly, a difference in scanning interval between three and six months doesn't tend to be significant, and there tends to be an element of judgment on the part of the oncologist, taking into account all of the relevant factors. That being said, if you really are uncomfortable with the interval, another discussion with your oncologist may lead to a reconsideration.

If you're not currently undergoing treatment and are feeling good, I don't know that there is any harm in getting a repeat colonoscopy, although that procedure is more in the nature of a long-term screening rather than one to detect a current problem. And you've had a recent scan of your abdomen which was clear.

I don't see a problem with getting the pap smear and mammogram either.

The dentist is where I draw the line...dentists cause pain! :)

Take care,

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Thanks are you saying you think something in the colon would have shown up on the CT scan a couple of weeks ago? I thought maybe they had to actually go into the colon to see any polyps growing...


Hi Marie,

Sorry if I gave that impression. Polyps would not show up on the abdominal CT, but a tumor in the colon would. Polyps are an indication that colon cancer may develop years down the road. Many oncologists feel that it is more important to treat the more pressing problem of a current cancer diagnosis, since screenings can reveal many benign findings that, while they may need to be investigated, can cause additional worry and possibly lead to invasive procedures that a cancer patient may not want or need to undergo. This is especially true for a patient who is currently being treated with systemic therapy, which places enough stress on the body as it is.

In your case you've finished treatment and had some clear scans, so such screenings shouldn't really cause such problems.

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