gramme
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Since completing treatment for Stage III B, mucinous (colloid) adneocarinoma (ALK +) in April, 2012. My oncologist orders CT with contrast and whole body bone scans every 3-4 months.
I had a clean CT of brain (with contrast) in Jul, 2013, and an MRI of brain in Nov. 2012, as well as a clear MRI of brain at diagnosis in 2011. At my Jul, 2014, appointment, I asked my doctor if I needed another MRI since it had been 1 year since the CT to check for brain mets. She said she did not find it necessary, as I was not having any symptoms. I have been "stable" for chest for 3 years. Bone legions on bone scan appear to be from trauma or degenerative disc disease, not mets. Should I insist on a MRI of brain?
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Reply # - September 4, 2014, 03:59 AM
Hi gramme,
Hi gramme,
Congratulations on your great scan results!
At diagnosis, a brain MRI is routinely ordered, but most oncologists do not use them for follow-up surveillance. The GRACE faculty is in general agreement on this practice:
Dr. Weiss has said:
“I typically acquire an MRI at diagnosis, then again if symptoms suggest. Some oncologist obtain more regular MRIs. I have no objection to this, but am not convinced that it improves actual patient outcomes compared to having a low threshold to get MRI once symptoms develop.” – http://cancergrace.org/lung/topic/should-brain-mri-be-done-even-in-abse…
And in the next reply, Dr. Aggarwal concurred: “I agree with Dr. Weiss. I obtain MRI brain if symptoms (headache, blurry vision, uncontrolled nausea, seizures etc.) develop, after getting a baseline scan.”
Dr. West also agreed, stating: “I follow the same approach. It is not the standard of care at this time to do surveillance brain MRI scans after diagnosis in people with advanced NSCLC who don’t have evidence of brain involvement at their initial work-up.”
JimC
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