Risk of CT scan worth it for my case? - 1261543

bmayb
Posts:2

I have a referral by my primary care physician to get a CT scan on Friday. I have read that CTs are often overprescribed by doctors, and I want to make sure that the risk of radiation and associated increased cancer risk is worthwhile based on my case.

The order for the CT scan is based on my persistent cough primarily at night (on and off for several years), plus recent incidences of bloody sputum.

The first time I saw slight pink spots in sputum was about a year ago. I was then tested for TB but it came back negative. Since then, and especially in the past two or three months, I've had more frequent bloody mucus (once a week or once every two weeks), and brighter red color/more quantity of mucus when it occurs. I have also recently been sweating a lot at night, but that could be due to our new memory foam mattress and/or anxiety, so I'm not sure it's a real symptom.

I had an X-ray that came back showing an azygos lobe vein (I'm translating, so not sure that's the exact terminology), but nothing else out of the ordinary. Could a tumor be mistaken for an azygos lobe variation?

I want to minimize my exposure to radiation, so would like the opinion of the doctors on this forum whether for my case the risk of the CT scan is worth the potential benefit.

Thank you in advance for your help.

Forums

JimC
Posts: 2753

Hi bmayb,

The question of radiation risk from CT scans comes up frequently, and if you search this site for "radiation risk CT" you will find plenty of discussions. The bottom line is that the risk from a single CT is quite negligible. In addition, you have symptoms for which your doctor is seeking a cause. The x-ray you received was apparently inconclusive, so your doctor feels that a CT is warranted, since it images your chest at much higher resolution. As GRACE's Dr. Manning has stated "A necessary CT should never be withheld for fear of radiation exposure." You can read her discussion of this issue here: http://cancergrace.org/cancer-101/2012/06/21/radiation-exposure-from-me…

There is also a previous discussion of this issue here: http://cancergrace.org/radiation/topic/time-magazine-on-the-radiation-i… It includes a link to a chart listing the radiation exposure from various sources at http://xkcd.com/radiation/

I hope your doctor is able to diagnose and easily treat your condition.

JimC
Forum moderator

bmayb
Posts: 2

Thank you very much for your fast reply, and reassurance that the risk of the CT scan is negligible. I have been reading many of the the forum discussions to find out information about diagnosis and symptoms, and will read the links you posted now.

Again, many thanks for being so available for my question and for many others.

Dr West
Posts: 4735

Yes. To highlight Jim's key points:

1) The risk of a single chest CT is absolutely negligible -- bear in mind that we get radiation also just from taking a transcontinental flight or living at a higher elevation, and it's not like pilots or residents of Denver are dying at a significantly higher rate from radiation exposure.

2) It's appropriate to be judicious about lots and lots of scans, especially if there isn't a clear rationale for them, but it's completely appropriate to use them to ask a clear question, such as whether there's a concerning reason for a pulmonary symptom.

Good luck.

-Dr. West