An ultrasound check only? - 1252429

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meli80
An ultrasound check only? - 1252429

Dear all,

My mom is receiving her 2nd line therapy (Alimta, mono) and yesterday she god the second chemo cycle.

I was expecting that her oncologist will check the efficacy of this treatment after the 2nd round via CAT and MRT, this was also the usual procedure when she was in Germany. But he told me he wants to do an ultrasound of the liver only (where she has two mets, deep in the liver). I must have looked worried and surprised, so he started telling me how there is no need for a CAT now, her cancer is not of a type that spreads quickly, besides she is under therapy etc... He said it was usual to do it so, but I know that it's not - at least not in Germany - and now I am all nervous and anxious.

What would you advice me to do? Can I trust this method or should I take my mom to a private radilogy practice and have her do the CAT and MRT there? I really do not understand how much he can see in the ultrasound, because the mets were discovered through a CAT scan in Germany. The previously done ultrasound check said all clear! I am all puzzled now! And what about the lung tumor?!

Many thanks in advance,

Meli

Dr West
Reply To: An ultrasound check only?

We can't give you medical advice here, but I agree that doing an ultrasound of a single area of metastatic spread is not the typical approach. It might arguably be a way to go if the only known disease were in the liver, but even then, doing an ultrasound won't provide information about whether any new lesions have emerged elsewhere. And while the doctor has said that this isn't a cancer that spreads quickly, it did apparently spread from the lung to the liver, so it has the capability of spreading to other distant sites.

There are always individual situations for individual patients, but you are absolutely right that it is definitely not standard to just do an ultrasound instead of a CT. In addition, ultrasound exams are very "operator-dependent", which means that there's a good bit of skill involved, and more variability from one exam to the next than we would see with a CT scan.

The only argument that I could see to favor an ultrasound was if there is hesitation to give radiation from CT scans if it appears that she's likely to need follow-up for a very long time because it's a very indolent cancer.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education