PET scan VS CT scan

[DJ13]

October 2007, I was found to have stage IIIC Serous ovarian cancer, I was 45.  I had a CT scan- it showed nothing.  Yet my oncologist sends me for one every 3 months.  In addition, to checking my CA125 marker.  I have now gained 30 pounds in 9 months.  I have never had a weight problem, I am active-walk several days each week one mile or more.  I juice and eat tons of fiber and vegtables.  Eat little white foods, however, I do eat one portion of sweets daily.  

It seems to me that I have a metabolic imbalance and a PET scan would be more appropriate that a CT scan to detect active disease.  I understand there is scientific data that supports that PET scans are more sensitive than either the CA125 and CT scan and can detect disease before either of the other tests.  Therefore, how do I get my health care provider to approve this test for me.

Thanking you in advance for your help my battle.

[jlock]

I had a PET scan because I have a few things that were found on ct scans that are covered for a PET scan.  I had nodules on my lungs and I also had a dx. of colon cancer and each of these problems are on the covered list for a PET scan.  So maybe you can see if something like that could work for you. Of course my nodules on the lungs are gone and the colon cancer was almost 4 years ago,but it doesn't matter. Other than that I agree with asking your onc to fight this to your insurance as well as you should fight for it.  I have heard that most of the time they do agree to cover the test.  Good luck~~Joanne

[JC145]

I've had CT scans almost every 3 or 4 months .. and once it did show a trace of ascites, then the next one, with the help of tamoxifen, the ascites were resolved.  On 5/22 of this year, I had a PET/CT and the only thing that showed was a small lymph node near my liver.  My CA is rising again, so I am to get another PET/CT next week or so (I haven't made the appointment yet.)  I am told that since there were findings on the last PET/CT that I can have another this soon (for ins. purposes).  Like Tybear, I think I should glow in the dark!  Good luck.  Judy

[CaydensMommy]

I've had multiple CT's done, an MRI, and one PET/CT Scan. My gyn/onc in OH recommended it  (the PET/CT Scan) and my gyn where I live in NC ordered it. My insurance company wouldn't approve the procedure because they said that it was still considered experimental for monitoring OVCA. Believe it or not, my gyn helped me get it done with no charge to me! The scan showed no cancer so it did ease my mind quite a bit, especially about the cyst I had on my ovary at the time. I still ended up having to have surgery, and was still somewhat nervous that I was having a cancer recurrance, but I did feel a whole lot better about it not being cancer after the PET. The PET that I had was done in late 2006-maybe they've made better strides at proving that the PET is effective. The gyn/onc that I had sure thought it was.....
Glenda

[Tybear]

I've never had a PET done, only CT's. I should be glowing by now from all the radiation I've absorbed, but my doc's don't seem to mind. I asked them once why I don't get PET's and he told me that he doesn't think they are any better than a CT. I also mentioned something once to a nurse and she said if my CT showed no disease, then they would do a PET to confirm it. I gather they are more expensive too....I would rather have MRI's then more CT scans. Now that I'm at a new doc I should ask him about this...
Becky

[alanpvegas]

oh, forgot to add, i think your issue is stemming from getting this approved.  Here are some strategies (beyond getting cozy with your PCP to get it pushed through):

1) Appeal.  If they reject your request, most appeals have something like a 70% ruling IN YOUR FAVOR.  Nobody appeals though...and that's what insurance companies hope for.  It's almost like 'rebates'...companies hope you never send it in (or forget) so they come out ahead.

2) I doubt you would ever get this approved routinely for monitoring...but there can possibly be some sort of schedule you can get on.  It's going to require your oncologist to 'make the case' that this is the most reliable for you (based on what you said).

3) You're right, CA-125 is only FDA approved for monitoring treatment, and even then it's up to the oncologist to see if it's a reliable marker for you (not everyone is).  I think I saw a post somewhere on this forum there is some sort of new test (ovasure or something?).  I know nothing about it but maybe someone can reply to see if this is helpful for you.

[alanpvegas]

Yeah, CT is typically used to monitor progress in treatment.  PET is used to detect a recurrance or possible return of cancer (it's used to detect the 'glucose' uptake by cancer tumors that are often too tiny to see when they are first forming with a ct or ultrasound).

It's...of course...expensive, so insurance companies would prefer CT above a PET.  Here is where you get cozy with your PCP (primary care provider) and oncologist to push it through.  Often your PCP is part of the insurance company and can often push through getting a PET if your onc. cannot.

[nyc lady]

PET Scans are not used often for Ovarian Cancer, not really certain why, but, they are not.  My GYN/ONC prefers a transvaginal sono vs a CT Scan to see what is going on, although he does send me for CT Scans too, they just show a larger area than a sono.

I have a friend that is going through her first recurrence, they did a PET Scan and she had two area light up, one her sigmoid colon and the other her liver.  Well when they went in, the area near the colon was not cancer, just the colon balled up.  The spots on her liver did come back positive.  So there you have a PET Scan on the same person is both correct and incorrect.

Unfortunately, there is no real test for OvCa.

Good luck,
Pam

[vegas2cr]

I have stage IV and 3 days before exploratory surgery I had a CT scan that showed nothing except a small inflammation near my apendix.. one of my tumors was over 22 cm and never showed so I think CT scans are a waste of money... at least for me..
I think a PET scan is more appropriate...My oncologist has never ordered another CT for me since...

Weight gain... I had thyroid problems before now no matter what I do I can not gain control of me weight again.. (Never had a weight problem)  I have gained almost 30 pounds since March and the next person who tells me to quit eating so much gets smacked...LOL.. My thyroid is up and down from hypo to hyper on a monthly basis no matter what dosage they give me... so........ maybe yours is thyroid related...

Also for me a transvaginal finds the smallest of tumors accurately... you might want to try that.. Good luck