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Doctor refusing PET scan
Emark
1 Posts
Hello, wondering if anyone has been refused a pet scan before? The dr says it’s unnecessary and not warranted because her “type of cancer” typically spreads in steps. And the only purpose she has at the moment is to do the 3 month post radiation ct scan to see if the cancer has been destroyed in both her throat and lymph nodes. Diagnosed as stage 4 laryngeal and spread to lymph’s (that they know of... refused a pet scan at the beginning too!!) Should I get a second opinion?? This is at Juravinski in Hamilton. 3 years ago she was diagnosed stage 2 lung and had a lobectomy. You would *think* that warrants some kind of desire to double check her whole body!?? Thanks
4 Replies
ACH2015
2007 Posts

Yes I have been refused PET scans in the past. Went right to the MOH - fought it and won - twice. Doctors need to justify PET scan funding that falls outside of those parameters they decide fit the model. They will also argue that PET scans would not change the path of treatment. PET scans also contain high levels of radiation, so pick your poison carefully. I was diagnosed in 2016 with unknown primary cancer. The first (I've had three to date) was not so difficult to obtain. the second (after recurrence) and third (for a new post recurrence baseline) were more “challenging” shall we say - but I fought and won both. PET scans are not used across the board and the approvals will differ across Canada. One province will do them regularly (Quebec did 4000 in comparison to Ontario that did less than a thousand a few years back) and to some extent we as patients are under the cost microscope. Type in "Stage IV laryngeal cancer and PET scans" and see how many hits you get saying that PET scan is a valuable tool for staging, spread etc… The key you need to determine is if the value of the PET scan exceeds the value of the monitoring and three month time frame you mentioned re the follow up CT scan. Didn't mean to write a book (but I could) here, but lots to consider here. We are all unique with unique needs. You and your loved one need to be comfortable with the current diagnosis / treatment and follow up path. Does not sound like you are - so get that 2nd opinion and or ask the oncologist if they took the case to the hospital tumor board for an in house “2nd opinion”. your right to ask and be confident in moving forward.

Keep well, hope this helps, and please let us know how this works out.

ACH2015

Boby1511
363 Posts
Emark
You can ask for a second opinion, you can ask for another hospital maybe ask for Toronto. They will send you to doctors that deal with the same type of cancer. My scans and treatment discussions were both Hamilton and Toronto sarcoma teams.
I too am waiting on the 3 month post radiation CT scan.


Cynthia Mac
3080 Posts
Emark‍ My answer to your question is “it depends.” Do you know if her laryngeal cancer is metastasis of her lung cancer from 3 years ago, or if it is a separate cancer?

When my dad was diagnosed with lung cancer, he had a PET scan booked before we knew it was a “thing.” Dad had surgery (resection) followed by chemo and 3-month CT scans. A year after his chemo, spots were found on his liver, and his oncologist knew that it was spread of his lung cancer, not a new liver cancer. At that point, I’d done enough research to know that another PET scan would be redundant: his cancer was on the move.

You are well within your rights to seek justification for their decision, and to seek out a second opinion.

JustJan
449 Posts
Emark‍, it is my understanding that PET scans are not a normal scan that is used for most cancers and it does depend on the type of cancer you have and the specific circumstances a person may have.

PET scan machines are scarce and a PET scan is a very expensive test and I know in Ontario there is criteria that must be met in order to get one. If PET scan results won’t alter the course of treatment, then it likely won’t be requested. A CT scan will verify whether the treatment worked on the existing cancer. However, you are certainly entitled to ask for a second opinion.

Hope this helps.
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