Use of high-tech imaging scans in older cancer patients has climbed substantially in recent years, a study found, raising concerns about costs and radiation exposure.
Use of costly scans climbing in cancer patients
Seeded on Tue Apr 27, 2010 4:08 PM EDT (msnbc.com)


Radiation is not your friend, no matter how it's used. To quote: It could cause cancer many years later.
In a person diagnosed with cancer, the risk of radiation-induced cancer is minuscule compared to the risk of dying of cancer that is already present. One should put things into perspective before writing such article.
While being hospitalized for Guillain Barre in 2006, I had a series of CT Scans ordered by my PCP "just to be sure". Sure of what? I still have no clue what those were about because they had nothing to do with my condition. I suspect I helped pay for the machinery. I was half "out of it" the entire time, but during the final scan I read the warnings on the machine and wondered what damage it would do. Who knows? Not I.
I was receiving a CT scan every 3 to 4 months for a year and a half due to lung cancer. Had one PET scan. I also underwent 12 weeks of radiation treatment as well. I'm just glad to be alive and people say I have a "Glowing Personality". I am disabled due to pain from sever nerve damage from the lung surgery. I hope I am ok due to the amount of radiation I have gotten.
The cost of scans should diminish with increased use. The fixed capital cost of a scanner requires recurring system maintenance and operational costs only. I postulate that patients are being over billed and bet it can be easily proven.
First off, the modality is better explained - and commonly known - as a Positron Emission Tomography / Computerized Tomography scan, or PET/CT for short. The medical imaging equipment provides an ingenious double scan whereby a high technology "underlay" X-Ray scan is made, over which the sensitive and specialized Fluorodeoxyglucose (FDG) - cancer avid liquid - is injected in the bloodstream which superimposes any areas of concern over the X-Ray image. The technique maximizes the efficient diagnosis and staging of cancers and dramatic recurrence assessment and visual monitoring of any radiation or chemotherapy performed.
How any financial cost or external radiation warning can be factored with the saving of human life - someone's mother or father - is difficult to understand. Perhaps one must experience a close, loved one undergoing the debilitating effect of a deadly cancer to better appreciate the argument for use of this meritorious technology.
Thanks for the informative quote. I am 51 and just had a pet scan done to insure that my pancreatic cancer had not spread prior to Whipple Procedure which I am recovering from. Without the results of the PET scan everything else they do now for chemo and radiation would be a gamble. Technology is saving my life, mostly due to early detection and fast response. Yes, it is expensive but I have happily paid for it in my insurance premiums my whole life not ever having had to use my insurance until now.
In researching my cancer I have also found many survivors who were diagnosed and operated on in there 70's and made a full recovery and are still alive 10-15 years later. Is it worth it? I say absolutely!!!
CT and PET scans are a very necessary tool to see if the cancer has spread, how big it is, what areas are involved. The increase in detail between a CT / PET over a regular X-ray is very high. Remember, we are talking about people who already have cancer. The extra radiation is the least of their problems. There is a much bigger problem than the possible overuse of CT and PET scans.
When you find out what kind of cancer the patient has, how big it is and how much it has spread, them the doctor comes up with a treatment plan. We are constantly reading about the new cancer treatments and drugs. The problem is that Medicare and private insurance will not approve the options just because a cancer doctor with years of schooling and continuing education thinks it is best. If it is not the cheapest way available, the patient is out of luck. Medicare and private insurance would rather see the patient suffer and die than spend an extra buck.
The best way to get the cancer care you need is to lose your job and go on Medicaid. Their standards are much more patient friendly than Medicare or private insurance. We should have held out for the single payer option, with the single payer being Medicaid.
I would love to hear from all the cancer patients who could not get the treatment their doctor recommended. That would actually be something worth the new media writing about.
By the way, one last thought. Quit smoking. Quit drinking milk. Quit eating chicken and beef thats has been treated with human growth hormone. It much better not to get cancer than to try to fight it. With help from Medicare and the private insurance companies, you will lose the fight.
My mom was diag. with Stage IV uterine cancer last Feb. 4 mos. into "Treatment' she was gone. In 6 mos. (from Jan - June ) she had the following: Ultrasound, biopsy, pet scan and a total of 3 cat scans. The uterine and ovarian cancer boards that I go to are full of women that are routinely having cats or pet/cat combos every 2-3 mos. In my mother's case it was too little too late and honestly I think her gyn/onc was so overbooked and stretched thin half the time he seemed confused and didn't really know what he was reading from her charts. Would I feel differently if she had lived? Probably. I don't know. I was just talking to my sister about this. She just a had a physical, the first one in about 20 yrs... LOL. First thing he did was send her for a cat scan. Just being thorough? Or looking to line his pockets with gold? This same dr. told her she needed to go on BP meds. She had no history of high BP. The day she had her appt. the nurse took her BP and said it was fine. He came in and took it again and said it was high... when she questioned him, he said,"if you change your mind call me." then he upped and walked out in a huff.
I am sorry for your loss. Hopefully one day there will be a cure for all types of cancer.
To diagnose high BP, usually more than one high BP is noted on more than one visit. Also, it is not unusual for a nurse to not get worked up over a blood pressure of 150/90(for example). That is not an immediately dangerous BP, however it is elevated. I would advise your sister to keep a diary of BP measurements at home. I suspect her doc walked out in a huff to have a word with the nurse!
In regards to the CT scan, I know you are probably close to your sister but in reality people don't tell you what is really going on with them. She may have voiced concern over something. Also, the doc may not be trying to line his pockets with gold. "Just in case" means "just in case you want to sue me." In other words, defensive medicine.
Thank you for your condolences. Yes that's true about my sister. Ever since my mom passed, we've all had Cancer on the brain so to speak. So I kind of understand him ordering the cat scan though I would have thought for my sister's symptoms (She was complaining of IBS type things) he would have just did a lower GI/colonoscopy and not a cat. I suppose fear of being sued is does motivate alot of doctors to order more tests than necessary, erring on the side of caution. Although, It is not easy to sue. People think it is. A friend went to a lawyer after her father passed from cancer. You basically need a smoking gun and not only that you have to prove that it caused a loss/dmages I.e. worse prognosis, fewer treatment options. The laws are def. written to protect medical personnel.
The study was done on elderly cancer patients to see how far/wide the cancer had spread. A CT is a diagnostic test that will not line your PCP pockets with gold--they will not be paid for the test at all, since all they do is order it. It will give your doctor information about how to procede with treatment. Would you rather drive your car with no lights at night or use your headlights? A CT can let your doctor know if the treatment is working, if something else should be tried, or if you should start planning your last days.
-The article mentions an increased exposure to radiation, but stops short saying the people in the study actually developed a second cancer because of the exposure. Sounds to me like they are more worried about the cost. Do we really want insur. co. deciding how many scans are person with cancer gets? What if the patient wants everything done, regardless of the odds? Who makes these decisions?
-People have to learn they can't have it both ways. You can't come in demanding a MRI and Neurosurgery consult for every headache or antibiotics for every sniffle...and then talk about the doctor when the doctor says no. Of course the greedy doctors who have to pay for their scanners, give their buddies business, and work for Big Pharma kickbacks would never say no...Whether a doctor say yes or no, they are criticized.
-Most nonemergent imaging like CT/MRI/PET scans require precertification. The insur. co. has to approve it, so the doc cannot make up some hogwash excuse to get one.
The new death panels will no doubt cause the number of tests and the overall cost to drop.
I am glad that they did a CT scan on me...it found the cancer.. If it was not for a bad gallbladder I would not of found the cancer in my right lung. If we have the technology we should use it. It also should be accessible to all. All things have a risk. Lung cancer kills a lot of people this is a fact. CT scans not so many if any at all.
How can you put $$ value on a human life, no matter the age of that person. My husband was diagnosed with lung cancer after a car accident and chest x-ray. He had a CAT scan and PET scan, then surgery. So far after almost two years he is cancer free. When he has a follow-up visit with the hemotologist, he only gets a chest x-ray, but I'm sure if the radiologist saw something questionable, our hemotologist would order more tests. We feel very fortunate that all his doctors were very thorough. I do believe that the lung cancer would have got him long before the exposure to radiation.
It will probably come as no surprise that some of the providers of these expensive radiology services are funding the practices of cancer specialists in return for referrals. This has been illegal for a number of years, because of past abuses, but the rules were not enforced during the Bush years (surprise, surprise).
It will probably come as no surprise that some of the providers of these expensive radiology services are funding the practices of cancer specialists in return for referrals. This has been illegal for a number of years, because of past abuses, but the rules were not enforced during the Bush years (surprise, surprise).
I have had five PET scans ,total body radiation and am on my second set of chemotherapy treatments. I am a senior and unless they give me a PET scan they cannot tell where in my body the cancer has matasticised to. This is life or death based on the level of treatment I recieve, if Obama has his way I better buy a cemetary plot.
This is the third article that I have seen recently that talks about over use of medical treatment for older people. Being an elderly person myself I take pause to wonder if this isn't coming from the kind of remarks that one of our congress members made about part of being old. Surely not! I am one of the best statisticians in my age group. Did you know that 100% of all sex offenders who are executed never offend again? And, 90% of the ones who are released do. So using those statistics we kill them all or never release any of them. Our congress and the rest of the affluent people don't have to worry about not getting treated equally by a doctor. You younger folks will be old someday. Is lop sided medical treatment what you want?