Doctor wants to give me a CT of Neck but already have cancer, afraid of radiation risk?

Question

Hi, I have thryoid cancer. I had a first surgeon who did an ultrasound of neck to look for suspiscous nodes for spread of thryoid to lymph nodes, then he was going to do surgery. But I got the flu, so I was rescheduled with a new surgeon. Now, he wants to do a CT Scan of neck to be extra sure of spread. I don't want it because I already have cancer and do not want anymore radiation than I have to have. I asked him for a MRI instead, but he said no. I know that MRI can be used to look for spread. I am so upset. Should I get the CT scan of neck and surgery or find another surgeon?????

Answer 1

I understand your reluctance to have a CT scan of your neck. But, I will tell you that patients with lung cancer have routine chest CT scans to check for growth/reoccurance. Patients with colon cancer undergo abdominal CT scans for the same reasons. The dose used in modern CT scanners are fairly low. MRI can visualize the neck, but there are problems with that. First off, motion from swallowing during long scan times can cause the images to be blurry and the cost is much more than a CT scan.

As for the actual dose of the CT scan, I have a great site which has Q&A from qualified medical personel. I could not find an example of a neck CT scan, but the brain CT is comparable. The dose for a Abdomen or Pelvis is higher than a neck. Here is what they said:

"Head CT: Effective dose 180 mrem (1.8 mSv), bone marrow dose 270 mrem (2.7 mSv), thyroid dose 190 mrem (1.9 mSv)


Abdominal CT: Effective dose 760 mrem (7.6 mSv), bone marrow dose 560 mrem (5.6 mSv), uterus dose 800 mrem (8 mSv), ovaries dose 800 mrem (8 mSv)


Pelvic CT: Effective dose 710 mrem (7.1 mSv), bone marrow dose 560 mrem (5.6 mSv), uterus dose 2600 mrem (26 mSv), ovaries dose 2300 mrem (23 mSv)


For comparison, most of us receive around 300 mrem (3 mSv) of radiation (effective dose) each year from natural radiation in the environment. Radiation workers are permitted to receive 5,000 mrem (50 mSv) (effective dose) each year; medical and environmental exposures are specifically exempted from this total.

Michael G. Stabin, PhD, CHP"

Hope that puts it into perspective.....

Answer 2

I've been an xray tech for 33 years and now do both Ct and MRI. Whenever that question comes up your decision needs to be based on the advantage vs the risk. If the CT scan determines that there is additional disease that needs to be treated then then the amount of radiation is a minor issue. Not treating the disease can be far worse than the radiation from the scan. We are all radiated in a minor way every day from the sun especially when flying in a plane. Radiation is also a means to curing cancer when given in a controlled environment such as Radiation Therapy. Although I can't answer the question for you pose these scenarios to your physician and seek his advice.

Answer 3

I think you need to find a surgeon that you can trust to do his job. I don't know about you but I am not a trained medical professional. What I did was find a medical oncologist for my son that we trusted, that we could talk to, that we knew always had the best interests of her patient in mind. I value her opinion and it carries great weight in our decision making for our sons health. If you do not trust this surgeon than you are missing an important element. I read once that you should find the best possible oncologist or surgeon whose skill you trust and than turn your care over to them. They will work for you to find the best possible treatment to insure your survival. If you have doubts about that, than you have the wrong physician. Seek out a second opinion immediately and find someone you trust. But be prepared for that surgeon to say the same thing . . the difference is he may be able to persuade you in the reason why he wants a CT instead of an MRI.

Good luck.

Incidentally, a CT is very good at picking up tumors in soft tissue. My son has had many CT. Usually they do a baseline CT that will be used to compare with all future CT in order to measure the progession of disease (or the shrinkage of tumors). Our pediatric oncologist also uses a PET scan in combination with the CT.

Answer 4

Listen to your doctor, but look into this. They had a research paper out a few years ago saying that the best cancer fighter was Interferon, at $15,000 a gram. What the paper also said was that Interferon was a product of the natural breakdown of Vitimin C in your system. A few months later the FDA tried to make Vitimin C a perscription drug. Guess why??? The FDA says that the RDA for Vit C is 65 mg a day. That is enought to stave off scruvy. Linus Pauling, who got a Nobel Prive for his discovery and work with Vit C said 1000 mg a day normally and 2000mg a day if you get sick. He played tennis up until the day he died at 96. It makes sense. I took large doses of Vit C when I was sick, a week flat on my back twice a year and after 20 years the doctors had no idea what my problem was. Vit C increased daily over a week and following a bell curve over the 2 weeks, 40,000 mg a day at the peak and 300,000mg over 2 weeks, and I was completely asymptomatic. Doing that for 2 years and I have not been sick in 10 years now. You might look into it.

Answer 5

MRI and CT show quite different things. Some things (eg soft tissue changes) are clearer on MRI scans, but other things (bone etc) are clearer on CT scans. I think it is important to check for spread of the cancer - your surgeon wouldn't suggest a CT scan unless he thought it was necessary. The risk of cancer from the radiartion from a CT scan is minimal, and the long term effects of MRI are, as yet unknown. Good luck.

Answer 6

OK: Wonderful helpful answers. I had cancer (no chemo by choice) and 10 days of radiation to reduce pain. I did NOT worry about the added radiation for extra xrays, mrci's CT Scans, as this is nothing compared to actual radiation treatments. It also lets you know where you are as far as your disease is. The one suggestion in the answers below is important. Get yourself an advocate (Someone you trust to help you through this that interceeds, with your medical professionals.) You are angry on many levels. Your mad you have cancer (been there) but it is vital you love your doctor and their opinions. So get a new doc if you don't like your present one. It is your life not theirs. Find someone who will listen to your fears and allay them. I turned to natural medicine as well as limited medical MD help, I was looking at a death sentence but my decision (having advocates etc) saved my life .. So yes it is important you have full confidence in your doctor. God bless you and may you be healed.

Answer 7

You are the only one who has your body. YOU must make your own decision. Reading all the answers, and there are very good ones, BUT, you must be the one to make the final decision.

I was in the situation 25 years ago, I made MY decision, it was not what everyone suggested to me. But I made it, and it was
a good one.

good luck to you.

Answer 8

Get the CT.....it'll be just fine!

Answer 9

you wil be fine just do it. radiation helps SHRINK cancer btw