bone scan v. PET scan

[joycelyn]

I am new to this site, so I appologize if I ask a question that has been
asked already. I have looked all over the internet.
My mother had breast cancer about 5 years ago. Stage 3. Since, she has
been
doing great, but lately has been sick often. She has been in the
hospital
with pneumonia twice in the last 6 months and has back and leg pain
continually. She had a bone scan that showed "moderate concern" for
cancer
in ribs on the same side as the breast cancer. She hadn't been going
back
to
her oncologist due to insurance problems, but she went back and we were
told
to have a PET scan. Her PET scan didn't show anything. I know that you
are
not supposed to eat for so long or have any alcohol for so long before
the
test. I am not sure if she understood the significance of this. Would
that
have affected the outcome? I am excited that the PET was negative, but
at
the same time, I am very worried. Her oncologist basically sent her on
her way due to the negative PET scan, but she is still not well and I am
afraid something may still be wrong. Is a bone scan that unreliable? I
appreciate any comments and thank you
for your help.
Joy

[DrDach]

On Jun 1, 3:52 pm, "joycelyn" <joycelynstall...@yahoo.com> wrote:
> I am new to this site, so I appologize if I ask a question that has been
> asked already. I have looked all over the internet.
> My mother had breast cancer about 5 years ago. Stage 3. Since, she has
> been doing great, but lately has been sick often. She has been in the
> hospital with pneumonia twice in the last 6 months and has back and leg pain
> continually. She had a bone scan that showed "moderate concern" for
> cancer in ribs on the same side as the breast cancer. She hadn't been going
> back to her oncologist due to insurance problems, but she went back and we were
> told to have a PET scan. Her PET scan didn't show anything. I know that you
> are not supposed to eat for so long or have any alcohol for so long before
> the test. I am not sure if she understood the significance of this. Would
> that have affected the outcome? I am excited that the PET was negative, but
> at the same time, I am very worried. Her oncologist basically sent her on
> her way due to the negative PET scan, but she is still not well and I am
> afraid something may still be wrong. Is a bone scan that unreliable? I
> appreciate any comments and thank you
> for your help.
> Joy

Dear Joy,

PET scan shows the metabolic activity with uptake of radio-labeled
glucose, so if the PET scan is negative, that is a very good sign that
the findings on the radionuclide bone scan are probably not
metabolically active tumor. One way to find out is to Xray a few of
the suspicious areas noted on the bone scan. Bone scans are
notoriously nonspecific, as areas of osteoarthritis or benign
compression fractures will show increased activity which is difficult
to separate from bone involvement by cancer. If the Xrays are not
particularly helpful, then a CAT scan of the area will almost always
resolve the issue.

Regarding prevention of breast cancer, please see my article:

http://jeffreydach.com/2007/05/05/je...achiodine.aspx

regards from jeffrey dach

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md

[Pami]

I agree with this as I had a bone scan and I had increased uptake on the
opposite side of the breast with the cancer. They really scared me as I had
to have a repeat bone scan. I then went for a mammo on that side and took
my films to that radiologist. He ordered chest x-rays and it showed to be
clean. I've never had a Petscan but will get one soon. The radiologist did
suggest repeating the bone scan in 3 months time as it showed uptake there
but not on the chest x-ray. I know we all have to be watched and the
waiting to find out is the worst.
Pami

[Jeffrey Dach]

On Jun 2, 11:02 pm, "Pami" <pdefr...@hvc.rr.com> wrote:
> I agree with this as I had a bone scan and I had increased uptake on the
> opposite side of the breast with the cancer. They really scared me as I had
> to have a repeat bone scan. I then went for a mammo on that side and took
> my films to that radiologist. He ordered chest x-rays and it showed to be
> clean. I've never had a Petscan but will get one soon. The radiologist did
> suggest repeating the bone scan in 3 months time as it showed uptake there
> but not on the chest x-ray. I know we all have to be watched and the
> waiting to find out is the worst.
> Pami

For an example of what a normal bone scan looks like compared to an
abnormal bone scan showing involvement with metastatic cancer, see
this page:

http://www.drdach.com/Bone_Scan_Breast_Cancer.html

jeffrey dach
http://jeffreydach.com/

[Tim Jackson]

joycelyn wrote:
> I am new to this site, so I appologize if I ask a question that has been
> asked already. I have looked all over the internet.
> My mother had breast cancer about 5 years ago. Stage 3. Since, she has
> been
> doing great, but lately has been sick often. She has been in the
> hospital
> with pneumonia twice in the last 6 months and has back and leg pain
> continually. She had a bone scan that showed "moderate concern" for
> cancer
> in ribs on the same side as the breast cancer. She hadn't been going
> back
> to
> her oncologist due to insurance problems, but she went back and we were
> told
> to have a PET scan. Her PET scan didn't show anything. I know that you
> are
> not supposed to eat for so long or have any alcohol for so long before
> the
> test. I am not sure if she understood the significance of this. Would
> that
> have affected the outcome? I am excited that the PET was negative, but
> at
> the same time, I am very worried. Her oncologist basically sent her on
> her way due to the negative PET scan, but she is still not well and I am
> afraid something may still be wrong. Is a bone scan that unreliable? I
> appreciate any comments and thank you
> for your help.
> Joy
>
>
>

Sickness, pneumonia and sciatica doesn't for me jell with "moderate
concern" on a bone scan and a clean PET. I'd guess it's not cancer.

Seem to me if she had bone-mets related sciatica her spine would light
up like a Christmas tree. Negatives on the bone scan are good. False
positives are common as it lights up for any sort of inflammatory
process, but false negatives are relatively rare.

I don't really know about the implications of eating or alcohol on PET,
but I don't really see any mechanism for a false negative there either.
Again PET is notoriously sensitive and prone to false positives.

Doesn't mean there aren't mets there, but it doesn't sound to me like
the symptoms are related to any spread of cancer, so there is no
particular evidence that there is any metastasis at all.

Sounds to me like she should maybe be seeing an orthopod not an
oncologist. Doctors tend not to diagnose mets until everything else has
been ruled out, so the book procedure is to approach her problems as a
new condition. Take it to her GP and get a diagnosis or reference to
specialists as necessary, disregarding the history of cancer.


Tim Jackson

[Louanne M]

My sister had a petscan several year ago, she lit up like you said like
a Xmas tree. Her oncologist, told her that her nodes behind her heart
were enlarged and that meant some kind of cancer, probably Hodgkins.
She had a biospy done by a well know heart surgeon, he came out of
surgery and told her she did not have any cancer. He, the surgeon and
the cancer dr almost got into it. He told the surgeion then you did not
do it right, or did not take enough samples. The heart dr said he took
multi samples. NO CANCER. Dr want her to repeat a biospy, which she
refused. She said was worse than her open heart surgery. Like I said
that was several years ago and she is still her. So Pet scans can be
WRONG.

[Mary Fisher]

"Louanne M" <[email protected]> wrote in message
news:26136-467[email protected]..
> My sister had a petscan several year ago, she lit up like you said like
> a Xmas tree. Her oncologist, told her that her nodes behind her heart
> were enlarged and that meant some kind of cancer, probably Hodgkins.
> She had a biospy done by a well know heart surgeon, he came out of
> surgery and told her she did not have any cancer. He, the surgeon and
> the cancer dr almost got into it. He told the surgeion then you did not
> do it right, or did not take enough samples. The heart dr said he took
> multi samples. NO CANCER. Dr want her to repeat a biospy, which she
> refused. She said was worse than her open heart surgery. Like I said
> that was several years ago and she is still her. So Pet scans can be
> WRONG.

they can be right too.
>