CT Scans
Posted 8/5/2010
Posted in
CT scans, X-rays, MRIs, bone scans and PET scans are frequently part of our lives. When you are first diagnosed, depending on the specifics of your breast tumor, your doctors may suggest some scans as part of your initial work-up or staging. Later, especially if you are enrolled in a clinical trial or if you have advanced breast cancer, scans will likely be ordered every few months Most women find the scan itself quite manageable and have more trouble with the anxiety around possible results. My best suggestion about that is to talk with your doctor, BEFORE THE TESTS, to establish how you will receive the news. Do you plan to wait until your next scheduled appointment? Will your doctor call with the results, and, if so, when is that likely to be? What you don't want is to have the test and be left not knowing when or how you will hear. That is guaranteed to leave to stress and very jumpy nerves every time the phone rings.
Here is a nice explanation from ASCO's Cancer Net about CT scans:
Computed Tomography (CT) Scan—What to Expect
Last Updated: June 28, 2010
Listen to the Cancer.Net Podcast: CT Scan - What to Expect, adapted from this feature.
A computed tomography (CT) scan, also called a CAT scan, is a diagnostic examination used to detect cancer and find out the cancer's stage (a way of describing a cancer, such as where it is located, whether or where it has spread, and whether it is affecting the functions of other organs in the body). Staging helps the doctor decide what kind of treatment is best and predict a patient's prognosis (chance of recovery). CT
scans can also be used to guide some types of biopsies (the removal of a small amount of tissue for examination to determine whether cancer is present) or to evaluate the effectiveness of cancer treatments, such as chemotherapy or radiation therapy. Common areas that may be scanned include the head, neck, chest, abdomen, pelvis, or limbs.
A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient's vein to provide better detail in the images. One risk of this test is radiation exposure. Usually, the potential benefit outweighs
the risk; however, if you are receiving multiple CT scans and x-rays, talk with your doctor about whether another type of test that involves less exposure to radiation can be done.
In some cases, your doctor may recommend an integrated PET-CT scan. This combines the images from a positron emission tomography (PET) scan and a CT scan, performed at the same time on the same machine. Together, the two scans create a more complete image than either test can offer alone..
The medical team
A CT scan is performed at the radiology department of a hospital or at an outpatient imaging center. It is performed by a radiologist (a doctor who performs and interprets imaging tests to identify problems in the body) or radiologic technologist (a health care professional who is specially trained and certified to operate a CT scanner).
Preparing for the procedure
When you schedule the examination, you will get detailed instructions on how to prepare.
Tell your doctor or nurse about all medications you are taking and ask whether you should take them on the day of the test. In addition, discuss any drug allergies you have, especially any allergic reactions to iodine that you may have experienced. In addition, be sure to mention any other medical conditions you have.
Women should tell their doctors if they are breast-feeding or if there is any chance that they are pregnant because a CT scan could put the baby at risk.
You may be told to drink only clear liquids starting at midnight the night before your examination and instructed to not eat or drink anything for at least four hours prior to your scan. However, for scans of some parts of the body, there will not be restrictions on eating prior to the examination.
Ask whether you can bring your own music; some facilities allow patients to listen to music during their examinations.
You will be asked to sign a consent form that states you understand the benefits and risks of the CT scan and agree to undergo the test. Talk with your doctor about any concerns you have about the CT scan.
During the procedure
When you arrive for your CT scan, you may need to change into a hospital gown or remove clothing or jewelry that could interfere with the scan. This includes belts, earrings, shirts with snaps or zippers, bras, and glasses.
Depending on which part of your body is targeted, you may receive a contrast agent (a special dye). It may be given orally (as a drink) or through an intravenous (IV) injection. The dye travels through your bloodstream and helps to create a clearer picture of specific parts of your body.
If you are given an injection, you may feel heat or itching at the injection site or have a metallic taste in your mouth; both sensations should disappear after a few minutes. If you experience a more serious reaction, tell the technologist immediately.
The technologist will help position you on an exam table. The table may have straps, pillows, or a special cradle for your head to hold you in place. You will probably lie on your back, although you may be asked to lie on your side or your stomach, depending on which part of your body is being scanned, especially if you are undergoing a biopsy.
During the examination, the technologist who monitors the procedure will be in an adjoining control room, but he or she will be able to observe you through a window or by means of a video camera, and you will be able to communicate through an intercom system.
The CT scanner resembles a large donut. The exam table will slide back and forth through the large hole in the center of the machine as the scanner rotates around you. For the first scans, the table will move rapidly through the scanner, which helps the technologist confirm that your body is properly positioned.
For the remaining scans, the table will move more slowly. CT scans are not painful. However, you will need to lie still for the entire scan, which may become
uncomfortable. Since the scanner is shaped like a donut, you will not be enclosed in the scanner at any time. You can also expect to hear whirring or clicking sounds from the machine; some machines are noisier than others.
You may be asked to hold your breath during part of the scan because the motion created by breathing can blur the images. The exam table may be raised, lowered, or tilted to create the correct angle for the x-rays; ask the technologist performing the scan to tell you when the table will move.
The examination will generally last up to an hour, although the scanning itself takes only 10 to 15 minutes or less. Newer scanners, including spiral or helical CT scanners, are even faster. If a larger part of your body is being scanned, the procedure may last longer. The technologist should be able to give you a time estimate before you begin.
When the scan is finished, you may be asked to remain on the exam table while a radiologist reviews the images to determine whether additional images are needed.
After the procedure
You can expect to resume your normal activities immediately after your CT scan, including driving. If you received a contrast agent for the scan, you may be told to drink a lot of water to flush it out of your body.
Questions to ask your doctor
Before having a CT scan, consider asking your doctor the following questions:
What will happen during the CT scan?
Who will perform the CT scan?
How long will the procedure take?
Will there be any discomfort?
What are the risks and benefits of having a CT scan?
Do I need to bring any of my other radiologic images—such as an earlier magnetic resonance
imaging (MRI) test—to my appointment?
Is the imaging facility accredited to perform CT scans?
Will I be given a contrast agent before the scan? If so, how will this be given to me?
May I eat or drink anything prior to the exam?
Does the facility have an emergency response plan in case I have an allergic reaction to the contrast
material used for the scan?
Will I need to avoid any activities after the CT scan?
When will I learn the results?
How will the results be communicated to me?
Will I need any additional tests?
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