DP almost certainly has cancer, why a CT scan as well as MRI?

[fish54]

DP was referred for a colonoscopy due to bleeding, he had this 2 weeks ago and they saw what they described as a malignant lesion and biopsies were taken. We were told that after an MRI scan he would be seeing a consultant to confirm the findings and discuss treatment. He had the MRI scan last week and they said the images were satisfactory and to ring the consultant's secretary to let him know that the tests were completed. She said that they would get him an appointment as soon as possible. He still has no appointment but received an appointment for a CT scan next week, which wasn't discussed previously. Can anyone reassure us as to why that is and that is not as we fear because there is something worse going on than we hoped. Thank you.

There will probably be someone more knowledgable than me around, but I do work at a cancer hospital and can tell you that practically everyone there gets a ct. I think it's a fairly standard procedure where there's a possible diagnosis of cancer. If it is cancer it will help them to check what stage it is at. Wishing you all the best x

Im so sorry to hear about the diagnosis. I don't really have any answers for you but just wanted to say that my mum had to have a colonoscopy (which thankfully was something benign) due to bleeding and she had a CT scan too, which had been booked at the time of the initial appointment. So i reckon it could simply be that give everyone who is having those investigations a CT scan as a matter of course, rather than them finding something more concerning.

I would say chase up the appointment with the consultant, you don't want to have to wait any longer for the results than you have to. Once you have a plan in place you will feel better. You know that caught early, bowl cancer is very curable don't you. I know someone who has survived it and is perfectly fit and healthy now. (i know you will hear a lot of annecdotes like that, but it really isn't as bleak as it used to be) I hope you get some answers really soon xxx

Not an expert but IM limited E they like to do lots of scans to see a) if there's evidence of cancer elsewhere
and
b) to help them see more clearly the location ,extent ,shape etc of any suspected cancer .

Apparently they do "tests in parallel ,rather than doing one and waiting for a result before they do the next " .

I recently had a CT scan arranged very quickly and before I was given any biopsy results .
And then I had a phone call the night before the CT scan to tell me that the consultant would see me after the scan to discuss results .

Don't know if that helps .
It's not always the same procedure and some cancers are slower than others and I think maybe this determines how they are treated .

The tamoxifen thread here is helpful and all cancers ,tests etc are discussed on it .

Good luck ,I feel for you .
It is ghastly being in limbo .

I know they are looking for spread and that is what is frightening me, they said the lesion was still polyp shaped and hopefully had not spread beyond the bowel, but when the CT scan appointment arrived we were both fearful that they had already seen something on the first scan or had discovered that the cancer was a particularly aggressive from the biopsies. Thanks for sharing your experiences and yes the being in limbo is the worst thing at the moment, we are finding it very hard, especially as we have both already been bereaved and DP's wife died of cancer. My mum used to nurse cancer patients, but I am finding it hard to talk to people in RL as I get too upset.

By the way I have namechanged for this thread as I know some people on here in RL and haven't felt able to tell them.

Think it is routine so they can assess the extent of what they may need to do before the operation . Try not to panic . ime things can happen very quickly once the results are given but there can be a gap between the earlier appointments.

It must be really tough, at least you'll know soon. I really wouldn't jump to conclusions about it spreading. To do a proper assessment they need to check other areas too- but you could try to think of it as confirming that it hasn't spread. Sorry you and dp are going through this.

MRIs are incredibly detailed but also very expensive! I agree, would think the MRI has been done to look at the source and they will be doing the CT to the broader areas to see if its anywhere else. Sorry to hear he's ill. I hope you get clear answers about whats going on soon and for his treatment to go well.

MRI and CT scans are complementary to each other - in other words they both show slightly different things, so are very often both done. The doctors need to get a lot of information to build up a really full picture of what is going on with your DH, and all this will be looked at by several different people so can take a little time.

Does he have a rectal lesion? If so then the guidance is that patients have an MRI as well as a CT scan. For other colon cancers then it is normally just a CT scan unless they particularly want an MRI.

Good luck.

We were told that there would be a Multi Disciplinary Team case conference before the consultant appointment, we just weren't given a timeline really and to get no appointment and then another scan threw us a bit. It has helped to get an idea of all the reasons that could be behind this, thank you everyone.

Yes it is in the rectum, I didn't realise that would mean different treatment, thanks for that information it is reassuring.

MRI takes 'slices' and can be used to make a 3D image.

CT with contrast is also known as 'virtual colonoscopy'.

So, I think, but my medical physics was a long time ago, the MRI has been used to look at substances / structures whereas the CT will look at the 'spaces'.

CT can also be used, this is difficult to explain but say you had a stack of 2p pieces and you want to look at the 7th from the top a photograph would show them all but a CT can be set to the depth of the 7th, the others are still there but it is as if they are out of focus.

www.schoolphysics.co.uk/age16-19/Medical%20physics/text/CT_scanning/index.html

Hi there,

I'm sorry that you are both going through this, and that things haven't been explained to you very well.

I deal with this every day as part of my job and can reassure you that having both scans is both absolutely routine and essential. With bowel cancers (if that is what it is, it's not a given until the biopsies come back), the routine scan is the CT, which looks for disease elsewhere throughout the chest and abdomen. The most common areas to which bowel cancer spreads are the lungs and liver, and MRI cannot look at the lungs for a start.

We only use MRI to look at rectal (low colon) abnormalities, and we use it to look at how far or if the growth has spread into the tissues in the local vicinity of the growth, as this determines how advanced the tumour is and the likely initial treatment. The options are straight to surgery if early, or some chemo or radiotherapy if it is encroaching on other structures down there.

So in essence, for bowel cancer, MRI just looks at the growth and its immediate vicinity, and CT also looks at the lungs and liver etc.

As regards the MDT meeting, it's almost better in a way if he's had the CT first, as the team will then be able to discuss the entire set of results, both the biopsy and full imaging (we call it "staging" the cancer), and will be able to make a decision on the spot about whether to proceed straight to surgery or whether other treatment is needed beforehand to try and shrink the growth.

MDT meetings are meant to be held regularly each week on the same day, so it won't be long till he's discussed. Also all suspected cancer patients are on a very tight timeline as regards their diagnosis and treatment, so there will be coordinators at the hospital who will be keen to get your DP through the meeting and treatment as soon as possible.

I hope this helps a bit and makes sense! Feel free to PM me with any questions as this is my daily bread.

Good luck to your DP. Bowel cancer, if that is what this is, can be cured completely if caught early.

Thank you so much everyone, I will show DP this later and I am sure like me he will feel somewhat reassured, it just the waiting and I do think a bit more explanation would have helped!

I had an MRI for scanning soft tissue damage on my knee cartilage. Cts are not used for that.
DH had cancer and he had only CTs and biopsies, but had read the MRI can detect tumours much smaller than a CT, but never had one.

Specialist told us they can stage the cancer from the biopsy analysis. The CT was to scan for where it had spread.

Bowel cancer is usually determined and biopsied by the colonoscopy and gastro endoscopy.

Having both CT and MRI is being very thorough and the best care available for your DH

Good luck.

FlamingGallah what a lovely clear reply .

( and sassh impressive and helpful too )

Having just ( like last 2 weeks ) been going through diagnosis for oesophageal cancer it can feel that you are just a body having tests done to it .

Everyone is so busy and inevitably ( and very impressively in my view ) you are being fitted in at the last minute and often you've not had the explanatory leaflets .

The tests ( inevitably again I suppose ) are carried out by people who seem to be more technicians than they are nurses IYSWIM and they're rushing people through on a conveyor belt .

I'm not complaining ,it must be tough working in the NHS ,especially when nurses are being so publicly ( and in 99% of cases unfairly ) pilloried .

Sending you strength fish ,the waiting will pass and things will become clearer .

MRIs show very good definition in certain soft tissue, CT scanning is better for others especially those in the chest, and of course bones. Your consultant simply wants all the information he can possibly get before considering possible treatment plans with your DH and yourself. This is not unusual or something you should worry about.
Good luck.

Sorry, just seen Flamings post, apologies for repeating.