Should I agree to yet another CT scan? Worried about radiation risk

[northernlights0710]

Hi,

I have been investigated for lung cancer twice in 13 years because of lung lesions. I'm asthmatic.

Each CT scan delivers a big dose of radiation and increases your risk of cancer.

In total I've had at least 4 CT scans, 1 PET scan and 3 further CT scans to guide biopsies. (The scans under biopsy have less risk).

Should I agree to my doctor's wish to do another CT scan? No cancer was ever found but I was diagnosed with a rare lung disease which has cleared up after two years of treatment. This was diagnosed through a sputum test, not my last CT scan in late 2016.

I asked why a new scan was necessary and he said "just to have a look at the state of your lungs so we know what's going on". He also warned me that the radiation exposure increases my risk of cancer, especially breast cancer as the breast tissue is particularly sensitive. He said I was "young" (52!?), with "decades of life ahead of me". All of which I needed to take into account.

I feel well and in 2016 the biggest lung nodule had shrunk and calcified, so they are no longer concerned about it. I did however, have new, small nodules.

If there were no heightened risk of cancer, I would have this scan without hesitation, or if lung cancer was suspected.

So far I've told him No, but will consider it some more.

What would you do? I'd be hugely grateful for your advice and thank you for reading.

Can you ask how aggressive the cancer they would be looking for in your lungs is, and what additional risk of cancer the scan adds to your overall risk of breast cancer and how aggressive would that be? Also, would a CT I change management of your lung condition? What need to know is: 1. if you don't have the scan, how does that change treatment? 2. Which is worse: to have lung cancer they don't find quickly, or to get breast cancer that you only got because of a CT?

Hi Lougle and thanks for your response.

It's a good question about which is the least dangerous option: lung cancer or breast cancer.

Sorry to drip feed but didn't want to overwhelm people: I am no longer being investigated for lung cancer - I was discharged 2 years ago by the lung cancer consultant after two biopsies failed to detect malignancy.

He suspected that my lung lesions might be a TB-type of disease and referred me to my current doctor, a TB specialist. Dr No2 diagnosed non-TB mycobacterium disease. That's what I've been treated for and which they now say has gone.

A new CT scan would show Dr No2 the state of my lungs upon conclusion of treatment but might also highlight a more sinister problem that could prompt a fresh referral back to the lung cancer unit. Which I am terrified of. It is so bloody scary, and disruptive - I suffered a punctured lung after both biopsies. Not fun.

When cancer was suspected, Dr No1 wanted to remove half my lung and strongly advised me to go ahead with surgery as soon as possible. I asked for the second biopsy as I wanted to be sure before having drastic, life-altering surgery. When the second biopsy showed no malignancy (as did the first) they finally said they were sure I didn't have cancer and discharged me.

Lung cancer is one of the worst types to get and the vast majority of those diagnosed are dead within a year or two. The best chance of survival is if it's caught at stage 1 - but I know of someone who had a lobectomy with stage 1 lung cancer and still died because it came back. So there are no guarantees even if it's caught early.

I think there's a better chance of surviving breast cancer but I'm no expert. All I know is that lung cancer is one of the worst.

Two years on, and almost a year since I had breathing difficulties and pain for 2 months after a chest infection, I feel fine - I've had no breathing problems, coughing or pain since. My asthma is well controlled and I can go jogging and do fitness classes without a problem.

This is why I'm reluctant to have another CT scan. That and the fear of lung cancer investigations - which as it turned out were all for nothing. Had I taken Dr No 1's advice (and he is a leading and highly respected Dr nationally for lung cancer), I'd be without my upper right lobe now.

But I digress. In answer to your question - I'd guess that breast cancer was the lesser of two evils but I'm no expert, of course. I'm due a mammogram soon too, which would hopefully identify a problem.

Thanks so much for your question though - which I'll put to my TB consultant.

Mammograms carry radiations risk too and do not meet the Wilson criteria for screening programmes

Overall, CT scans are relatively low risk, and I'd be surprised if the doctor would have suggested a CT if it wouldn't be for your benefit.

I’ve had five CTs in the last 12 months. The last one was a week ago and the Reg wanted to hold off due to my age (42) but the Consultant did it. I’ve had at least ten in total over the last 6 years. For me I’ve given up thinking about any risks from radiation. Frequent CTs are likely to continue for me as for now they seem to scan me every time I get a bowel obstruction. So not much I can do about it.