Study: Imaging follow-up not indicated for common-type cancer

Study: Imaging follow-up not indicated for common-type cancer

by John W. Mitchell, Senior Correspondent | April 06, 2015
CT Rad Oncology X-Ray
A just released study from the Dana-Farber Cancer Institute aims to shed light on a long-running debate concerning the diagnostic value of follow-up imaging versus cost, and radiation exposure, for certain patients in Lymphoma remission.

With hospitals and physicians increasingly required to control costs under the Affordable Care Act, the study compared imaging and non-imaging follow-up exam methods patient cohort groups over a two-year period. There was minimal survival rate benefit found in the imaging follow-up, with associated costs for PET/CT or CT studies averaging about $165,000.

“I tend to agree with the results,” Dr. Peter Emanuel, Director of the Winthrop Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences told DOTmed News. Dr. Emanuel, who did not participate in the study, based his comments on the study results published on the Journal of Clinical Oncology website. “But I don’t know that it is going to change physician practices overnight.”

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Dr. Emanuel explained that, as the study notes, patients experience anxiety while awaiting imaging results. However, he added there is also a segment of the patient populations who find imaging studies reassuring and expect such tests to be performed.

“This is the first study I have seen that really looks at the cost effectiveness of follow-up imaging studies for this type of cancer. It makes the point that those patients who are destined for relapse can also be identified through symptoms and other indicators observed in regular follow-up check ups,” said Dr. Emanuel.

According to Dr. Emanuel, the Large B-Cell Lymphoma in the study is a common form of Lymphoma, which has about 20 variations. It is a moderately fast growing tumor with about a 50 percent survival rate. Dr. Emanuel cautioned that while certainly cost effectiveness is a consideration in any treatment, cancer patients are especially sensitive to such issues.

“Individuals don’t want to be reminded about the costs when they are fighting for their lives,” he said.

Dr. Abel noted in his article about the study that a lower cost modality known as peripheral-blood assessment, which is used to make measurements in other areas of medicine, might offer promise for oncology patient surveillance.

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