Saturday, May 3, 2008

On PET scans and detecting cancer...

A national study appearing in today's Journal of Clinical Oncology (JCO) demonstrated the value of positron emission tomography (PET) scans for treating patients with ovarian, prostate, pancreatic and other types of cancers.

PET scans are commonly used for the diagnosis, staging and restaging of cancers as well as the monitoring of tumour response to treatment for Medicare patients with nine types of cancers covered by the Centers for Medicare and Medicaid Services (CMS): breast, cervical, colorectal, esophageal, head and neck, non-small-cell lung, thyroid, lymphoma and melanoma.

In making the positive PET reimbursement decision for these nine tumour types, CMS used the standard "that all evidence currently available must be adequate to conclude that the item or service is reasonable and necessary." Clinical oncology, however, deals with many more than nine tumour types, and some major human diseases, such as pancreatic, ovarian, and prostate cancers were not included; patients with these tumours and a variety of others were, therefore, potentially being denied the benefits of PET imaging.

By providing images of cancerous changes at the molecular level, PET scans for cancer have given physicians the ability to detect developments that can be undetectable with routine medical imaging and have become a powerful tool in fighting cancer.

The accompanying editorial by Dr Larson put it admirably. He noted that, "One can only hope that this approach by CMS will be expanded to other aspects of diagnostic imaging practice in oncology."

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