Imaging and Cancer Podcast 61

Dr. Stegall speaks to the many different imaging modalities for cancer, like mammograms, PET scans, and MRIs, and many of the concerns surrounding each of them

61 Imaging and Cancer.mp3: Audio automatically transcribed by Sonix

61 Imaging and Cancer.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Speaker1:
Hi and welcome to the Cancer Secrets podcast. I am your host and guide, Dr. Jonathan Stegall. Cancer is like a thief who has come to steal, kill and destroy. I have personally seen it wreak havoc on patients, friends and even my own family. But I am on a mission to change the cancer paradigm. Who? The practice of integrative oncology cancer treatment that integrates the best of conventional medicine with the best of alternative therapies backed by science and personalized to each patient. You need a positive voice you can trust. This podcast will share valuable information to give you practical hope for a better outcome. So I invite you to join me on this journey as we seek to change the cancer paradigm together. Hello and welcome back to the Cancer Secrets podcast. I’m your host, Doctor Jonathan Seagal. This is season four and episode number 61. In today’s episode, we will be discussing imaging, PET scans, MRIs, CT scans, X-rays, mammograms, ultrasounds and thermography, plus a lot of the concerns surrounding each of those modalities. As always, I encourage you to listen with a family member or friend. Today’s episode is going to be a great one. So our first question is, why do we need imaging when it comes to cancer? Well, as the saying goes, a picture is worth a thousand words. If you’re a cancer patient, think back to when you were diagnosed. You likely had a biopsy to diagnose your cancer, but imaging was probably a component of that diagnosis as well.

Speaker1:
Whether cancer was first discovered on imaging obtained for another reason, or imaging was performed after your diagnosis to measure the extent of your cancer. Imaging provided valuable information about your cancer that would not have been available otherwise. So let’s discuss each imaging modality now. We’ll start with mammograms. Mammograms use X-rays to produce an image of the breasts. They are considered the standard of care for breast screening. Advantages include their low cost, wide availability and their ability to accurately detect both cancerous and non cancerous lesions. Mammograms aren’t perfect, however, they do contain some radiation exposure. However, the amount is low. There is the possibility for false positive results, meaning that a finding concerning for cancer turns out after additional testing, not to be cancer. And finally, mammograms are uncomfortable for patients due to compression of the breasts. Now let’s discuss x rays. X rays were the first form of imaging developed. They create a simple image by passing x ray beams through an area of the body. They’re especially helpful in imaging the bones and the lungs. Advantages of x rays include being fast, inexpensive and using a low level of radiation compared to some other forms of imaging. In terms of disadvantages, x rays are limited in the amount of areas of the body they can image. When it comes to cancer, x rays aren’t very helpful except in possibly detecting a lung cancer or bone cancer that we did not know was there. Ultrasounds use sound waves to image an area of the body, especially areas closer to the skin, such as the breasts and liver.

Speaker1:
Advantages of ultrasounds are that they’re inexpensive and they don’t use any radiation. A disadvantage with ultrasounds are that they are operator dependent, meaning that the quality of the images is based upon the individual who is performing the ultrasound. Another disadvantage of ultrasounds is that they don’t allow for a wide variety of areas of the body to be visualized effectively. Now an important note here is that ultrasounds are not designed for full body imaging. There are doctors in clinics out there who use full body ultrasounds for the purposes of detecting cancer and monitoring cancer treatment. This is a ridiculous notion because ultrasounds are not able to effectively image deeper areas inside the body. Don’t fall for the promise of non-toxic or radiation free imaging using full body ultrasounds to measure your cancer. It’s bogus, the doctors doing this and charging people money for it. No, it’s bogus. And you should too. Now, when it comes to appropriate use of ultrasounds, they can sometimes be helpful in confirming the presence of a suspected cancer seen on a screening mammogram. And they can also aid in obtaining a biopsy safely. They can sometimes help identify liver cancer in someone who has abdominal pain. Beyond that, they’re not very helpful in diagnosing cancer metastasis or in monitoring cancer treatment. Magnetic resonance imaging, known as MRI, uses radio waves and a magnetic field to create an image. Mris are good for evaluating the brain, muscles, tendons and even nerves.

Speaker1:
Advantages include no radiation being used, and also they provide detailed images. There are a few disadvantages, though. Mris are more expensive, so costs can be a concern. In addition, MRIs take longer to obtain than other forms of imaging, meaning that the patient is lying in an MRI tube for longer periods of time. There can be claustrophobic concerns for some patients. And finally, MRIs don’t allow for much of the body to be measured at the same time. For example, you can do an MRI of the breasts, but if you also need to image the rest of the chest as well as the abdomen and pelvis, you can’t really do that with an MRI, at least not at the same setting. Computed tomography known in medical circles as a CT scan and informally known as a CAT scan, uses multiple x ray beams to form an image. Ct scans can evaluate organs, bones and the brain. Ct scans allow for a wide area of the body to be imaged at once, such as the entire chest, abdomen and pelvis. However, a disadvantage of CT scans is that they have a greater radiation exposure. Positron emission tomography, known as a PET scan, evaluates the body from a metabolic and a physiologic perspective. A PET scan is considered the gold standard for imaging cancer in the body. In terms of advantages, PET scans measure metabolic uptake, meaning that they can detect the degree of cancer activity within areas of the body.

Speaker1:
They also use much less radiation than a CT scan. However, it’s important to note that PET scans are almost always accompanied by a CT scan, which we refer to as a pet CT. Thus, a pet CT scan will have more radiation exposure compared to a standalone CT scan. In terms of other disadvantages. Pet scans are expensive. This can be problematic when it comes to insurance reimbursement, as many insurance plans will require a CT scan to be performed prior to a PET CT scan being approved. Now’s a good time to discuss thermography as well. Thermography uses thermal energy, in other words, heat patterns to detect areas of inflammation as opposed to the aforementioned imaging modalities. Thermography is not part of the standard of care for any indication. It is not FDA approved as a screening tool or as a diagnostic tool. Thermography has become a popular alternative to mammograms, though, due to the fact that it doesn’t involve any radiation or compression of the breasts. Thermography certainly is not perfect, though it has difficulty detecting deeper tumors and also has a high false positivity rate because it simply shows areas of inflammation. It can’t easily distinguish between cancer and non cancerous findings. In those instances, additional testing such as mammograms or ultrasounds is typically needed. I do not feel that thermography should be used instead of mammograms. If you want to effectively screen for the presence of cancer or monitor for a cancer recurrence after breast cancer treatment, mammogram is far superior. However, I do feel that thermography can be a helpful imaging modality in addition to mammography in some cases.

Speaker1:
This is especially true in those patients who have extremely sensitive breasts or who have a history of inconclusive results on mammograms. I’ve seen cases where thermography detected lesions that turned out to be cancerous when mammograms did not. But I’ve also seen thermal Grahams fail to detect lesions that turned out to be cancerous when mammograms did. Again, thermography should always be used in addition to something like mammograms and not instead of mammograms. Now, another question you may be asking is, well, if thermography can be used for the breasts, can it be used for other parts of the body? And the answer is yes. But as is the case with breast imaging, the concern with thermography is that it really doesn’t image very deep in the body. So if you’re dealing with something that’s fairly close to the skin and would therefore reflect inflammation onto the skin that thermography can detect, it could be a helpful imaging modality, but again, not instead of standard of care imaging. A common concern I hear regarding imaging is the concern over radiation exposure. I’ve had patients who refuse to have any imaging if it includes radiation. The most common justification given for this is that radiation can cause cancer. While that is true, the risk of imaging radiation causing cancer down the road is estimated to be extremely small, if it even exists at all. If you have cancer or if you think you have cancer.

Speaker1:
A much greater concern is that your existing cancer is properly located and monitored. Refusing appropriate imaging studies and thus failing to adequately assess cancer currently in the body has a significantly greater chance of harming you than a hypothetical cancer developed years later due to radiation exposure. Another concern you might have is the contrast agent used. Many imaging modalities will require the use of contrast, typically given intravenously, but sometimes given orally to provide the best pictures. The type of contrast varies depending on whether it’s an MRI, a CT scan, an x ray or a pet CT scan. But in any case, this is typically only a concern if you have any kidney issues, decreased kidney function can certainly complicate matters in some instances. So please remind your doctor if you have impaired kidney function. There is also some concern about contrast agents not being flushed from the body and instead lodging in various areas such as the brain. You might have heard some practitioners express concern over toxicity, which can result from contrast agents. I’m not convinced this is a significant issue, but if you’ve had a lot of contrast based scans in your life, a well orchestrated detoxification regimen done periodically would not be a bad idea. But still, I don’t feel that this should prevent you from having the imaging you need to best evaluate for cancer. As with all choices, we must weigh the pros and cons. The information we obtain from proper imaging is well worth the tradeoff.

Speaker1:
If your doctor recommends an imaging test, I recommend that you follow his or her advice and get it. With that said, there is some evidence that antioxidant supplementation taken a day or two before the day of and a day or two after an imaging test involving radiation or contrast can help protect against damage. This is not been well studied, but it makes sense to me to consider this strategy. We know that Vitamin E, vitamin C, Coenzyme Q10, spirulina ginkgo biloba and curcumin are all strong antioxidants, and they all seem to be safe when taken and typically recommended amounts. I don’t believe you need all of these supplements, and there’s nothing wrong with deciding not to take any supplements around the time of an imaging study. But if you’re concerned about ionising radiation and its potential effects on your body, this strategy could possibly mitigate some of the potential damage. I hope you found this episode helpful. If you’re enjoying these podcasts, please take a minute and provide a review on iTunes, Spotify or wherever you listen to podcasts. As a reminder, please subscribe to the Cancer Secrets podcast to be notified when new episodes are released. We have some great shows planned and I can’t wait to share them with you. As always, please share this podcast with your family and friends. All previous episodes are available for free on our website at Cancer Secrets dot com. I look forward to many great episodes coming your way soon. Until next time.

Speaker2:
Bye bye. I. Oh.

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