Little background: I've been involved in the fire service in various capacities for the last 15 years. Unfortunately we have about a 70% chance of getting cancer compared to around 20% for the general population. More recently we've been losing a lot of people in their 30s-40s.

I'm not symptomatic but I'd like to add some sort of cancer screening to my annual checkup. Unfortunately my next physical isn't until October, and I'd like to find out about some sort of full body screening. I know that skin cancer screenings exist and the MA fire academy actually has them regularly. But as far as everything else, I haven't found anything good. There are full body CT scans available for it but they seem to have mixed reviews.

If I'm going to get it, I'd like to catch it before I'm symptomatic.

Any help is appreciated.

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Unfortunately we have about a 70% chance of getting cancer compared to around 20% for the general population.

What does this mean? What specific cancer(s)? You can't just say you have more chance of getting all cancers compared to the general population. Got to be certain specific cancer that is occupation related? You should screen based on that, and not jump in to scan the whole body. You will likely find things that are totally benign but that will freak you out more than finding cancer by doing shotgun screening like that.

CT Scans seem to be to fairly good for screening but I doubt insurance will pay for them without a doctor order for what they consider a valid reason. Out of pocket it would probably cost about $3500 to do for CT Scan with and without contrast and for radiologist to read. Problem is most cancers are pretty fast growing so a CT Scan would need to be done fairly regularly to be effective and they don't like to do that without good reason because of radiation exposure. I am not a medical professional, just going from me experiences with having several CT scans.

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You will likely find things that are totally benign but that will freak you out more than finding cancer by doing shotgun screening like that.
Q

Yep, there are a bunch on mine including "lesion on pancreas". They just compare them to prior scan and note changes, if any. No changes are best of course I have been advised.

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Originally posted by grumpy1:
CT Scans seem to be to fairly good for screening but I doubt insurance will pay for them without a doctor order for what they consider a valid reason. Out of pocket it would probably cost about $3500 to do for CT Scan with and without contrast and for radiologist to read. Problem is most cancers are pretty fast growing so a CT Scan would need to be done fairly regularly to be effective and they don't like to do that without good reason because of radiation exposure. I am not a medical professional, just going from me experiences with having several CT scans.

Great points. Bottom line is, there are no current medical recommendations for whole body CT as a screening tool for "cancer" detection for asymptomatic individuals. Only a quack doctor would order such a thing.

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Originally posted by 12131:

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Originally posted by grumpy1:
CT Scans seem to be to fairly good for screening but I doubt insurance will pay for them without a doctor order for what they consider a valid reason. Out of pocket it would probably cost about $3500 to do for CT Scan with and without contrast and for radiologist to read. Problem is most cancers are pretty fast growing so a CT Scan would need to be done fairly regularly to be effective and they don't like to do that without good reason because of radiation exposure. I am not a medical professional, just going from me experiences with having several CT scans.

Great points. Bottom line is, there are no current medical recommendations for whole body CT as a screening tool for "cancer" detection for asymptomatic individuals. Only a quack doctor would order such a thing.

Thanks for the expert opinion.

Great points. Bottom line is, there are no current medical recommendations for whole body CT as a screening tool for "cancer" detection for asymptomatic individuals. Only a quack doctor would order such a thing.
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I agree with the above as far as CAT scans are concerned. You are correct that firefighters have an elevated risk of getting cancer due to occupational exposure. The best examples are the firefighters who worked after 911. I would suggest you see a physician who practices occupational medicine, and sees a lot of these folks. It is a medical subspecialty.

Yes, full body cancer screening CT scans would save a lot of lives.

However, even if you are willing to pay for them, one is hard pressed to find a facility who will do them.

During a routine checkup and bloodwork my Doctor found an unusual increase in my white blood cell count and that I had no signs of a virus and bacterial infection. Long story short, the Doc ordered more screenings including a Colonoscopy and that's how my cancer was found. I had no major symptoms other than being tired a lot and a loss of appetite. The point I'm making is that you need to voice your concerns to your Doctor and have him do non-invasive screening fairly often.

Jim

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Originally posted by lbj:
Yes, full body cancer screening CT scans would save a lot of lives.

However, even if you are willing to pay for them, one is hard pressed to find a facility who will do them.

In Dallas the Cooper Clinic does them as a matter of course. I'm unsure how much insurance pays for these exams, I believe it caters more to the wealthy. Dale went there for at least 15 years.
https://cooperaerobics.com/Coo...bout-Prevention.aspx

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Originally posted by ryan81986:
Little background: I've been involved in the fire service in various capacities for the last 15 years. Unfortunately we have about a 70% chance of getting cancer compared to around 20% for the general population. More recently we've been losing a lot of people in their 30s-40s.

I'm not symptomatic but I'd like to add some sort of cancer screening to my annual checkup. Unfortunately my next physical isn't until October, and I'd like to find out about some sort of full body screening. I know that skin cancer screenings exist and the MA fire academy actually has them regularly. But as far as everything else, I haven't found anything good. There are full body CT scans available for it but they seem to have mixed reviews.

If I'm going to get it, I'd like to catch it before I'm symptomatic.

Any help is appreciated.

My wife works in a position that educates against health care fraud. They have seen a huge increase in fraudulent activity around this. Proceed with caution. Perhaps a referral from your health care professional. If someone is reaching out to you it's likely bogus.

Absent some reason (heredity, occupation, prior issues) here are three potential issues for the general non-symptomatic populace:

What does it catch/miss?
If you are specifically worried about (X), make sure this actually can reliably check for (X). (i.e. what is the 'false negative' chance)

If you're of an age, it will find stuff. Guaranteed. Be ready for that.
Most/all of the stuff will turn out to be 'full of sound and fury, signifying nothing' - meaning it will essentially say "subject is no spring chicken" which you knew, going in. So, you need to be mentally ready to see a laundry list of stuff without automatically freaking out. Your next job will be to figure out where to go to have that laundry list put in context and, if necessary, run to ground. Meaning more doctor visits, potentially more tests. You are hoping these findings all prove to be false positives, as most of them will undoubtedly be.

Economics.
You may wonder why HMOs and insurance companies aren't all over these things, and why medical professionals are skeptical. It is about the bang for the buck. Yes, if you test a few million folks you will diagnose some stuff very early, which is a good thing. However, in the course of doing that, as a society we would have borne the costs of a few million scans, and a lot of followups on incidental findings that have no clinical impact.

Medical economics needs to factor in all of that before deciding that would be a good use of funds (vs., say, free vaccines) and that's why most medical pros don't buy into scans of seemingly healthy folks.

If you're otherwise healthy, spending your own money on it and just doing it for peace of mind, if the cost seems OK to you, go for it. It is an uphill battle to convince health plans and medical pros for the reasons above.

(Disclaimer: I am not a doctor, but have discussed this topic with several of them. I was initially thinking 'what the heck, why not' when I got the nice brochure in the mail, but after said discussions, I didn't bother.)

I was a frontline firefighter for over 31 yrs. Exposed to a BUNCH of bad stuff over the years.
If you don’t have symptoms, save your $$$$ and get yearly physicals...which everyone should do regardless of occupation.
Insurance won’t cover it and radiation exposure is another known risk you don’t need without a reason.

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Originally posted by lbj:
Yes, full body cancer screening CT scans would save a lot of lives.

However, even if you are willing to pay for them, one is hard pressed to find a facility who will do them.

They may save some lives. But they will also cause unnecessary morbidity and mortality in far more otherwise healthy people who end up having complications related to more invasive tests and procedures to follow up on an equivocal CT scan. A scan cannot reliably tell you if a mass is benign or aggressive. There are radiologic features that can strongly suggest the former or latter, but a definitive diagnosis requires a tissue biopsy. This is why the radiologist note will always say something like "Clinical correlation suggested" or "Recommend biopsy to confirm diagnosis". And if the imaging shows something that even the radiologist can say with almost 100% certainty is aggressive, something that advanced is often past the point of curative treatment. All radiologic imaging has limited resolution, and a CT is not necessarily the best test to look for particularly fine/granular abnormalities. So in other words, a negative CT scan at a given point in time doesn't mean you're "cancer free".

There are good data driven reasons why these whole body scans, for the majority of people, are not recommended. The number needed to treat, or the number of otherwise healthy people you need to scan in order to save one life is unacceptably high. This is one reason why most insurance won't pay for a "screening" full body CT. A CT scan is not completely benign, either. As far as radiologic imaging goes, it's a massive dose of radiation that isn't without risk (and that risk is difficult to quantify) and itself may cause or increase the risk of cancer, especially if you're coming back every 6 months or year to "follow up" on a "suspicious" finding of questionable clinical significance.

https://xkcd.com/radiation/

Everything in medicine is a risk/benefit analysis. There is no 100% "safe" medication or procedure.