3 ms·

>The go-to for a lot of the "take a look at that" procedures is a biopsy It's not, sounds like you're not familiar at all with any of this. There's some road

>The go-to for a lot of the "take a look at that" procedures is a biopsy It's not, sounds like you're not familiar at all with any of this. There's some road to cover from imaging -> biopsy. Blood tests, more detailed imaging, even keeping an eye on it for some time, etc... Have you heard of Pap tests? A lot of them come out find signs which could be indicative of a developing cervical cancer. Do all these women get their cervix removed the next week? No, not at all. Most of the time the symptoms go away in a few weeks, after some care and treatment. Pap tests are done for a reason. Pap tests are the single thing that completely obliterate the "screening everyone is bad" argument.

godsfshrmn 3y ago
Except it is. "Tissue is the issue" I have yet to see any of my radiologists differentiate a lung nodule that was actually a metastasis from the colon (which can easily miss on PET ) from primary adenocarcinoma/small cell/etc. Neither a pancreatic neuroendocrine tumor from an adenocarcinoma based on a CT or PET. I have (and often) see my patients incidentally discover masses on imaging. Perfect example- a pancreatic mass on imaging. Next stop is an anxiety filled few weeks while they wait for their biopsy to be scheduled. You then have an additional radiation exposure as these are CT guided. You hope the radiologist doesn't poke a hole in a nearby vessel, induce pancreatitis just by doing the biopsy itself, nor develop a subsequent infection related to the procedure. They then wait an additional week for pathology to result, often only to see normal pancreatic cells indicating this is a cyst. All of this is often the result of looking for a seemingly innocent diagnosis. Eg an ultrasound to reassure your patient that their abdominal pain is not their gallbladder. I had a similar event earlier today with a cervical lymph node seen on an ultrasound. Thyroid nodules, renal masses, lung nodules. How long do you have?
- cyberax 3y ago
  Now imagine that you started getting MRI screening every year. You'll be able to afford to wait to make sure a strange mass doesn't get larger.
kevinmchugh 3y ago
I got bloodwork done for the first time in a long time. My liver enzymes were high. I don't have hep C. I cut out drinking for a while, liver enzymes were still high. They did some imaging and maybe saw some fat on my liver. They did some more imaging later and didn't see the fat. Enzymes are still high. My next option is a biopsy, the hepatologists tell me. If I do the biopsy and they don't find cancer or something, they'll just tell me to drink less and eat better. Seems like mostly downside to doing the biopsy.

godsfshrmn 3y ago

Except it is. "Tissue is the issue" I have yet to see any of my radiologists differentiate a lung nodule that was actually a metastasis from the colon (which can easily miss on PET ) from primary adenocarcinoma/small cell/etc. Neither a pancreatic neuroendocrine tumor from an adenocarcinoma based on a CT or PET. I have (and often) see my patients incidentally discover masses on imaging. Perfect example- a pancreatic mass on imaging. Next stop is an anxiety filled few weeks while they wait for their biopsy to be scheduled. You then have an additional radiation exposure as these are CT guided. You hope the radiologist doesn't poke a hole in a nearby vessel, induce pancreatitis just by doing the biopsy itself, nor develop a subsequent infection related to the procedure. They then wait an additional week for pathology to result, often only to see normal pancreatic cells indicating this is a cyst. All of this is often the result of looking for a seemingly innocent diagnosis. Eg an ultrasound to reassure your patient that their abdominal pain is not their gallbladder. I had a similar event earlier today with a cervical lymph node seen on an ultrasound. Thyroid nodules, renal masses, lung nodules. How long do you have?

cyberax 3y ago
Now imagine that you started getting MRI screening every year. You'll be able to afford to wait to make sure a strange mass doesn't get larger.

kevinmchugh 3y ago

I got bloodwork done for the first time in a long time. My liver enzymes were high. I don't have hep C. I cut out drinking for a while, liver enzymes were still high. They did some imaging and maybe saw some fat on my liver. They did some more imaging later and didn't see the fat. Enzymes are still high. My next option is a biopsy, the hepatologists tell me. If I do the biopsy and they don't find cancer or something, they'll just tell me to drink less and eat better. Seems like mostly downside to doing the biopsy.