How often should I get scans to monitor my Non-Small Cell Lung Cancer

Surveillance Scans for Non-Small Cell Lung Cancer

The frequency of your surveillance scans depends on several factors, including your cancer stage, the type of treatment you received, and how well you've responded to treatment. Let me walk you through what the guidelines recommend.

After Definitive Treatment (Surgery, Radiation, or Chemoradiation)

According to NCCN Guidelines for Non-Small Cell Lung Cancer, surveillance schedules vary based on your stage:

Stage 1-2 Cancers (Early Stage)

Years 1-2:

• Every 6 months: CT scan of the chest (with or without contrast) + medical history and physical exam

Years 3+:

• Every year: Low-dose CT scan of the chest + medical history and physical exam

Stage 3 Cancers (Locally Advanced)

Years 1-3:

• Every 3-6 months: CT scan of the chest (with or without contrast) + medical history and physical exam

Years 3-5:

• Every 6 months: Low-dose CT scan of the chest + medical history and physical exam

Year 5+:

• Every year: Low-dose CT scan of the chest + medical history and physical exam

Important Points About Your Scans

What imaging is used:

• CT scans are the standard for monitoring NSCLC. The NCCN Guidelines recommend chest CT with or without contrast for initial surveillance, then transitioning to low-dose CT scans in later years to reduce radiation exposure.
• Brain MRI or CT is NOT routinely recommended for surveillance in patients without symptoms
• PET/CT scans are not routinely used for follow-up unless there's a specific clinical reason (like evaluating an unclear finding on CT)

Why the schedule matters: Recurrence is common after NSCLC treatment, so regular imaging helps catch any return of cancer early when treatment options may be more effective.

Questions to Ask Your Oncology Team

Since your specific situation is unique, discuss these with your care team:

1. "Based on my stage and treatment, what is MY specific surveillance schedule?" (Your doctor may adjust based on your individual risk factors)

2. "Should I be getting contrast with my CT scans, or low-dose non-contrast scans?" (This depends on your kidney function and other medical factors)

3. "If I develop new symptoms between scheduled scans, should I call you or get imaging sooner?"

4. "Are there any signs or symptoms I should watch for that would warrant earlier imaging?"

5. "How long will I need these regular scans?" (Guidelines typically recommend 5 years of surveillance, then as clinically indicated)

Key Takeaway

The NCCN Guidelines emphasize that surveillance schedules are based on your stage and treatment type, but your oncologist will personalize this based on your complete medical picture. More frequent scans in the first 1-3 years make sense because that's when recurrence is most likely to occur.

---

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.