Saved $2,000 with Groupon on Cancer Screening

[myrdale]

There is a company is a company in Atlanta which does CT scans for early heart disease and cancer detection. After hearing their advertisements on the radio for years, I decided to give it a go.

Unfortunately they don't do much in the way of publishing their price list, though they do advertise free heart scans if you meet certain requirements which they say is an $799 value. When I first called and asked about the full body scan, they said they'd have to discuss in person.

After signing in, their customer liaison explains the process, the cost, and other options. By their price list the full body scan (throat to pelvis) is $2,999. However they offer discounts for signing up for multi year plans. $7,995 for 6 annual scans, $6,995 for 10 annual scans if they can use you in a study.

She really did an awesome job in laying all of the options out. But prior to the visit I had checked Groupon, and they had a coupon. Full body scan, 67% off, $999 total. When I showed that to her, there a sigh. I don't know but I suspect there are sales commissions for signing up for the multiyear plans.

The scan itself was <10 minutes of laying on my back. Super easy.

They gave me a CD with all of the images on it. I believe it was 45 images total for the heart, and 250 images for the full body. The resolution is OK, though I was expecting a bit more. Looking though it I can recognize most of my parts. I have not yet received the consult from the Doctor who will review the scans, so I don't want to start to speculate. I am assuming I'll hear from them over the next week.

I absolutely recommend checking them or similar services out in your area. I don't think ongoing annual scans at $3,000 is worth it, but a one off, or every few years probably is. My personal plan is to get a follow up scan in one year, then probably every 5 years after that.

I am really glad I had the coupon code. It shows its worth taking the time to double check.

[QuarterMillionMan]

If I go to my doctor and ask for one will my insurance deny it if there are no valid reasons for it?

[disneysteve]

If I go to my doctor and ask for one will my insurance deny it if there are no valid reasons for it?

https://www.fda.gov/radiation-emitti...-you-need-know

It isn't a scam as you get exactly what you pay for, but it's not a good idea either. A full body scan exposes you to a tremendous dose of radiation for absolutely no reason. If you are having any type of symptoms, you should see your doctor and get only the testing that is appropriate and relevant to your issue. If you aren't having symptoms but want to have routine screenings done, that's also fine (for example, ex-smoker getting a screening chest CT). There are well-established guidelines regarding who should be screened for what and when.

Going outside of the system and paying hundreds or thousands of dollars for high dose radiation of your whole body is ill advised at best and in many cases may lead to a lot of unnecessary follow up procedures to chase down whatever is found on that test.

If you ask your regular doctor to order one of these and they agree to do so, I would immediately find a new doctor.

[ua_guy]

We had a friend do one of these, and it was bad. The images led to follow-ups, chasing her regular providers and trying to get care based on this body scan- biopsies, more scans, lab work. The follow-ups led to nothing significant, but she was worried and totally stressed out the whole time (is it cancerous? is it normal? will I be OK? Is this or that doctor's opinion correct?). Not only did she blow a whole bunch of money for the scan, then she spent a mint on deductibles and everything else using her insurance. I don't think she'd do it again.

But, maybe, some people find them beneficial or comforting?

[disneysteve]

We had a friend do one of these, and it was bad. The images led to follow-ups, chasing her regular providers and trying to get care based on this body scan- biopsies, more scans, lab work. The follow-ups led to nothing significant, but she was worried and totally stressed out the whole time (is it cancerous? is it normal? will I be OK? Is this or that doctor's opinion correct?). Not only did she blow a whole bunch of money for the scan, then she spent a mint on deductibles and everything else using her insurance. I don't think she'd do it again.

But, maybe, some people find them beneficial or comforting?

That's the problem with unnecessary screening tests (and even recommended screening tests to be fair). They can identify "abnormalities" that then lead to additional, often more invasive, tests to determine if the "abnormality" is truly anything of concern.

[myrdale]

It isn't a scam as you get exactly what you pay for, but it's not a good idea either.

I will admit my opinion is still on the fence.

The article you linked is a good one. Another one from the FDA is https://www.fda.gov/radiation-emitti...ation-risks-ct

The company's website only states it is a "Low Dose CT Scan". I'll have to follow up with the on what the effective dose is. I've seen some references that "Low Dose" is 20 to 50% of what a standard CT scan would be.

The link above list CT Abdomen as 8 mSv for diagnosis. Presumably what I received would have been half that or less. I will confirm.

Per the link you provided "The radiation from a CT scan may be associated with a very small increase in the possibility of developing cancer later in a person's life". In my case, at 42 with a family history of prostate cancer (father died at 62) I have a better than 50% chance developing prostate cancer as is, for a one off, I'm not terribly concerned about the radiation.

The following link is an excellent discussion on the scale of radiation.

https://www.youtube.com/watch?v=TRL7o2kPqw0

Per the video:

An hour in an airplane at 30,000 ft is equal to 2 uSv of exposure.
A dental x-ray is 5 uSv.
A CT scan is 7,000 uSv (7 mSv).
Radiation workers may receive up to 50,000 uSv per year (50 mSv).
A smoker received upwards of 160,000 uSv per year (160 mSv).

Saying smokers receive x2.2 the radiation annually, therefore it is safe, isn't an argument for it, but it does help to put it in perspective.

There were a few points from the liaison who what trying to sell the service to me that I thought were off.
1) Recommending 10 annual scans. To me this is over board.
2) A comment about women receiving mammograms annually why shouldn't everyone receive a CT annually, there is more than a x1000 between 5 uSv and 7 mSv.
3) Chlorine in water is causing an increase in cancers today. I just nodded to this one, kidney cancer at 80 is better than dysteria at 10 as far as I am concerned.

As I stated I am on the fence. I see a value in being proactive, even if it is outside of the system. I don't think whole sale across the board is needed / good idea. I do think it is worth taking advantage of the technology in some cases, and I think it will play a larger function in the future.

[disneysteve]

A CT scan is 7,000 uSv (7 mSv).

I'm not sure that is accurate, or at least it's misleading. A targeted CT scan of one body part might be 7mSv but scanning head to pelvis is going to be a lot more than that. You're getting a head and neck CT and a chest CT and an abdominal and pelvic CT all at once. That's probably more like 25-30 mSv.

[disneysteve]

I do think it is worth taking advantage of the technology in some cases, and I think it will play a larger function in the future.

It would be a lot better if they could do the same thing with MRI instead of CT so there’d be no radiation involved.

[QuarterMillionMan]

I wondered about the radiology technician which must be a hazardous job being exposed to all that radiation.

[kork13]

I wondered about the radiology technician which must be a hazardous job being exposed to all that radiation.

To some extent, yes .... But modern x-ray/CT/etc. systems are decent about keeping the radiation directed mostly in just the intended direction. Plus, radiology techs also live behind the radiation shields, which block most of what stray radiation does leave the machine. They certainly do get higher than normal exposure, though, and typically all wear a radiation detector switch to monitor for excess exposure.

[myrdale]

I wondered about the radiology technician which must be a hazardous job being exposed to all that radiation.

There should be little or no exposure at all for them.

My limited understanding of the x-ray sources used is it is the equivalent of a light bulb. It's outputing x-rays, not visible light, in the same way a radio station outputs radio waves. It is all photons, just different frequencies. It doesn't turn on until they start the scanning process, it shoots out a narrow beam, and they are operating the machine from a room over.

[myrdale]

I received the report back and it is relatively good. I do see how the findings could lead to unnecessary follow up procedures as Disneysteve mentioned. I'll discuss with my person doctor next month and get her opinion, but for the moment I'm not terribly concerned.

Findings:

For the thyorid they listed mild asymmetric thyromegaly of the right lobe. They also say a CT is not great for evaluating the thyroid, and recommend an ultrasound. I do have a history of thyroid issues, but for the moment I'm assuming its nothing.

For the kidneys, there is a probable small cyst in the right one, benign features. They recommend CT/MRI or ultrasound followup. Again I'm not terribly concerned.

The liver has mild fatty infiltration. I can fix this presumably with lifestyle changes.

Lastly the prostate which is what I was most concerned with. On the scans I'd seen a white spot in the prostate which had me mildly concerned for the last few days. But past being able to identify my parts in general, I really don't have a clue what I'm looking at. Per the report though: "Mild prostate enlargement containing nonspecific calcifications. Correlation to a PSA may be helpful." I've had my PSA checked annually for the past several years, and it is normal (<1).

For the heart scan the score is 0. I find that to be surprising as the liaison indicated pretty much no one ever registers 0. Based on blood work in the past, I am curious though. My bilirubin runs high and could be Gilberts syndrome which is more or less harmless, but I've read that it can reduce cholesterol buildup in your arteries.

[ua_guy]

I find it strange that they provide you with the scans before they're interpreted, leaving your mind to wonder without any specialized training in reading the scans? In regular settings aren't they usually interpreted first, then released?

[disneysteve]

I find it strange that they provide you with the scans before they're interpreted, leaving your mind to wonder without any specialized training in reading the scans? In regular settings aren't they usually interpreted first, then released?

Unfortunately not. Congress (I think) changed the law a while back. Now test results are released to patients as soon as they are available. It is a god awful stupid practice but here we are. Complex results are shot out to patients through whatever portal they have before the ordering provider has had a chance to see them or contact the patient to discuss them. I'm all in favor of patients having access to their records, but they absolutely should not see their results before their provider does. All it does is cause a lot of fear and anxiety and upset and generates a lot of phone calls to providers that could all be avoided. Of course, if a test is negative, it can ease someone's mind sooner, which is nice, but even that isn't as simple as it may sound. We get calls all the time at urgent care because patients don't know how to interpret "not detected" or they can't tell the difference between the reference range (what the result should be) and their actual result, so they see both "negative" and "positive" on the same report because "negative" is the normal outcome and "positive" is their outcome.

[ua_guy]

Unfortunately not. Congress (I think) changed the law a while back. Now test results are released to patients as soon as they are available. It is a god awful stupid practice but here we are. Complex results are shot out to patients through whatever portal they have before the ordering provider has had a chance to see them or contact the patient to discuss them. I'm all in favor of patients having access to their records, but they absolutely should not see their results before their provider does. All it does is cause a lot of fear and anxiety and upset and generates a lot of phone calls to providers that could all be avoided. Of course, if a test is negative, it can ease someone's mind sooner, which is nice, but even that isn't as simple as it may sound. We get calls all the time at urgent care because patients don't know how to interpret "not detected" or they can't tell the difference between the reference range (what the result should be) and their actual result, so they see both "negative" and "positive" on the same report because "negative" is the normal outcome and "positive" is their outcome.

Interesting. I was unaware of the legal requirement to release results ASAP. I can see both sides of it. I know when my husband had cancer, he would look for test results on his portal (Cerner) after his various visits. Some were there fairly quickly, and in the early visits when nothing was detected, I know the results came fast. The images and test results which caused concern, and spurred the immediate move towards surgery were not made available until after his provider called him. I wonder if that was just staged timing. I'm grateful that he heard it from his doctor first.