Asked by
QT
QUESTION

"Early" 1 yr PET/CT at 6 months, due to high platelets?

Head and Neck Squamous Cell Carcinoma Survivor.  I didn't realize before, but my high platelets were a symptom/cause of cancer tumors. I saw my Onc for a follow up and after I mentioned my platelets were still high he suggested the PET. I was doing research and somehow missed during treatment that platelets affect cancer and vice versa.

Now I'm scared for my PET.

Is it possible to have high platelets and have them stay high when NED?

I could just have high platelets naturally, but I'm scared.

RESPONSE FROM DR. SAGER
Dear
QT
,

There are cancers that can cause platelet counts to be higher, but the platelet increase is unlikely to be caused by H&N SCC. I saw some case reports coming from melanoma due to 'chronic inflammation' but I think it is more likely to be related to as many other causes (a virus, etc.) as cancer recurrence. However, I see the 'early' scan as a positive thing - it sounds like your oncologist is being proactive. The NCCN, the organization that sets oncology standards in the US, says that after HNSCC NED, a "FDG PET/CT should be performed within 3–6 months of definitive radiation or systemic therapy/RT for assessment of treatment response and to identify any residual tumor." Did you have one at 3 months? If not, I would say that your oncologist is simply following national standards, and perhaps your platelet situation reminded him to review the current scan recommendations and get one at 6 months. Hope this helps and fingers crossed for continued NED!

Best Wishes,
Jason Sager, MD