Hello, fellow lung cancer warriors! I'm here to share my personal journey as a Stage 4 ALK-positive non-small cell lung cancer patient, thriving for 6 years since my diagnosis in 2019. Like many of you, when I was first told I needed regular chest and abdominal CT scans every three months, a wave of anxiety washed over me. "Could this constant radiation exposure from CT scans actually cause another cancer?" I wondered.
After years of consistent monitoring, effective treatment, and in-depth discussions with my medical team, I can now confidently say: for advanced lung cancer patients, regular CT scans are not a risk, but a lifeline.
Understanding My Annual Radiation Dose
My regular check-ups include chest CT, abdominal CT, and X-rays every three months, plus an annual brain MRI. While MRI uses magnetic fields and involves no radiation exposure, and X-rays have minimal radiation, CT scans are the primary concern. A chest CT typically involves an effective dose of around $5 \sim 8 \text{ mSv}$, and an abdominal CT $8 \sim 14 \text{ mSv}$. This sums up to an estimated annual total of $60 \sim 80 \text{ mSv}$. Compared to the average background radiation of $1 \text{ mSv}$ per year, this figure can seem alarming.
Is the Risk of Secondary Cancer Real?
The fear of developing a secondary cancer due to radiation exposure is a common one. However, current medical consensus and data from organizations like the ICRP provide a crucial perspective:
Benefits Far Outweigh Risks: For Stage 4 lung cancer patients, quarterly CT scans are vital for detecting progression or treatment resistance at the earliest possible stage. Missing these crucial signs can lead to delayed treatment adjustments, with potentially life-threatening consequences. The very low, uncertain risk of a secondary cancer developing decades later pales in comparison to the immediate, certain risk of unchecked cancer progression.
Body's Repair Mechanisms: While acute exposure to over $100 \text{ mSv}$ can increase cancer risk, our bodies have DNA repair mechanisms. The fractionated doses received over a year allow time for these repairs, making the actual risk lower than acute exposure. Adult cells are also less radiosensitive than rapidly growing cells.
Advances in CT Technology: Modern CT scanners in leading hospitals utilize low-dose protocols and automatic exposure control, significantly reducing radiation doses (by 30-50% or more) compared to older equipment.
My Six-Year Survival Story: The Power of Targeted Therapy and Monitoring
Since November 2019, I have been under the care of Professor Sun-min Lim’s team at Severance Hospital, taking Alecensa capsules (Alectinib), a targeted therapy from Roche Korea. Alecensa has been remarkably effective in controlling my ALK-mutated lung cancer. However, even the best targeted therapy can eventually face resistance.
This is why the regular CT check-ups are so critical. They serve as my navigational system in this journey with cancer. By adhering strictly to the three-month monitoring schedule, we ensure that if any signs of progression or resistance appear, we can detect them instantly and pivot to a second or third-generation ALK inhibitor immediately (such as Brigatinib or Lorlatinib). This vigilance is a major reason why I have not only survived but thrived for six years and continue to work actively.
