Monitoring or Remission
The primary tumor site of ACC patients often is treated successfully with surgery and/or radiation. Many patients never experience a recurrence of the tumor at the original site, achieving what physicians call “local control”.
However, some patients do have a recurrence at the original site and even more patients develop new tumors in other parts of the body called “distant metastases”. The risk of either local recurrences or distant metastases is very real for ACC patients, even after many years without any evident disease, and therefore it requires a regimen of lifelong monitoring.
Typically, a combination of CT and MRI scans are used to check for and track any residual disease or potential recurrences. CT scans are particularly effective at identifying tumors in the lungs and harder tissues, while MRIs are most helpful for soft tissues and the head and neck region. In the months following a patient’s initial diagnosis or subsequent treatments, these imaging studies may be ordered by the patient’s physicians every 2-3 months. Patients with evident disease after treatment may have imaging studies every 2-6 months, depending upon the particular circumstances. For patients without any evident disease for multiple years, the scans may be spread out to every 6-12 months.
Younger patients without evident disease may wish to minimize their overall radiation exposure from CT scans by occasionally substituting x-rays in consultation with their physician. PET scans often do not pick up slow-growing ACC tumors, but may be instructive for fast-growing tumors.