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Thread: Can a general doctor (regular practitioner) order a CA-125?

  1. #1
    Senior User Midnight_Butterfly's Avatar
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    Can a general doctor (regular practitioner) order a CA-125?

    Hi there,

    Am feeling extremely p...ed off.

    A couple of months ago (several months ago), I asked if my doctor could give me a CA-125 and CA19-9 blood test (to check for tumor markers). I had ovarian cancer almost 5 years ago and I was living in NZ at the time (the surgery cost nothing and my GP (that's general physician) could order a CA-125 blood test.

    Anyway, she said she wanted me to see an oncologist.

    So knowing this is going to cost me, but expecting a referral for an ultrasound at the hospital or local clinic through an ob-gyn, I went. I know the blood tests are not conclusive, but it's part of the follow-up treatment I was getting in NZ, so I merely following up as per was standard.

    I get to the hospital who starts asking me if I want to get genetic testing...there is no history of ovarian or bowel cancer in my family (mine is odd - I was 27 when I got it too). I questioned what the benefits of this and then I declined. There is no benefit in my opinion - not for someone who doesn't show a family history of it or predisposition.

    So then he tells me that he can do the CA-125 and CA19-9 but he will have to send me to Kansas City to see a proper Gyneoncologist who will have the tools etc to be able to do the ultrasound.

    I asked: so can no one here in Topeka (where I'm at) perform an ultrasound and interpret the results (you know, healthy ovary and all that). He said no.

    This is supposed to be the Capital of this State...anyway, to back-track...

    I am now looking at the bill for an oncologist that could only perform a blood test and a pelvic exam, trying to offer me genetic counseling and a referral to someone over an hour away (which means I take a day off work). I would lose money from not working and I would lose money because of this ballsed-up appointment.

    Bottom line: What are radiologists trained to read in ultrasounds in a hospital clinic and also can a regular family doctor give a blood test for CA-125 and CA 19-9? IF they can, then I should send my doctor the bill.

  2. #2
    Senior User Midnight_Butterfly's Avatar
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    Okay, I am slightly (a lot confused).

    I made some inquiries and found that the hospital where I had my knees x-rayed (which is the same hospital I saw the oncologist at) can do the ultrasound that I need.

    Why would someone undermine their own hospital and try to send me an hour away? I received a very nice reply from the Chairman of the Radiology department advising me of their capabilities, which is exactly what I need.

    I also followed up with the doctor who performed a life-saving operation on me in 2005 and his opinion was, if I feel fine, I could probably forgo the ultrasound, but if I Have really good insurance, I should probably get it - just because it's been a while since my last one.

    Why would a doctor lie to a potential patient? I must admit that on his part he did state that if I were his sister he would prefer to send me to a gyne-oncologist (which he wasn't one - at the time i thanked him for his honesty). But asking if there was no one whom could read an ultrasound in this town to discern something abnormal on my remaining ovary and the reply twice was no, appears to have been either a lie or he doesn't know his own hospital.

    Has anyone encountered anything like this?

  3. #3
    Senior User Midnight_Butterfly's Avatar
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    Update:

    This is a little late, but after wasting my time and money, my general (regular doctor) sent me for an ultrasound, per my original request. I clearly did not need to see an oncologist at all.

  4. #4
    Administrator Top User brainman's Avatar
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    Hi MB. I am sorry that I did not see this thread before . Yes, tests can be ordered by a GP although more technical test option decisions are usually referred to specialists. The problem is in interpreting test results. Yes, many GPs can look at test results and say "There is something wrong here". However, that is not enough. Putting all the individual parts together and knowing what to do next takes a specialist. Any mechanic might know there is something wrong with your BMW but I would still take it to someone who knows BMWs to get it fixed

    So, what did the ultrasound show?
    Jim
    Long-term cancer survivor
    1992 Astrocytoma grade 2, left motor strip
    2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
    http://cancerforums.net/viewtopic.php?t=2405
    My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
    My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
    My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029

  5. #5
    Senior User Midnight_Butterfly's Avatar
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    Hey Jim,

    All results from last year were normal, which I expected, but it was a routine check-up as prior to that I had been getting checked every 3 months and now I'm past my 5 year mark, I'm supposed to be in the clear!
    How are you doing?

  6. #6
    Administrator Top User brainman's Avatar
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    I am great! I just read about your pregnancy and am so happy for you
    Jim
    Long-term cancer survivor
    1992 Astrocytoma grade 2, left motor strip
    2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
    http://cancerforums.net/viewtopic.php?t=2405
    My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
    My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
    My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029

 
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