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Thread: New cancer patient with questions regarding chemo treatments and second opinions

  1. #1
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    New cancer patient with questions regarding chemo treatments and second opinions

    I am a new cancer patient and have questions regarding chemo treatments and second opinions

    I had colon re section surgery as a result of a narrowing of the colon due to many years of diverticulitis.

    A 10" section of colon was removed which caused a bowel obstruction. There were no visual indications of a cancer just scar tissue from 20 years of diverticulitis damage.

    The biopsy results revealed isolated cancer cells on the outside walls of the removed colon section. Further testing revealed that 14 out of 22 lymph nodes in the removed section contained "cignet ring cancer cells"

    My oncologist has prescribed chemo therapy treatments over 6 months separated by 18 day intervals and said they could be done in the oncology practice she belongs to.

    I also am planning a second opinion consult with another highly regarded medical oncologist to see if they agree with the specific recommended chemo drugs and intervals prescribed.

    As my oncologist is 15 miles from my home, is it permissible for me to consider a chemo infusion facility that is more convenient and is only 3 miles way.

    Is such an arrangement possible, and would they work with my oncologist, or would that not be proper medical protocol.
    Thank you very much for your advice in this concern, and any advice dealing with my second opinion consult with another medical oncologist

  2. #2
    Moderator Top User Doug K's Avatar
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    Quote Originally Posted by provlima View Post
    I am a new cancer patient and have questions regarding chemo treatments and second opinions

    I had colon re section surgery as a result of a narrowing of the colon due to many years of diverticulitis.

    A 10" section of colon was removed which caused a bowel obstruction. There were no visual indications of a cancer just scar tissue from 20 years of diverticulitis damage.

    The biopsy results revealed isolated cancer cells on the outside walls of the removed colon section. Further testing revealed that 14 out of 22 lymph nodes in the removed section contained "cignet ring cancer cells"

    My oncologist has prescribed chemo therapy treatments over 6 months separated by 18 day intervals and said they could be done in the oncology practice she belongs to.

    I also am planning a second opinion consult with another highly regarded medical oncologist to see if they agree with the specific recommended chemo drugs and intervals prescribed.

    As my oncologist is 15 miles from my home, is it permissible for me to consider a chemo infusion facility that is more convenient and is only 3 miles way.

    Is such an arrangement possible, and would they work with my oncologist, or would that not be proper medical protocol.
    Thank you very much for your advice in this concern, and any advice dealing with my second opinion consult with another medical oncologist


    Pro

    I think the second opinion is warranted in your instance and should always be accepted. As for the procedure, I am not familiar with the cancer you describe, and the requisite treatment. My experience was with adenocarcinoma, which was on of the more common cancers in bowel cancers.

    I think you are on the right path. Listen carefully to the Docs and take someone with you to also lend an ear, very helpful in these situations to have two heads working in your behalf.

    good luck to you. please come back and let us know what you discover.

    doug
    MyJourney:
    August 2004 Colonoscopy Clear
    June-July 2013 Abdominal Discomfort Upper Abdomen X-ray, UltraSound, CTScan all clear
    8.23.13 Diagnosed 5cm tumor on rectum wall: adenocarcinoma @age 66
    Aug-Sept2013 Met with Surgeon,Hematologist and Radiation oncologist
    Oct.-Nov.: Xeloda concurrent with radiation: 25 doses
    November CTScan, MRI and surgeon scoped: Tumor gone, scar tissue
    1.6.14 Surgery LAR: Rectum removed, sphincter remains: Pathology: no lymph node,
    Tumor downgraded from Possible T3 to T2
    Feb. - April Chemo:5 FU and Oxilaplatin:6 infusions over 14 weeks
    9.4.14 ColonoscopyClear,CT Clear
    Dec.14 Follow up BlWk +,CEA .9
    Mar.15Follow up BlWk +,CEA .6
    June.15 Follow up BlWk +,CEA .7
    Sept2015Followup BlWk + CEA .7 CTScanClear NED
    Dec2015SurgicalHerniaRepair
    Sept2016Followup BlWk + CEA .7 CTScanClear NED
    Sept-Oct2017Followup All clear NED
    Sept-Oct2018CTScan+Clear Bldwk+
    Mar2019Bldwk+NED
    Continue ColoRectal Support Group monthly

  3. #3
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    Quote Originally Posted by Doug K View Post
    Pro

    I think the second opinion is warranted in your instance and should always be accepted. As for the procedure, I am not familiar with the cancer you describe, and the requisite treatment. My experience was with adenocarcinoma, which was on of the more common cancers in bowel cancers.

    I think you are on the right path. Listen carefully to the Docs and take someone with you to also lend an ear, very helpful in these situations to have two heads working in your behalf.

    good luck to you. please come back and let us know what you discover.

    doug
    Doug,

    thank you for your message...Could you please advize if you think it is ok if I choose to get my infusions at a chemo infusion facility that is 3 miles from my home rather than to my medical oncologists office which is far. This will save me 20 trips to my oncologist's office. I would go to my oncologist for followup office visits when needed. Would this be considered a common arrangement if it is for the convenience of the patient?

    Thanks for your thoughts on this

  4. #4
    Moderator Top User Doug K's Avatar
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    Quote Originally Posted by provlima View Post
    Doug,

    thank you for your message...Could you please advize if you think it is ok if I choose to get my infusions at a chemo infusion facility that is 3 miles from my home rather than to my medical oncologists office which is far. This will save me 20 trips to my oncologist's office. I would go to my oncologist for followup office visits when needed. Would this be considered a common arrangement if it is for the convenience of the patient?

    Thanks for your thoughts on this

    Pro,
    I guess I'm not sure I have an opinion related to the question you pose. Convenience to you is of course a reasonable position. If you could ask someone who has used the facilities you are questioning, maybe that would help? You do need to have some continued relationship with the oncologist and his/her staff. The question might be if you can have that same relationship with the doc and staff at the place closer to you. Certainly I would want to visit and know who is in charge of my treatment.

    Good luck...

    doug
    MyJourney:
    August 2004 Colonoscopy Clear
    June-July 2013 Abdominal Discomfort Upper Abdomen X-ray, UltraSound, CTScan all clear
    8.23.13 Diagnosed 5cm tumor on rectum wall: adenocarcinoma @age 66
    Aug-Sept2013 Met with Surgeon,Hematologist and Radiation oncologist
    Oct.-Nov.: Xeloda concurrent with radiation: 25 doses
    November CTScan, MRI and surgeon scoped: Tumor gone, scar tissue
    1.6.14 Surgery LAR: Rectum removed, sphincter remains: Pathology: no lymph node,
    Tumor downgraded from Possible T3 to T2
    Feb. - April Chemo:5 FU and Oxilaplatin:6 infusions over 14 weeks
    9.4.14 ColonoscopyClear,CT Clear
    Dec.14 Follow up BlWk +,CEA .9
    Mar.15Follow up BlWk +,CEA .6
    June.15 Follow up BlWk +,CEA .7
    Sept2015Followup BlWk + CEA .7 CTScanClear NED
    Dec2015SurgicalHerniaRepair
    Sept2016Followup BlWk + CEA .7 CTScanClear NED
    Sept-Oct2017Followup All clear NED
    Sept-Oct2018CTScan+Clear Bldwk+
    Mar2019Bldwk+NED
    Continue ColoRectal Support Group monthly

  5. #5
    Moderator Top User IndyLou's Avatar
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    Jan 2014
    Posts
    516
    Could you please advize if you think it is ok if I choose to get my infusions at a chemo infusion facility that is 3 miles from my home rather than to my medical oncologists office which is far.
    "Convenience" for you equals "compliance" to a treatment regimen, and your doctor should be fully supportive of that, unless they have some reason to believe that the infusion facility doesn't have the capability that your treatment requires.

    Please keep in mind that chemo infusion isn't necessarily a passive process. Sure, many patients go and sit back in a bed or reclining chair for several hours, and nothing really comes of it. It's also possible for patients to have infusion-related reactions that require emergency medical treatment, and that requires a staff and facilities to handle those reactions.

    I would have this discussion with your doctor, and be frank with them, but listen to their reasons if they suggest against doing what you're proposing.
    Age 54 Male
    early Feb, 2013 - Noticed almond-sized lump in shaving area, right side of neck. No other "classic" cancer symptoms
    late Feb, 2013 - Visited PCP for check-up, PCP advised as lymphoma. Did blood work, orders for CT-scan, referred to ENT
    3/7/13 - CT-scan inconclusive, endoscopy negative
    3/9/13 - FNA of neck mass
    3/14/13 - Received dx of squamous-cell carcinoma, unknown primary
    3/25/13 - CT-PET scan reveals no other active tumors
    3/26/13 - work/up for IMRT
    4/1/13 - W1, D1 of weekly cetuximab
    4/8/13 - W1, D1 of IMRT
    5/20/13 - complete 8 week regimen of weekly cetuximab
    5/24/13 - Complete 35-day regimen of daily IMRT
    mid-July 2013 - CT-PET scan reveals no active tumors, but shows necrotic tissue at site of original tumor
    early Sept 2013 - partial neck dissection to remove necrotic tissue. Assay shows no cancer present.
    Spring 2014 - No signs of cancer
    Spring 2015 - NED
    Spring 2016 - NED
    Spring 2017 - NED
    Spring 2018 - NED
    Spring 2019 - NED

 

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