Is my oncologist doing everything possible

LBG10

I had my double mx on 6/7/2018 for Stage 1 IDC I've been taking tamoxifen since and see my oncologist every 6mos now. My question, is my oncologist doing everything that should be done? He does lab work and a manual exam when I see him. I asked at my last visit what labs were done, he said to check my liver function since Iam on tamoxifen, so just a basic CBC and CMP panel. Are there lab tests to check tumor markers? Should I be getting these? Also, I have Never had a CT scan, is this usually a standard of care?

What tests do you do routinely with your oncology follow ups??

MCBaker

What is your hormone receptor status and your HER2 status? I suspect it is all appropriate, not knowing the rest.

Salamandra

That sounds like my protocol. Through my surgeon's office, I also have imaging every 6 months (hopefully, we are trying to get the insurance to cover rotating MRI and mammogram).

Fairydragonfly

My oncologist told me that there are no tumor markers for breast cancer, so no blood test to check.

dtad

Hi everyone...this is the 60,000 dollar question! The theory behind not doing any scans or MRIs is that by the time something shows up on them, you will be symptomatic and thus stage 4. Really? Can't we do better than that? Yes there is bloodwork to check tumor markers. However they are not done for stage 1 because they are thought to be invalid. Some docs do use them for more advanced stages.

Salamandra...the reason you have imaging done is because you still have your breasts. MRIs and mammograms are done to check for a recurrence in them. They are not routinely done if you had a mastectomy.

Hope this answers some questions. Good luck to all.

Betrayal

dtad

My Mo does tumor markers and I am stage 1. I asked why and she said she uses it as an early warning system. It is done in conjunction with other routine blood work so no harm done. So I think the decision to do these, no matter the stage, is based on the MO's experience. In this instance I defer to her decision.

salasila

I just saw my oncologist last Friday for our regular quarterly appointments. Since I finished active treatment (chemo, Herceptin) mid last year, I don't even get my blood checked by her anymore. I come in, she does her manual checks (she's very thorough), asks 10,000 questions, then declare I'm still in remission. I see my breast surgeon every 6 months, same deal. I get sent to do my pelvic exam once a year (because I'm on Tamoxifen)and I think that's it. I have no mammo because I had a mastectomy.

Beesie

For hormone positive, HER2- breast cancer, here are the NCCN Guidelines for follow-up monitoring. I've boxed in red their recommendation with regard to screening for mets.

gb2115

Yup sounds about right!!!

exbrnxgrl

Ladies,

My mets were found completely by accident (long story), about six weeks after my BMI, staged II b. I had no symptoms. According to studies, I won’t live any longer due to finding mets early, I’ll just know about it longer. I think you can look at vigilant monitoring both ways. Constant scanning and bloodwork are very stressful for many. People forget to live while they “fight”.

On the other hand, some find vigilant monitoring comforting. I think you need to go for whatever comforts you, and doesn’t heighten your anxiety and stress. It took me a while, but I have greatly reduced the frequency of my scans and my mo never did tumor markers. I’m good with it now and my stress levels are way down

dtad

Betrayal...I don't want to contradict your MO but tumor markers for stage one are not reliable. My MO and BS at a major NYC university teaching hospital both told me this. The study above also points that out. As long as you understand that you can get false positives I guess there is no harm done. IMO there is no reason to get alarmed for nothing. There are other factors besides recurrence that can elevate these markers. Any kind of inflammation is one of them. So maybe just talk to your MO about this. Good luck to all.

edj3

exbrnxgrl, I love what you wrote: People forget to live while they "fight".

sflow

Every doctor is different. When I was diagnosed in 2006, my oncologist did chest X-ray, nuclear bone scan & abdominal scan every 6 months for first year or two after. Also they took tumor markers. As I understand, that is a traditional approach, but it did give me peace of min