Medical oncologist consultation

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wyldblumusic
wyldblumusic Member Posts: 59

Hello, everyone.

I just finished radiation, so now it's time for the med onc consultation.  When I went for the rad onc consult, I did not know what to expect.  After a two hour appointment, I walked out of there with my head spinning.  So, this time, I'm doing a little research first.

What happens at the first med onc appointment?  About how long is it?  Do they order additional tests?

Thanks much!

Comments

  • Mantra
    Mantra Member Posts: 968
    edited June 2010

    Is the appointment with the oncologist just standard protocol or do they expect that you'll need chemo? I didn't think chemo is given for DCIS but I'm sure someone will come along who knows a lot more than I do. I only saw an oncologist once and although my surgeon felt I would not need chemo or radiation, she said it is standard practice to send patients to see an oncologist. I didn't have radiation or chemo so my experience is quite limited.

  • helenap
    helenap Member Posts: 105
    edited June 2010

    my first appt was one hour but this was before surgery so I would know what to expect. he spent most of the time going over my current pathology report. basically he said with masc no radiation but tomixin and with lump - you get radiation and then tamoxin..

  • AlohaGirl
    AlohaGirl Member Posts: 213
    edited June 2010

    I first met with the radiation oncologist after lumpectomy and rads.  The appointment was about an hour, I think.  Probably no further cancer-related testing (at least none in my case other than obtaining ER/PR status from my pathology) but I did get some bloodwork done so they had a baseline.  Mostly we discussed the benefits and risks of tamoxifen to help me decide whether to take it or not.  (I am taking it with minimal side effects.)  I now meet with the med onc every three months or so and get bloodwork done before every visit.  A couple of times I have had to get bloodwork done in between when something was a little elevated, but that is it for me.  Hope this helps.  Good luck!

  • CrunchyPoodleMama
    CrunchyPoodleMama Member Posts: 1,220
    edited June 2010

    Interesting thread -- I didn't know people with DCIS had an oncologist, but I guess I wasn't referred to one because I declined Tamoxifen and radiation. (Just call me Ms. Anti-standard-of-care, LOL!) I'm sure the appointment will go great, especially if you keep track beforehand of any questions you want to ask.

  • sweatyspice
    sweatyspice Member Posts: 922
    edited June 2010

    An hour long, we discussed my pathology report, my risk of recurrence, likely risk reduction w/Tamoxifen, possible side effects of Tamoxifen, likelihood of side effects with Tamoxifen, etc.

    The only thing an onc can really do for DCIS is prescribe Tamox, so that's what the convo will probably be about. 

    Didn't do a blood draw, just talked. 

  • speech529
    speech529 Member Posts: 337
    edited June 2010

    Great question!  I have an appointment later this month with an oncologist.  I was not sure the purpose, but I assumed it was to go over pathology and then next steps.  Thanks for the input from others.

  • CTMOM1234
    CTMOM1234 Member Posts: 633
    edited June 2010

    My BS referred me to a med.onc. after my follow-up appointment about 10 days or so after my lumpectomy. Thought I was just going into his office to have him check on my scar/healing, when, surprise, he drops the bomb that the final pathology report lists 1.75 mm of IDC along with the DCIS. Nothing had shown up in the MRI he'd had me do before the lumpectomy.

    Had second surgery to check sentinel nodes, which thankfully were clean.

    Met with med.onc. for 1 hour max. She just reviewed my file and said that with DCIS with such little IDC, she doesn't give chemo. Her cut-off was IDC of 1 cm or more, or node involvement.

    With any DCIS diagnosis, pre-meno, ER+/PR+, lumpectomy with rads, she gives tamox. option after finishing rads. After running stats, have opted out (see other thread about tamox. or no tamox. that someone posted).

  • tweetybird
    tweetybird Member Posts: 815
    edited June 2010

    I had my first oncologist appointment about 3 weeks after my lumpectomy, and a about a week before I started rads. I remember it being about an hour, and didn't need any sort of tests before hand. We just discussed my pathology report, and what to expect after rads, which is 5 years of tamoxifen. I just hit the 3 1/2 year mark on June 1st, but who's counting! I also get blood work done once a year, just to make sure my numbers are OK.  I was seeing her every 3 months the first year, and was getting blood work each time, the second year was every 4 months, and now twice a year. Some oncologist also give you your referrals for your mamo/ultrasounds/MRI's. I still see my breast surgeon twice a year, and she gives me the referrals for that, and I just have the results sent to my oncologist.

    Good luck! ;)

  • roseg
    roseg Member Posts: 3,133
    edited June 2010

    I thought the Oncologist was about the most trustworthy of anybody I saw.

    DCIS is not a terrible event cancer-wise, and he did a reasonable job of conveying my risks to me. Way better than my surgeon who told me that tamoxifen would put me into menopause.

  • wyldblumusic
    wyldblumusic Member Posts: 59
    edited June 2010

    A great big Thank You to everyone for the information.

    I'm seeing the med onc to talk about tamoxifen.  I am still uncertain about this decision, but hopefully this appointment will help me to get off the fence.

    If I may ask for your help again, did anyone ask to have the tamoxifen metabolism test (CYP2D6) before starting tamoxifen?

    Tweetybird: Wow! Just wow.  Every three months?  Yikes, that makes me want to start a new thread about post-treatment, follow-up appointments.  I suppose that I should wait until I'm acutally am in the post-treament time.  Laughing

  • sweatyspice
    sweatyspice Member Posts: 922
    edited June 2010

    I asked about the CYP2D6 test, onc wasn't a fan.  He didn't think it was conclusive enough and said it wouldn't change his recommendation.

    I said something like "what if I have all these horrible side effects and the pill isn't even working?"  He said it didn't play out like that. 

  • tweetybird
    tweetybird Member Posts: 815
    edited June 2010

    WY,

    It was rough going every 3 months, and I also had follow ups with my rad oncologist in there. Thank God that both my oncologist, and rad oncologist is in the same office/hospital, so I tried to schedule my appoints one right after the other.

    I also had a hysterectomy in January 2007, which was 2 months after I was done with rads. I had weekly follow ups with my OB/GYN, since I ended up with a wound infection a week and a half after surgery. I look back on it now, and wonder how I made it thru it all.

    I started a thread after the last visit with my breast surgeon, wondering how many people are still seeing their surgeon, it was an interesting topic.

    Hope all goes well!

  • almagetty
    almagetty Member Posts: 316
    edited June 2010

    I met with my oncologist today and she prescribed tamoxifen, as expected. I had a RMX on June 2. I won't have rads, because I have good margins with the MX. I do have a question for you all. The oncologist told me she would schedule a mammogram for me on my remaining breast for August and a MRI for February. This pattern will continue with me having one test or another every six months. When I met with the scheduler, the nurse had also included an order for a chest x-ray in August. I called the nurse to question that, and she said it was standard so that they could spot nodules (?) in the chest wall or lungs. I really think that the nurse may have ordered that in error, since DCIS is non-invasive. The only other reason I could think of to order a chest x-ray would have to do with radiation, which I didn't have. So here's my question ... has anyone's oncologist ordered a chest x-ray for you if you have pure DCIS with no invasive component? And, if so, why?

  • Jelson
    Jelson Member Posts: 1,535
    edited June 2010

    wyldblumusic -  I had the tamoxifen metabolism test (CYP2D6) and was found to be an extensive metabolizer.It made me feel better about taking the tamoxifen - I would have been worried that I wasn't metabolizing it because I have not had any noticeable side effects!

    almagetty- I am on the mammogram and then the mri rotation too. I had a lumpectomy and do not get chest xrays. I would check on that xray with your oncologist. why be exposed to more radiation than absolutely necessary? 

    Julie E

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