what screening after chemo and rads?

bilat, chemo, rads....my onc does physical each visit as well as history (questions) and labs including tumor markers....he only does scans if patient is symtomatic.....for me, I'm okay with this....

My onc. does blood work, including markers every 6 months, now. I only get scans if I have a specific complaint, and even then refers me first to a specialist.

This is very helpful information since I'm getting close to surgery and rads. I had neoadjuvant chemo first.



Has anyone taken tamoxifen during rads? I was told by my mo that tamoxifen and rads work against each other. I want to take systemic hormonal therapy as soon after surgery as I can.



Thanks, Ladies.

I switched medical oncologists earlier this year. Both of mine have done labs every 6 months and chest x-rays annually. I see my oncologist next month and will ask her if I can stop having the x-rays. I'm just not comfortable with the extra radiation.

I'm IBC, Stage IIIC, 19 pos. nodes, ER+.  I started Femara a week after starting rads.    I did 4 neoadjuvant DD A/C, followed 2 weeks later by mod. rad. mast., followed 3 weeks later with 12 weekly Taxol.  A week after last Taxol, I started rads.  That all started in Aug, 09.

Since then, I see my PA every 6 months (she's been my PC for 17 yrs so I see her for any issues that need addressing more often IF needed) and have blood work done then.  I see my Chemo Dr every 6 months (falls 1/2 way between when I see my PA).  He does not order blood work but goes off the most recent she hads done.  I have an annual mamo.  That is the extent of all 'testing' unless something specific comes up.  I had a head MRI done in Oct 10 because of head pain but it showed nothing and the conscience of opinion was that for some strange reason a nerve had gotten 'irritated' as 2 weeks of of Dex took care of it.  I was having more back pain (from arthritis so had a bone scan to be sure it wa 'just' the arthritis which it was.  That's all I remember having had. 

I do not want any more radiation than is actually NEEDED.  I had had radiation done to my throat when my tonsils weere taken out at 1 1/2 yrs (a fairly common practice back then in the 1940's).  I was always warned to keep my thyroid checked as the potential for thyroid cancer was a possibility - did develope but IBC did and Drs have said that radiation could be a contributing factor - so no unnecessary/unneeded radiation for me.  I have had 3 surgeries since end of TX and VA's protocol is that a chest X-ray had to be done before surgery if there has not been one done in 6 months.  I got my Drs to waive that requirement when I had the surgeries when I explained to them about the radiation as a very small child.  Two of the surgeries (2/12) were cataracts and the other for really 'messing up' my wrist last Jan by slipping on one of the dog bones in the hall. 

So anyway, I will do what needs to be done but not a 'just because'.    

I am 13 years out from the first BC and almost 8 years out from the second BC. Because my second was Stage IIIC with 23/23 positive nodes I still see my oncologist every 6 months and my breast surgeon every 1 year.  I get blood work including Ca 27:29 tumor marker every 6 months and annual CT scans.  I am a strong believer that "waiting for symptoms to appear" is possibly waiting too long in some cases.  I understand the concern about radiation exposure and "false positive" results, but I also believe that treating a single small spot of local recurrence is much easier and provides better quality of life, than waiting until treatment options are limited by a widespread or distant recurrence.

Everyone has their own approach and comfort zone when it comes to post-cancer treatment monitoring.  I am much less worried about the radiation from an annual scan than I am worried about missing an early recurrence.  The old mantra that "early detection does not change survival outcomes" may have been true 30 years ago when Stage IV was considered terminal with less than a year predicted survival, but that is certainly not the situation today. With today's detection and treatment options patients can live many years with advanced cancer as a chronic illness. 

My oncologist had me on low dose Xeloda (oral chemo) during my 7 weeks of radiation because it was supposed to make the cancer cells more susceptible to the radiation.  I also started on Aromasin as soon as I finished chemo and prior to starting radiation.  I have been on Aromasin for 7.5 years now and will continue it indefinitely.  I also had 5 years of IV Zometa which ended in 2011.  While I know we can never guarantee that the cancer won't come back, I prefer to feel that I am doing what I can to stay on top of things.  If it comes back anyway, then at least I won't be second guessing or regretting my choices.  Again, this works for me but does not have to work for everyone else.  Each of us must make the choice that we can best live with and still put cancer on the back burner so we can get on with our lives.