Advice needed: can't see my oncologist

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tarry
tarry Member Posts: 156
edited December 2014 in Hormonal Therapy - Before, During, and After

i'm getting treatment at MD Anderson in Houston. My psychiatrist is concerned that I'm getting more depressed, and has said I should discuss my meds with the onc.. But the nurse practitioner, whom I see today, says she will relay any questions she can't answer to the onc. I haven't seen an onc for 3 years.

Is there any downside to going off femara for 2-4 months? I had a large tumor but it was at stage one. I had a disfiguring lumpectomy, but I'm 72 and no one is much interested in how I look naked. Including me, actually, though I'm quite concerned about how I look dressed.

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  • Fourminor
    Fourminor Member Posts: 354
    edited December 2014

    I would be concerned at why you haven't seen your oncologist in 3 years. Is there a reason for that?

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  • doxie
    doxie Member Posts: 1,455
    edited December 2014

    tarry,

    Many of us have taken breaks due to SEs, sometimes in transition from one med to the other or to see if an SE will go away while off AIs. I took a 2 month break once. It scared me to do it, but was requested by my MO.


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  • tarry
    tarry Member Posts: 156
    edited December 2014

    Not seeing one's onc but instead seeing a nurse practitioner seems to be MD Anderson's policy. It saves them money, I guess. My husband is coming with me today. We're going to argue against the policy. I'm cross to think he'll be taken more seriously that I will.

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  • tarry
    tarry Member Posts: 156
    edited December 2014

    doxie, thanks. Insomnia is my worse probblem, followed by urinary track problems. I also seemed to put lot of fat on my abdomen

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited December 2014

    We may all need to get used to seeing mid-level practitioners for routine assessments: there aren't enough oncologists being trained to take care of everyone in the future (I attended a University of Wisconsin cancer conference this fall which analyzed these trends)...

    That being said, perhaps an exception can be made for tarry's situation especially if the NP feels that s/he cannot OK a "drug holiday". Certainly the psychiatrist would take any possibility of seasonal affective disorder into account. Has the vitamin D level been checked recently?

    Lack of sleep can lead to a downward spiral just by itself. Exercise can help or perhaps a short course of medication. Some people use melatonin which does not require prescription. I hope you were successful in establishing a treatment plan at this week's appointment!


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  • Kicks
    Kicks Member Posts: 4,131
    edited December 2014

    vinph mentioned SAD (Seasonal Affective Disorder) which causes depression. There are some very easy 'things' that can help drastically without meds.

    Most/Many women are low in Vit. D which is associated with SAD. The farther north you live, the more likely but it's possible anywhere. The older we get the more likely. I have also read that low Vit. D can be associated with BC. I've been dealing with SAD for 20 years (long before my IBC) and I'm 68 now. What works for me is taking Vit. D year round and doubling it from late Sept - late May. I also use a Light Box daily from late Sept - late May. This is per my Psychiatrist orders. I am able to keep it well under control with this regime. I refuse to take 'anti- depression' drugs as they are a 'downer', not letting me feel ANYTHING - the good feelings along with the bad. I have my every 6 mth appt with my Dr this afternoon. Primarily it's my ADD that she insists on seeing me every 6 mths so I can just call in for refills monthly. (Yes, contrary to some ignorant, though common 'thought' - females can be ADD and even OLD women - but that's another issue.)

    A Light Box is simply a 'light' that simulates day light which stimulates Vit. D. Actually I have 2 of them. The first one I got looks sort of like an older office desk light. My new one (2 yrs old) is more of an upright 'cube' that directs light straight out to the front. (An off side of having them - they are great for starting seeds early inside in Spring in northern/cold climates.). I have my new one plugged into a timer and sitting where it will come on and hit my face at about the time I would wake up anyway and then it goes off after 40 mins if I don't turn it off sooner. Though it simulates sunlight, it does not have the harmful parts associated with skin cancer - at least according to my Dermatologist (I've had SCC and BCC).

    How I look? Doesn't matter to me how I 'look' when 'naked'. The only people who ever see me that way are medical personnel and Hubby. Medical personnel are just that - medical personnel - so what. Hubby is happy that I'm still alive! With my pros., I look exactly like I would if I hadn't had a modified radical mastectomy.

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  • WinningSoFar
    WinningSoFar Member Posts: 951
    edited December 2014

    Well, so much for a cancer team. It's too bad that your psychiatrist can't just pick up the phone and conference with your oncologist, and instead relies on you to be the intermediary. I hope that you and your husband get this settled, but it's disturbing to see MD Anderson undermine the team philosophy.

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