Traveling during first two weeks of chemo?

Trvler
Trvler Member Posts: 3,159
edited March 2015 in Chemotherapy - Before, During, and After

How bad is this idea? Dr. Stolier in NOLA wants me to start right away. I have an appt with them IN NOLA on March 16. That was the only day I could meet at least one of the PS's that was close.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited February 2015


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  • SpecialK
    SpecialK Member Posts: 16,486
    edited February 2015

    If it is your first chemo you have no idea what your side effects will be. Also, your WBC nadir is at 7-10 days, so it makes you vulnerable to opportunistic infection, during cold and flu season. If you are having chemo first is there a reason you need to rush your surgical consult?

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  • Trvler
    Trvler Member Posts: 3,159
    edited February 2015

    I was doing it so that we could meet the people at NOLA and get comfortable with them. Otherwise, I won't get to meet them at all before we go there for surgery.

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  • Trvler
    Trvler Member Posts: 3,159
    edited February 2015

    What's a WBC nadir?

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  • Trvler
    Trvler Member Posts: 3,159
    edited February 2015

    NOLA told me to start chemo right away so should they have booked me to come there on the 16th? Should that concern me?

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited February 2015

    Chemo can have an impact on all of your blood cells. At the 7-9 day mark (the nadir, or low point) your white blood cells, which help you fight infection, drop to their lowest point in the cycle.

    If the docs at NOLA want you to have chemo first you have months before you need to determine what to do about surgery.The decision regarding whether you travel for a consult during chemo is up to you, it is not really their responsibility to determine whether it is a good idea. That decision would be more in the oncologist's wheelhouse.

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  • Trvler
    Trvler Member Posts: 3,159
    edited February 2015

    How long does chemo last?

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  • Trvler
    Trvler Member Posts: 3,159
    edited February 2015

    The BS at NOLA IS an oncologist so you would think he would at least KNOW that. He didn't know when they were booking me to come in but his nurse did.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited March 2015

    Trvler,

    Chemo usually lasts 2 - 5 months depending on the regimen. I had dense dose AC (two months) and then Taxol-Herceptin-Perjeta (three months), so I had five months total. My last chemo was December 3, and I didn't meet with my surgeon until mid-December to discuss surgery.

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  • Trvler
    Trvler Member Posts: 3,159
    edited March 2015

    Oh, wow. Ok. I had no idea it went on that long.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited March 2015

    Well, you might get lucky and only do two months.

    I had to do all that Herceptin/Perjeta because I'm HER2+.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2015

    If you are looking at possible node positive and multi-focal disease (correct, right?) I would think you would be looking at a minimum of three months, more likely closer to five to six months. I had 6 rounds of TCH and was in chemo from Feb to June. You have to allow a period of time between the end of chemo and surgery to clear the drugs from your system, and recover your immune system and ability to heal. Taking on a big surgery like autologous reconstruction requires being in an optimal position to recover. I would think your surgery would be at least 6-7 months from now at the earliest.

    Also I think you might be confusing an oncological breast surgeon and medical oncologist. An oncological breast surgeon is a general surgeon who specializes in breast cancer surgery after a training fellowship. This is different from a medical oncologist who specializes in systemic treatment.

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  • Trvler
    Trvler Member Posts: 3,159
    edited March 2015

    I was told the surgery would be like 2 weeks after chemo ends. They won't do recon at the first surgery. They do the cancer breast mx and implant, rads, then after rads heal, they do other side mx and recon on both.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2015

    The decision regarding when they do surgery cannot possibly be made until you finish chemo.  Your WBC status, and how you have handled chemo dictate when the surgery is, not someone's arbitrary calendar.  Even if no recon is done you can have healing and incision closure issues. Not to mention, you may not be physically able to travel or handle a surgery that quickly. 

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