Why do I even have to see an Oncologist?

Hi Sammia, congratulations on completing your treatment. With regards to your question, I don't think you have to do anything if you don't want to. It's your choice. If you are asking what the benefits of regular follow ups with MO might be, I can list a few:

1. regular manual exams can catch a new lump before you notice it,

2. you can discuss any new symptoms no matter how small,

3. you can ask questions about new treatments, trials, etc that you are interested in

consider this an onco physical of sort

You are doing something preventative...you are taking letrozole. You may have symptoms that develop while taking that and you'll need to discuss those with your MO so he/can can give you strategies to deal with them, etc. Your MO should also be doing a clinical breast exam at your visit, and do a physical exam looking for things that could signal trouble or cancer spread. I know it seems that a family doctor could do that. Some can, but most are not that familiar with these medications that we're on to know dosing, side effects, interactions, etc. Mine had no idea that the AIs put you at increased risk of trigger finger. Nor did the orthopedic who treated mine. I showed her the information on it and she was glad; she'd noticed a lot of women on them who came in with trigger finger, but thought it was just coincidence. Doctors know their specialties well, but can't know everything about everything. Family docs know a bit about a lot of different things, but with the rapid rate that new drugs come out, they can't possibly know everything about all of them. How you choose to follow up and who you follow up with is up to you, but your MO is the one who will be most up to date on preventing and detecting recurrence.

If the SEs from letrozole are becoming a burden you have options. Are you taking supplements - Vit D and Calcium? I'm sure others will chime in with supplements they find useful.

Have you tried other mfg of the letrozole? Some people think the fillers in different mfg can cause side effects. I'm using Teva and so far, so good.

Does your MO recommend trying a different AI. You might not react to one of the other ones.

If your MO doesn't work with you to find the best solution then you might need a new MO.

Hi Sammia, how old are you and how long have you been on letrozole? In my experience, it might get better after the body adjusts to it - takes 5/6 months. The thing that works best - again, in my experience - is regular exercise.

If your onc hasn't suggested another another AI or switched you to a different manufacturer I would get a new onc. There are some onc's who know a great deal about this. If it were me I would switch oncs. Rather then being unwilling with work with you, she may not have the latest information . Good luck!

Also, try getting more regular exercise, including stretching, cardio and weight lifting (start with small weights.) You will be surprised how much better - both physically and psychologically - you will feel. Swimming is great if you have access to a pool.

sammia...she should be examining your breasts even though you had a BMX. Its rare but there could be a local recurrence in the breasts still. Actually someone should be checking them. Do you still see your breast surgeon?

Hi Sammia:

Your breast surgeon should check the lymph nodes along the sides of your neck, along your clavicles (the bones that run horizontally from shoulder to shoulder), and in the axilla (underarm). She should feel the front of the chest, and along the surgical scar. In my most recent exam, the physician's assistant also did a visual inspection from a distance.

You can do your own manual monthly or bi-monthly inspections of your underarm, chest and scar (e.g., in shower), and of the overall visual appearance in the mirror to learn the landscape and spot any change early.

BarredOwl