Do you all do bloods at your follow-up appointments?
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I get blood work right before every MO appointment.
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I have yet to get blood drawn. Other than kidney function tests prior to the MRI, no labs. Not even preadmission labs before surgery. The hospital said since I'm otherwise healthy....
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When going through treatment you get labs drawn regularly. Once you are put on hormone meds, some oncs do and some don't unless they suspect there may be an issue. Mine doesn't routinely now as I don't have symptoms that would say check my labs, like infection or something. As for hormone status, that doesn't tell them anything either since you can recurr/mets at any level and you'll never be at 0 ER. She did hormone labs on me to make sure I indeed was in menopause and not just chemopause before starting me on hormone therapy. Labs are pricey and if there isn't something that says you should check, it's not needed once out from treatments on a routine basis. It's my pcp that follows me more closely with labs that don't have to directly do with what an onc looks at, like my liver panel for fatty liver or cholesterol levels which are high. How often pcp will order this (and cc onc) depends on what she sees.
So if you are looking for routine labs, ask your pcp about your concerns, not your onc.
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I always have it done prior to appointments b/c my MO wants to check my liver function and WBC/RBC count.
For what it's worth, I would not be okay with a doc who's moody, has bad days that affect the way she treats me, and around whom I feel I have to tiptoe.
Have you considered switching docs?
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The most important thing is do you like/trust your onc. Pcp and onc are for lifetime, at least mine are. My onc told me it's the pcp who does the thorough check. When I go to fu at my onc, she checks my heart, breathing/ungs, abdomen for bulging or pain, and fake breasts for lumps/bumps. Some practices may be too busy with chemo to do it all so they tell you to check in with your pcp. My pcp has me on a every 4 month check so far. It all depends on what she sees on labs. I have high liver function and cholesterol. Everything else is fine. I'm sure if my liver function and cholesterol become comfortable for her then I'll see her less often. I anticipate if those look good then I'll be like everyone else to be seen once a year max twice and only more if I have issues. It's all on a we'll see as to how often I'm checked with labs- and for scans it's if you have suspicious symptoms. I have lower abdominal pain that an abdominal u/s didn't show anything. Pcp ordered that and now has me going to do a pelvic u/s to check my uterus to see if the fibroids are the culprit due to Tamoxifen. I may be referred back to my gyn for more in depth consultation. The way I see it is there is a team. Onc was the chemo doc and getting me on hormone therapy and keeping periodic tabs on me with these physical exams. If I express an issue with her then if it's not her specialty then she refers me to the doc that is- like my pcp or gyn. While she is a doc and understands lab results, pcp is the one who really does the referring around to the specialists. So if pcp gets the results that my lower abdominal discomfort is my reproductive system, she'll refer me to my gyn to discuss options. Onc will be cc'd on everything and will be updated and will participate as needed when I go to an appt with her. Not sure if this makes sense but that's why I'm not hounding my onc about doing routine lab work, because I have a team who are working together in monitoring me.
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You're welcome. Best wishes!
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I still have standard blood work before every MO visit - now every 6 months since I'm 2-1/2 years past active treatment. I also push and get the cancer antigen test, but many docs won't do that one because it isn't definitive. That said, I am ER/PR negative and HER2 positive and had a recurrence w/node involvement. Although we all have breast cancer, all of us are different. If you enter your diagnosis & treatment in My Profile, it will help us to better address your questions.
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Loya - I probably would be pushing for at least standard CDC & Comprehensive blood tests on a regular basis.
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I get a full chem panel (but not lipids) before each bone treatment (first Zometa & now Prolia); before I started on those, I would stop off at the lab first before going upstairs to my MO for my 6-mo. followups. She’s looking primarily for calcium levels as well as liver & kidney function, and the panel throws in RBC/WBC/H&H for good measure to make sure I’m not anemic or fighting some major infection. Glucose gets measured just because it’s part of the panel, but she’s not that concerned about it. As to lipids (cholesterol & triglycerides), she says that’s my PCP’s territory—as are immunizations & heart, pulmonary, orthopedic and digestive matters.
No tumor markers are tested, nor will they be unless I show symptoms of possible mets.
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Hi all. I'm 2 years out from diagnosis and haven't had blood work done since prep op. I'm being treated at a major NYC university teaching hospital. It's just not in their protocol for stage one unless you have a complaint. IMO it's a bit ridiculous not to check on overall health. Good luck to all....
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I have a CBC, CMP, CA27/29, CEA and Vit D prior to each appt with my MO, always have, and I am at 6 years post-diagnosis. I get a Prolia injection every six months, and am still on anti-hormonals (Femara). My MO orders periodic scans, some based on symptoms and some on time, and my DEXA every two years. He has also prescribed Metformin, based on study data particularly correlating Her2+ and recurrence prevention with the drug even though I am not diabetic. I do not receive a lot of care from my PCP (military) they usually function as the conduit to more specialized care outside of the military system, they coordinate any imaging that can be done on the military base, and treat nuisance stuff that comes up infrequently.
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I have routine labs done every 6 months when I see my PCP for my maintenance meds. She gives me extra copies for the BS, RO & MO. I either fax them to the docs or bring them with me if I have a follow-up appointment.
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My MO does no blood tests whatsoever once you are done with chemo. Says there is no reason to do any. My family doc does basics, CBC and cholesterol and whatever else is routine, annually, because of my cancer history, otherwise they only do it every few years.
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hi Loya
I didn't get chemo. I am in the hormone therapy phase of my treatment and have never had blood work done during any of my treatment. I go for my first follow up since starting tamoxifen soon, so who knows if she will draw anything.
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