Wanting to start chemo ASAP

[nomoretacos]

Hi all,

I had LAR surgery on 21st March and recovering really well. I've been told I am stage 3. My surgeon scheduled my initial oncologist appointment for 29th April which is nearly 6 weeks after the surgery. Is this pushing it a bit too long? I wanted to move the appointment earlier but the oncologist is on leave. I'm a bit stressed that the appointment is so far away and it is only the initial appointment, so actually starting chemo will then be even further away.

Do you guys think this is okay or should I try and be more proactive?

I know the oncologist will want me to do a PET scan (since i've only had a CT completed) and I assume bloods (what bloods exactly?) is there anything else? At the very least I could try and arrange for these tests to be completed prior to the oncologist appointment so she has everything she needs and there will be less delay in starting chemo.

Sorry i'm quite stressed about everything and having to wait around.

I appreciate any responses, thanks.

[Ragman]

Hey nomoretacos,

Is there any other oncologist that can see you earlier? My surgeon/doctor wanted to get me on chemo within 6 weeks of the surgery. They generally want you to recover so that your body is strong enough for chemotherapy, so I can see that they would not want to start the chemo right away. Six weeks for your first consult seems a bit long in my opinion. But I am not a doctor so it doesn't really matter what I say. It certainly doesn't hurt to follow up though. Remember, you are your best advocate for yourself. The medical establishment is built around what works best for them -- the establishment -- rather than what is necessarily best for the patient. Some doctors will go the extra mile to cut through long wait times for appointments, etc. to speed things along, but often you are dealing with administrators and secretaries that do this everyday. Don't get me wrong, I'm not suggesting that anyone is trying to delay your case; just that in most cases -- in their eyes -- you are just one of many. Your case might (or might not) warrant being seen earlier -- but you never really know unless you follow-up. Give the oncologist office a call and see if there are any openings/cancellations or if another oncologist can see you in the meantime to get some of these tests, etc. set up until your primary oncologist comes back.

Best of luck.

[squak]

Hi Nomoretacos,

Not sure if this is any real consolation to you but I had an open LAR on Feb 10th - and have still not met with an oncologist I am scheduled for my first appointments with oncology only next week (week of Apr 11) - making it just over two months. My CRC has not even been fully staged yet, though it was a T3 tumor - so almost certainly a stage II or III..

I have been assured from multiple folks (ie surgeon, nurses, family physician etc) that the timeline is primarily driven by completion of the suggested healing time for your particular type of surgery (in my case 6-8 weeks, could be less if you had eg a laparoscopic one) as well as the surgical pathology report (which took ~10 days from surgery day.)

While not confirmed, my surgeon suggested that my tumor had been festering and growing in my body for approx 6-10 years, based on his experience. When I think about that, the few weeks difference didn't seem to bother me, although the waiting is not easy. My guess is if pathology had found something particularly alarming or a highly aggressive form or high-grade of cancer - the whole process may well have been fast-tracked.

Hope this helps, wishing you all the best

[jhocno197]

My husband's first appointment with the oncologist was 6 weeks after surgery; started chemo two weeks after that.

[cmrl]

You'll probably need to have a port put in, but they can use it immediately, if need be. Why not consider making an appointment for a second opinion, if you can get one sooner. Then you can get your questions answered, and see who you prefer. When I went for a second appointment, I was told that the treatment was the same, but I should start soon .

[AnnClare]

nomoretacos,

There are some good responses here and just wanted to add my two cents.

I met with my oncologist approximately two weeks after my laproscopic surgery and began FOLFOX chemo on March 28th (4 days after my port was placed, and 6 weeks after surgery). I tend to agree with squak in that if there was a belief you needed to be fast-tracked, they would've done so. That being said, it never hurts to get a second opinion or see someone sooner, if for no other reason than to lessen your anxiety of a long wait time.

From what I've read, beginning chemo itself is usually at least 6 weeks after surgery. Your body needs time to heal before tackling something else. I know this is a stressful time - unfortunately all of us here can relate. But know that you're not alone. This board is a great resource.

Best of luck to you and please keep us up to date.

[nomoretacos]

Thanks for all the replies, they have been very informative and helping with my anxiety

The reason i've been stressing out so much is I read an article saying your survival rate decreases when you start chemo 8 weeks post surgery as opposed to starting it earlier. Whether this is the case or not id rather not take the risk. I understand the need to heal and recover from surgery but if the standard time to start chemo is 4-6 weeks post surgery then I want to be within that timeframe, also considering that my surgery was laparoscopic so healing time would be faster (hell its been 2.5weeks since surgery and I feel great).

At this point i'll do whatever I can to move the appointment earlier or see a different oncologist. If that fails then ill just have to stick to the set appointment.

[BeansMama]

Nomoretacos,

You can't believe everything you read. I had my initial surgery on November 18th. I did not start chemo until the end of January / beginning of February. I just got my scan results and I had decent shrink in both my liver tumors. The small one went from 4.7 to 2.9 and the large went from 10.1 to 7.2.

Everyone is different, it depends on how your particular cancer responds to the treatment. I am not even getting the full treatment yet as my incisions from my surgeries have not fully healed so they cannot give me the Avastin. I am still having a good response, no spread, and I had to wait longer than six weeks.

Just wanted to give you an example of the flip side of having to wait. I know all too well the stress of waiting and thinking about those cells in your body. Your doctors know what they are doing. At some point you have to trust them. If you cannot trust them then it is time to find different doctors.

[Redtexa5]

As someone who has been on this path for far longer than you Nomoretacos I suggest laying off Dr. Google. He will have you picking out your coffin five times a day if you let him. But for the record colon cancer is slow growing for the most part so a few weeks one way or another won't matter. I assure you that you will be doing very well if this is the only delay you face during your treatment.

It sounds like you want to come to grips with the cancer and kick its ass which is a great way to respond when you are scarred half out of your mind which I am sure you are, I certainly was when I was first diagnosed, but I am sorry to say the treatment process takes its own time and there are pit falls through out.

Try to save your energy for treatment and get yourself in the best shape you can before treatment, that will help immensely.

[ANDRETEXAS]

I know everyone is different, but I met my goal of starting chemo within 4 weeks after my colon resection. I know you can wait longer, but that time frame worked for me because my surgery had healed in time to start with that time frame in mind. Best of luck to you! Andre

[Jacques]

...Do you guys think this is okay or should I try and be more proactive? ...

I think the best way to be proactive right now is to make sure that you are in top physical shape for the start of chemo. Also, if possible, you should be sure that you have a complete set of labs before you start chemo so that you have a good pre-chemo baseline that will tell you if your body is deficient or borderline in any way as it starts dealing with chemo.

Initial Recommended Blood Tests
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=53111&p=419599#p419599

Chemotherapy treats the body very harshly in many way, so the stronger and healthier you are when you start chemo, the better. You may find that you will need to take some kind of supplements before or during chemo if your labwork now is only borderline. For example, it might turn out that you are low on Vitamin D, iron, or some other minerals like magnesium, selenium or potassium.

During chemo you will have to have some labwork done before each new cycle is initiated, and it often happens that patients will fail a required lab test and then be forced to postpone the next cycle until their lab values improve.

Also, if you are going to have a baseline PET/CT scan done, be sure that you obtain the PET/CT prep instructions from the hospital and follow them closely. This is to make sure that you get a good, accurate baseline scan that is not cluttered with false positive signals.

http://www.texasoncology.com/CMSPages/GetFile.aspx?guid=79347d82-41bd-48c4-a4ae-274e69f7c330

[peanut_8]

Thanks for all the replies, they have been very informative and helping with my anxiety

The reason i've been stressing out so much is I read an article saying your survival rate decreases when you start chemo 8 weeks post surgery as opposed to starting it earlier. Whether this is the case or not id rather not take the risk. I understand the need to heal and recover from surgery but if the standard time to start chemo is 4-6 weeks post surgery then I want to be within that timeframe, also considering that my surgery was laparoscopic so healing time would be faster (hell its been 2.5weeks since surgery and I feel great).

At this point i'll do whatever I can to move the appointment earlier or see a different oncologist. If that fails then ill just have to stick to the set appointment.

I think you have made a wise decision.
Best Wishes, peanut

[Tarsal69]

You have come to the right place for advice an hour journey will hopefully be positive I started my chemo 8 weeks post Lar and just had my first scan post chemo and am Ned for now stay patient an strong you will get through this try an get your ct an pet scans done along with a port in an today the opinion is 6 to 8 folfox txs are needed so do your research an stay positive I know it's tuff rite now but enjoy life while you can