Basil wrote:... I have an appointment Wednesday afternoon to discuss whether additional adjuvant chemo is worthwhile. My PCP says it's not. We'll see. MDA should be taking outpatient by then.
Basil wrote:All outpatient at MDA is cancelled tomorrow.
Basil wrote:My meeting with my onc was delayed because Harvey shut the city down this week...
Still going to meet with the onc next week and the surgeon after that before making a final decision.
Basil - When you eventually meet with your doctor(s) this week, I think you should be prepared for this meeting in case it turns out to be an end-of-treatment meeting. In other words, if the net result of your next meeting is that you and your doctor(s) decide "No more chemo needed", then you will be at the transition between active treatment and the five-year surveillance period (after you have had your ileostomy reversal, of course).
This transition is an important event because it represents a shift from treatment-guided
decisions to surveillance-guided
decisions. The treatments you have had so far have been surgery and FOLFOX chemo, directed by a surgeon and an oncologist. After you have made the transition into the followup period, however, there is no longer any direct need for a surgeon and no direct need for an oncologist apart from scheduling and interpreting periodic tests. The main focus for a Stage II or Stage III followup patient would be in other areas related to long-term effects of previous treatment -- for example long-term, delayed effects of chemo or surgery. These problems may require other kinds of expertise, and other kinds of specialists such as dermatologists, urologists, proctologists, gastro-enterologists, neurologists, cardiologists, endocrinologists, physical therapists, etc., for resolution.
Thus, for a Stage I, Stage II. or Stage III followup patient, it is important for this transition to be acknowledged openly and for explicit plans to be made to orient the patient's medical team in a different direction in order to be prepared for this new and different sort of challenge -- the challenge of dealing with various treatment-induced disorders.
Normally at this transition stage the patient is given two documents: (1) A treatment summary document giving details of DX and all DX-related treatments, and (2) A customized follow-up care plan with a schedule for the next five years:https://www.asco.org/sites/new-www.asco.org/files/content-files/practice-and-guidelines/documents/colorectal-cancer-treatment-summary-and-survivorship-care-plan.docx https://www.livestrong.org/we-can-help/healthy-living-after-treatment/late-effects-of-cancer-treatmenthttp://www.healthline.com/health/cancer/effects-on-bodyhttp://www.cancer.net/survivorship/long-term-side-effects-cancer-treatmenthttp://www.cancer.net/research-and-advocacy/asco-care-and-treatment-recommendations-patients/follow-care-colorectal-cancer
Good luck on your meetings this next week. Let us know the outcome.