Starting Chemo

[cherylandmark]

My husband Mark has not started chemo yet. He had surgery on Nov 17th.
The surgeon seems to us to be dragging his feet about getting Mark referred to an oncologist. I know time is very important in starting chemo, can anyone tell me what is the general time between surgery and starting chemo. Thank you all for prayers and help. God Bless
Cheryl

[rthornton]

Hi Cheryl

I had a total colon resection on May 23, 2005, and started chemotherapy around the first week of July. The doctors wanted to give me time to heal from surgery because I would be getting infusions of Avastin. Avastin can present problems when healing from surgery. So, it was about six weeks post surgery, for me, before chemotherapy started. By the way, I was diagnosed stage four with liver mets considered unresectable.

Best wishes for successful treatment,
Rodney

[Magnolia]

You need time to heal from the surgery before starting chemo. Avastin is a problem with healing, but so is any chemo. It attacks dividing cells and so will interfere with the healing process and can also impair immunity. About 5 weeks after surgery is what I hear is the most you want to wait, but it's up to your docs. There may be some variation based on the type of surgery and the type of chemo.

[meighan]

I just wanted to add that as the others have stated it was about 5-6 weeks between surgery and chemo. We had our surgery at sloan in NYC and met with the oncologist about day 5 post op before discharge as that is when they had the pathology report. At that point chemo was discussed and folfox 6 came out as the first line treatment of choice..... i have wondered since then if we should have further discussed other medications but we trusted our oncologist and he worked directly with the oncologist here at home and she also agreed with the treatment plan. Avastin seems to be the big do or don't for stage three....... We were told it stops blood flow to tumors so if there are little tumors there it could zap them before they start to grow. The problem is with stage III technically you don't have any tumors to kill so do the benefits outway the risks.... there are people who believe strongly both ways but the verdict isn't in... if you have small microscopic tumors you would most likely benefit from it if not it does come with some risks .... it was our toughest decision but we did not get it and with my husbands elevated liver enzmes with the oxciliplatin i think it was the right choice for him and if god forbid we need it in the future it could be added. Each case is slightly different and you want that 100% but listen to all they have to say ask the questions and in the end my husband felt this was what was right for him and that is a huge part of being in this fight....feeling good about your treatment and confidence in the team treating you. Good luck I know this is excruciating and please know that the above is just how i was told, others on this board may have more to add or corrections to make in my statements it is a new world and vocabulary to learn...... Lastly is how is your husband doing??? up and walking??? Take care of eachother and you are in my thoughts and prayers

[Magnolia]

Folfox in some form or other, (it can be given several different ways) seems to be a very popular regimen. Avastin in Stage III is still a plus minus. We aren't sure if it helps with no measurable tumors, but in theory, it could. It can have side effects, though, so is one more drug worth the "maybe" benefit? Maybe. I'm on it, but I'm having no problems with it. Other posters have had problems and have had to stop it. We know it helps in Stage IV where there are tumors to starve out. We don't know yet if it helps PREVENT recurrances. The study I'm on will help decide that. Get all the information you need and make the decisions that are right for you. Talk to your docs, get a second opinion, and move forward. There's more than one right way to treat this disease, and you just make the decision that feels right. Don't get too upset if someone else is doing something different. There are a lot of options now, and lots of things work.

Trust your docs, especially if you get another opinion that agrees with the first one. If it doesn't get a third and go with the two that do agree. The docs know what they're doing most of the time. The exceptions are rare. They are monitored and peer reviewed. You can trust them, but not blindly. Read stuff. Ask questions. There's a good book out. "Things Your Doctor May Not Tell You About Colon Cancer" or something like that. Written by a doctor. It helped me a lot.

[ASTEPHENS33]

My experience is consistent with the other posts - I was five weeks after chemo. However, I saw an oncologist about 2 weeks after surgery and thought it was worthwhile. There was lots of information to process and choices to make. In my case, I wanted a second opinion and it took time to get another appointment. You didn't indicate the staging of your husband's chemo and I found it worthwhile to post my situation to get specific feedback on people's experience.

[Hannah]

Hi Cheryl,

It is definitely "normal" to wait six weeks before starting chemo, but I would insist on being referred to an oncologist ASAP. You will get a lot of info thrown at you, and you will want time to think about it and possibly seek a second opinion. I know that you and Mark are already concerned about getting good information, and it wouldn't be a bad idea to go ahead and meet with an oncologist if Mark already feels recovered enough from his surgery.

Hannah

[Lifes2short]

Cheryl,
As the others have pointed out, you do have some time before the chemo should start, but you certainly should be involved with an Oncologist by now. Sometimes it can take a couple weeks to get the first appointment. Also, remember that the Oncologist is the person who is going to be working with you for the duration of treatment and follow-up. You have to like and trust this person. If you have any reservations or questions, then you should get a second opinion.

I got inolved with my oncologist before surgery (but I did chemo and radiation prior to surgery). I knew early on that she wasn't the right person for me, but I was hesitant to make a change. By late October I just couldn't stand it any longer. Her treatment of me borders negligence. I found a new oncologist and couldn't be happier. This guy is on top of all the latest stats and treatment plans.

I have learned this month just how important it is to trust and feel good about your doctor. I'm even finding that my chemo goes better with the new doc - I think it's because I know that I can pick up the phone and call if I have any problems. With the last doc, it wasn't that way at all. "oh, sorry you don't feel well. Get some rest, we'll see you in two weeks. No, the doctor can't speak with you".

Good luck. And if your surgeon doesn't refer you to someone, take matters into your own hands and start making calls. Sometimes you can tell how an office runs just by the way you are treated when you call. If they are warm, helpful and friendly then it's likely that the docs are that way as well.

[cb]

My husband didn't start chemo until 8 weeks after surgery. They wanted him to be fully healed from surgery and made sure his blood counts looked good. You want him to be strong enough to fight off infection. Definitely talk to an oncologist asap so you can get your questions all answered.