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Oncologist Follow-ups Post Treatment ?????

cbs6931's picture
cbs6931
Posts: 63
Joined: Mar 2010

Question for those of you post treatment regarding follow-up visits to your oncologist.

Post Treatment how often did you have follow-up visits with the oncologist and what occurred during the follow-up (blood work, etc.)???

I'm two months out and the oncologist was not particularly diligent during treatment, he seems to be wanting to see me more frequently now that I'm out of treatment. I'm wondering what everyone else experienced. I don't want to have purposeless follow-ups.

Thanks a bunch, I'll talk to him next time to get a better idea of what to expect.

Cathy

pjjenkins's picture
pjjenkins
Posts: 173
Joined: Mar 2009

My first post treatment followups were about six weeks after treatment. They included sessions with both radiation oncologist and medical oncologist and included another PET scan not quite 3 months after end of treatment. Then another round of visits at 6 months and 9 months to about a year from diagnosis. Then it went to 6 months and now, at my radiation oncologist's suggestion, I see one each about six months apart. This September it will be an "annual" with my radiation oncologist and I had one with my medical oncologist in June and am scheduled again for next June. To be sure, I have continued NED all this time. I had PETs twice following treatment the first year and now have sigmoidoscopy every 6 months.

The sessions so far have included blood tests each visit and a "nurse assessment" before seeing the docs.

Hope this helps.
Priscilla

z's picture
z
Posts: 1269
Joined: May 2009

Hi Cathy,

I had follow up dr visits every 3-4 months alternating between my oncologist and my colo-rectal surgeon. Every oncologist appt, blood was drawn to make sure my levels were returning to normal. I had dres. I had a biopsy/hemrodectomy 4 months post treatment. I had an anoscope 6 months post tx. I have had 2 pet-ct scans post treatment. I completed treatment 6-30-09. The oncologist should certainly check your blood levels to make sure they are returning back to normal. Also your drs should do an exam of your anal canal. Not everybody has the same type of scans, some have just ct scans. From what I have learned you should be seen every 3-4 months for the 1st year, and thereafter the visits will probably stretch out longer. Lori

mp327's picture
mp327
Posts: 3104
Joined: Jan 2010

I have been seen by my oncologist every 3-4 months since finishing treatment and have had a PET scan prior to seeing him each time. He only checks me for liver and lung issues and discusses the scan results--he does not do a DRE. He always does blood work on me. I seem to be getting more PET scans than most (and am having one on Wednesday). My colorectal doctor sees me every 3 months for DRE and scope. My rad onc now sees me every 6 months and does DRE and checks for nodes. I am coming up on 2 years post-treatment on September 9th.

duckyann
Posts: 162
Joined: Jun 2009

I see my medical oncologist every 3 months and he does do a DRE, blood work and checks my nodes. I was seeing my colorectal doctor every 3 months up until March and now I am on every 6 months. He does a DRE & scope. I only saw my radiation oncologist right after treatments and I don't see him at all. I get PET/CT scan once a year, so I am due to have one in October. I will be 14 months out on Aug. 10th.

cbs6931's picture
cbs6931
Posts: 63
Joined: Mar 2010

Appreciate the info - very helpful.

:)

Cathy

Chris3
Posts: 53
Joined: Mar 2010

I finished all my treatments on 6-3-2010.
CT Scan 7-6-2010 & PET Scan 7-14-2010 were clear.
Rad Onc 7-16-2010
Med Onc 7-22-2010
Colo-Rectal Surgeon 7-30-2010
Seems like I am seeing my 3 doctors more often post-treatment than I did during treatment. And those "latex glove" exams are no fun at all!

Upcoming appts:
Rad Onc 9-2-2010
Colo-Rectal Surgeon 9-7-2010
CT Scan & Blood Work 10-18-2010

Question: My Colo-Rectal Surgeon does a "Latex Glove" exam and a Procto-Scope. At my appt on 7-30-10 we set up a new appt in early Sept. He said we would discuss doing a biopsy after that appt. This took me totally by surprise. I figured if my scans were clear and the scopes were clear, what would we be doing a biopsy on? I asked him if this was normal procedure and he said it was. For those of you in the post-treatment phase, have you had biopsies done?

Chris

cbs6931's picture
cbs6931
Posts: 63
Joined: Mar 2010

Chris,

My surgeon plans to biopsy in October if he's satisfied everything has healed up. I finished treatment about a month before you; my surgeon checked me last week. He wants to see me every three months until we're a year out. I need to ask him if he'll want to do biopsies every three months too...

The oncologist does seem to want to see me more frequently now that he did during treatment
for some reason. I saw my Rad Oncologist weekly during treatment, once immediately post treatment and I have to go back to see him next week.

Cathy

mp327's picture
mp327
Posts: 3104
Joined: Jan 2010

My colorectal surgeon has only mentioned biopsy post-treatment once and that was only because I had some bleeding, which she could see the source of upon anoscopy. She told me she would do biopsy during my colonoscopy, which was 3 months later. However, when she did the colonoscopy, she didn't see anything to biopsy so didn't do one. She does not like to do them post-treatment unless absolutely necessary because radiated tissue does not heal well. My rad ond is also opposed to doing them routinely.

I would suggest that you google National Comprehensive Cancer Network and register on their site. Once registered, you can access the most current treatment and follow-up protocol for anal cancer. Just scroll down to the colorectal section and you will see anal cancer listed--click on it and you're there. You will see that routine biopsy is not recommended unless there is clinical evidence of residual or recurrent disease.

cbs6931's picture
cbs6931
Posts: 63
Joined: Mar 2010

Thanks - already registered there and have reviewed the guidelines again. They just cover the cancer stuff. I'm wondering about the blood work to check for kidney function ect (tired of being a pincushion but don't want to refuse something important. How often have they checked your blood?

Thanks a bunch,

Cathy

z's picture
z
Posts: 1269
Joined: May 2009

Hi Cathy,

My blood was checked every week during chemo and several times after, until my values were within normal limits. The main concern during chemo was the white blood count, they watched to make sure it didn't get to low, as if it had other procedures would have had to be done. Lori

mp327's picture
mp327
Posts: 3104
Joined: Jan 2010

Hi Cathy--

My med onc checks my blood every time I see him, which is about every 3 months now. He does a complete blood count, comprehensive metabolic panel, and sometimes a CEA. I think it's important for all of us who have had this treatment to get the CBC and met. panel on a regular basis. Kidney function has been one area of concern that my internist has had for me, since my creatinine levels have run high for the past year. One of the side effects of the chemo can be kidney damage. Tests that measure kidney function are creatinine, creatinine clearance, BUN, BUN/Creatinine ratio, and eGFR. You may want to ask your doctor about running these tests. I was very surprised to learn that a person can have kidney damage with no noticeable symptoms. The good news for me is that the last time my internist ran blood work on me, my kidney function levels were within normal limits. It's important to drink plenty of fluids, especially after having chemo, as I've had to learn the anxiety-filled way.

Martha

cbs6931's picture
cbs6931
Posts: 63
Joined: Mar 2010

Thanks for all the info. I'll make sure to ask that he run the tests you mention. It would be about my luck to have damage and not know it... yikes.

Cathy

mp327's picture
mp327
Posts: 3104
Joined: Jan 2010

Hi Cathy--

That was a real surprise to me too, as I always thought kidney damage would produce symptoms, such as less urination with fluid retention, back pain, etc.

Martha

nonichol's picture
nonichol
Posts: 114
Joined: Jul 2010

Cathy,
Where are guidelines?
Norma

mp327's picture
mp327
Posts: 3104
Joined: Jan 2010

Google National Comprehensive Cancer Network (or go to www.nccn.org). You will need to register, but then you'll have access to the list of diseases for which they have guidelines. Anal cancer is lumped in with Colorectal Cancer, so just find it, click, and you'll be there. This is a very good source of information.

pjjenkins's picture
pjjenkins
Posts: 173
Joined: Mar 2009

I had a couple of biopsies between end of treatment and about 15 months post treatment though the exam at about 18 months out he said it all looked like "normal irradiated tissue"! I hope there will be no more biopsies! I wish they'd seen the recommendations against it!
PJJ

lemonade
Posts: 62
Joined: Feb 2010

I'm 1 year out of treatment and have had no biopsies. Just follow-ups with my colon/rectal surgeon and oncologist.

duckyann
Posts: 162
Joined: Jun 2009

I had a biopsy done at 6 1/2 weeks after treatment and then again at 6 months. I am 14 months out. I think it depends on the doctor and if you trust your doctor then I guess you do what they say. My radiation oncologist also agreed that it should be done. My medical oncologist well he didn't have an opinion one way or the other on it. I will see my colorectal doctor in Sept. and I don't know if he will want to do one then or not. I hope not.

Nancy

cbs6931's picture
cbs6931
Posts: 63
Joined: Mar 2010

What did the biopsy involve? Were you given a local or some other kind of anesthetic?

Thanks for all the input on this,

Cathy

JDuke's picture
JDuke
Posts: 443
Joined: Nov 2009

I have had a flex-sigmoidoscopy with biopsies every six months after the completion of treatment for my original diagnosis, first one was April 09. At my request I am sedated (now I know how Michael Jackson got hooked on propofol) for the procedure. I have read with interest the threads regarding non-recommendation of biopsies following treatment unless something suspicious is observed. Guess I will be asking my gastro about this before the next one in October. He just takes a look around and a couple tiny snips to send off and I leave his office with some very colorful photographs of my insides :) I usually experience some mild bleeding with BM for a day afterwards. Hope this helps.
Regards,
Joanne

cbs6931's picture
cbs6931
Posts: 63
Joined: Mar 2010

Yes, it helps... I'm a real wienny so I'll make sure to ask about the sedation.

Cathy

z's picture
z
Posts: 1269
Joined: May 2009

Hi Cathy,

On my 1st biopsy I was sedated as I had a hemrodyctomy as well. That was 2 months post tx. At 8 months post tx I had a biopsy in the office, with no sedation, and had minimal discomfort, as I had no sedation. Lori

duckyann
Posts: 162
Joined: Jun 2009

Cathy,

I had twighlight sedation for my first biopsy at 6 1/2 weeks. He took several swatches plus removed 4 skin tags. The 2nd biopsy was done in his office with a local and only 2 snips. I also only had minimal discomfort.

Nancy

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