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First app. w/new onco..Good and not so good

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

Stressful afternoon, I always get soooo anxious and nervous...luckily my husband was there.I was having some doubts about my oncologist so I went back to the cancer center where I was originally treated, but saw a different onco...

He was very direct and almost short and curt, basically admonishing me for leaving the cancer center in the first place. When he stepped out for a minute, it was all I could do not to tear up...First he asked why I'm on Megace not Tamoxifen..I explained I don't know, the previous onco never suggested Tamoxifen, only Megace. I'm ER+ 99%, PR+ 70%. I posted a while back that I asked him about the Megace and all he said was "why are you asking", which prompted me to see a different onco. A lot of that decision was because of Ms. Gebby talking about her new onco! Well, he told me I should Absolutely Not be on Megace for hormone positive----only used for bc mets to help gain weight, and it's an older medicine. He said for the last 9 months since I finished treatment, I've had nothing to stop the estrogen! He talked about this for 5 mins!

I also told him of how fatigued I still am,(16 chemo TAC, 36 rads)..He said "I've never heard of fatigue 9 months out of treatment,most pt's are better after 3-4 weeks and certainly after 2 months" This upset me so badly. Am I crazy? I thought the fatigue and se's can last for a couple yrs. sometimes? I'm still so upset, then what's wrong with me? He was so very direct and almost rude.

At the end of the appt when I was walking out(husband just left -back to work) He called me back into the exam room and sat next to me - He apologized for coming across harsh!

He said when he found out I was taking Megace not Tamoxifen, he got very angry! He even said "I'm extremely livid you were not prescribed the proper meds"

So I guess that explains why he was so short with me..But I'm a little bothered that on wrong med.
My husband really liked him because he was very informative and spent almost 45 mins with me..I have bloodwork on Monday then a bone scan sometime next week.I've never had a bone scan...
Other bc survivors have long term se's and fatigue right?
Sorry for the long post, just upset. Any input would be great!!
Thanks!
Joyce

DianeBC's picture
DianeBC
Posts: 3888
Joined: Jun 2009

I am sorry that he was so mean to you. He did apologize, yes, but, that is no excuse for treating you like this.

I remember your posting about Megace and from what I remember, no one here knew anything about it. I am sorry you took it instead of tamox, if that is what you are suppose to be on.

As far as being tired from rads, I was for a very long time. My rads oncologist said it can take a year or more for some to regain their strength, so, he is wrong in what he said about that. Just remember, he is not a radiation oncologist!

I am wishing you good luck Monday for your bloodwork and your bone scan. We can get the pink bus out for you! The bone scan is the easiest test you can have. You can keep your clothes on! lol You just lay on a table & the machine goes slowly, very slowly over you. Keep your eyes closed at first because it is very close to your face at first. You will be given an injection and then you come back after a couple of hours for the actual bone scan. Just ask if you have more questions. We will try and help you. Also, your husband or someone can be in the room with you during the bone scan if it will help you and comfort you.

Hugs, Diane

carkris's picture
carkris
Posts: 4527
Joined: Aug 2009

I still struggle with fatigue. My NP said it could be the delayed reaction to rads. I think its the whole thing. I cant count how many times someone has posted about fatique. I see why you have mixed feelings. On one hand he is informative, on the other hand he is yelling at you for something you didnt do. Not right to take out his frustration on you.
I am not sure would stay, but knowing me I would give him another chance. But if he continued to act this way I would fire him. Cant deal with being intimidated by my doctor. I have found with cranky docs (I am a nurse) I call them on their behavior, and someohow they seem to straighten up. Hey we all put our pants on , one leg at a time.

New Flower
Posts: 4099
Joined: Aug 2009

I had fatigue for 12 months do not worry it is normal
I am glad you got a proper advice from a doctor
Bone scan is ok you need to be checked
Sending positive thoughts
Hugs

Melaniedoingwell
Posts: 80
Joined: Nov 2011

You were absolutely right to seek a 2nd opinion. The new onco was absolutely wrong about side effects.

On the other hand, even though he may have not been warm and fuzzy, he was right to be angry about the improper treatment you had received. Also - for him to apologize for coming across harshly was a good sign.

The fact is - "warm and fuzzy" doesn't get the job done. You need the right treatment, not something that will do nothing.

Bone scan IS easy -- you will be absolutely fine there. I am 3x +, stage 3A. I completed my year of TCH chemo (Herceptin was the only one for a year)in April, and completed rads October 17 '11. I still get tired and I fear 'chemo-brain' may be a permanent situation.

The good thing - no, the GREAT thing - is I'm here to tell about it and love my family and so are you. Keep fighting girl. The best doctor in the world doesn't know everything....

Melanie

MAJW
Posts: 2515
Joined: May 2009

All 3 of my physicians said that getting over se's of treatments will take about as long as your treatment lasts....thus if it took 9 months to complete all treatment it will take about that long to get over the se's.....

I agree that the onc was upset with what he believed to be the wrong treatment for you and not angry with you...especially since he apologized....sounds like someone who cares...I'd say he's a keeper!

Hugs, Nancy

Alexis F's picture
Alexis F
Posts: 3604
Joined: May 2009

I think for most of us, it takes awhile to get back to the way we used to feel, if ever. For some, it can be a matter of weeks, some months, and, some years. There is no set rule as to when it will happen for anyone. I actually still blame my being tired, more than before bc, on the treatments, the surgery, just everything related to bc. And, rads for sure will wear you down and it takes time to recover from that.

You just take it one day at a time and don't worry about it if you can.

Very sorry for your onco's behavior. I hope he treats you better from now on.

Great big hugs,

Lex

CypressCynthia's picture
CypressCynthia
Posts: 4015
Joined: Oct 2009

I do not usually comment on anyone's medical treatment, but I can't figure out why the other doc prescribed Megace. Of course, you need to be on hormone therapy (tamoxifen) and I can understand your new onc's concern and frustration.

He was not as diplomatic as he could have been, but it sounds like he 1) has you on the right path and 2) apologized (huge points there) and 3) spent a great deal of time with you. Also, I would not discount the fact that your husband related to him well.

As far as fatigue goes, it took me about a year after chemo to really feel better and I was always a little tired on tamoxifen (worst the last year of treatment).

Also, please know that cancer and depression (anxiety, fatigue, irritability) can go hand in hand. Cancer patients may have at least a >25% of experiencing depression. Most oncologists are aware of this, but they may not necessarily recognize fatigue as a symptom.

And fatigue can be symptom of depression. I personally feel that the emotions that come with the diagnosis and treatments can be exhausting physically and emotionally. If your fatigue continues past what you feel is normal, ask the onc about an antidepressant. Mine had no problem prescribing one. If you go that route, make sure that you ok the antidepressant with the onc. A few will keep the tamoxifen from working as well (paxil and prozac come to mind). I take just 1/2 pill of the lowest dose of lexapro and it really helps me.

Lastly, the bone scan is not a big deal at all. They will inject you with a tracer and have you return in a couple of hours. Then it is essentially like a CT scan or whole body xray.

Big (((hugs))) and I am rooting for you!

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

I will continue seeing my new onco. My husband also said he has my best interest in mind, especially to be "livid" by no tamoxifen.. And I'm so glad I'm not crazy by still being fatigued!..Melanie, I liked what you said "the best dr in the world doesn't know everyting"

Also CypressCynthia, I agree with you 100% that depression/anxiety causes fatigue too..about 4 months ago I started Cymbalta and Paxil and the onco did say I need to switch to Effexor. He's calling my pcp so we can wean me off then start effexor...Last night I took half the dose of Megace--for one week--then half of that for another week--then start tamoxifen.......
My prev onco said megace will take away my hot flashes in a few days, and a se is blood clots...I didn't start questioning it until I started on this site a few months ago...
Thank-you everyone!
Joyce

MsGebby's picture
MsGebby
Posts: 659
Joined: Oct 2011

Haven't you been through a lot. WOW!

You know, I read and re read your post. This new oncologist actually sounds quite good to me. I know he was harsh. I am glad he got angry about the wrong meds for you. He should not have taken his frustration out on you but he apologized for it and that shows he is human. From what you said, it sounds like he is going to get you back on track. THAT is great news!

I've never had a bone scan .... bone density test .... that I've had. It sounds very much the same as a bone scan. It's painless. Easy peasy.

I agree with my other pink sisters regarding depression and the effects it has on one's body. Fatigue is a major problem when one is depressed. Not sure you are, but it is something to think about. I had 38 rounds of radiation and the fatigue was so hard. I finished up in March and haven't really had an issue with it since. Everyone is different. You could still be bothered by this side effect. Obviously, rest when you can. Take care of yourself. That is something we all seem to forget to do. We are always looking out for others. It's inherent.

I hope you find this new oncologist to be (haha) just what the doctor ordered!

Hugs,

Mary

Megan M's picture
Megan M
Posts: 3001
Joined: Dec 2009

I had a bone scan and they just inject you with some dye, then we went and had lunch, drink lots of water too, to get the dye thru your system, then came back, laid on the metal table, my husband sat and talked to me and within maybe 40 minutes it was done. And my clothes stayed on!

Good luck to you!!!

Noel's picture
Noel
Posts: 3101
Joined: Apr 2009

Wow is about all I can say too! I think I would have screamed back at him if he were my onco. I don't put up with a lot anymore, can you tell? lol

I hope he is much nicer to you from now on. If not, look for a new onco.

Good luck and know that you are in my prayers.

CypressCynthia's picture
CypressCynthia
Posts: 4015
Joined: Oct 2009

Effexor is the safest choice with tamoxifen. Another reason to like this onc :-) See
Antidepressants and Tamoxifen

http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2010/June/antidepressants-and-tamoxifen

jnl's picture
jnl
Posts: 3873
Joined: May 2009

I am very sorry Joyce that your onco was like this with you. I am glad that he apologized, as he should have. I have always felt that anyone in the field of oncology need to be the best, and, I mean the best in kindness, empathy, respect and caring. After all, we aren't just dealing with someone with a cold here or something.

I am sending you all the good luck for your test and praying for good news.

Keep posting,

Leeza

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

Thank-you so very much!! I had bloodwork today with a tumor marker test, then bone scan scheduled for Thurs...Do the results from scan only take a few days?

also,I checked out the link Cypress posted..On the right track!!

Thinking of you all,
Joyce

CypressCynthia's picture
CypressCynthia
Posts: 4015
Joined: Oct 2009

My tumor markers usually come back in about a week, because one of the tests is sent out (not done at the hospital or lab where it is drawn). The bone scan result usually comes back in a couple of days--that just depends on how long it takes the radiologist to read it and then how long it takes your onc to relay the radiology results.

If you want to know the bone scan results, call your onc's office in a couple of days, so they know you are waiting.

My prayers are with you. I know waiting sucks!

DianeBC's picture
DianeBC
Posts: 3888
Joined: Jun 2009

My oncologist doesn't do tumor marker tests, so, I don't know about that. I saw my doctor in 2 days for my bone scan results. Just call them and have them check to see if the results are in. You shouldn't have to wait too long and they should understand that.

Good luck!

Ritzy's picture
Ritzy
Posts: 4384
Joined: Aug 2009

No, you are not crazy about being fatigued! Heck, I still am from treatments! I am here for you, supporting you, encouraging you and just an ear if you need to vent anytime!

Sue :)

Kylez's picture
Kylez
Posts: 3765
Joined: May 2009

I will be praying for you Joyce!

Kristin N's picture
Kristin N
Posts: 1969
Joined: Mar 2009

Even though your onco was upset at your previous treatment, I don't think he should have taken it out on you. It is good he apologized and I hope he never acts like that again with anyone else.

Good luck with your scan!

disneyfan2008
Posts: 5490
Joined: Oct 2010

so sorry..he was short with you..as professional even if upset with another dr NO way should he have treated your like he did...

I am on tamoxifen...starting my 5th yr next week...I did have total hysterectomy due to the med...but other then that NO side effects to speak of..

I"ll check back for an update

Denise

Alexis F's picture
Alexis F
Posts: 3604
Joined: May 2009

Good luck with your bone scan. Hoping and praying for good results.

Hugs, Lex

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

Thanks everyone
I forgot to mention I have the option of surgical removal of my ovaries, then I won't have to switch anti-depressants...I would then take Arimidex...I'm still weaning off Megace-and some minor hot flashes have started-no big deal though....
Sooooo glad I found this site!!
Hugs,
Joyce

jnl's picture
jnl
Posts: 3873
Joined: May 2009

Good luck Thursday! Glad the hot flashes aren't bad for you!

Hugs, Leeza

survivorbc09
Posts: 4378
Joined: Jun 2009

I am glad you found this site too! Good luck today with your appointment!

Jan

laughs_a_lot's picture
laughs_a_lot
Posts: 1368
Joined: Mar 2011

Am I glad you switched doctors. Yes an apology goes a long way. It shows the doctor is not arrogant and unconcerned about your feelings. Keeping you in prayer.

Lynn Smith
Posts: 1265
Joined: Mar 2011

I can understand his reaction.He may be a little harsh but don't think he wanted to direct it to you. Just very upset you are taking the wrong drug.I would be upset if I was a doctor and I know it's getting to you and your husband.I would be Very very mad.All that time and the wrong treatment.I'm happy tamox is what your new doctor says is the best drug.I've been on it for 2 1/2 years.I was Stage 0 and non imvasive but still take it.Like you mentioned after he calmed down he said "he was sorry".He is a doctor who stands his ground.I had one like that.One that always watched out for me.When I tell people how he told me to get rid of this doctor or that,It amazed my friends.But Hey I was getting the wrong care and he knew it.He wasn't going to back down.I cared alot for that doctor(now retired).He cared enough to tell me when I was wronged.Stick with this new doctor.

Wishing you the best and hope you will stay with this new doctor.

Lynn Smith

jnl's picture
jnl
Posts: 3873
Joined: May 2009

How did the bone scan go today? I pray that you will get clean results!

Thinking of you,

Leeza

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

of you replied to my post!! The bone scan was easy breezy. I got the injection at 8:00 then back at 12:30 for the scan..it only lasted about 30 mins tops...there were 2 nuclear med assistances that scanned. They both were very nice to look at, so I didn't mind the scan too much!!

Now I just need to make the decision to have ovaries orthoscopically removed and take Arimadex,,,or wean off anti-depressants and start effexor, then take Tamoxifen...
My new onco (which I am going to keep since all my pink sis's and my husband agree), wants me to decide sooner than later so I can get on the right treatment.. I've spoken to both doc's about it, now I just need to research and decide...I'm assuming the ovary removal would be same day surgery? I just need to find out if Arimadex has side effects similar to Tamoxifen. Meaning- some of you had female probs on tomx and hysterectomies....I forgot to ask onco if Arimadex has same possible side effect.
I hope our other pink sisters tests and surgeries went well today and for tomorrow too..How noisy was the bus?
I would be feeling lousy if wasn't for this site,
Joyce

VickiSam's picture
VickiSam
Posts: 8421
Joined: Aug 2009

I too, would feel betrayed and confused by options, or lack of options given to
me by your original Onco .. while, you did not get the warm hugs, and rainbows
when first meeting your NEW Onco -- it appears to me ... that I would stay with
him -- based on his medical knowledge -- ability to be HUMAN, and angry when a patient
has not been prescribed the correct medication. His apology speaks volumes.He called
you back to explain himself... hummmm, sounds like a keeper, to me.

Take 1 issue at a time, write things down or record them -- allow your new ONCO
the time to get you back on track --- ..

In my humble opinion, you've made the right choice.

Strength, Courage and HOPE for a Cure.

Vicki Sam

survivorbc09
Posts: 4378
Joined: Jun 2009

Yes, a bone scan is easy and our clothes stay on. Woohoo!

When do you get your results? Praying for a clean bone scan for you!

Hugs, Jan

Angie2U's picture
Angie2U
Posts: 2993
Joined: Sep 2009

Good looking techs are a bonus! LOL Glad you got through it! Praying for good news!

Hugs, Angie

DianeBC's picture
DianeBC
Posts: 3888
Joined: Jun 2009

I will be watching for an update for your results. Crossing everything for you!

SIROD's picture
SIROD
Posts: 2200
Joined: Jun 2010

Hi Joyce,

I remember your post on Megace titled "Megace or Tamoxifen?" back in July. New Flower and I both responded to your post.

http://csn.cancer.org/node/243270

The oncologist who prescribed Megace according to your post was responding to the hot flashes in hopes that this drug would banished them. It is a very old drug and used mostly to help those with stage IV gain weight these days. I was surprised that it was prescribe as first line of treatment. As for hot flashes, I have used most of the hormonal drugs and have had hot flashes now for 17+ years. I learn to adjust to them. I always think it's a pity that they never work when your cold and need a little bit of a hot surge:)

You have had good advise by the other ladies, no need for me to say the same thing.

You mentioned Arimidex which is very different than Tamoxifen. All these hormonal drugs have serious side effects and each woman reacts to them in their own unique way. Arimidex, an aromatase inhibitor does often have bone and joint pain, hot flashes, vaginal dryness and etc.

I did have endometrium thickening on Tamoxifen (used 4 years) and ended it up with a D&C that solved my problem. By that time I was no longer using Tamoxifen (recurrence). I used Arimidex for many, many years before my next recurrence. I did not have any problems with endometrium thickening. It was a new drug at the time I began to use Arimidex and there was no suggestion that estrogen deprived bones would lead to fractures. I had 3 vertebrae fractures from a minor fall. I began using bisphosphonates which led to my developing uveitis. Not everyone has this problem.

My thinking is that if these drugs keep me on planet earth a little longer then they are worth the inconveniences of the side effects.

Wishing you the best with your decision,

Doris

Kristin N's picture
Kristin N
Posts: 1969
Joined: Mar 2009

Hoping and praying you will post happy news about a clean scan.

susie09's picture
susie09
Posts: 2933
Joined: Jul 2009

Such great news about your bone scan Joyce! Offering the biggest of congrats to you!

trsmith0104
Posts: 35
Joined: Jul 2012

I had ovary removal orthoscopically. The procedure is not bad at all. It too is a drive-through procedure (in and out the same day). The pain was minimal because the sutures are so small. If I had to weigh everything that you are tossing around I would choose ovary removal too.

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

Hi everyone, bone scan and blood tests were great! Sorry I haven't been on for a few days..I'm dealing with my second bout of bronchitis in 5 weeks, but feeling better.. Thanks for all your input!! I am keeping the new onco with everyones suggestions! He does seem to be very good, I see him again on Tuesday to talk more about medications and/or ovary removal..I'm wondering if he will be saying anything to my previous onco? I think I'll ask him on Tuesday..Sirod,thanks so much for sharing with me your experience with both meds! I agree, it is unusual for him to prescribe megace as a first choice..
Even though I haven't been on, I think of you all! My husband commented on how much better I seem to be doing emotionally since I've been on here!
Hugs,
Joyce

Kylez's picture
Kylez
Posts: 3765
Joined: May 2009

Congrats Joyce on your good results! Hoping you feel better soon from bronchitis. I've had that and it is awful

Hugs, Kylez

DianeBC's picture
DianeBC
Posts: 3888
Joined: Jun 2009

Take care of yourself Joyce as bronchitis can turn to pneumonia easily. Wishing you fast healing!

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

Hi everyone, you are all so thoughtful to reply with so much info about my situation....I had my onco appt today and will be having ovaries removed in the next couple of weeks then starting arimadex after that...I brought my 15 yr old daughter,Pamela, to the appt and she commented on how nice and informative he was.....His demeanor was excellent..
I feel soooo taken care of now...I can't say how relieved I am to have a great onco...
Thanks everyone for encouraging me to stay w/him.

I almost felt like God disappeared from my life for the past 1 1/2 yrs....even though I know thats absolutely not true...Now I feel like he's taking care of me thru this site and my onco.

I'm still struggling with bronchitis and seeing my pcp tomorrow
xoxo
Joyce

Angie2U's picture
Angie2U
Posts: 2993
Joined: Sep 2009

So glad you like your onco! I think that is always important Joyce! Hoping your bronchitis will clear up for you soon. Let us know what he says.

Hugs, Angie

survivorbc09
Posts: 4378
Joined: Jun 2009

How are you feeling now Joyce?

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

Hi survivorbc09...feeling better with the bronchitis being gone! I've been in tons of pain in my pelvis and hip area though since I stopped taking Megace...That's not a side effect though...so not sure what's going on...I've taken 16 advil so far today!

I'm still waiting for the surgeon's office to call so I can get the ovary removal done soon!

Yeah! school has started here, my kids are no longer bored!!

How's everything with you?

Thank-you survivorbc09!
Joyce

jnl's picture
jnl
Posts: 3873
Joined: May 2009

Just saw your update Joyce and I am glad to know your bronchitis is gone. I usually get it once a year and it is no fun!

Sorry about the pain and I hope your doctor can give you some help as 16 advil is a lot to take to try and kill the pain.

Let us know when your surgery is scheduled so we can get the pink bus out for you!

Hugs, Leeza

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