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Chemo/Surgery does it matter where?

kihonkumite
Posts: 14
Joined: Oct 2013

I would like to have my chemo at a hospital close to my home. If I have the chemo at Sloan I will have to get on a dirty subway to get the treatment and get home. My surgeon is at Sloan and wants me to get it there. It's Friday, no dr. is returning my calls and I need to get this started next week. I'm confused. Does anyone have insight if it really matters where I get the chemo? Can I get it at hospital near my house and surgery at Sloan? Does anyone think it will make that much difference?

z's picture
z
Posts: 1249
Joined: May 2009

Hello, Your Surgeon would probably like you at his hospital as he knows how well you'll be taken care of there.  You could ask him and tell him your concerns about the traveling to Sloan, and he might find a closer treatment center that he would feel comfortable with.  As far as the chemo the treatment and dosage would be the same.  I wish you well and keep us posted. Lori

kihonkumite
Posts: 14
Joined: Oct 2013

Thank you Lori. It makes sense, however, it is really inconvenient for me. I'll post once I know more.

Best to you.

kihonkumite
Posts: 14
Joined: Oct 2013

I recently heard something about not having to have a port? Does anyone have any info? I just found out yesterday that I have to have chemo and of course am terrified. Any insight will be greatly appreciated.

K

eihtak
Posts: 833
Joined: Oct 2011

Hi, I won't say stay calm, because we were/are all anxious during this journey at different times, but try just to concentrate on one day at a time and soon you'll have a couple months done and be on the road to recovery! As far as the location for chemo, I would also bet that if your doctor understood the need to uncomfortably travel, he may approve of a center closer to home, and at least I would ask about it.....hopefully all works out. I had a port and actually still do over 2.5 yrs later with never a problem. Most have them out shortly after done with treatment but unfortunately I had to continue with treatment for breast cancer after anal. Some people have a pic line, and although a bit more combersome, seem to do just fine with that also. My husband had a pic line a while back and I had to learn to flush it for him everyday, but it was an easy process. The port is under the skin, so don't have to be so concerned about it catching on something, whereas a pic line is external, usually upper arm. Some doctors just prefer one over the other, but both do the job!

I will surely have you in my thoughts and prayers as you face this challenge.

TraceyUSA
Posts: 135
Joined: May 2013

I recently read somewhere (sorry that I can't recall where) that 5-FU is now available in pill form.  If that is available for you that would eliminate the need for a port.  I had a port and it really wasn't a big deal but if I could have done a pill I would have.

lp1964's picture
lp1964
Posts: 852
Joined: Jun 2013

...and the dosage is the same, as long as you keep your surgeon informed you can get your chemo close to your home.

The choice between the PICC line and port: if your chemo is six months or less, PICC line will work as long as its flushed once a week. Port is harder to place, it's a minor surgery, but it doesn't need maintainance, can be used longer and showering is easier.

I'm very happy with my PICC line. Good luck and keep us informed.

Laz

mxperry220
Posts: 360
Joined: Mar 2011

Just for futher information, ports must be flushed regularly to avoid blood clots.  I had a port and they flushed my port on a regular basis during treatment.

Mike

eihtak
Posts: 833
Joined: Oct 2011

That is true, I left that out in my post. Though I've had it going on 3 years, the months it is not used I get it flushed. It usually works out to every 3-4 weeks.

Marynb
Posts: 1134
Joined: Aug 2012

I have to say that you MUST get the best care possible. Survival rates and results of treatment differ greatly! This is LIFE or death and will effect your quality of life! Go to Sloan. Really, there is no question! You are lucky you live close enough to a top rated hospital.

TraceyUSA
Posts: 135
Joined: May 2013

I had 3 doctors:  the surgeon who removed the tumor, the oncologist who oversaw the chemo and a radiologist who oversaw the radiation. The surgeon referred me to the oncologist & radiologist and really have nothing to do with the actual cancer treatments.  The chemo/rad is standard treatment from what I've been told or read.  So, I don't see why you could not have the chemo and/or radiation wherever you choose.  I think closer to home is best because the treatments themselves take little time (15-30 min.) and the travel time could turn out to be longer than the treatments themselves.  I would not want to travel in a crowded place with a compromised immune system.  I had diarrhea throughout the course of treatment and would not have been able to be away from a toilet for any length of time.  The discomfort would also have made an extended trip difficult.  I don't want to scare you but I was very grateful to be able to have treatments 15 min. from home.  While it was not a big city facility, I believe I received excellent care and the most up to date treatment. Good luck to you!

mp327's picture
mp327
Posts: 2889
Joined: Jan 2010

As Lori said, your doctor is probably recommending treatment at Sloan because he knows all the doctors there who would be involved in your care.  However, I can totally understand your reluctance to ride the subway, exposing yourself to who knows what with a compromised immune system.  Is it possible to speak with someone at Sloan about lodging near the hospital?  Some of the large hospitals have this and it can be relatively inexpensive or perhaps even at no cost to the patient.  Also, contact the American Cancer Society--they might be able to help.  If you look at the left side of this screen in the light blue box, lodging is listed as one of the topics, so check it out.  If none of that works for you, then getting your treatment closer to home can be done.  I had my treatment at the small hospital in my community that is a satellite facility for a larger hospital in the city.  I had excellent care and wonderful doctors.  I was staged between Stage 1 and Stage 2 and I am now a 5-year survivor, so I would say that my treatment was most effective.  I think getting treatment at a larger facility that has experience in the treatment of this disease is never a bad choice, but for some people, including myself, it's just not an option.  I hope you can get this all worked out to your satisfaction.  Please keep us posted.

jcruz
Posts: 222
Joined: Jan 2013

I agree with traceyusa about chemo closer to home.  My surgeon did the initial biopsy and then I didn't see him again until I needed  a follow-up biopsy about 6 months later.  My oncologists were the ones who treated me and saw me weekly during that time.  In addition to thinking about the days you go in for chemo you may want to think about the possibility of going in more frequently for hydration.  That was something I had not anticipated.  I was sure I could keep myself hydrated and it was just impossible for me to do. So towards the end of my treatment I was going to the infusion center 3 times a week for hydration.  That's a lot of trips on the subway if you need it.  The chemo and radiation will be the same closer to home as what you would get at Sloan.  I know others here have differing opinions about the care at a major cancer center versus other hospitals or doctor's offices.  I live in a semi-rural county several hours drive away from 2 cancer centers.  I had no choice about where I got my care because my insurance is an HMO and because I simply could not afford to go anywhere that was covered by my insurance.  I believe I received excellent care from my local doctors and their staff.

On the question of port vs. picc line, I was very glad I had a port.  It was a minor surgery to put it in but then I didn't have to think about it again after that.  The number of times it was accessed for chemo, blood draws and hydration made me very glad that I had the port.  I live alone and I don't know if I could have flushed a picc line on my own. 

I wish you all the best as you move forward

Marynb
Posts: 1134
Joined: Aug 2012

I had a picc line and it was removed after each week of chemo. I never had to have it flushed. I had no problem at all with the picc line.

Phoebesnow
Posts: 447
Joined: Apr 2011

Can you please tell me more about your picc line?  I wore mine every day from the first day to the end of tx. I had it flushed every week and every time it was used for something, change in chemos, medication, blood draws, fluids. I was in a surgical room, under sedation for the placement.  Was your procedure the same?

Marynb
Posts: 1134
Joined: Aug 2012

I had the picc line put in twice. Once on the first day of each week of chemo. I had it put in without sedation in a surgical room, so they could guide it. It was used for chemo only. I never took medication. Blood draws were done the usual way. When I needed shots to boost wbc, I had the shots the usual way. At the end of each week of chemo, it was taken out. No problems.

OMG 1012
Posts: 61
Joined: Dec 2012

I live in upsate NY about 5 hrs from NYC I was all set to go to NYC for treatments--unfortunatly hurricane Sandy came when I was starting treatment, didnt want to deal with driving into the city during that disaster, I asked my Dr's to speak with NYC Dr's and decided I could do treatment close to home--I was worried but so far so good, last RAD was Jan 10th.  

horsepad's picture
horsepad
Posts: 82
Joined: Apr 2012

I too lived far away from Cleveland Clinic and did not want to drive to Cleveland everyday but was willing too, if needed.  My onologists (all 3) said it didn't matter where I had the treatment because I would receive same radiation/chemo treatment at either place.  I had a port for almost two years and then had it removed.  I had no problems with port and it was flushed regularly.

qv62
Posts: 264
Joined: Nov 2012

not sure where you are located in relation to Sloan in NYC but keep in mind the Commack Sloan facility offers chemo/radiation, I have seen a wonderful radiologist there twice and although my surgeon/oncologist is in NYC they work together, I know there are more locations such as Rockville Center but I am only familiar Commack and NYC, not sure if that helps ?

 

Phoebesnow
Posts: 447
Joined: Apr 2011

I went to City of Hope for a second opinion.  They set the guidlines and my facility  agreed to them.  When it came time for chemo they did not want to give me the second round ofmitomycin. I demanded it.    I also think it is important who does the planning.  When doing the  planning and the tattooing they inserted a tampon.  The first week of tx they burned my uretha badly due to having no tampon in.  I had to do the planning and the tattooing again.  If I hadn't spoken up and told the drs about the tampon they would have continued to burn me.  The outcome is I'm cured stage II almost III due to size of tumor. I drove 45 minutes each way  to tx thru downtown LA.  It was hell, but yet I had to pull myself together each day and force myself to do things.  I think it helped me.  My husband drove me to the last 3 appointments, which were the most difficult, mentally and physically.  Onefoot in front of the other and then it will be over.

In the end I'm cured , there were many screwups getting dxed  and screwups  with tx but the results are awesome!

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