Normal to take 2 1/2 mths before getting chemo ??

vtspa6
vtspa6 Member Posts: 172

Since July 10th the rectal tumor was spotted.  After all the normal testing drs said possible mets to the lungs.  After a Fiberoplic Bronchoscopy and then a needle lung biopsy was confirmed stage 4 w/mets to the lungs. For 2 mths, only complaint my husband told drs was his rectal area hurt & hard to have bowel movements.  Finally Dr scheduled chemo, but decided for him to get a colostomy bag before he starts chemo which will postpone treatment for at least another 2 - 3 weeks.  I can understand Drs reasoning for this, but he should have had the done a mth ago!  Is this the norm or should we be looking for another Oncologist after he starts his treatments ??

Comments

  • JanJan63
    JanJan63 Member Posts: 2,478 Member
    I don't know what's normal

    I don't know what's normal for his situation but I didn't start chemo and radiation until  a few weeks after I had my illeostomy and had to wait for chemo for 3 months after my bowel resection and tumour removal but they like to not wait that long. I'd had an infection in my incision site and they had to wait until it healed.

    How was the lung biopsy? What did they do exactly? I have to have one in the next while and dont know what to expect. Thanks.

    Jan 

  • vtspa6
    vtspa6 Member Posts: 172
    JanJan63 said:

    I don't know what's normal

    I don't know what's normal for his situation but I didn't start chemo and radiation until  a few weeks after I had my illeostomy and had to wait for chemo for 3 months after my bowel resection and tumour removal but they like to not wait that long. I'd had an infection in my incision site and they had to wait until it healed.

    How was the lung biopsy? What did they do exactly? I have to have one in the next while and dont know what to expect. Thanks.

    Jan 

    After rectal cancer was dxed

    After rectal cancer was dxed July 15th they did the needle biopsy to lungs and found he has stage 4 rectal cancer w/mets to lungs.  During all this time getting tested I sure wish the did the colostomy bag surgery during that time.  Dr wants to give Tim Avastatin which slows down new blood vessel growth w/his chemo but you cannot have any surgery while on this drug.  Dr decided he better get him the colo bag done incase he has blockage down the road & can't have surgery to correct this.  He will leave the tumor alone for now so the healing time will be cut short so he can start chemo 2-3 wks later.  By then it will be 2 1/2 mths before any treatments.  He will not get radiation, just chemo.  It just seems to me this is a long time and we are worried.

     

  • John23
    John23 Member Posts: 2,122 Member
    vtspa6 said:

    After rectal cancer was dxed

    After rectal cancer was dxed July 15th they did the needle biopsy to lungs and found he has stage 4 rectal cancer w/mets to lungs.  During all this time getting tested I sure wish the did the colostomy bag surgery during that time.  Dr wants to give Tim Avastatin which slows down new blood vessel growth w/his chemo but you cannot have any surgery while on this drug.  Dr decided he better get him the colo bag done incase he has blockage down the road & can't have surgery to correct this.  He will leave the tumor alone for now so the healing time will be cut short so he can start chemo 2-3 wks later.  By then it will be 2 1/2 mths before any treatments.  He will not get radiation, just chemo.  It just seems to me this is a long time and we are worried.

     

    Oncologists….

    I’m curious why you and spouse haven’t sought other opinions from other physicians?

    Colorectal surgeons are best for both diagnostics and opinions regarding colorectal cancer, not Oncologists. And they’re not being partial to their practice if they recommend the tumor is best removed via surgery, rather than treating it with chemicals or radiation. Oncologists will usually recommend chemical treatment as first line of attack, even if surgical removal is the better choice.

    Your “other opinions” should come from Colorectal surgeons (and other physicians) that are not of the same group or organization. Get second (third or more) opinions from physicians of a different town, if necessary; you need impartial opinions, not opinions complementary to a physician’s golf buddy.

    Cancer and it’s treatments are a life-changing episode; you need as many different qualified opinions as you can get to be able to decide the best course of action. The individual that has the cancer is the only one that should make the final decision. One’s “gut feeling”, or intuition is all that seriously counts, and no-one but the patient can make that choice; it is that much of an individual decision. Treatments that work for one person may not work at all for another.

    There’s a belief that I personally agree with, that each of us has a natural instinct for survival, just as all living things have; that instinct should be listened to, it’s there for a purpose. Going down someone else’s path does not always get you where you intended to go.

    The bottom line, before too much more time passes? Go to different Colorectal surgeons and get different opinions regarding treatment.

    Best wishes to you both,

    John

     

     

  • NewHere
    NewHere Member Posts: 1,427 Member
    Mine Was Surgery First

    Went to two different surgeons, both had the same general opinion.  Check a bit with scans first to see if chemo needed before or if surgery was better.  The second doctor I felt more comfortable with, at MSK.  He had bloods drawn and a scan done before saying definately to go surgery first.  The whole time from my colonoscopy, which confirmed cancer, to schedule surgery was about 5 days.  Tentatively scheduled surgery, pending the tests at MSK, for 10 days later.  When tests came back a few days later, it was a go.  My surgery was somewhere around 14 days after pathology report from colonoscopy.

  • vtspa6
    vtspa6 Member Posts: 172
    John23 said:

    Oncologists….

    I’m curious why you and spouse haven’t sought other opinions from other physicians?

    Colorectal surgeons are best for both diagnostics and opinions regarding colorectal cancer, not Oncologists. And they’re not being partial to their practice if they recommend the tumor is best removed via surgery, rather than treating it with chemicals or radiation. Oncologists will usually recommend chemical treatment as first line of attack, even if surgical removal is the better choice.

    Your “other opinions” should come from Colorectal surgeons (and other physicians) that are not of the same group or organization. Get second (third or more) opinions from physicians of a different town, if necessary; you need impartial opinions, not opinions complementary to a physician’s golf buddy.

    Cancer and it’s treatments are a life-changing episode; you need as many different qualified opinions as you can get to be able to decide the best course of action. The individual that has the cancer is the only one that should make the final decision. One’s “gut feeling”, or intuition is all that seriously counts, and no-one but the patient can make that choice; it is that much of an individual decision. Treatments that work for one person may not work at all for another.

    There’s a belief that I personally agree with, that each of us has a natural instinct for survival, just as all living things have; that instinct should be listened to, it’s there for a purpose. Going down someone else’s path does not always get you where you intended to go.

    The bottom line, before too much more time passes? Go to different Colorectal surgeons and get different opinions regarding treatment.

    Best wishes to you both,

    John

     

     

    opinions of other drs but all working on Tim's case

    He will not have his tumor removed via surgery.  He will just be getting a colostomy bag so if the tumor grows more it will not block him up.  Dr plans on giving him chemo first and later see if it is best to have tumor surgically removed.  I guess why we are so upset is because the oncologist waited until last test results came back to verify his dxs. of stage 4 rectal cancer with mets to the lungs.  THEN thought it best to get him a colo bag before chemo starts.  Why couldn't the Dr decide to do this a mth ago while he was being tested?  Now we have to wait until this heals before he starts his treatments.  We were always under the impression that the Oncologist was the Dr that was the 'ring leader' with Tim's case.  All Drs did speak with each other to decide on different matters.  After he starts chemo we will be looking for different Drs around Pittsburg Cancer Center.

  • John23
    John23 Member Posts: 2,122 Member
    vtspa6 said:

    opinions of other drs but all working on Tim's case

    He will not have his tumor removed via surgery.  He will just be getting a colostomy bag so if the tumor grows more it will not block him up.  Dr plans on giving him chemo first and later see if it is best to have tumor surgically removed.  I guess why we are so upset is because the oncologist waited until last test results came back to verify his dxs. of stage 4 rectal cancer with mets to the lungs.  THEN thought it best to get him a colo bag before chemo starts.  Why couldn't the Dr decide to do this a mth ago while he was being tested?  Now we have to wait until this heals before he starts his treatments.  We were always under the impression that the Oncologist was the Dr that was the 'ring leader' with Tim's case.  All Drs did speak with each other to decide on different matters.  After he starts chemo we will be looking for different Drs around Pittsburg Cancer Center.

    No surgery?

     

    The choice of not to operate until tests returned with a positive indication of cancer was a wise choice. Abdominal surgery is tough. There are subsequent hernias and adhesions that too often follow abdominal surgery; why do it if the tumor is benign? It wasn't, so you move forward with whatever is usually required under the new circumstances.

    I really can not stress more, the importance of consulting with a colorectal surgeon (two or more if possible) and get their opinion regarding this cancer.

    Removing the tumor is important. It may mean a permanent colostomy, but it's usually the best route to go. An experienced surgeon will know what has to be removed; he will be able to see exactly the extent of cancer's involvement when he operates. A skilled colorectal surgeon can remove all of what he considers cancerous; chemicals and radiation can not. (I'm gonna' get hate mail for that one).

    I may be off base here, but waiting to see if a tumor gets bigger would not be a viable option for me. If I have a tumor, I want it taken out/removed. I don't want it "shrunk", or made to disappear from view, I want it out. Usually, colorectal cancer can be slow moving, providing some time to address a more time sensitive growth. The lung has a tremendous amount of blood cells moving through it, each one can carry a cancer cell to a new area.. "mets to the lung" would mean that the colon cancer has moved into the lung.. Has tests proven that it is colon cancer in the lung?

    Not knowing exactly where the cancer started can end up with setbacks. Biopsies will identify it all, and treatments planned accordingly. But you should really be consulting with qualified surgeons, and only surgeons and physicians that don't have lunch together. You don't need a consultation of Frat house buds, you need independent opinions from surgeons that have no vested interest in professional relationships.

    I just lost a good friend and neighbor to Melanoma. I pleaded with him and his wife to get other opinions. They asked their Oncologist and their Oncologist sent them to his associated physician. Oddly, that opinion was exactly the same as the first Oncologist. I pleaded again for them to get an opinion from outside the area. Again they told the same oncologist, and he sent them to Florida's major cancer clinic, where he was an associate member. His Melanoma was a stage 1, about 95% curable. It advanced rapidly due to chemical treatments failing to work. Immediate surgery could have saved him, or so his wife has learned since...

    Please, get other opinions from qualified surgeons. Ask some nurses who they feel are good surgeons, they see things we don't. And you should have a Gastroenterologist to consult with. Abdominal surgery leaves an impact on one's life; your guy needs all the help he can get.

    "Never carry all the eggs in one shopping bag"

    Good luck and best wishes,

    John

     

     

     

  • vtspa6
    vtspa6 Member Posts: 172
    John23 said:

    No surgery?

     

    The choice of not to operate until tests returned with a positive indication of cancer was a wise choice. Abdominal surgery is tough. There are subsequent hernias and adhesions that too often follow abdominal surgery; why do it if the tumor is benign? It wasn't, so you move forward with whatever is usually required under the new circumstances.

    I really can not stress more, the importance of consulting with a colorectal surgeon (two or more if possible) and get their opinion regarding this cancer.

    Removing the tumor is important. It may mean a permanent colostomy, but it's usually the best route to go. An experienced surgeon will know what has to be removed; he will be able to see exactly the extent of cancer's involvement when he operates. A skilled colorectal surgeon can remove all of what he considers cancerous; chemicals and radiation can not. (I'm gonna' get hate mail for that one).

    I may be off base here, but waiting to see if a tumor gets bigger would not be a viable option for me. If I have a tumor, I want it taken out/removed. I don't want it "shrunk", or made to disappear from view, I want it out. Usually, colorectal cancer can be slow moving, providing some time to address a more time sensitive growth. The lung has a tremendous amount of blood cells moving through it, each one can carry a cancer cell to a new area.. "mets to the lung" would mean that the colon cancer has moved into the lung.. Has tests proven that it is colon cancer in the lung?

    Not knowing exactly where the cancer started can end up with setbacks. Biopsies will identify it all, and treatments planned accordingly. But you should really be consulting with qualified surgeons, and only surgeons and physicians that don't have lunch together. You don't need a consultation of Frat house buds, you need independent opinions from surgeons that have no vested interest in professional relationships.

    I just lost a good friend and neighbor to Melanoma. I pleaded with him and his wife to get other opinions. They asked their Oncologist and their Oncologist sent them to his associated physician. Oddly, that opinion was exactly the same as the first Oncologist. I pleaded again for them to get an opinion from outside the area. Again they told the same oncologist, and he sent them to Florida's major cancer clinic, where he was an associate member. His Melanoma was a stage 1, about 95% curable. It advanced rapidly due to chemical treatments failing to work. Immediate surgery could have saved him, or so his wife has learned since...

    Please, get other opinions from qualified surgeons. Ask some nurses who they feel are good surgeons, they see things we don't. And you should have a Gastroenterologist to consult with. Abdominal surgery leaves an impact on one's life; your guy needs all the help he can get.

    "Never carry all the eggs in one shopping bag"

    Good luck and best wishes,

    John

     

     

     

    John, thanks for the info!

    Yep, he first had a biopsy of the rectal tumor and then the last biopsy was a needle lung biopsy which confirmed it was rectal cancer in the lungs.  His poor lungs are full of 'nobes'? (spots).  There are at least 10 in each lobe.  Oncologist said unless the spots shrink there really is no place to operate to remove anything in his lungs.  Maybe later they can remove tumor in his rectum.  They are going to put him on a drug called AVASTIN.  It should stop/slow down the growth of new blood vessels to help stop the cancer from spreading.  Have you heard of this drug?  I really think while is doing chemo we should consider going to a large cancer center.  We live in a small town and maybe Drs are not up to date?

  • John23
    John23 Member Posts: 2,122 Member
    vtspa6 said:

    John, thanks for the info!

    Yep, he first had a biopsy of the rectal tumor and then the last biopsy was a needle lung biopsy which confirmed it was rectal cancer in the lungs.  His poor lungs are full of 'nobes'? (spots).  There are at least 10 in each lobe.  Oncologist said unless the spots shrink there really is no place to operate to remove anything in his lungs.  Maybe later they can remove tumor in his rectum.  They are going to put him on a drug called AVASTIN.  It should stop/slow down the growth of new blood vessels to help stop the cancer from spreading.  Have you heard of this drug?  I really think while is doing chemo we should consider going to a large cancer center.  We live in a small town and maybe Drs are not up to date?

    “small town Drs are not up to date?”

    Physicians are human and have the same human failures we all experience, regardless of town.

    I think most cancer patients that have been through this initial experience would highly recommend getting other opinions before beginning any treatment. Once treatment begins, anything can follow.

    Avastin has been around awhile. A New York Times article from 2008 summed it up quite well.

    There is no known “cure” for cancer. Some of us do go for quite awhile in spite of it, regardless of treatments, but there is never a guarantee any treatment is better than the next. It is the reason I strongly suggest that anyone that is diagnosed with cancer gets other opinions from qualified surgeons prior to beginning any treatment.

    Let me clear (if you don’t know already), that I am not an advocate for western pharmaceuticals. After a stage four diagnosis of colon cancer in 2006 (3~5 year prognosis with chemical/radiation therapy), I took a totally different route to fight the cancer within me.

    Each of us has to use the instinct; the intuition we all were given, for self preservation. Some drugs seem to work for some, and not for others. Some drugs make people so ill they wish they died, while others taking the same drug feel no effect. Some people have no lasting effects from a drug, while others suffer debilitating ills long after the immediate problem disappears. We’re all different, and there may not be any one silver bullet to solve the problem. Only the patient can hear his/her body and instinctual language screaming: it doesn’t sound like a good idea - don’t do it.”  No one else can hear that inner voice, and no one else should make a life or death choice (unless the patient is incapable of doing so).

    Although I went a different route, if my wife was diagnosed with cancer it is she and she alone that would have to make the choice of treatments. All I would do, is no different than I do here - encourage second and third opinions, do not allow fear to direct your decisions, learn about all the options for care, and do not ever disregard the perils of certain treatments.

    Rushing blindly into any harsh treatment out of the fear of not doing that treatment has been reflected by many former posters here, and perhaps many remaining here (they can speak up if they choose to). I’ve read it too many times, the words “if I had only known; if I had only been told”. Unfortunately, when anyone ever spoke up against a treatment, they were denounced for speaking up. Most all that have been successful using an entirely different modality have left this forum. It should be understood however, that there are indeed other ways to fight cancer. You just won’t find out from anyone here; it’s usually not worth the ridicule and insults. It’s not that they don’t care, they care about helping others as much as I do…. It’s just too frustrating to fight the industrial hype that has managed to convince everyone that there is only one way for a resolve to cancer, even though the industry has not yet found one.

    There are new surgical procedures that involve killing tumors and nodules using radio waves, freeing temperatures, etc, injected directly into tumors. They may want to address both the surgical removal of rectal cancer, and work on the lungs at the same time. Many times the surgical procedures help more than the debilitating radiation or the harsh chemical therapy!

    That said (did I type all that?), please do your guy a favor and get other opinions before starting treatment? It seriously is that important to do so.

     

    Be well,

    John

     

  • Trubrit
    Trubrit Member Posts: 5,796 Member
    John23 said:

    “small town Drs are not up to date?”

    Physicians are human and have the same human failures we all experience, regardless of town.

    I think most cancer patients that have been through this initial experience would highly recommend getting other opinions before beginning any treatment. Once treatment begins, anything can follow.

    Avastin has been around awhile. A New York Times article from 2008 summed it up quite well.

    There is no known “cure” for cancer. Some of us do go for quite awhile in spite of it, regardless of treatments, but there is never a guarantee any treatment is better than the next. It is the reason I strongly suggest that anyone that is diagnosed with cancer gets other opinions from qualified surgeons prior to beginning any treatment.

    Let me clear (if you don’t know already), that I am not an advocate for western pharmaceuticals. After a stage four diagnosis of colon cancer in 2006 (3~5 year prognosis with chemical/radiation therapy), I took a totally different route to fight the cancer within me.

    Each of us has to use the instinct; the intuition we all were given, for self preservation. Some drugs seem to work for some, and not for others. Some drugs make people so ill they wish they died, while others taking the same drug feel no effect. Some people have no lasting effects from a drug, while others suffer debilitating ills long after the immediate problem disappears. We’re all different, and there may not be any one silver bullet to solve the problem. Only the patient can hear his/her body and instinctual language screaming: it doesn’t sound like a good idea - don’t do it.”  No one else can hear that inner voice, and no one else should make a life or death choice (unless the patient is incapable of doing so).

    Although I went a different route, if my wife was diagnosed with cancer it is she and she alone that would have to make the choice of treatments. All I would do, is no different than I do here - encourage second and third opinions, do not allow fear to direct your decisions, learn about all the options for care, and do not ever disregard the perils of certain treatments.

    Rushing blindly into any harsh treatment out of the fear of not doing that treatment has been reflected by many former posters here, and perhaps many remaining here (they can speak up if they choose to). I’ve read it too many times, the words “if I had only known; if I had only been told”. Unfortunately, when anyone ever spoke up against a treatment, they were denounced for speaking up. Most all that have been successful using an entirely different modality have left this forum. It should be understood however, that there are indeed other ways to fight cancer. You just won’t find out from anyone here; it’s usually not worth the ridicule and insults. It’s not that they don’t care, they care about helping others as much as I do…. It’s just too frustrating to fight the industrial hype that has managed to convince everyone that there is only one way for a resolve to cancer, even though the industry has not yet found one.

    There are new surgical procedures that involve killing tumors and nodules using radio waves, freeing temperatures, etc, injected directly into tumors. They may want to address both the surgical removal of rectal cancer, and work on the lungs at the same time. Many times the surgical procedures help more than the debilitating radiation or the harsh chemical therapy!

    That said (did I type all that?), please do your guy a favor and get other opinions before starting treatment? It seriously is that important to do so.

     

    Be well,

    John

     

    Is there a 'Like' button?

    I second John in all he says. 

    And I was one who went into treatment because all I knew was chemo and radiation was the only thing that would give me a fighting chance. I was wrong, of course, but it's ancient history now. 

    I do NOT regret doing chemo or radiation, but sadly I was one who suffered every imaginable side effect and then some. I would NEVER do radiation again. I would seriously have to consider chemo. Of course, I hope I never have to make that decision. 

    my husband and I both felt absolute confidence in my team, and that was very important. 

    I wish your your husband the best. With multiple lung mets, he has a hard battle ahead. 

    Right, I hear something large in the underbrush (I am up a canyon)  I' had better keep my eye out for predators. 

    Sue - Trubrit

  • Trubrit
    Trubrit Member Posts: 5,796 Member
    Each place seems different

    I was diagnosed in November and did not start chemo until January, so it was around the two month mark. 

    It just seems like they should start everything immedietely, as its your  husband's life (and your) that is on the line. But they want tests. They want surgery and recovery. And for me, they wanted their Christmas and New Years break. 

    I wish your husband all of the best.

    I hope you continue to visit us here on the forum, as we are a great bunch of people, both patients and caregivers. 

    Sue - Trubrit

  • ron50
    ron50 Member Posts: 1,723 Member
    I started as soon as possible

                               Hi VTSPA6 and John .good to see you still doing well mate. I was very lucky. I had my cancer dxed in a small regional area of Qld Australia. I could have gone down to the Qld capitol Brisbane but I chose to stay in the home area. One of the reasons was the surgeon I had. My gi chose the surgeon whilst I was still out to it after the scope. She said I could change the surgeon if I really wanted to but it will delay the op and you really don't have much time. I knew the surgeon well from work he had done on my dad. I was under the knife the next night. What impressed me the most about my treatment was the speed of dlivery. I had an very aggressive cancer and they decided I needed very aggressive treatment. My surgeon sent the oncologist to see me whilst I was recovering from surgery. My surgeon much preferred radiation to chemo which he eferred to as that filthy stuf. He said it was impossible to target the area of my cancer because it shiftsf. I started my chemo three weeks after surgery and had 48 weekly sessions of 5fu and levamisole (no longer used because of side effects). My survival has not been problem free ,long term side effects not cancer , but this coming January I will start year 18 of survival ex stage 3c into 6 nodes. All the best and wishing you a swift recovery. Ron.

  • PhillieG
    PhillieG Member Posts: 4,866 Member
    Second Opinions

    Ask yourself this question, if the tumor was in this doctor's colon would HE be taking 2 1/2 months before he did anything about it?

    I firmly believe in second opinions.