Surgeon vs. Oncologist

Cat64

This is my latest dilemma. My last treatment of Chemo was on October 26th. My Oncolgist said it was time to see the surgeon to determine is I was ready for surgery.(did this the 12th) My tumor started at 3cm. After the 1st round, no change, 2nd it got down to 2cm. My gut feeling said I would probably do at least 1 more round of Chemo so I was ready for it. I was surprised when the surgeon said I was ready for the Lumpectomy and no more Chemo. Yet, relieved on the other hand to not do anymore Chemo! I was hoping to get it down to at least 1cm where I started from. I went in the 16th to see the Onc. He said he would of done between 2-4 rounds of Chemo,but didn't argue against the surgery either. Then he told me instead of the original 48wks of Herceptin, I would only get 6wks/1xweek+6wks.radiation. I know I need to get this beast out of me because everyday that it is in there can leave it to spread. I also can't shake the possibility of having it shrink even more. In the beginning,the surgeon told me I was looking at a 6mo. window for surgery, which will be in January. I know I shouldn't put if off until then, but I also feel like I have time. I have been waiting for both of them to call since yesterday to dicuss my confusion & uneasy feeling about the difference of opinions. My questions are: How long did you wait after Chemo to do surgery? What are your thoughts or opinions on who I should listen to foremost? Shouldn't the Onc & the surgeon speak to each other & determine what the best plan of action is? This brings me back to my very first post which was "Stuck in the Middle"! Here I am again! :-) I really appreciate your input!
Thanks!
♥ Cathy

LC815

Team Approach
I only have this to say:

Yes, your onc and surgeon should be talking to one another -- definitely!!! This should be a joint treatment plan.

Peace.
Linda

jennN

onc/surgeon
I would ask your surgeon to contact your oncologist to discuss the course of action. You are the customer and should feel comfortable and informed about what they are doing to your body. A re-do isn't really an option. I would think you might even be able to set up a conference call...where you could be on one end too.

Jenn

contrail

Decision!
You're right, the surgeon and the oncologist should be on the same page as far as your treatment is concerned. I remember when I first met with my surgeon, she gave me the option of having some chemo before I had my mastectomy. My tumor was 2 1/2 cm. She said it might shrink it down a little, but I just wanted the beast out of me. So that's what we did, and I'm very thankful, because the cancer had already spread to 2 of the centinel nodes, but no further. I had 8 rounds of chemo followed by 30 radiation treatments. Now I'm waiting for reconstructive surgery in December. I think you should sit down with both you surgeon and oncologist at the same time and come to a decision, and you need to put in your two cents, because it's your body. Connie

lanie940

LC815 said:

Team Approach
I only have this to say:

Yes, your onc and surgeon should be talking to one another -- definitely!!! This should be a joint treatment plan.

Peace.
Linda

I agree! My Oncology surgeon
I agree! My Oncology surgeon and my Medical Oncologist are associates.

Marcia527

I had 4 cycles of A/C chemo
I had 4 cycles of A/C chemo before surgery. Then had surgery about a month later. Didn't shrink as much as the surgeon liked I guess because they had me take 4 more cycles this time of Taxotere. Then waited another month and had 6 weeks of radiation. I didn't have the Herceptin but don't know why. I was a stage 3a with tumors of 6cm and 3cm. After the first 4 cycles I was a stage 2.

The onc and surgeon should talk to each other and decide which treatment is best for you.

Rague

My surgeon and Onc talk to
My surgeon and Onc talk to each other. I saw my surgeon first - within days of positive biopsies - but he would not think about doing surgery until after I had chemo to shrink it. I had 4 doses of A/C 2 weeks apart and then had a mod. rad. mastectomy 2 weeks after the last A/C. The day of the last A/C I saw the chemo Dr and he was unsure if he wanted to do a bit more chemo first or not so he was going to talk with surgeon so they could decide the best route to go. They decided to go ahead with surgery and start chemo again after - so 3 weeks, 1 day after surgery (a week ago today) I started Taxol weekly for 12 weeks then will go on to rads and Femara. I'll be seeing my PA on Monday as I haven't seen her (though I have talked with her on the phone) since the day the biopsies were taken.

Different cancers proceed differently and call for different protocals. I have a very aggressive form (Inflammatory Breast Cancer) that had literaly progressed rapidly within a very few weeks to VERY large so time was of the utmost concern. Talk with your Drs about your concerns and do research to better educate yourself of options.

Good luck and prayers!

Susan

Sam726

Rague said:

My surgeon and Onc talk to
My surgeon and Onc talk to each other. I saw my surgeon first - within days of positive biopsies - but he would not think about doing surgery until after I had chemo to shrink it. I had 4 doses of A/C 2 weeks apart and then had a mod. rad. mastectomy 2 weeks after the last A/C. The day of the last A/C I saw the chemo Dr and he was unsure if he wanted to do a bit more chemo first or not so he was going to talk with surgeon so they could decide the best route to go. They decided to go ahead with surgery and start chemo again after - so 3 weeks, 1 day after surgery (a week ago today) I started Taxol weekly for 12 weeks then will go on to rads and Femara. I'll be seeing my PA on Monday as I haven't seen her (though I have talked with her on the phone) since the day the biopsies were taken.

Different cancers proceed differently and call for different protocals. I have a very aggressive form (Inflammatory Breast Cancer) that had literaly progressed rapidly within a very few weeks to VERY large so time was of the utmost concern. Talk with your Drs about your concerns and do research to better educate yourself of options.

Good luck and prayers!

Susan

Hey Cat
Well...you know what I think. Personally...I dont understand why only 2 rounds and Herceptin is typically taken for a year when HER2+...Im on it already with chemo and I would think you should be too....Im going to have surgery asap after chemo. Yes, my surgeon and onc are talkin..girl, you know your body better than those docs. Those are words spoken directly from the mouth of my Onc Surgeon, lol...so demand it. Dont get pushed around...you own your body! You deserve it..and if you dont like it, get another opinion. Stand up for yourself...wish I was there with ya...Id tell em for ya!
Sam

always

Sam726 said:

Hey Cat
Well...you know what I think. Personally...I dont understand why only 2 rounds and Herceptin is typically taken for a year when HER2+...Im on it already with chemo and I would think you should be too....Im going to have surgery asap after chemo. Yes, my surgeon and onc are talkin..girl, you know your body better than those docs. Those are words spoken directly from the mouth of my Onc Surgeon, lol...so demand it. Dont get pushed around...you own your body! You deserve it..and if you dont like it, get another opinion. Stand up for yourself...wish I was there with ya...Id tell em for ya!
Sam

Cat
I am in a different situation. My surgeon and Onc collaborate very well though. I had the surgery...lumpectomy for IDC and sentinel lobe before chemo. But the number one issue here is you have to be comfortable that you are getting the best treatment possible. I would press for them to communicate. In my prayers as always.
becky

S3

I have to wait 4 weeks from
I have to wait 4 weeks from chemo for surgery, or until my blood work is okay for surgery. In regards to surgeon v/s oncologists is concerned, mine disagree and I feel it is their job to explain both sides, than I decide.
I have no tumor, cancer showed up as a lump in my nodes in armpit and spread to the muscle under the breast by the side. Onc wants me to have a mastectomy with axillary clearnce. Top breast surgeon in the area recomends node dissection only because there is no tumor and radaition will take care of what little cancer is in the breast. I decide on just the nodes.