Oncologist help?

TulsaMomof3

Just wondering... Is it weird that I have had a surgical biopsy ( showing IDC ) and have been scheduled for a masectomy but I havnt seen or been refered to an oncologist yet? Does this come later or should I be seeing one prior to the surgery?

Diana77

I was told that I could wait
I was told that I could wait untill after surgery , but went ahead and interviewed two med onc and one radiation oncologist before surgery

sunny_girl

oncologist
I wondered exactly the same thing. You don't need an oncologist yet. After your oncological surgeon takes out your lymph node(s) and the cancer, and a pathology report is issued, then you can be properly staged. After that, an oncologist will come up with a treatment plan based on the stage/grade/extent of the cancer. They can't help you yet.

HOWEVER, the only thing I'd do right now, if I were you, is make sure the surgeon orders an onco-type DX or mammaprint test (if you qualify). I believe one or both need "fresh" tissue, so it MUST be arranged before your surgery. You want this test because it helps your oncologist (once you have one) answer the question about whether or not chemo will help you - and you will find that is one of the most difficult decisions to make.

Best of luck with everything.

mariam_11_09

At our clinic we get


At our clinic we get assigned a breast surgeon, Oncologist and radiation Oncologists right after our diagnosis. Of course we can choose from the list if we want to but I had no preference. I met with the Oncologist before surgery but that was just to discuss chemo in general, how it works and what I 'might' have because we did not know the staging. I liked knowing who my doctor's were upfront however the meeting wasn't necessary. Right after surgery, when the path report came back I was given an appointment with the Oncologist.

You might want to ask for a referral or who your Oncologist will be, if it gives you peace of mind. Otherwise you can deal with one thing at time and meet with the Oncologist after surgery when he will have more information for you specifically.

TulsaMomof3

sunny_girl said:

oncologist
I wondered exactly the same thing. You don't need an oncologist yet. After your oncological surgeon takes out your lymph node(s) and the cancer, and a pathology report is issued, then you can be properly staged. After that, an oncologist will come up with a treatment plan based on the stage/grade/extent of the cancer. They can't help you yet.

HOWEVER, the only thing I'd do right now, if I were you, is make sure the surgeon orders an onco-type DX or mammaprint test (if you qualify). I believe one or both need "fresh" tissue, so it MUST be arranged before your surgery. You want this test because it helps your oncologist (once you have one) answer the question about whether or not chemo will help you - and you will find that is one of the most difficult decisions to make.

Best of luck with everything.

Wow! excellent information I
Wow! excellent information I am so glad I asked!

cindycflynn

I remember
thinking that was weird, too. When I first started looking for doctors, I called an Oncologist office and was told I needed to see a surgeon first. I ended up going to a cancer center that has everyone under one roof, but they also had me meet with the surgeon first, and I didn't meet my medical oncologist until after surgery.

I think they (the medical oncologists) often want to have as much information from the final pathology report in order to plan the treatment. Otherwise, they could meet with you, but the treatment plan you put together might well change based on the final pathology.

Christine Louise

sunny_girl said:

oncologist
I wondered exactly the same thing. You don't need an oncologist yet. After your oncological surgeon takes out your lymph node(s) and the cancer, and a pathology report is issued, then you can be properly staged. After that, an oncologist will come up with a treatment plan based on the stage/grade/extent of the cancer. They can't help you yet.

HOWEVER, the only thing I'd do right now, if I were you, is make sure the surgeon orders an onco-type DX or mammaprint test (if you qualify). I believe one or both need "fresh" tissue, so it MUST be arranged before your surgery. You want this test because it helps your oncologist (once you have one) answer the question about whether or not chemo will help you - and you will find that is one of the most difficult decisions to make.

Best of luck with everything.

I wasn't given any info or option to arrange for the Oncotype test before my mastectomy. Surgery was Jan. 25 and my first meeting with the oncologist was Feb. 10. The Oncotype people (Genomic Health) called Feb. 18 and we arranged to go ahead with the test. (Very expensive. Be aware that insurance may or may not pay and that Genomic Health can help with cost if you meet income guidelines.) Met with the oncologist when she got the results and decided on chemo on March 2. All in all, more of that long waiting we all hate.

Miss Murphy

Not Weird
I also had a surgical biospy and then a masectomy. I didn't see a onco till about three weeks after the masectomy. When I saw the onco I knew that I was Stage 1, no node involvement and estrogen positive. At my fist visit the onco was the one who suggested the OcnoType test (I'd certainly never heard of it before). I had to wait for the results of that test to determine my treatment. I had a low recurrence so didn't need the chemo. So, based on my treatment, I don't think you need "fresh tissue" to do the OcnoType test. I do know there can be insurance issues - fortunately, my insurance paid for the test but I know from my doctor's office that there are ways to get help to pay for it if necessary.

I do sometimes think it's strange that after a biopsy you aren't immediately refered to an onco so they can advise you on various treatment options from the get go. I kind of think that most surgeons just want to cut it out but maybe something else would be better - who knows. Good luck with your surgery and whatever treatment you have.

sunny_girl

sunny_girl said:

oncologist
I wondered exactly the same thing. You don't need an oncologist yet. After your oncological surgeon takes out your lymph node(s) and the cancer, and a pathology report is issued, then you can be properly staged. After that, an oncologist will come up with a treatment plan based on the stage/grade/extent of the cancer. They can't help you yet.

HOWEVER, the only thing I'd do right now, if I were you, is make sure the surgeon orders an onco-type DX or mammaprint test (if you qualify). I believe one or both need "fresh" tissue, so it MUST be arranged before your surgery. You want this test because it helps your oncologist (once you have one) answer the question about whether or not chemo will help you - and you will find that is one of the most difficult decisions to make.

Best of luck with everything.

mammaprint
As I recall, the mammaprint seemed like a better test, but I was unaware of it before my surgery and it was too late afterwards because the tissue was fixed already. I had the Onco-type DX test instead. And yes, it was expensive, and it took about 2 weeks to come back -- BUT if you are borderline (Grade 1/2, ER+, with no nodes involved) then who wants chemo if it is unlikely to help you? And, the sooner you order the test (either of them) the sooner the results come back.

Cairmaid

Two different oncologists
I met with my radiation oncologist prior to surgery, but only because the surgeon needed to know if I was a candidate for accelerated radiotherapy, which required a balloon to be implanted by the surgeon.

I didn't meet with my medical oncologist until 3 weeks after I finished radiation.

sweetvickid

Cairmaid said:

Two different oncologists
I met with my radiation oncologist prior to surgery, but only because the surgeon needed to know if I was a candidate for accelerated radiotherapy, which required a balloon to be implanted by the surgeon.

I didn't meet with my medical oncologist until 3 weeks after I finished radiation.

I met with my oncologist
I met with my oncologist first and together we came up with a treatment plan. I love that he wants me to be an active partner in this. A firend of mine also used Dr. Jay. For her they meaning surgeon and radiologist, were rushing her right into surgery first and she balked. By going to Dr. Jay they shrank the tumor down and instead of a mastecomy she ended up with a lumpectomy. That was I think 6 years ago.

For myself being a triple negative and the size of my tumors I will have a mastecomy but we are doing chemo first so that he can determine what works best. The tumors have shrunk and I will have surgery in May.

I wanted the whole team working together from the start. I just didn't think it made sense to bring in my oncologist at the end.

sbmly53

Onc after surgery
I did research and decided - word of mouth, travel time, etc - before hand who I would see, but it was 2 1/2 weeks after surgery before I met with oncs. Onc needed all info first and Oncotype test was suggested and ordered at that time.

Sue

Taina

you see him/her after surgery
You will see you oncology after surgery. If your surgent
thought you need it treatment before the surgery she would have
given you some names....do some reseach on your own....like my
oncologist said you have to feel comfortable with him/her since he's
going to be your doctor till you quit him or he retires....
the surgent you only going to see for surgery and f/up's; if the do
radiation only for the treatment but you're stuck for life with
your oncologist.....
if they do chemo is not going to start until after you're heal which
could be at least 3wks.....
big hug your way...

Rague

A lot depends on the type of
A lot depends on the type of cancer and how advanced it is. I really don't know anything about IDC but in my case with IBC, I saw the surgeon the Mon. after the results of the biopsy were in (Fri). He immediately sent me to the Radiological and Medical Oncologists as chemo had to be done before surgery to try to shrink it. Turned out that I had 8 weeks of chemo, 2 weeks later surgery, 3 weeks later started 12 weekly chemo, and 1 week later then 25 daily radiations. Talk to your surgeon about your concerns, as we are all different your Dr is the one that knows your situtation and what the protocol is for it.

Good Luck!

Susan

Rague

Sorry!
Sorry - I goofed and accidentally double posted!

Susan

susie09

TulsaMomof3 said:

Wow! excellent information I
Wow! excellent information I am so glad I asked!

I met with my oncologist
I met with my oncologist right after I had the needle core biopsy to plan my treatment. I actually met with all of the doctors, the oncologist, plastic surgeon, nutritionist and the rads oncologist. The cancer center I went to tried to make it as easy on me as possible.

Good luck!

Eil4186

I had my surgery the last
I had my surgery the last week of April, saw my onc. in May and started chemo June 7th. This was all in 2006. As far as I know, the path report is reviewed by the onc. prior to meeting w/a patient so that he can make his recommondations for treatment.

Flakey_Flake

Surgeon before Onc
I know how you feel, Tulsa. My family practioner was the first one to tell me I needed to see a surgeon, and it took two weeks to schedule because they need a rather large crew there to check the tissue samples while you are in surgery. But after surgery, I couldn't understand why I had to go see a surgeon again. I thought it made more sense to see an oncologist, since the surgeon had already done his part. Not how it works though. The surgeon has all the information on type, grade, size, etc that the oncologist will need to determine a course of treatment. And he will want to check your incisions too. In my clinic the surgeon refers you to the oncologist. If you would like to talk to one earlier, maybe your surgeon will refer you before surgery. Good luck with your surgery Tulsa. I hope all goes well.