Help with differing treatment recommendations

Susie2

I'm relatively new here, and very glad to have found this discussion forum. I wondered if anyone has received different treatment recommendations from gyn/onc and medical-chemo/onc? Gyn/onc strongly recommends 6 chemo, but chemo onc recommends 3. It feels like the decision is now on me, and it's hard to be in this position. On one hand, I'd love to be done early with treatment. However, I also want do everything possible to ensure no recurrence. I was diagnosed with stage 1a UPSC. My pathology also showed early serous carcinoma on ovary. It was interpreted as a synchronous primary cancer, not a spread of the UPSC. In a way, this makes me a little nervous. I've read other posts about differing pathology reports. There is a part of me leaning toward 6 chemo, just in case that pathology report was wrong, and it was a spread.

I wish the treatment recommendations were cut and dry. Has anyone else had this happen, and who, ultimately, is the more qualified to make the treatment recommendation? The gyn/onc, or the medical onc? Thanks for any thoughts.

bluesmama

Get a third opinion

It sounds like you got two different recommendations. Most insurance companies allow for a tie-breaking third opinion. If yours does, I would encourage you to seek another doctor's opinion. Any doctor's recommendation should be backed up with evidence from research. If one recommends one course of treatment, always ask why?

I did a quick search for yours and it appears the 3 cycles was recommended because some studies show diminishing returns after the third cycle. 3-6 cycles is a typical range for treatment plans. I had 4 rounds of carbo-taxol but my cancer type, grade, and staging is different from yours. 

I'm curious by the your differentiating between a gyn/onc and a chemo/onc. Do you mean your surgeon vs. the medical onc? I had a team of 3 oncologists - gyn/oncologist (surgeon), medical (chemo) oncologist and radiation oncologist. They worked together on a treatment plan. Assuming both your doctors are from the same hospital, it's a little surprising they have a difference in opinion. If they're not from the same team, then that makes more sense.

In the end, you have to make your choice based on your comfort level. Will you kick yourself if you opted for 3 and have a recurrence later? Will 6 cause long-term side effects that you're willing to live with? These are tough questions to answer and ultimately the best choice depends on you. I know that's a lot of pressure on you and you don't deserve to be in this position. None of us do but it is what it is. Do what's best for you. Good luck.

NoTimeForCancer

Susie, who is more qualified?

Susie, who is more qualified?  I would say the gyn onc.  They specialize in below the belt cancers and see them everyday.  That is all they see everyday. Ultimately, bluesmama is correct, you need to make the decision for yourself.

For what it's worth, I was USPC Stage 1A Grade 3. I had the chemo/radiaition (external and brachy)/chemo sandwich.  

Please let us know how you are doing and feel free to ask anything.

Susie2

bluesmama said:

Get a third opinion

It sounds like you got two different recommendations. Most insurance companies allow for a tie-breaking third opinion. If yours does, I would encourage you to seek another doctor's opinion. Any doctor's recommendation should be backed up with evidence from research. If one recommends one course of treatment, always ask why?

I did a quick search for yours and it appears the 3 cycles was recommended because some studies show diminishing returns after the third cycle. 3-6 cycles is a typical range for treatment plans. I had 4 rounds of carbo-taxol but my cancer type, grade, and staging is different from yours. 

I'm curious by the your differentiating between a gyn/onc and a chemo/onc. Do you mean your surgeon vs. the medical onc? I had a team of 3 oncologists - gyn/oncologist (surgeon), medical (chemo) oncologist and radiation oncologist. They worked together on a treatment plan. Assuming both your doctors are from the same hospital, it's a little surprising they have a difference in opinion. If they're not from the same team, then that makes more sense.

In the end, you have to make your choice based on your comfort level. Will you kick yourself if you opted for 3 and have a recurrence later? Will 6 cause long-term side effects that you're willing to live with? These are tough questions to answer and ultimately the best choice depends on you. I know that's a lot of pressure on you and you don't deserve to be in this position. None of us do but it is what it is. Do what's best for you. Good luck.

Thank you, bluesmama. I hadn

Thank you, bluesmama. I hadn't considered a third opinion. Good idea! From other posts I've read from women with stage 1a UPSC, treatment can vary from observation to 3-6 rounds of chemo. Guess it's just a tricky stage. Yes, I also have a team of 3 oncologists from the same hospital. It surprised me they didn't have the same treatment recommendation. You are right, in the end it will be a choice based on what I'm comfortable with. No need to decide right now. It might be best to wait until I have that 3rd chemo under my belt to decide. Appreciate your thoughts on this.

Susie2

NoTimeForCancer said:

Susie, who is more qualified?

Susie, who is more qualified?  I would say the gyn onc.  They specialize in below the belt cancers and see them everyday.  That is all they see everyday. Ultimately, bluesmama is correct, you need to make the decision for yourself.

For what it's worth, I was USPC Stage 1A Grade 3. I had the chemo/radiaition (external and brachy)/chemo sandwich.  

Please let us know how you are doing and feel free to ask anything.

NoTimeForCancer, thanks for

NoTimeForCancer, thanks for weighing in. It was helpful to know your treatment for the same stage. Maybe I shouldn't have used the word 'qualified', as I really do consider my whole oncology team very qualified. I guess I meant what you said- Who actually sees the most of this kind of cancer and best understands the way it behaves? I was thinking probably my gyn onc. With that said, I'll have to do some more reading, thinking, and soulsearching when it comes time to deciding whether to stop or go the full 6. Thanks for sharing.