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Scheduling all the doctors

Maxster
Posts: 56
Joined: Apr 2020

I am finally done with treatment (6 rounds of carbo/taxol) followed by 25 radiation.  My oncologist told me I would see one of the three doctors involved (gyn onc, radiation onc and onc) every three months.  However, I have appointments with all three scheduled in one week (May29-June3).  I was wondering how others juggled these appointments.  I was also told I should have the CA125 test done every three months.  If I'm not seeing my oncologist who schedules that?  I find this all confusing.  Anyone have a suggestion?  I feel so glad to have found this discussion board.  It is a real help to read about the journey others have been on and how knowledgeable you all are.

Donna Faye's picture
Donna Faye
Posts: 430
Joined: Jan 2017

I can only speak for my clinic but when I had the chemo, I only saw my gyn/oco. Then when I had the radiation I saw my gyn/onc one month and rads doc the next. I also have to see the hematologist every 6 months. I have had 2 recurrences since 2016, so I see the gyn/onco every 3 months and have a scan every 3 months. Your docs may all want to see you this time to see how you are doing, then they may rotate your care. Ask them about their routine.

 

TeddyandBears_Mom's picture
TeddyandBears_Mom
Posts: 1707
Joined: Jun 2015

Congrats on finishing your treatments! My appointments were rotated between my gyn/onc and my radiolgist/onc. I saw one or the other every 3 months. Both were at the same cancer center and worked together on things. I also had a CA125 for each appointment at the center. I did have an oncologist at a different clinic closer to home but I stopped seeing him. Just didn't see the need to go in and answer the same questions with no check up. After 2 years, I went to 6 month check ups and only see the gyn/onc. I celebrate 5 years post treatment in January and will move to a regular gyn for yearly checkups.  Like Donna Faye said, your clinic may be different.

Love and Hugs,

Cindi

cmb's picture
cmb
Posts: 594
Joined: Jan 2018

As Donna Faye and Cindi have noted, different clinics have different protocols.

I had a post chemo appointment with the medical oncologist one month after treatment ended. He had ordered a CT scan after I concluded chemo, which we discussed at that appointment.

Then he released me back to the gynecological oncologist's care for all the follow-up exams. I did not see the radiation oncologist after I completed the 25 sessions of external pelvic radiation. But I had done radiation as a preventative measure, not in response to an identified spot of cancer. The gynecological oncologist did order another CT scan a couple of months after radiation and checked my CA125 at that time too.

I saw the gynecological oncologist every three months for the first two years after treatment. I'm now on a 4-month schedule for years three and four. I switch to 6 month exams in the 5th year. We haven't discussed if I go back to a regular gynecologist after five years or stay with him for future exams.

I had another CT-scan a couple of years ago when I had one incident of bleeding and a CT-scan last year when I was having ongoing stomach aches. No sign of cancer on those scans. But my doctor doesn't routinely order scans – only when I report a problem.

And I don’t have the CA125 test on a regular basis. This has never seemed to be a cancer marker for me since I was only at 18 before surgery, although it dropped down to 9 and then 8 the couple of times it's been tested since treatment ended.

Congratulations on being done with treatment!

LisaPizza's picture
LisaPizza
Posts: 331
Joined: Feb 2018

I didn't have a medical oncologist. I only saw the radiation oncologist once after radiation finished. I only follow up with my gyn oncologist, so I have  no confusion on who is ordering things. I think your docs need to pow wow and determine how it's doing to be done.it shouldn't depend on you.  Maybe one wants to take charge. Maybe whoever has just seen you can put in the order for the next followup test so you can get it done prior to your next appt. I know my onc puts in her labs way ahead of time, and just marks them to be done in the few weeks before my next appointment. 

Tamlen's picture
Tamlen
Posts: 281
Joined: Jan 2018

I think LisaPizza is right -- this shouldn't be your job to figure out, but your doctors' jobs. After chemo ended my doctors explained to me that they'd each see me every 3 months, with my medical oncologist being my main oncologist and my gyn oncologist being my specialist. Initially the appointments were happening at the same time, but I decided I'd rather spread them out, so I changed the schedule so that I essentially saw one of them every 1.5 months. I'm now on a 6-month schedule and see one of them every 3 months. My radiation oncologist stepped out of the picture after brachytherapy finished. My gyn onc schedules my bloodwork and PET scans and I see her one week after a scan has been done. My medical onc schedules bloodwork to be done when I arrive to see her. CA-125 hasn't been a good marker for me (it was at 8 when I was diagnosed, later hovered around 2 after treatment), so it's not regularly done anymore.

Do you have access to a patient portal? All my scheduling shows up there and I can use it to adjust scheduled appointments that conflict with business travel (back when there was business travel!), etc. I find it a helpful overview of what's coming in the next 6-12 months.

janaes
Posts: 800
Joined: May 2016

Hello, I have two doctors that i see.  Am out 3 years from cancer treatments so i see one next week accually and then i will see the other one in six months from my appointment. One doctor is my radiation ocilogist and does a vaginal exam eaxh time. The other is the doctors assistant of my medical oncologist. They do blood wook each time there. I have done two or three ct scans in that rhree year period. Thats what works for me.

Primavera's picture
Primavera
Posts: 217
Joined: Mar 2019

After my operation, I had a follow-up with the gyn/onc who did the operation.

She sent me to a radiologist/onc and after brachytherapy with him, I had only one follow-up appointment to check that everything had gone right and then it was back to the gyn/onc. I didn't have any chemo.

Gyn/onc had seen I had nodules on my lungs and a cyst liver and sent me to a pulmonologist for follow-up on the lung nodules and a gastroenterologist for the colonoscopy and cyst liver. Once that was done, I had one follow-up with each of these and results were sent back to gyn/onc. She also sent me for genetic testing and got those results and sent me to have mammographies and breast ultrasounds every 6 months.

I actually decided on my own to go to my regular gynecologist and I got yelled at by the gyn/onc for "excesive amount of doctors involved in the same thing." Apparently, the gynecologist sent a report to the gyn/onc about "changes in the look of vagina" although all the tests were normal, and the gyn/onc said that was the normal "look" of a vagina after radiation. She said I wouldn't need to go back to a regular gynecologist until five or so years have passed.

So, gyn/onc is my central doctor and she gave me referrals for mammographies and liver ultrasounds; she'll also order blood tests. I will go to the pulmonologist every six months for lung nodules, but that's all.

Your gyn/onc might take the lead since he/she was probably the one who ordered the chemo and radiation treatments?

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2840
Joined: Mar 2013

Another example of how this is all over the place!  Primavera, getting "yelled at" by the gyn onc?  That's crap!  My gyn onc said I could follow up with them or the radiologist - whatever office I wanted to see.  I hated the radiologist and they only provided treatment, not dx, and stuck with my gyn onc.  I also kept seeing my gyn, and still do.  

While I appreciate their expertise, it is also about us doing what makes us feel good.  I think our choices are driven my our MENTAL health on this too, and that is as important as physical.  

Molly110
Posts: 182
Joined: Oct 2019

Maxster, I so agree that you should not have to worry about the scheduling. Maybe the reason it works so smoothly for me is that all of my care has been within the same large academic health care system. My surgery and chemo was handled by the same wondeful gyn/onc, and he and the doctor who did the brachytherapy conferred once a week on all their joint patients.  I will be seeing my gyn/onc every three months for the first two years, then the same strecthed schedule others have described. Anything I have needed, such as acupuncture, CBCs, etc. was handled by referrals/orders from my gyn/onc, leaving me with nothing to do but respond when they called me to schedule. 

Congratulations on finishing!  If you've just finished and you're feeling weak or worn out, hang in there and it will get better week by week. I finished in mid January and my energy returned to normal a few weeks ago, for which I am so grateful. I'd gotten too weak to manage washing the dishes between the fifth and sixth cycle, so I was pleasantly surprised at how relatively quickly I was able to do ordinary things again.

Molly

 

Maxster
Posts: 56
Joined: Apr 2020

Thanks to all of you.  You have been so helpful.  My nurse navigator called to see if I needed anything.  I plan to call her about this.  I was in three different medical systems for all my appointments which may be why this was so difficult.  You all helped me to ask the right questions and to have better expectations about coordination.  I will let you know how this all gets resolved.  Thanks again for all your input.

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