Follow up care after chemo complete/ scans
 

Hello ladies,
Questions... I will be having my last chemo tx on May 6th, then the mastectomy,
Rads and 1 year herceptin . Ct scan in May before surgery. In discussing my follow up care with oncologist (pending results of path report after surgery) she said my next scan will be yearly and that she doesn't do blood checks for tumor markers. She does basic labs CBC, bmp. So unless I become symptomatic no follow labs or scans.( will still see her once every 3 weeks for herceptin).Her reasoning is that with the ct scans she doesn't want to introduce any unnecessary radiation into my body as it will put me at higher risk of other cancers . As for the labs ,she doesn't do tumor markers as in my words that I can understand they don't always tell the whole story and everyone is different plus does not want undue stress on patient. With having ibc plus her2 neu I truly am concerned about the waiting periods between scans, and yet I don't want to risk developing other cancer . Advice please. And I am sure my oncologist will do a compromise with me to make sure I am comfortable with my tx.
Hope this all makes sense... Chemo brain today at its best

Re: Follow up care after chemo complete/ scans
 

Hi this is Joanne, I just joined in April had my first neoadjuvant TCH-P April 17th. I have worked in my Oncologist's office since 1990. Unless you have active disease or symptoms the current opinion is less radiation from scans is better the chemo already makes you susceptible to a secondary malignancy. The following paragraph was in Uptodate.com physician web sit but you have to have a login so I copied and pasted the paragraph.

"Screening studies — New screening diagnostic procedures have been developed, including coronary CT screening, whole body CT screening, and chest CTs for lung cancer screening [68-70]. For these patients who are either asymptomatic or vaguely symptomatic, the increased risks, such as radiation-induced cancer, may outweigh the benefits of their radiologic procedures, and a full discussion of risks, benefits, and alternatives is of particular relevance"

This probably carries over to screening for for recurrence in asymptomatic cancer patients post treatment. Physicians don't want to cause more harm!

I'll be checking in with you if you don't mind, as I just started chemo. I will finish the first week of August.

May we find ourselves looking forward to renewed health 1 year from now!!

Re: Follow up care after chemo complete/ scans
 

Congratulations on getting the hard part done in just a few days.

What your doctor had said is very standard. Routine scans don't necessary catch recurrence sooner. My scans had been misread (as scar tissues) for three years straight before I went to the original surgeon and confirmed the recurrence. So, just pay attention to your body and bring any new concerns to your doctor's attention.

Sending you good vibes.

Re: Follow up care after chemo complete/ scans
 

My oncologist also did not believe in routine scans. During the year I received herceptin, I had routine blood work, including MUGA scans. Tumor markers were done during this time. I continued to see my oncologist quarterly for years 3+4 post treatment...with blood work, including tumor markers. Year 5 I saw her twice, and then was "released" . It felt like my lifeline was severed!!! My oncologist told me that I could make an appointment any time, she would order any scans, blood work, etc. As time goes on I am more comfortable with no oncologist, scans, etc. At my last regular doctor's visit I asked, any had, tumor markers done...normal. At first it was hard to wrap my head around the idea that I shouldn't worry as long as I was asymptomatic...after all, I was asymptomatic when I was first diagnosed!!! And as far as not "worrying", HA!!!I still worry about every little twinge. And I have gone to the ER on more than one occasion with symptoms...dizziness and nausea (sure it was recurrence to brain) was really a bad case of vertigo. Burning pain and numbness ( sure it was tumor pressing on spine) was really SHINGLES. You get the picture! That is another reason I love this support group...we all "get it"!!!

Re: Follow up care after chemo complete/ scans
 

The more I read about doing scans after tx risk vs benefits the more I just may wait for the yearly scan. My hope is softer surgery my path report is good/great and that will ultimately help me with my final decision.

Re: Follow up care after chemo complete/ scans
 

I agree I hope with you for softer surgery and great path report, also speedy and easy recovery.
Joanne

Re: Follow up care after chemo complete/ scans
 

I see my oncologist every 3 months, get complete blood work (cmp, CBC, ca15 tumor marker).

Had my first breast MRI since bmx a couple of weeks ago, all clear (yea!). Have never gotten any kind of pet scan and don't think my doc will order one unless I am symptomatic of something. I will get an mri every year.

A word on tumor markers - when my new primary was found, my tumor marker was 17. Go figure

Best
Janis