Recently, I have had many customers ask me questions about their therapies and doctor visits. The theme seems to be why this and not that? Why does this doctor prescribe this, but my friends doctor did not? Why is there not a standard protocol, a checklist? I also get the question, is there a test that the oncologist does to make sure there is no more cancer?
All of those answers are different, all the doctors seem to follow different protocols, and each person is different. I will clarify, that I am not a doctor and I am most certainly far from an expert, but I do hear many stories. I also keep myself informed about what is new and what is happening on the cancer scene – from a patient point of view. Here is what I can tell you.
Think about a cold or flu. Consider how they are so very different. The strains, the cough, sore throat, or no sore throat, green or yellow mucous (I know, gross), how badly it kicks you in the ass. How long it sticks around. There are many factors that make your cold, your experience. It is kind of the same with cancer – except it is in your pathology report, not a throat swab.
The pathology report is, I think, the guideline for treatment. The chemo oncologist prescribes the treatment plan on what the results of this report state.
When I had chemo, I had one lymph node positive for cancer out of 19. My tumour was less than 2 cm in size, grade 1, DCIS. I had a mastectomy. My treatment was 6 rounds of chemo and 25 bursts of radiation – did I need all that treatment? Maybe. That is what the doctor ordered, and I agreed. I made sure I knew what was happening to my body. Was it overkill (no joking), perhaps. Maybe I was over-treated. For me, my decision, it was the right thing to do. I know that I have done everything that I can do to decrease the risk of recurrence. If it comes back, I won’t think to myself – oh I should have more. On the other hand, I also think, holy crap that was horrible. Months of poison running through my veins, bone pain, neuropathy, extreme exhaustion, hair loss, losing my toenails and the recovery. Oh, the recovery.
I guess, to answer the question regarding treatment plans – they are simply different. Not right or wrong, just personalized based on what is best for you. The best outcome your doctor sees for you. It is the patients’ responsibility to ask questions, find out what is what and challenge decisions if they are concerned about their own treatment plan. Some patients are happy to go with the flow, others question everything and once again, neither is right or wrong.
Now when it comes to the end of treatment, I have questions too. Once you are finished all the treatments that are set out and the cancer doctors feel you are finished, you are discharged from CancerCare. Back to your GP for follow-ups. Yearly mammograms or other cancer screenings are ordered by your GP now.
The other day, a customer told me they were having a three month CT scan. She had been finished treatment and her oncologist had ordered a scan.
Why, was there a concern? No, she said, this oncologist does this as well as blood tests.
I have not had a blood test since my last round of chemo. Why was her follow-up different from mine? Was her cancer different in severity?
I asked my oncologist the last time I saw her, she said because it was not necessary. There was no reason to do a blood test and it was not necessary to have a scan. I would feel so much better if there was a test that definitively indicated there were no stray cancer cells searching for a vacation home. Perhaps that’s too much to ask for.
I suppose there is no answer for the protocols of individual doctors, each practice their profession in their own ways. I still really wish there was a checklist of what to expect. From start to finish, something that is in bullet form so it’s easy to process and understand. Ideas are changing in cancer treatment – treatment of the whole person.
Resources have changed in the past four years; I know this because care has moved towards the well-being of the patient. Publications are available now that were not when I was diagnosed. Patient journals developed by CancerCare, from what I understand, with patient input. That’s progress!
Ask questions, get answers and chart your path.