• What does oncologist do??

    Asked by Ranrose on Thursday, August 29, 2019

    What does oncologist do??

    I had the surgery the radiation and now take Letrozole. I see the oncologist every six months. All he does is come into the room look at his computer and say do you have any questions. Is this all I can expect? I guess see my PCP if I think my cancer has returned?

    16 Answers from the Community

    16 answers
    • RockTom's Avatar
      RockTom

      The oncologist is the one who sets up your plan of treatment and oversees it. You should be seeing him weekly during treatments if not more often. After treatments are over you will see him monthly for a term, then move to every 3 or 6 months, until finally annually.

      24 days ago
    • Ranrose's Avatar
      Ranrose

      Wow!! I have never seen him that often. Saw him once before surgery and then not till radiation was over. He has never done an exam on me.

      24 days ago
    • carm's Avatar
      carm

      You didn't see him during that time because care fell to the surgical oncologist followed by the radiation oncologist. After that, your care falls to the general oncologist. Letrazole is ordered by your general oncologist and is considered a maintenance therapy. So you will see him to make sure the drug is still effective by ordering your labs for markers and an occasional scan.

      24 days ago
    • Bengal's Avatar
      Bengal (Best Answer!)

      Next time he looks at his computer and ask of you have any questions I'd be prepared with a very long list.

      23 days ago
    • Skyemberr's Avatar
      Skyemberr

      @Bengal is right. I would be going in to your next appointment with a good long list of questions about your care, your treatment plan, and anything else that has been on your mind in regards to your cancer.

      Ask if there are scans he can show you and also what you can expect out of your care and progression (if there is any). Ask your oncologist what his plan is.

      23 days ago
    • andreacha's Avatar
      andreacha

      I agree with the others. You have the right to expect more from him. I had my 1st Oncologist from 2006 to 2013. I saw him every 3 months immediately following my 2 MRIs and 1 CT. I had to change to another Oncologist closer to home as my car was no longer reliable. I had the same schedule with the second Oncologist up until about a year and a half ago. I now see him once a month but have weekly blood tests as I also have Hemochromatosis. They call me every Thursday afternoon the same day as the tests and tell me if I can go on my chemo for that week or not. It's all determined by my blood results. I've been very fortunate with both doctors. Both of them are very good about explaining everything and do ask if I have any questions - and sometimes I do. It's your right to ask questions. He has the degree, not you. And if he doesn't accept your questions gracefully - find another doctor !!

      23 days ago
    • MarcieB's Avatar
      MarcieB

      Maybe your first question should be, "What, exactly, are you doing for me?"

      23 days ago
    • emmmi's Avatar
      emmmi

      Carm, what is a general oncologist?

      23 days ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      I see my MO every 6 months, with a Prolia shot right after (last one coming up next week). I had an early-stage non-aggressive IDC, and my only treatments were lumpectomy/SNB, short hypofractionated targeted radiation, and letrozole (3-3/4 yrs. down, a year-and-a-quarter to go). The only blood tests I get from her are CMP (to determine glucose & enzyme/electrolyte levels) and CBC/ferritin (I'd been intermittently mildly anemic so she & my primary are keeping an eye on that). The hospital's bariatric program monitors my a1c and lipids.

      She doesn't believe tumor markers or circulating estrogen level testing is reliable unless mets are suspected or have already been diagnosed. And scans are totally unnecessary if there have been no symptoms suggesting mets--a waste of resources and excess radiation exposure. The only imaging I get now is my annual bilateral screening mammogram (6-mo. "diagnostic" mammos on my cancer breast are behind me now). She does a physical breast exam, weigh-in (the most traumatic part), and palpates lymph glands. She discusses test results and takes any questions I may have about medications, nutrition, other procedures, etc.

      I have my third DEXAscan coming up in Nov. If it hasn't shown progression of osteopenia, I will be done (knock wood) with Prolia, and seeing her only annually thereafter.

      Of course, if I had a more aggressive cancer and chemo, the frequency of visits would have been different. The fact that your MO is so terse and perfunctory goes not to his competency, but his personality & bedside manner (and maybe oppressive caseload) and the satisfactory state of your health. Come prepared for your visits with a list of questions & concerns. If he sees no problems on your test results & charts, he's not supposed to be a mind-reader. He may be a jerk and incompatible with you (in which case, ask for a different MO), but he's neither negligent nor incompetent.

      22 days ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      He's a jerk with lousy bedside manner (and possibly overworked with a heavy patient load), but unless your chart is showing red flags or you have troublesome symptoms, he's doing a competent job. It's up to YOU to ask the questions & voice your concerns--and draw up a list of them in advance!

      With a non-aggressive cancer that did not require chemo and had no "bumps in the road" along the way, MO visits more than twice a year are overkill--and any scans other than 3D mammography (twice-yearly diagnostic on the cancer breast, annual screening on the other--and then annual screening after four normal diagnostic mammos) and--if you have dense or fibrocystic breasts, ultrasound &.or MRI--are also wasteful and overexpose you to unnecessary radiation if you're having no symptoms of mets and your routine bloodwork (complete metabolic panel, blood count, lipid profile) raises no red flags.

      I had a Grade 2 Stage IA IDC, low-Oncotype. Lumpectomy/SNB, partial-breast rads, and am approaching the end of my fourth out of five years on Letrozole. I'm osteopenic, so I get twice-yearly Prolia shots (my second DEXAscan showed improvement, and if my third this Nov. doesn't show worsening, next week's Prolia shot will be my last.

      My MO sees me twice a year: takes the CMP & CBC (the bariatric dept. takes my a1c and lipid panel), does a complete breast & lymph node exam, weighs me (ugh, hence the bariatric referral), and takes any questions I may ask her about my treatment, other meds, diet, or other procedures. She doesn't take estrogen levels, as they can fluctuate independent of AIs; nor tumor markers (says they're unreliable unless mets are suspected or already diagnosed). No PET scans either. I am back to annual bilateral screening mammos and breast surgeon visits (discussing oncoplastic reduction of my non-cancer breast). And if it turns out this Prolia shot will be my last, I can see her annually if I want (actually, she gave me that choice last spring).

      I really like her. If your think your MO is too perfunctory and abrupt (some of the best have lousy "people skills") it's no reflection on his competency--but you do have a right to switch MOs to one who "gets you." But you have to do the work, and jot down symptoms, concerns & questions before you come in.

      22 days ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      Sorry for the duplicative posts--What'sNext has been weird about hanging sometimes when I try to post, and at first it appeared that my first post had disappeared.

      22 days ago
    • carm's Avatar
      carm

      @emmmi,
      A general oncologist is one who has no sub speciality, like gyne-oncologist for example. They will treat most cancers and are also versed in hematology but they are not surgeons not are they radio-oncologists. They handle the chemo, targeted therapy, biologic and immunotherapies.

      22 days ago
    • Bengal's Avatar
      Bengal

      Hey, I don't mean to be flippant 'cause I know this is a serious question but every time I read it I can't help but think of the ad on TV where the little girl says " my mom washed the dishes BEFORE she puts them in the dishwasher so WHAT DOES THE DISHWASHER DO? "

      22 days ago
    • fiddler's Avatar
      fiddler

      Switch docs at the clinic.

      20 days ago
    • Bengal's Avatar
      Bengal

      I chuckle every time there's a suggestion in the comments to switch doctors. I'm envious of those of you who have that choice. Where I come from there is ONE doctor. In order to switch I would have to switch facilities which would mean driving many miles to get services. Before they added a cancer care center to our local hospital folks had to dive 100 miles or more (one way) sometimes daily to get treatment so it's wonderful to now be able to get treatment less than 20 miles away. But we have one oncologist who specializes in BC. Sometimes you just have to make it work.

      20 days ago
    • emmmi's Avatar
      emmmi

      My medical oncologist is well educated and feels that cancer patients need a lot of compassion and TLC. That is what he wrote about himself. On my introductory visit, I was still awaiting the results from my Oncotype test. I wanted to know if I needed chemo if I could wait 2 months, as I had a trip planned. He pulled his chair out and just hung his head .... never answered the question. I felt stupid. He said he would call to check on my oncotype. He never followed up. To be fair, he was not the doctor that ordered the test and this was going on in December. I waited over a month for my Oncotype score, because the original specimen sent was too small. Prior to my second appointment, his office called and wanted to change my appointment because the doctor did not want to see me until I started and finished radiation. I had about 2 more treatments to go and would be finished well before the next appointment. What medical oncologist doesn’t know if I, his patient, started radiation? On the second visit, my med onc said he was going to order a dexascan ..... never did. I asked my primary to order and she made sure he had a copy. Third visit, we’re discussing the dexascan and something just came over me and I suggested we meet once a year instead of every six months .... he looked up, surprised, said that’s fine and literally jumped up and ran out of the room. Needless to say, we are not a good fit, right? However, I did learn something ..... be your own advocate. Treat your doctors with respect, but demand their respect. I was the one who called the facility in California to find out why my Oncotype was taking so long. I was the one who made sure I had the dexascan before I started anastrozole. I think that I was not Ill enough for my med onc to care much. I did make that appointment for next year, however, hoping that by then I will have a new doctor. I’m a very fortunate woman ,who did not need chemo, missed it by 1 point, finished 6 weeks of radiation with no issues, stage 1, grade 2, Lumpectomy with no node involvement. It’s almost a year now, and I’ll be going for my first mammogram since I found out I had breast cancer. So, I guess I don’t know what a medical oncologist does.

      .

      19 days ago

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