Oncology appointment advice

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Hi , I am finally seeing the oncologist tomorrow after what seems forever waiting .  I feel like I have been written off . Anyway I have metastic  TNBC with mets in liver, lungs and chest nodes , with a question mark over brain mets ( MRI on 29th Feb ).  I need advice on what I should be asking him ?  As well as some answers to these from those that have been or are going through it.  Can I have the same chemo as last time ?  Or do I start with new drugs?  How many lines of treatment are there before there is nowhere else to go ?   Why is surgery on any of my mets not even being considered?  Any help would be appreciated x

  • Hi ,

    Surgery is only usually performed if it can remove all the cancer before it can spread. In certain cases it may be used to remove residual cancer if systemic treatment (chemo etc.) was very successful and little residual disease is left, and can be safely removed.

    I read your bio, and it looks like you've really been through a lot. I'm so sorry this is happening to you.

    Questions I would ask would be:

    - Biopsy results - Have they tested for useful mutations that would be suitable for targeted treatment (BRCA, PD-1/PDL-1, PIK3CA, HER2low etc.)?

    - If not, what is the recommended treatment? Chemo? CDK4/6 inhibitors etc. (It's unlikely they'll use the same chemo as before, unless it worked very well then)

    - Would radiotherapy be of any use? Usually this is offered for symptom control, such as pain caused by bone mets.

    Those are off the top of my head. Fingers crossed that you find a treatment that works for you.

    Cheers,

    Andy

  • Hi Harleybear

    people advised me to write a list of questions and that is a good idea. I didn't need to ask them all but it helped to focus my thoughts. Please don't think anyone will write you off. I can honestly say that it is really scary but everyone on the team will be working behind the scenes to figure out how best to treat you. I also have breast cancer with secondary mets in lungs, liver and bones and got the whole diagnosis in one go when I was on my own just before Christmas so am still just learning my way through this. Thankfully the results of my brain scan came back clear so that is a huge relief.

    I don't know all the answers to your questions but I was told that they don't do surgery on mets because it will interfere with the chemo process and your body is already coping with so much so surgery is avoided as the mets are all the same (breast) cancer so will all be targeted by the chemo. My first reaction was to want it all cut out but now I am glad not to have to cope with surgery ontop of everything else. There are lots of different treatments out there and I've been reassured that if one drug stops working then there are others. Getting this diagnosis is just the first step - and I just keep being thankful that I found the lump and am now on treatment as this means hope.