Scheduling Chemo

December 26, 2003 11:47 AM

My father was recently diagnosed with colon cancer and had about 1/2 of his colon removed. He's recovered well, but tests - done at the time of the surgery - revealed cancerous cells in three of his lymph nodes, so a course of chemotherapy has been scheduled.

Here's my question - the surgery was around Dec. 7th. The test results took over two weeks, and now there's a 5 or 6 week time lag between the positive test results and the scheduled chemo. Any opinions on whether this time lag is normal procedure? My worry is that my father - not one to be overly assertive in working the HMO system to get the best possible care - is getting less prompt or aggressive treatment than might be warranted.

Also - in the "Modified Duke Staging System" colorectal cancer classification - that would be a "C1" or "C2" cancer.

In the more recent "TNM Staging System" it would be a type 3 cancer.

posted by troutfishing to Health & Fitness (4 answers total)

5-6 weeks is par for the course; in cases of lymphoma, there's always the issue what rate the cancer may be spreading. As the doctors determine this, scheduling has to be arranged for the available clinic where the chemotherapy may be taking place, as well as steps taken to determine which specific type of chemo will be administered, and in what proportions.

It may have been mentioned to your father or not, but the physicians may even be conferring with a specialist in radiotherapy. It's not unusual in lymphoma cases for the nodes to be exposed to doses of x-rays in addition to the chemotherapy. Otolaryngologists can be brought in to determing what they may be able to contribute, if at all, depending on the location and maturity of outbreak.

If at all possible, a grace period is also arranged to allow the patient to mentally prepare themselves for the effects of chemotherapy. The changes in blood cell levels and other side effects aren't something which specialists care to rush someone into, particularly since it can take several months to even a few years for treatment to effectively do its work.
posted by Smart Dalek at 12:53 PM on December 26, 2003

My mother-in-law didn't start chemo until a few weeks after her colon surgery, and her cancer was particularly agressive. So I wouldn't worry too much about the lapse. All the best to your family during this time.
posted by Ruki at 1:00 PM on December 26, 2003

I forgot to mention the consultations which will be in order; the usual non-disclosure concent forms will also have to be filled out and processed and referred to your dad's insurer. But all things considered, it's a nice break not to have that thrust upon you within hours or even a couple days of being notified of the scheduling.

Hope this helps, troutfishing. I'll be rooting for your father.
posted by Smart Dalek at 1:06 PM on December 26, 2003

Response by poster: Smart Dalek - Thanks, very much - for the comment and the sympathy. It's really helpful to see your (obviously informed) comment which is further supported by Ruki's experience.
posted by troutfishing at 4:44 PM on December 26, 2003