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Fear, Anxiety and Changing Oncologists
Phaine
1 Posts

Hi Everyone,

I think that I’m still in a state of shock, so if it sounds like I’m rambling, I truly apologize. The information on this website and reading the posts has been incredibly helpful this weekend.

My Mom is 78 and this past Thursday, she was diagnosed with breast cancer. To say the diagnosis came out of the blue would be an understatement. Last month, I took her to the emergency room for a suspected bleeding ulcer. The doctor ordered a bunch of tests, which included a mammogram. We later got a call from the hospital to come in for a biopsy and on Thursday we were given the results.

The first doctor who spoke with us was very kind and compassionate. He said that he was an oncologist and dealt with surgeries. He informed us that my mother has a large aggressive tumour in her right breast that it is cancerous. He said that surgery would be necessary but another oncologist on their team would tell us if chemotherapy was needed beforehand. He left and then the second oncologist, the one dealing with chemotherapy and radiation treatments, came into the room.

The second oncologist is probably the rudest doctor that I have ever encountered in my life. He immediately said that chemotherapy was off the table because of my mom’s age. I don’t know much about cancer treatments, but I always thought that chemotherapy was a very important part of the treatment. When I tried to ask him questions about why chemo was not an option, he was very dismissive. He briefly mentioned her age and risk of infections. He actually leaned back in his chair and put his feet on the table while talking to us. The doctor started talking about radiation, 5 years and a 30% chance without chemotherapy. I’m not quite sure about the details, because I was still trying to digest the news about my mom’s diagnosis. The (chemo) doctor then left and the first doctor (Surgeon) came back. I asked him about the stage of my mom’s cancer, and the doctor (surgeon) said that more tests were needed to see how far the cancer had spread.

On Friday, we got a call from the hospital that the tests are scheduled for Tuesday and Wednesday. I was also told that we were being switched to Brampton civic.

I’m grateful that everything is moving at a fast pace but it also scares me that it’s a sign that my mom’s cancer is at an advanced stage. I’m truly terrified of losing her. I’m also confused about why we are being switched over to Brampton Civic.

It’s just my mom and me, so it’s been a tough weekend trying to act upbeat, confident and supportive for my mom, while also trying to hide the fear, worry, anxiety and sadness that I’m feeling.

I hate to say this but I’m not comfortable with the chemo oncologist. He was rushing through things and appeared annoyed whenever I asked a question. He made us feel as though we were wasting his time. The nurse navigator mentioned that the chemo oncologist would go on paternity leave soon, so we will have another doctor step in midway through my mom’s treatment plan.

I want to call my family doctor tomorrow and ask for a referral to Princess Margaret Hospital, because I read that it’s one of the best Cancer hospitals and that the staff are kind, compassionate and patient. However, it takes a month to get an appointment with my family doctor and I’m not even sure if he’s aware of my mom’s diagnosis because of the speed that everything is moving. I’m afraid that waiting for an appointment with another oncologist/cancer team will take too much time and I don’t want the cancer to get worse during the wait.

5 Replies
ACH2015
2545 Posts

@Phaine

Hi Phaine, Sorry for the situation that brings you here. I wanted to share a link from the Canadian Cancer Society with you that talks about getting a second opinion or changing doctors, and suggests how to go about it. https://cancer.ca/en/living-with-cancer/coping-with-changes/working-with-your-healthcare-team/getting-a-second-opinion

Oncologists can be very good at their jobs, but be very poor in communicating with patients and caregivers. You are right that chemotherapy is a tool used to deal with cancer, but many times it is something that may not be recommended for various reasons.

I hope the link gives you some guidance toward a resolution for you and your mother's treatment path.

Keep well

ACH2015

Trillium
2372 Posts

@Phaine - It is shocking to hear the words that our loved one has cancer and it is a whirlwind of emotions when things move so quickly.

I hope you find the comfort and support here that I did when my son was first diagnosed but I’m so sorry that you and your mom have to go through this turmoil.

I would not want to delay any treatment either. We don’t have any answers about how or why her doctors make the decision’s they did about treatment but your family doctor may be able to clarify some of it for you. Your mom’s doctor will get all of this information electronically so will know what’s happening. Since you are the only one supporting your mother your GP may be able to refer you to some resources that may be helpful. Will you need to take time off work to care for her?

Were are here for you to talk to whenever you feel up to and you are not rambling. I found it such a relief to talk about it all while it was happening. You may have read there are many wonderful folks on the breast cancer forum who can share their experiences with you both.

Does your mother have friends she can talk too?

Warm hugs ❤️‍🩹

Essjay
2153 Posts

@Phaine I’m so sorry to hear of your mothers diagnosis. I am sure you are all in shock, especially when she’s dealing with other health issues as well.

im attaching a booklet about treatment for you which is a good start and better than Dr Google…

Leaving aside the terrible bedside manager of the medical oncologist, it sounds like the figures he was giving you relate to her chances of a recurrence.

Chemotherapy is used in some cases to reduce the size of a tumour before surgery or where cancer has spread already and surgery is not appropriate.

If they are discussing surgery and radiation then there must be a good chance that there is no spread or only local spread. In this case removing the tumour and some lymph nodes if cancer has reached them will give her a good chance of cancer free life - the figures the terrible medical oncologist quoted sound like he was saying a 30% chance of return in 5 years but I wasn’t there so I am guessing.

Having been through chemotherapy at age 50, I have had multiple conversations with my mother who is now 77 about my treatment and what she would do if she got cancer. She told me she wouldn’t have chemotherapy, and I would support her in that choice. Chemotherapy is hard on the body and there are long term impacts on patients. For example, I was fit and healthy but I had to have my heart checked out to see if I was fit enough for the chemo that was planned, and I know women of my age and younger who are living with heart issues or have even gone into heart failure post treatment. I don’t have heart issues but my body has been permanently impacted by the chemotherapy.

The infection issue the doctor talked about is huge - as we age our bodies are not so good at maintaining the components that fight infection in our blood. Chemotherapy kills these components off and so the gap between treatment is there to enable the body to recover. For a healthy young person like me that was fine, but for older or less healthy people they may not make the infection fighting components, get sick and end up in hospital. The risks of serious infection like pneumonia or sepsis are real. The medical oncologist was painting a poor picture because they have to - I left my first consult with my medical oncologist feeling pretty bleak about chemotherapy. It turned out ok as in not as bad as it could have been for me.

The main purpose of chemotherapy after surgery is to mop up cancer cells that were missed or couldn’t be reached by the surgery that could slowly grow over the next few years into cancer elsewhere.

For me to take 9 months out of my normal life to go through cancer treatment and then take another year to recover was worth it for a good chance at a long and healthy life.

When we get to age 77-78 we don’t know how many years we have left - life expectancy for women in Canada is 84. Your mother may want to push for chemotherapy and there are plenty of older patients who do go through medical treatments for cancer, but she might also want to think about the impact of spending almost 2 years going through all her treatments and recovering from them.

I know these issues are difficult to talk about and to think through - your mothers cancer clinic will have a counsellor who is there for your mother and her family members. I would encourage you to seek them out, as they are great to talk things through with.

And of course, we are here too - anytime.

best wishes to you both, Essjay


JenG
282 Posts

@Phaine I am sorry about this very shocking and distressing news. Take a few deep breaths and get ready to advocate for your mom. It’ll be tough but it will give you more answers. The age thing is bs. My mom was treated for stage 4 lung cancer at the age of 90. They stopped it after three years because it wasn’t working and the cancer had spread to her brain.

Now, it may be (as others have said) that her type of cancer means chemo isn’t an option. You’ll have to get more info.

Also, if I understand correctly, this was all done during an ER visit? So yes, please call the family doctor. Ask for the referrals. You will get more information and your mom will be able to make better decisions once she has all the info.

Big hugs to you and keep us posted, ask more questions, as you feel comfortable.

jeng

Cynthia Mac
4217 Posts
Phaine‍ I’m sorry you and your mom have to go through this, and that you’ve had a run-in with one of the doctors.

My Dad was 78 when he was diagnosed with lung cancer, so I’ve walked the mile you’re setting out on. It’s really hard to be faced with the reality that we really won’t have them with us forever, and sometimes it’s harder to know that they have to deal with cancer at this stage in life.

As ACH2015‍ said, some doctors (specialists in particular) don’t have good people skills, but that doesn’t mean that extends into their professional abilities. They see a lot more in a day than you or I ever will. I got a first-rate view of that one day when we were being taken to Dad’s onco appointment and I saw the doctor by the side of a woman on a gurney in a side room. In that moment, I realized that he could be having a really bad day, and that I was fortunate that my dad was walking in to his appointment.

That being said, if your mom’s oncologist continues to exhibit unprofessional or inappropriate behaviour that goes beyond your own personal receptors’ objections, the hospital will have a process that you can undertake to report it.

There could also be several reasons why they’re transferring you to another hospital - could be the cancer centre there is more robust, for example - so don’t be alarmed by that. Besides, that switch might get the doctor you’re not happy with off your mom’s case (literally).

When my Dad was in the “testing phase” where you are now, we used the waiting time to get organized; I set up a book just for this purpose. It had dividers for medication lists, contacts, appointment dates and times, and a section for “interviews” - questions to ask at the next appointments (and I left space to write in answers.) We cooked or bought in a bunch of freezer meals to pop into heat if we were late getting home from an appointment. I checked his smoke detectors, and he set up a bedroom on the main floor of his house (once we knew he was having surgery) so he wouldn’t have to do the stairs. I remember sweeping down cobwebs, so he wouldn’t try to do it at a time when he shouldn’t be reaching up with a broom. These types of activities can be productive and keep us focused on moving ahead.

Cancer Connection is a safe place for you to learn and vent, so keep us posted and ask any questions you may have.



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