1. < Gynecologic Cancers

Delay between chemo & radiation-time for cancer to grow? Why wait?

Posted by cialonel @cialonel, Oct 24, 2023

I had a hysterectomy with bilateral salpingo-oophorectomy in Jan 2022 - Stage 1a, Grade 2. No follow-up treatment, checks every 3 month. In June 2023 cancer returned with a soft tissue mass in the anterior upper pelvis and in iliac lymph nodes. No distant metastasis. I am currently undergoing 6 sessions chemo (carboplatin and paclitaxel, keytruda) and have 1 more session to go Nov 8th. I'm told that I will have a scan done after that last session but that I can't schedule it ahead of time- I have to wait for the infusion on Nov. 8th. So it won't be done most likely until late Nov. Then I have to schedule appointments with they Gyn/Onc/Surgeon and the Onc/Chemo doctors. They've already indicated that I will most likely need follow-up radiation. So now we're talking Dec and doctors on holidays/vacation. Radiation prep will mean meeting with RadioOnc, scheduling etc. It seems like we're talking well into the new year. My concern/question is if my last chemo is Nov. 8th and nothing more is done until late Jan or into February - isn't that delay just giving any lingering cancer time to replenish and grow? Shouldn't there be less of a delay between treatments? I'm tolerating the chemo very well and would like to just get on with it.

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val64 | @val64 | Oct 24, 2023

Have you asked your Dr about the timeline and told him/her that you would like to just get on with it?

Your concerns certainly make sense to me, but I'm not a doctor. In the recent past, it was common for them to do "sandwich therapy" where they would do 3 rounds of chemo, then immediately do external beam radiation for a month, then 3 more rounds of chemo. But that was before they started adding Keytruda, which has just been in the last year. (I was being treated exactly a year ago, and one of the three opinions I got, which were all different, was sandwich therapy. Chemo was just carboplatin/paclitaxel. No Keytruda.).

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1 reply
cialonel | @cialonel | Oct 25, 2023
In reply to @val64 "Have you asked your Dr about the timeline and told him/her that you would like to..." + (show)
@val64

Have you asked your Dr about the timeline and told him/her that you would like to just get on with it?

Your concerns certainly make sense to me, but I'm not a doctor. In the recent past, it was common for them to do "sandwich therapy" where they would do 3 rounds of chemo, then immediately do external beam radiation for a month, then 3 more rounds of chemo. But that was before they started adding Keytruda, which has just been in the last year. (I was being treated exactly a year ago, and one of the three opinions I got, which were all different, was sandwich therapy. Chemo was just carboplatin/paclitaxel. No Keytruda.).

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Thanks for the reply. I've put in a call to the doctor with her nurse. She said she'd check with the doc and get back to me. Hopefully I'll get an answer soon.

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aardvark2118 | @aardvark2118 | Oct 25, 2023

Hi. I had similar experience and time frame and wonder if you can at least get your first consult with rad onc sooner. I had the first meeting with the rad onc md in January even though I wasn’t starting chemo for a couple of weeks and would not start rad treatments until June. It was great to get to meet him in advance and find out the plan I finished chemo may 11 and was told they wanted to wait a couple of weeks before starting rad treatments to give my body a chance to recover. I saw rad Onc June 6 had the simulation needed to plan the rad treatments June 12 and started first treatment June 21. The treatments could not have been easier even though they were five days a week for five weeks. So for what it is worth I had a similar frame. Take care

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1 reply
cialonel | @cialonel | Oct 25, 2023
In reply to @aardvark2118 "Hi. I had similar experience and time frame and wonder if you can at least get..." + (show)
@aardvark2118

Hi. I had similar experience and time frame and wonder if you can at least get your first consult with rad onc sooner. I had the first meeting with the rad onc md in January even though I wasn’t starting chemo for a couple of weeks and would not start rad treatments until June. It was great to get to meet him in advance and find out the plan I finished chemo may 11 and was told they wanted to wait a couple of weeks before starting rad treatments to give my body a chance to recover. I saw rad Onc June 6 had the simulation needed to plan the rad treatments June 12 and started first treatment June 21. The treatments could not have been easier even though they were five days a week for five weeks. So for what it is worth I had a similar frame. Take care

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Thank you! This information is helpful. I'm glad your team was proactive in setting this up. I feel like between scheduling and insurance pre-certs, if I don't push things just drag and drag.

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