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Does your Onc give you a basic physical when you see them?

DDIL1 profile image
44 Replies

When you have your onc visit do they listen to your longs, heart or feel your stomach? Mine does nothing - his assistant dies blood pressure, oxygen, pulse, and weight . He comes in and just asks if I have any questions, then says they’ll be on to take your blood.

I would expect he would do more, but being new maybe I have high expectations.

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DDIL1 profile image
DDIL1
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44 Replies
DDIL1 profile image
DDIL1

Sorry for the typos!!

Ycats277 profile image
Ycats277

Same here

DDIL1 profile image
DDIL1 in reply to Ycats277

They listen to your lungs, heart etc?

Hazelgreen profile image
Hazelgreen

In Saskatchewan, we are still having telephone consultations. The last time I remember seeing the oncologist (and radiologist) in person, I think both men did do a basic physical, checking lungs, heart and stomach while the female nurse had already taken the other measures.xo,

Cindy

Kaylab profile image
Kaylab

My original oncologist or RN always checked those things and my ankles. Since moving my new oncologist does not. I asked the RN about it just this week and she said she doesn’t do,it and did not know what the onc did. I now have a PCP that I see monthly and I am going to o make sure she does the checks.

13plus profile image
13plus in reply to Kaylab

Same with me, my original one did (he was much older ) and two since then do not. Perhaps it’s one of those things newer younger docs don’t feel is necessary? My current one does occasionally feel my abdomen and under armpits

Hmmm...interesting....my main onc, local, hasn't had me sit on the exam table for *years*....As you said, the nurse takes vitals every 28 days and the lab takes blood.

If I had thought about it without you posting, I would have assumed it's because she knows I just don't like medical stuff, so she was sparing me...

But when I went to Duke last week, to see my new secondary onc, he did examine me...heart & lungs w/ stethoscope, felt around for lymph nodes, and pressed on my vertebrae and manipulated my legs to see if any of my mets were causing me pain....

I don't know if this is because I was a new patient, or if that's their protocol...and maybe if I had lung mets my local doc would take a listen?

I'm actually a bit happier without the exam...

Good question!

Lynn

Aprilfoolz1 profile image
Aprilfoolz1

I have my blood pressure and temperature taken first with a nurse (after I've had my blood draws at the lab). Once I'm in a room, I have to put on a gown . After discussing my labs and scan if I've had one , I get on the table and she does a breast exam , feels my neck / lymph nodes thoroughly, listens to my heart and lungs and palpitates my abdominal area. My recurrence that made me stage iv was in my superclavical nodes and deeper chest nodes - never in my breast tissue, organs or bones (so far ). But - I don't argue with her ;) currently I have been stable or NEAD so I'm seeing her quarterly for the exam and get the blood work and fulvestrant at one of their clinics closer to my home the other 2 months in the quarter. She orders quarterly pet/Ct scans and I go in after the scans and see her in person and have this exam .

urthmothr profile image
urthmothr in reply to Aprilfoolz1

I do get annual breast exam with my surgical oncology nurse. I don't remember what else they check.

DDIL1 profile image
DDIL1 in reply to Aprilfoolz1

That’s great. My onc is younger and it’s the new way. But I would think the minimum would be to listen to lungs, heart, and stomach since the meds can do crazy things.

Next appt. I’m going to ask

Gingerann1 profile image
Gingerann1 in reply to Aprilfoolz1

Hi Aprilfoolz1. Just curious about your current status. Stable means no progression and NED is no evidence of disease so complete remission. Since I am now NED I’m wondering if I need to get more clarification at my next visit although my scan report clearly stated “no evidence of metastatic disease” . If nothing changes I would expect to see NED again and would not be told I am stable…I think it is important that we are getting the right information.

Aprilfoolz1 profile image
Aprilfoolz1 in reply to Gingerann1

My current status is no evidence of active disease . Per the scans there is no evidence of any disease but my oncologist is fairly conservative so she prefers NEAD and stable (no progression). After 6-9 months on Ibrance / fulvestrant, my scans have been NEAD. The radiologists recap at the bottom of my scans state " no pet/Ct evidence of local recurrence, nodal or distant metastatic disease". My oncologist told me she will never tell a patient they have complete remission once cancer has spread beyond local lymph nodes, even when the scans show NED. She is assuming there are cancer cells circulating about that are too small to pick up and or haven't "set up shop" anywhere so we much stay vigilant . She is thrilled that I have had such a good response and of course, we are all hoping I can stay on I/F for many years .

Gingerann1 profile image
Gingerann1 in reply to Aprilfoolz1

Thanks for your reply. I am on the same meds as you with NED status after 15 mos of treatment. I know there are cells still floating around that will rear their ugly heads at some point but for now I will enjoy the NED status and the extra gift of time I’ve been given and wish the same for you.👍

Aprilfoolz1 profile image
Aprilfoolz1 in reply to Gingerann1

100% agree with you ! May we all reach NED / NEAD and stay there for years to come :)

Gingerann1 profile image
Gingerann1 in reply to Aprilfoolz1

I think the big difference is being told you are in complete remission and being told you are cancer free. Those are certainly not the same and hindsight being 20/20 my drs should have never said cancer free when I had really only been in remission for 8 yrs before being diagnosed with MBC. Then I learned the truth that if you are Her2+ you have a 50% chance the cancer will return at some point. It is hard enough being diagnosed with BC or MBC but at least give us the information we need to help manage expectations.

Discocat profile image
Discocat

Hi,In the first few times, when I was taking Kisqali, I would be given an ECG to check my heart…but now that I’m on Ibrance that is not done. My oncologist regularly does physical breast exams, also checking glands in the armpits and as part of my routine blood pressure and weight are checked once a month before the Zometa is prepared and administered…but that’s done in a different area of the clinic not by the oncologist.

I think it would depend on your symptoms and history. Mine always asks me how I feel, whether I have any new pains or difficulties….and I believe if I mentioned breathing issues or something else specific then these would be investigated.

Because I previously had thyroid problems (Hashsimoto) my blood work is extended to check specifics related to monitoring this…so that’s how I’m basing that it depends on your personal health record.

The most detailed initial analysis was created in the first few weeks of diagnosis via scans, biopsies and extensive blood tests. I had mammogram and ultrasound (at time of discovery of primary), two types of biopsy samples were taken at this time also…then I had MRI of chest, full body bone scan, CT scan of chest and a full body MRI….in that order.

Hope your settling into your treatment plan and feeling well😀 👍 take care.

Best wishes Zoe x

DDIL1 profile image
DDIL1 in reply to Discocat

My last visit I was in the ER a couple days prior to my appointment. I had weezing in my chest and a few other things. When I saw my onc 2 days later He didn’t even listen to my chest or ask how I was. I do have a FES/PET scheduled for April 26th. But being relatively new 3 months into this I would think he would be more thorough when I see him.

Discocat profile image
Discocat in reply to DDIL1

Yup, your right in your circumstances I would have thought he might of been more concerned and checked your chest. Perhaps it’s a more exclusive set up in your clinic…being that due to work load, funding and time …they only want to look at your cancer and don’t consider other health issue unless there’s a direct connection? My oncologist is the opposite and actually told me to consider her to be my “Doctor of everything”and said I should run stuff by her first and then if need be I would be sent onto a specialist.

Could you ask around to find other peoples experiences with your doctor? Or May be look into options of another oncologist?

JKMS profile image
JKMS

Hi there aside from once when I thought there was an abnormality, I have never been examined by the onc I see. I see him less as a doctor and more in the vein of running clinical trials! At my clinic in the UK, I get bloods taken once a month and a three monthly scan and I’m only examined if I request it.

urthmothr profile image
urthmothr

That's all my onc's nurse does - checks my vitals, and does a blood draw before prescribing my meds for the day. I guess they depend on your Internist to take care of the rest.

NShaft profile image
NShaft

My onc gives me a short physical exam every month. Heart, lungs abdomen, etc. I am part of a research study so that may be part of the reason for it, however, the study is supposed to just follow me through standard of care.

Claireperth profile image
Claireperth

I think most oncologists are looking at the blood work and scans and assume you get check ups done by your local doctor. There seems to be a line drawn on who does what and it's up to the oncologist as to what and when they do their particular body checks.

DDIL1 profile image
DDIL1 in reply to Claireperth

That’s the hard part which dr does what.

Claireperth profile image
Claireperth in reply to DDIL1

Ask your oncologist what you should get checked by your local GP 🪷

JustmeMary profile image
JustmeMary

Yes, my oncologist listens to heart, lungs, presses on my stomach and feels my neck and lymph node areas as well as legs and ankles at every visit (once a month).

DDIL1 profile image
DDIL1

Thank you - that’s what I would think they should do. I appreciate hearing what other docs do!

AvidBooklover profile image
AvidBooklover

I see my oncologist every three months and have scans every six months. The other months I just get shots in the lab. The month I see the oncologist weight, blood draw etc are in the lab. She reviews scans and examines me. Right now I am NED and this works. Know things can chg at any time.

DDIL1 profile image
DDIL1 in reply to AvidBooklover

Thank you. That’s great you are NED!! Hoping it stays for you for a long time. I know ladies who for many years have no progression.

AvidBooklover profile image
AvidBooklover in reply to DDIL1

Fingers crossed. It had been one met in my hip, but I know at any time another can be spotted. Ended up with dropped foot on my left foot from radiation, so I do not have cancer, but have this souvenier!

cpidacks profile image
cpidacks

I have blood work drawn monthly. My temp, heart rate and oxygen level are taken also. The oncologist or nurse practitioner (I see the nurse prac every other month) both do exams. They listen to my heart, lungs, press on my abdomen, and look at my ankles for swelling. We discuss the results of my lab work.

Gingerann1 profile image
Gingerann1

Hi DDIL1 — my Onc does a general physical every 3 months when I see him to discuss my scan results. Monthly in between I see his PA to review lab results and she does a checkup as well. Additionally because I take BP meds I see my reg Dr. every 6 mos and she does a mini physical and she gets caught up about my cancer care. I would be concerned that your Onc is not doing more and I would have a discussion about it for sure. I also receive a full report of every aspect of every visit online that I can review. Being very thoroughly cared for goes a long way in my feeling that nothing will be missed and helps to alieve anxieties between scans. I hope this helps. Lin

Sashay2020 profile image
Sashay2020

My last oncologist did full gynecological exam including rectal palpation, every three months. He retired last November and my new younger oncologist has never given me a physical exam. I once asked new onc about a little lump near my post debulking scar and he gingerly felt that. Sometimes I think he is afraid of me. Sashay

MaryCos profile image
MaryCos

I never even saw my oncologist in person for the first (almost) 1.5 years after my de novo diagnosis. (Video calls only.) I moved my care to Johns Hopkins in November, and... along with vitals... they fully check me out every two months... including checking my breasts. In fact, they want me to do a mammogram, where my old oncologist told me we don't bother after a stage IV diagnosis. So, yup... my new team is keeping an eye out for anything that might be of concern; heart, lungs, etc. Makes me feel a lot safer, especially as they are extending the time between my scans to every 6 months.

DDIL1 profile image
DDIL1 in reply to MaryCos

Thanks Mary, if I have to go there for the appointment, then check me over.

mariootsi profile image
mariootsi

My onc does a basic physical every visit.

Gmaoftriplets profile image
Gmaoftriplets

When I see my oncologist she always listen’s to my heart and my lungs, asks if I’m having any unusual pain. I’m lucky. Is it possible to change MD?? I did until I found someone that I was going to be happy with on this journey.

Guitarbella profile image
Guitarbella

I only saw my oncologist when I first had my MBC diagnosis in March 2021. Since then I have had 3, 15 min telephone appointments post CT scans. In between times my MBC nurse calls me monthly post bloods to see how I have been doing. At no time have I had a physical exam. If I have any questions I can ask my MBC nurse. I think it varies according to where in the UK people are based. I am grateful that my cancer has been stable so far and I hope the team will get more involved if/ when the treatments need to change. For now I am encouraged to live my best life and so the less medical interventions and appointments the better.

BarbieBeat profile image
BarbieBeat

He doesn't check anything just asks questions. If I have an issue that requires an exam, he sends me to my PCP>

debbiedo2063 profile image
debbiedo2063

I’ve never met mine. In Uk it’s still telephone consultations. When I go for my Faslodex injections monthly they check blood pressure, oxygen, temperature and weight etc. This is done by the same oncology nurse. They test my blood in the instant analysis machine and if ok give me injections and Ibrance to bring out. Generally in half hour each month. Quite happy as I never have to wait, I live in a very small seaside town and it has a small outreach unit of the large cancer centre in Newcastle where the consultants are and I live next door to the outreach centre which is fab as I can nip in if I had a problem and ask the oncology nurse. They would ring the oncologist if they needed to. They also have the CT scanner there too .Debra xxx

love2golfwell profile image
love2golfwell

My oncologist here has never done an exam on me, but her nurse checks me over before the doctor comes in and I am encouraged to ask any questions I have to the nurse who answers them and relays this information to the doctor. When I lived in Illinois, my oncologist always did an exam, listened to my lungs, heart, felt my stomach area and did a breast exam. She was a warm and friendly doctor and answered all of my questions as well as inquiring about my family, etc. My doctor here has great academic credentials but is not very warm and is much more businesslike. The care is very good, but I miss the comfort that I experienced before.

TammyCross profile image
TammyCross

I am uncomfortable about exactly the same thing, and it does seem to be generational. I noticed that the online form for each visit with oncologist (monthly) says she has done a breast exam, etc. She never has. She doesn't listen to heart and lungs. The only time she looks at anything is if I bring it up. Rash on my torso. She will ask, may I look? Lumps in my groin area, "May I look?" -- I think she, or the nurse, should be doing more of a physical exam. They just do weight, bp, oxygen each time., and blood monthly.

To say they assume the internist does it makes no sense to me and is no excuse. I see my internist annually. She doesn't do those things either. If she did, it would be in my online record and the oncologist could see it. Instead, she claims she has done it.

There is one doc I see 4 times a year who does all those things: looks at me, kind of takes me in, noticing if I am losing or gaining hair; listens to breathing; palpates abdomen, etc. A real old fashioned physical exam. He is 84. He does all this and writes it down. Not too handy with the online system. He is a rheumatologist. I don't really need to see him anymore; my auto-immune disease has vanished, a few months before my MBC diagnosis. I see him because he acts like my primary in some ways, and if the oncologist or primary doc is not doing their job, he calls them.

I have a bump, maybe a lymph node, in my neck and am concerned. If I don't bring it up with oncologist, she wouldn't know. She would wait for the PET. If it shows up there....

I wish I still saw the nurse practitioners. They were more relating, thorough, easier to talk to. Since I am in a clinical trial, I see only research nurses. They are more researchers than nurses.

DDIL1 profile image
DDIL1 in reply to TammyCross

I was seeing a rheumatologist and I had the same situation as you. I stopped RA meds then I was diagnosed with MBC. I think I had cancer the whole time and the methotrexate and placquenil which was used as a breast cancer drug I think in the 50’s and 60’s. I obviously do not see them anymore.

TammyCross profile image
TammyCross in reply to DDIL1

Huh, always wondered how treatment for auto-immune disease (mine was giant cell arteritis) related to the appearance of cancer. I was finally weaned off prednisone and methotrexate, had 3 months of feeling good for the first time in two years, then this cancer turned up in my chest. It was so fast and so huge.

Yes, methotrexate is still listed as a possible treatment for mbc. I was on a high dose of prednisone for a year and a half, however, before I switched rheumatologists and the new one said prednisone was killing me and eased me over to methotrexate then eased me off over the next six months.

I said to my oncologist's nurse practitioner that I wondered if the prednisone was suppressing my cancer and when I went off it, it made up for lost time. She muttered that it was more likely the opposite: by suppressing my immune response, the prednisone allowed the cancer to take hold. I mentioned this to the oncologist but she said no. I distrust her answers. Usually contradicted by the other oncologists in this practice.

kearnan profile image
kearnan

Nope. My onco and palliative care doctor will suggest (like they did bc it is in my lungs) that I need an inhaler but neither of them would write an rx for that. They said I would need to go to my primary doctor for that so I did.

My onco takes care of my cancer meds, my palliative care doctor takes cares of my pain meds (oxycodone and fentanyl pain patch) and my primary doctor is the one that prescribes my ambien and inhaler.

They have a strict "stay in your lane" kind of thing which I understand. They are specialists so if I need a physical I go to my primary doctor. The palliative care doctor would not even write me an rx for sleep. But they both know my primary doctor writes me the rxs for those medications.

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