possible delay? - 1247141

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dkm5859
possible delay? - 1247141

I realize this might be one of the big $64K questions...
My mother who was diagnosed with Stage 3A aden is considering in delaying the start of her radiation/chemo or at least delaying the onset of the radiation by possibly one to up to three weeks in order to pursue treatment at another facility which would be UPenn in Philadelphia, PA. She is not showing any current symptoms other than the hacking normally non productive cough at times and when productive it is clear. She did not have this cough prior to the attempted surgery on July23rd. She had two lymph noes involved in the medtasium area..specifically two contiguous at/near the aorta on July23rd. I guess the specific question is...would delay of treatment have detrimental impacts and possibly change the ultimate outcome by delaying treatment for up to two or three additonal weeks versus starting at another facility that may not be as good in administering, monitoring her treatment? Thank you so very much.
I plan on keeping to just the two current/most recent posts of today.
Thank you very much for your time, caring and information.
I sincerely apologize if this is covered also as I still cannot get 'search results'. Thanks.

catdander
Reply To: possible delay?

Hi dkm, I'm glad your mom isn't having any symptoms other than her cough.
What do you get when you search "delay in treatment"? and what browser are you using?

certain spring
Reply To: possible delay?

Hallo dmk5859. I'm sorry about your mother and the stress you are going through.
I was using an older browser until recently, and I found a good workaround was to google "cancergrace and x". If you do that you'll find a useful post by Dr Pennell about treatment delays, showing that there is no association between time from diagnosis to treatment and outcomes:
http://cancergrace.org/lung/2009/11/06/delays-in-treatment-for-lung-canc...
People panic about this a lot, but as Dr Pennell says in his post, cancers grow over months rather than weeks. I delayed my chemotherapy by a fortnight because we changed hospitals, and I doubt very much that it made any difference.
The other thing to consider is that your mother may well get the same regime regardless of which hospital she is treated in. I think it is really a matter of convenience and how she feels about it. Some people want their treatment as soon as possible. We went on holiday as I was not ready to face it.
I know you are worried about your mother's cough, but coughing is incredibly common in lung cancer, for all kinds of reasons other than progression, so I really would not worry too much about it. I know that's easy to say. The time to worry is when the cough is painful, comes with fever, or with sputum that is coloured (ie not clear as hers is now).

double trouble
Reply To: possible delay?

I just wanted to chime in that concurrent chemo and radiation causes cumulative fatigue, and the easier the trip to and from the better. I think the care will be the same either way, so for me the question would be which place provides her with the most comfort.
Debra

Dr West
Reply To: possible delay?

We really want to minimize the delays, and a few weeks is probably the most we'd want to accept, but it's true that treatment outcomes can be expertise-dependent, so it may well be more favorable to defer treatment to a location with greater expertise. But it's a balance between timeliness and the best care feasibly available.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

dkm5859
Reply To: possible delay?

Update: I believe the 'search' issue may have been due to a web browser issue.
I believe we will be sticking with the regional health system for radiation and chemo treatment for various reasons.
It is geographically closer to home. My brother lives nearby. I think they should be able to do well.
One related question...once the very first radiation and or chemo treatment is started at a given facility no other facility will./would start off where the 1st facility finished..correct? I'm sure this is correct but just wanted to make sure.
I fully realize I may be over reacting and blowing these issues/overlooks (I explained in these two most recent posts) out of proportion but it is something that I just can't underrstand how it could be overlooked and it gives me a good deal of apprehension of what might/could happen no matter what level of vigilance I and my family undertake to counterattack any potential mistakes/blunders. Thank you all and I wish all of you the absolute best! Sincerely, Dwight.

catdander
Reply To: possible delay?

Thanks Dwight, We are all certainly in the same boat with lung cancer and giving over control to the cancer centers that give treatment. Know that when it comes to actually getting the chemo from the drug dept to administering it there are many redundant steps to make sure it's all done correctly.

I'll let someone else speak to changing sites in the middle of treatment.

Absolute best to you and your mom,
Janine

Dr West
Reply To: possible delay?

Never say never, but it's definitely quite unusual to switch institutions in the middle of multidisciplinary treatment.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education