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We schedule your first appointment within two weeks of your or your doctor's first phone call. Prior to that appointment, we coordinate all the testing that must be done and, with your participation, obtain reports or copies of any tests that you have already had completed, such as X-rays and colonoscopies.
We will explain what additional tests you need, but most patients will have a CT scan of the torso (chest, abdomen, and pelvis), an MRI of the pelvis, and often an ultrasound of the rectum. These tests will be arranged and completed before your first appointment. Our nurse practitioner will explain everything to you, help make the necessary arrangements, and provide support and advice. Our goal is to make this process as convenient and quick as possible for you so you can begin treatment.
By the time you arrive for your first appointment, our team of specialists will have carefully reviewed and discussed all your records and formulated a comprehensive, individualized treatment plan in our multidisciplinary conference. This plan reflects the consensus of all the experts potentially involved in your care, including colon and rectal surgeons, medical oncologists, and radiation oncologists.
We encourage you to bring a family member or trusted friend with you for your appointment, which will take several hours.
First, a doctor will do a thorough physical examination and take a detailed medical history. In some cases, after having examined you, we may order additional tests.
Then our multidisciplinary team of cancer specialists will all meet with you at one time to describe and explain the reasons for your preliminary treatment plan, answer your questions, and provide you with any information you need to fully understand your treatment.
Even if you do not require a specific type of treatment - radiation therapy, for example - our radiation oncologist will be present to explain why and to answer your questions.
At this meeting, we actively encourage you to discuss your needs and take those into account when recommending your treatment plan, which may be modified based on these discussions.
Once your treatment is agreed upon, we will explain what will happen during each phase of treatment and arrange the dates. Many patients will have radiation therapy and chemotherapy before their operation, followed by more chemotherapy after surgery, so an appointment for placement of a port for chemotherapy will be arranged, if necessary.
Our goal is to start your treatment as soon as possible; usually treatment begins within one to two weeks of your first appointment.
After your first appointment and throughout your treatment, you will have continued support and contact from our nurse practitioner, who will be your primary contact with us. She will be your "go-to" person, able to address your needs quickly and efficiently. You will be given her e-mail address and phone number, and encouraged to contact her directly with questions, concerns, or for help and advice.
After your treatment ends, you will need to come back to the hospital for regular follow-up appointments for approximately five years - every three to four months for the first two years, and every six months for the remaining three years. Your doctors will explain what those visits will entail and our nurse practitioner will help make the necessary arrangements.
But we continue to be available to you anytime you need us - to answer questions, suggest resources, and provide support on an ongoing basis.