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Oncology or Haematology

I was put on Dasatanib about 2 months ago but recently oncology have made the decision that I have to have an appointment with them as well as with haematology before I am allowed my drugs. They both want blood tests and an appointment but as yet I cannot get an explanation as to why seeing them both is necessary. Has anyone else had a similar problem?
Many thanks
Karen

Hi Karen, I started on Nilotinib around the same time as you and I only attend haematology. I havent been asked to go to oncology as well. Both these drugs are 2nd generation Tyrosine Kinase inhibitors. Perhaps its down to your local health authority.
All the best.

Hi Karen,
this seems very strange as oncology depts. usually deal with solid tumours and NOT haematological tumours as it is so specialised.
It might be internal power struggles within your treatment centre... where are you treated?

Sandy

Hi Sandy
They are saying that Haematology are not allowed to prescribe the Dasatanib as it is a chemo drug and that it has to be done by Oncology. I now have an appointment at Oncology, followed by one at Haematology and then have to wait a week before they will let me pick the drugs up. My Haematologist thinks its ridiculous but can't do anything about it. I am treated at Kent and Canterbury under East Kent.
K

Hi Karen......... well I would take issue with the description of dasatinib as chemotherapy. If that is the case then so is imatinib/Glivec as they are both the same kind of drug, i.e TKI's -tyrosine kinase inhibitors, and are more usually described as 'molecular targeted therapy'. They do not kill all cells, unlike chemotherapy drugs which do not discriminate between normal cells and cancer cells.

If your haematology department can prescribe imatinib/Glivec then there is no reason to suppose that they should not prescribe dasatinib/Sprycel or nilonitib/Tasigna.

So it seems to me that this is an internal departmental problem which is usually to do with allocation of resources...i.e money.

You should not suffer delays from this sort of internal struggle. It is really not enough for your haematologist to just say he can't do anything about it as it is having an impact on your therapy and he is responsible for that.

There is no difference in the classification of these two drugs so the oncology department should be made aware of this and the process should continue as it was before.

If you feel strongly enough then you might want to write to the management of the hospital and ask for an explanation. Oncologists are not haematologists and are not expert enough in CML to manage your case.

Sandy

HI Sandy

Thanks for that - I used to work at the hospital and I know how disorganised they are!!! I may well take up the challenge of getting a reply from them as it may help others - many thanks again

K

I was under the impression that all these TKI'S are a form of chemo. Since I have been on Nilotinib I have been given a chemo record book from the hospital The drug is writen in the book along with the dosage and all my blood results. If I dont have "the blue book" with me then I cant get my drugs. The booklet calls Nilotinib chemo.
Confusing!
Ali

HI Ali

I have a little red book! Out of interest do you go to Oncology or Haematology for your appointments?

K

Hi Karena, I go haematology, where do you go?
Ali

HI Ali

I now have to go to both! If I don't go to Oncology they won't let me have the drugs and then I have to go to Haematology for my normal appointment. Waste of time and money I would have thought...

K

Hi Ali,
I suppose all drugs could be considered 'chemo' as they are made up of chemicals... but 'chemo' is usually used as a shortened form of 'chemotherapy' which means to most to describe the type of general cytotoxic drug that destroys all cells-healthy as well as malignant- and does not target only the particular cancer cell. To change the use (and understanding) of this word when it is so well established is in my opinion more to do with funding decisions between departments than as a correct description of a targeted therapy like imatnib/dasatinib/nilotinib.

Best wishes,
Sandy