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To change Medical Oncologists that is the question?

Dragons7-7-2010's picture
Dragons7-7-2010
Posts: 79
Joined: Aug 2010

To change my medical oncologist or not to change my medical oncologist that is the question? (a bit of play on the quote - "to be or not to be"

History:
I am going to MD Anderson, Houston Texas for treatment of my tonsil cancer right neck metastisis. I love my coordinating doctor who is my surgical oncologist. And on first meeting loved my radiation oncologist. However, on my initial appoinment disliked my Medical oncologist, who is part of the Head and Neck ongology team. Who has been on vacation since I saw her August 27th. I had to remind the nurse to do things put in the RX for the anti-naseaua medication and then when they failed to schedule the neulasta injection had to follow up. While assigned medical oncologist was out I had an appointment with another doctor filling in for her and said well I will give the medical oncologist a second change.

Well, I started Chemo today at the MD Anderson Bay Area Regional office which is 15 minutes from my house and free parking. Though they are only coordinating the chemo orderd by my primary team I had a meeting with the medical oncologist there today prior to chemo and really liked him and his nurse. While he does not specialize in head and neck cancers I wanted some thoughts on switching medical oncologist? no offense to the one assigned but we did not 'click' and since I want a nurse I can be more confident is it wrong to switch doctos since chemo has begun. Keeping in mind I will only see the medical oncoloist I dislike in a coulple weeks.

~ Thanks,

E. Cibil

RushFan's picture
RushFan
Posts: 218
Joined: Aug 2010

Sorry you have to deal with this. I firmly believe that you should feel secure and confident with the team around you. I would talk with my coordinating doctor, express concerns and ask about making a switch. Your coordinating doctor will likely agree with you and facilitate the change quickly.

BTW, I live in NW Houston and had my treatments at the Katy Regional Center. What a blessing to live close, park for free and be in the office minutes from the car door.

All the best to you, and everyone here
Chuck.

kimmygarland's picture
kimmygarland
Posts: 313
Joined: Aug 2009

I would talk to your lead doc, surgical oncologist and see what he thinks. But there is no reason to keep going to a doc you are not comfortable with. I guess it might be a little awkward, because they do seem to have a "team" type concept (at last at our hospital). But I'm sure they could substitute one doc for another. I would be interested to hear what you find out.

This is hard enough as it is, can't imagine trying to go through it with a doc you don't care for.

D Lewis's picture
D Lewis
Posts: 1523
Joined: Jan 2010

I was not completely comfortable with my radiation oncologist. She was of foreign extraction, a bit of a cold fish, and not good at follow up. I had to ask her twice for things, remind her of things, and be very specific about what I needed. But, as the radiation oncologist, her role was pretty much limited to just administering the radiation. I depended on all the other team members to take care of my general well-being and medical needs. Since this is your medical oncologist, you might do better with one you trust. They do play a larger role in the treatment process. Good luck.

Deb

Hal61's picture
Hal61
Posts: 656
Joined: Dec 2009

My three docs all have different styles, and I think they acted as a team more on the phone than around a desk. I try as much as I can to let their competence trump their attitudes, but I don't actually dislike any of them. The fact that your medical oncologist seems too busy to engage you, and his staff has failed to make two needed RXs
is more telling. Now's the time to switch though, early, and no feelings hurt.

Hal

zinniemay's picture
zinniemay
Posts: 534
Joined: Mar 2009

If you do not like this doctor , there will be a failure to express your needs or her to hear them. You need to have trust in them , if not then tell your doctor, how you feel. I am sure they came get another one. You have to be able to trust and feel comportable.

Scambuster's picture
Scambuster
Posts: 975
Joined: Nov 2009

If I were you, I'd switch. You need to be comfortablke and not stressed about check every thing they do. Wen things get rough you wil not need any additional drama.

Scam

Kimba1505's picture
Kimba1505
Posts: 557
Joined: Apr 2010

Hey Dragon,
In traveling this road with Mark, I have made some medical observations along the way. I found Mark's H&N surgeon and H&N radiologist to be God sent. These two men, I credit, with Mark's success to date. Both have an amazing skill and ability to perform their craft like a fine artist. (Mark once told the radiologist that I am in love with him...in a way I am...not only his skill but he never made us feel like the next patient was waiting. He answered all of our -my- questions without hesitation.)
Anyway...Mark's medical oncologist, he met with once. After that we met with a nurse practitioner named Faith. We came to have faith in Faith and never wanted to see the doctor again. Mark and I both assessed that the medical oncology piece of treatment was the least complicated and did not seem as highly skill based as the surgeon and the radiologist. "You either get this drug or that drug, you take this or that for side effects...these are the chemo drugs for head and neck..." Did not seem like rocket science to us.
My two cents would lean towards going with what feels good. You already have the recommendation of the drugs to use...might as well not be aggrivated with the goings on of the vacationing doctor.
Best,
Kim

Douglas08
Posts: 18
Joined: Jul 2010

This is not about right or wrong. It's about what works for you!! It's vitally important that you are happy and comfortable with all the people who you entrust to help you have a successful rx. You don't need to explain or apologize to anyone.

You are experiencing enough stress without having total control over what's happening to you. At least this is something you can do something about. You emotional well being depends on having doctors you have confidence in. I* believe your mental state plays an important role in getting better.

Of course you'll handle the request with grace and sensitivity. Don't worry about hurt feelings.

Good luck and god Bless

Hondo's picture
Hondo
Posts: 5674
Joined: Apr 2009

I would say if you are not satisfied with the treatment you are getting then you need to do one of two things, Switch or complain. I have a local oncal doc who keeps telling me I need more Chemo and the last PET I did at MD Anderson is saying I am Cancer Free and need no more Treatment, Who is right who is wrong.

I have been over radiated & chemo by the local guys trying to kill a cancer that might not have been there, so I have to make a choice on who to believe. I like both doctors but the doctor at MD Anderson will sit down with me and explain things in my understanding while the local doctor tells me everything in medical terms.

I like the support and help I get at MD Anderson and in your case I would complain first to the main office, if that does not get you the change you need then I would look somewhere else.

All the best to you
Hondo

Dragons7-7-2010's picture
Dragons7-7-2010
Posts: 79
Joined: Aug 2010

I reflected on this and think that since both are still MD Anderson Oncologists I am going to see how to go about switching to the Medical Oncologist at the MD Anderson Bay Area, but keep my coordinating surgical oncologist and radiologist. It is as many indicated not worth the stress and aggravation of dealing with a medical oncologist (and her team, nurse / PA) that are too busy or too distracted to do things right and take the time to explain. Not that they are bad medical people just not the people I am confident will be there when I need them.

Hopefully I can find something out monday or tuesday when the 5FU pump comes off.
I did not realize how must I would be looking forward to that..or a real shower. Ah life...the things you learn to appreciate.

Positive healing thoughts to all fighting cancer.

~ E. Cib

Skiffin16's picture
Skiffin16
Posts: 8058
Joined: Sep 2009

STG III Tonsils and a lymphnode to the same side, HPV+...

Nine weeks (three week cycles) of Cisplatin, Taxotere and 5FU pumped. that followed by seven weeks of concurrent weekly Carboplatin and daily rads with Amifostine Injections.

I too had Neulasta the second week of each cycle, made my bones ache like the flu for the first injection.

I also couldn't wait for the 5FU bag to come off. I hated hearing that pump every 30 seconds or so. Plus it made me smell like cat urine, LOL...a medicinal tea bag.

Hoping only the best for you, thoughts and prayers,
John

bswali
Posts: 2
Joined: Mar 2011

I was just diagnosed two weeks ago and have to go for my first appointment at MD Anderson downtown. Can I change to the hospital close to my house later? what happens on the first appointment? I have to go on 3/24/11

bswali
Posts: 2
Joined: Mar 2011

I was just diagnosed two weeks ago and have to go for my first appointment at MD Anderson downtown. Can I change to the hospital close to my house later? what happens on the first appointment? I have to go on 3/24/11

Dragons7-7-2010's picture
Dragons7-7-2010
Posts: 79
Joined: Aug 2010

Bswali,

welcome to the club you did not ask to join. The first appointment you can expect to meet your surgical oncologist, medical oncologist and find out who your radiation oncologist will be if you are assigned one They will go over your initial medical record, and then they will order their own tests, CT SCAN, blood work and likely schedule you for an exam under anestesia. I would bring a notebook and write any questions you have in advance as I get overwhelmed at times and forget what I meant to ask. When you initially show up you will meet with the Business office representative who will get your insurance and financial information. You will be assigned a social worker and person who schedules all your appointments. Once you have the initial tests all your oncologists will meet to come up with a treatment plan then you will meet with one of them to review the treatment plan. At least this is what happened with me.

I started out with an exam under anestesia (spelling?), tonsillectomy, then 3 weeks later started chemotherapy (3 rounds - each round was chemo 5 days a week - chemo drugs Cisplatin, 5FU and Doxetaxel) then I had 30 rads or 6 weeks 5 days a week of radiation. Then because my lymph nodes were still an issue at the post treatment CT scan I had surgery to remove them on March 8, 2011. I am now happy to say I am cancer free. No evidence of disease. Of course I dont' have my next ct scan until June 2011 but prayers that the CT scan in June shows I am still cancer free. I will have a CT scan every 3 months for the next year then they re-evalluate to see if I can go to every 6 months.

Not sure what part of town you live but MD Anderson has some great regional location for example I live in Clear Lake so my medical oncologist is at the Bay Area MD Anderson, but my surgeon Dr. Weber is at the main campus AKA Holcombe Blvd. So if you live in one of the areas where they have a regional care center check that out. I believe they have regional care centers in the Woodlands, Katy and Sugarland. But you can find out on the MD Anderson website and the care you get at the MD Anderson regional centers is just as good as the main campus just no surgeons at the regional centers.. In my opinion MD Anderson is the best if you live in Houston stay there. If you really want to you may be able to switch to a hospital close to your house but unless it is one affiliated with MD Anderson I would stay with the MD Anderson network as they know their stuff. they are rated one of the top Cancer centers in the USA so for me that is the world.

I also suggest if you need financial assistance start applying now through CanCare, American Cancer Society and any other resource you find. I did not apply until I was further along in my treatment and you get more assistance if you apply up front.
it is a tough journey and I am still in recovery mode and will be on the discussion board so if I can answer more questions feel free to send me a note or many others on the board who have gone before on this journey can offer tons of information.

Best wishes. Sorry your received the diagnosis and are part of this family.
But one thing I can say there are excellent people here that can help you in the journey through diagnosis, treatment and on to recovery.

Keeping you in prayer.

Eileen

Dragons7-7-2010's picture
Dragons7-7-2010
Posts: 79
Joined: Aug 2010

Bswali,

welcome to the club you did not ask to join. The first appointment you can expect to meet your surgical oncologist, medical oncologist and find out who your radiation oncologist will be if you are assigned one They will go over your initial medical record, and then they will order their own tests, CT SCAN, blood work and likely schedule you for an exam under anestesia. I would bring a notebook and write any questions you have in advance as I get overwhelmed at times and forget what I meant to ask. When you initially show up you will meet with the Business office representative who will get your insurance and financial information. You will be assigned a social worker and person who schedules all your appointments. Once you have the initial tests all your oncologists will meet to come up with a treatment plan then you will meet with one of them to review the treatment plan. At least this is what happened with me.

I started out with an exam under anestesia (spelling?), tonsillectomy, then 3 weeks later started chemotherapy (3 rounds - each round was chemo 5 days a week - chemo drugs Cisplatin, 5FU and Doxetaxel) then I had 30 rads or 6 weeks 5 days a week of radiation. Then because my lymph nodes were still an issue at the post treatment CT scan I had surgery to remove them on March 8, 2011. I am now happy to say I am cancer free. No evidence of disease. Of course I dont' have my next ct scan until June 2011 but prayers that the CT scan in June shows I am still cancer free. I will have a CT scan every 3 months for the next year then they re-evalluate to see if I can go to every 6 months.

Not sure what part of town you live but MD Anderson has some great regional location for example I live in Clear Lake so my medical oncologist is at the Bay Area MD Anderson, but my surgeon Dr. Weber is at the main campus AKA Holcombe Blvd. So if you live in one of the areas where they have a regional care center check that out. I believe they have regional care centers in the Woodlands, Katy and Sugarland. But you can find out on the MD Anderson website and the care you get at the MD Anderson regional centers is just as good as the main campus just no surgeons at the regional centers.. In my opinion MD Anderson is the best if you live in Houston stay there. If you really want to you may be able to switch to a hospital close to your house but unless it is one affiliated with MD Anderson I would stay with the MD Anderson network as they know their stuff. they are rated one of the top Cancer centers in the USA so for me that is the world.

I also suggest if you need financial assistance start applying now through CanCare, American Cancer Society and any other resource you find. I did not apply until I was further along in my treatment and you get more assistance if you apply up front.
it is a tough journey and I am still in recovery mode and will be on the discussion board so if I can answer more questions feel free to send me a note or many others on the board who have gone before on this journey can offer tons of information.

Best wishes. Sorry your received the diagnosis and are part of this family.
But one thing I can say there are excellent people here that can help you in the journey through diagnosis, treatment and on to recovery.

Keeping you in prayer.

Eileen

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