Private Oncologist vs Those Biggie Cancer Centers??

NDY2010

Hi, I'm brand new to these boards but have read lots of good advice for about two months now.

Does anybody see an advantage for seeking care from one of those big cancer centers--you know the ones: Cancer Centers Of America, M.D. Anderson, Farber, etc. Most of the cancer care that I have seen on these boards are the usual: surgery, chemo, radiation, maybe pills for awhile. Can anybody give examples of any "extra care or benefits" that the biggie cancer centers have provided? We all want to feel confident that we've chosen the best care for our own situations.

My story: Healthy 65 yr old, dx'd in May 2010 with IDC stage IIIC, ER+PR+HER+, 10 nodes out of 13 positive. I have had a right breast mastectomy, port input, and am on my 3rd chemo regimen of TAC. In my opinion all my care so far has been excellent. After the 6 chemos then I'll have radiation and weekly herceptin infusions plus I'll be taking arimidex for supposedly 5 years (Note: Doesn't 5 years sound so reassuring when you hear this from your oncologist & you guys know what I mean. When you have stage IIIC--hoping we even make it 5 years with such a nasty cancer). At any rate, I too have gone thru the usual emotions: devastation, fear, anger, questioning why it wasn't dx'd sooner, then--finally--acceptance and the determination to fight this with all that I can.

Judy

missrenee

Welcome, Judy--your situation sounds much like mine
I was diagnosed in Nov. '09-IDC, Stage IIIC, ER+PR+ but HER2-, 10 positive nodes out of 23. Had 2 surgeries (lumpectomy and revision of lumpectomy, port insertion), 6 rounds of TAC (finished May 6) and just finished 33 rad treatments today! Started Arimidex about 2 weeks ago. Also, like you I love my surgeon, med. onc. and rad. onc. and feel like I have had the best treatment I could. So, I say, if you're happy with your team, don't second guess yourself. I can't say any of the treatments were fun, but I got through with a minimum of side effects (and believe me--I can be pretty wimpy), and you'll get through too. All of this is tough, but definitely doable.

Stay strong and brave!

My prayers and positive energy go out to you.

Hugs, Renee

Hubby

There is good and bad
There is good and bad everywhere; doctors, nurses and even waiting rooms. You want to feel sure that you are getting the appropriate reccommendation for chemo and a facility that has up to date radiation technology.

If you are happy with a small office and the services they provide then you made the right choice for you.

Statistically, you want someone who specializes in breast cancer, other than that, bigger may or may not be better.

In my wife's case, the local surgeon was a nice guy and seemed competent, but Sloan-Kettering takes our insurance also, so we went with reputation. The surgery was in NYC, but the chemo treatments are in a satellite center of Sloan's which is closer to home, smaller in scale and more welcoming.

Hugs,

Bob

Marcia527

I went to the bigger local
I went to the bigger local main cancer center instead of a branch because they had the equipment to test the blood samples there. The small branches were closer to home but I'd have to wait for the results. I just went to the local cancer center and not the famous ones because I couldn't get transportation to the famous ones and I thought my surgeon was skilled anyway.

Aortus

Hubby said:

There is good and bad
There is good and bad everywhere; doctors, nurses and even waiting rooms. You want to feel sure that you are getting the appropriate reccommendation for chemo and a facility that has up to date radiation technology.

If you are happy with a small office and the services they provide then you made the right choice for you.

Statistically, you want someone who specializes in breast cancer, other than that, bigger may or may not be better.

In my wife's case, the local surgeon was a nice guy and seemed competent, but Sloan-Kettering takes our insurance also, so we went with reputation. The surgery was in NYC, but the chemo treatments are in a satellite center of Sloan's which is closer to home, smaller in scale and more welcoming.

Hugs,

Bob

Exactly
Bob makes a good point: it basically depends on one's comfort level. We were thrilled that even though we went with the St. Louis oncologist's chemo regimen, Moopy could still do her chemo at the cancer center here in Springfield. But when we found out hyperthermic radiation would bring Moopy extra benefit, we spent summer 2009 getting it up in St. Louis.

What I know about Cancer Centers of America comes from a student whose Dad had advanced metastatic liver cancer. The clinic in Kansas City told Dave's dad that they could do nothing more for him... sayonara. The Cancer Center in Tulsa took him in and were able to help him somewhat; I'm sad to say that Dave's dad died last summer. Whereupon - here's the kicker - Cancer Centers of America presented Dave's mom with bills totaling close to $300,000. The insurance carrier said, "uh-uh." How Dave's family managed to get out of that situation, I don't recall, but they pretty much did. I'm sure it wasn't easy, though.

Bottom line as I understand it is that CCA has wonderful facilities, caring and well qualified staff, and can accomplish amazing things in some certain cases. On the other hand, this top-notch care costs lots of money. And the bills do pile up.

Marcia527

Aortus said:

Exactly
Bob makes a good point: it basically depends on one's comfort level. We were thrilled that even though we went with the St. Louis oncologist's chemo regimen, Moopy could still do her chemo at the cancer center here in Springfield. But when we found out hyperthermic radiation would bring Moopy extra benefit, we spent summer 2009 getting it up in St. Louis.

What I know about Cancer Centers of America comes from a student whose Dad had advanced metastatic liver cancer. The clinic in Kansas City told Dave's dad that they could do nothing more for him... sayonara. The Cancer Center in Tulsa took him in and were able to help him somewhat; I'm sad to say that Dave's dad died last summer. Whereupon - here's the kicker - Cancer Centers of America presented Dave's mom with bills totaling close to $300,000. The insurance carrier said, "uh-uh." How Dave's family managed to get out of that situation, I don't recall, but they pretty much did. I'm sure it wasn't easy, though.

Bottom line as I understand it is that CCA has wonderful facilities, caring and well qualified staff, and can accomplish amazing things in some certain cases. On the other hand, this top-notch care costs lots of money. And the bills do pile up.

Yes, I only considered the
Yes, I only considered the cancer centers that were in-network so the insurance would pay. I always called and talked to the insurance company and also checked online. I wanted to make sure they agreed and usually printed out the screen just so I had proof. Also I wrote down who I talked to on the phone and date and time and what was said. Once when the insurance was stalling on paying I sent all of it to the state insurance board and they paid up.

Rague

Actually being able to take
Actually being able to take my Femara for the next 4+ years, I find very comforting. I am daily fighting the monster that can raise it's ugly head again any day. I will always have to fight the beast so having that bit of help is great.

A year ago today, I saw my PA - I was already sure what she would say. That afternoon I had a new mammogram, sonogram and needle biopsy done - the next morning I got a call from the radiologist on the path and it was indeed what all had expected - Inflammatory Breast Cancer.

I'm out in the 'boonies' - western South Dakota - as far as I know there is only one center/source within a couple hundred miles. I have absolutely no complaints about any of the care I've gotten there - it's been excellent.

mwallace1325

As everyone's already said
As everyone's already said it doesn't make any difference where you go as long as you're comfortable with the medical team and confident in the care you're getting.
Good luck, keep coming back here any time you need. This is without a doubt the most awesome group of people you'd ever want to know.

marge

cahjah75

I agree
Judy, that if you're comfortable with the care you've received so far then all is good. My gyn found my lump and referred me to oncology surgeon who specializes in breast cancer. I'm ER+, PR+ and HER2-. I had 6.1cm Invasive Lobular Carcinoma (only 10-15% of all breast cancers) in right breast and LCIS in left breast. I'm the 5th in my family with bc so even though I tested negative for BRCA gene I opted to have bilateral mastectomy June 22. I had my port placement today and start TC on Tuesday. My journey has just begun. I'm 61 and the oldest of 4 girls. My youngest sister had a benign tumor when she was 16; my mom has had a couple of benign lumpectomies; maternal grandmother died at age 62; maternal aunt dx age 68, had mastectomy and is still alive at 90; 1 sister with DCIS lumpectomy & rads; other sister lumpectomy, lymph nodes, chemo & rads. One took Tamoxifen and other took Arimidex. Both are past their 5 years.

What I really liked was my surgeon asking if I'd like to go for treatment closer to home. YES! I'm as happy as one can be on this journey and pleased with the care I've received so far.
Char

Mama G

cahjah75 said:

I agree
Judy, that if you're comfortable with the care you've received so far then all is good. My gyn found my lump and referred me to oncology surgeon who specializes in breast cancer. I'm ER+, PR+ and HER2-. I had 6.1cm Invasive Lobular Carcinoma (only 10-15% of all breast cancers) in right breast and LCIS in left breast. I'm the 5th in my family with bc so even though I tested negative for BRCA gene I opted to have bilateral mastectomy June 22. I had my port placement today and start TC on Tuesday. My journey has just begun. I'm 61 and the oldest of 4 girls. My youngest sister had a benign tumor when she was 16; my mom has had a couple of benign lumpectomies; maternal grandmother died at age 62; maternal aunt dx age 68, had mastectomy and is still alive at 90; 1 sister with DCIS lumpectomy & rads; other sister lumpectomy, lymph nodes, chemo & rads. One took Tamoxifen and other took Arimidex. Both are past their 5 years.

What I really liked was my surgeon asking if I'd like to go for treatment closer to home. YES! I'm as happy as one can be on this journey and pleased with the care I've received so far.
Char

Good question.
I've heard stories of newer meds being used at these cancer centers and having better results than your local onc (with the old standby a/c & T) so i've often thought that if this bugger comes back I'll go to one of the big centers and see what else they've got to offer. Has anyone got any input for that idea?

carkris

Mama G said:

Good question.
I've heard stories of newer meds being used at these cancer centers and having better results than your local onc (with the old standby a/c & T) so i've often thought that if this bugger comes back I'll go to one of the big centers and see what else they've got to offer. Has anyone got any input for that idea?

A woman I met was stage 4
A woman I met was stage 4 she said, that her local onc could not offer her any treatment, just to make her comfortable. She went to a bigger cancer center and they did aggressive chemo and she is currently in remission. I think it depends on the doctor. having said this I went to two places in Boston, one for chemo one for radiation. It seemed like the "bigger" cancer center had more to offer. My fear with the big centers was that, with so many patients you get lost in the system, but that did nt happen.