How many Drs.?

I have my gyn/onc who did my surgery and is my "primary" doc and I have a medical onc who does the chemo.  I didn't do radiation, but did meet with a rad/onc "just in case" and is on stand by if I ever need radiation.

My Gyn/On c was also my surgeon. A Radiation Oncologist handled radiation. My surveillance is with a P.A.

This is an interesting question, and one I had myself. I went from biopsy to hysterectomy to chemotherapy in VERY short order, so I took some time for the dust to settle and my lack of confidence in my oncology surgeon to set in. Upon quizzing the nurse navigator at my hospital - where, incidentally, Dr. Not-Wonderful has head of gynecological oncology - she explained that the model for gyne onc was different than other cancer specialties. In our corner of the world, the surgeon was also the treating oncologist, for no reason that she could articulate other than "that's how the doctors decided to do it". Made absolutely NO sense to me, and it was increasingly clear that my surgeon was way over her head once I was sewn up and healed. I left that practice and went to someone in a traditional oncology/hematology practice, and never looked back. If there's any legitimate medical reason for gynecological oncology to follow their own model, I'd love to know what it is as it made, and makes, no sense to me.   

Like derMaus, I went from biopsy to surgery to chemo in no time flat, and I never thought to question that my gyne onc was in charge of all of it......even till just now when I read these comments!  I suppose I just figured that every cancer surgeon handled the chemo too.  I did get a second opinion with a gyne-onc at MD Anderson and she concurred with my treatment plan, but now that I look back at the nightmare I had with the first chemo and having to change it up, I wonder if I should have asked for a medical oncologist to consult for the chemo.  Food for thought!

did surgery and chemo. My next followup isn't till October or i would question my doc about the rationales behind the 2 options 

BluebirdOne said:

Depends on where you go for treatment

My first GO that I saw does the surgery, and also was providing chemo and office visits. I did not like the idea of the surgeon also providing chemo, etc. and I just didn’t like the guy after seeing him.  To me only having one person was not prudent, I was worried that he would miss something, dismiss something, or just get sick himself (he was in his late 60's). Plus the comparison of a single provider who may or may not be up on all the latest care, techniques or rapidly evolving therapies was a bit scary versus the team approach by people who were very specialized at a research and teaching hospital. My second opinion was at Mayo where they have a team approach. My GO surgeon did the surgery, which is what she specialized in. I then had a different GO take over my case who reviewed all of my test results, surgical results, confirmed my staging, created a treatment plan and recommended the chemo, radiation plan. I had another GO radiologist who advised me on the brachytherapy, and gave me the radiation. I have a CNP who I saw during treatment and after I was finished for scans and bloodwork. I am now seeing an oncologist as I am NED, but I also had sessions with nurses who did patient education, and survivorship education. So the advantage is that many GO eyes see your case, and a highly trained NP follows up. I am comfortable with that. The downside is that I don’t get to form a relationship with my doctors, but my case was extremely uncomplicated so I did not need any extra care. I shudder to think if I had stayed with the jack of all GO, who did everything, how much I would have disliked or distrusted his judgement. But there are many incredible doctors who are not affiliated with a large institution that are 1st rate. In my case I was looking more for a facility that handled lots of the rare USPC as I had no idea if I was going to be staged 1a or much worse. 

 

Denise

 

Edit: My point is that I don’t think one way or the other affects the outcome based upon the anecdotal evidence here. The most important thing for ME was the confidence in my team having seen this cancer MANY times, in all stages and having seen the many reactions to the myriad side effects. I trust the team approach. Another may want and need the comfort of one person managing their care, and there is a lot of merit to that approach. I remember initially being so distraught, so fragile, so vulnerable that knowing I had the best team I could get helped me to cope. As long as you feel you are getting the best standard of care how many docs or where you get treatment should not matter. The psychological component of this disease is almost as important as the physical. 

 

 

Yes, exactly to your edit. That's what I was looking for: breath and depth of experience, preferrably via more than one person. I have a rare and unpredictable cancer (Grade 3, undifferentiated, low hormone, high neuroendocrine content). A surgeon who'd been out of residency for 4 years, regardless of how (reputedly) great a surgeon she was, simply didn't have the experience to develop a comprehensive treatment plan. My radiation oncologist, however, was the stereotypical crusty older man who knows EVERYTHING in his field. Since radiaton is the only thing that has consistently worked on my cancer, I was thrilled to have him on board as I shopped around for another oncologist. 

derMaus said:

Yes, exactly!

Yes, exactly to your edit. That's what I was looking for: breath and depth of experience, preferrably via more than one person. I have a rare and unpredictable cancer (Grade 3, undifferentiated, low hormone, high neuroendocrine content). A surgeon who'd been out of residency for 4 years, regardless of how (reputedly) great a surgeon she was, simply didn't have the experience to develop a comprehensive treatment plan. My radiation oncologist, however, was the stereotypical crusty older man who knows EVERYTHING in his field. Since radiaton is the only thing that has consistently worked on my cancer, I was thrilled to have him on board as I shopped around for another oncologist. 

I also have Grade 3, undifferentiated, low hormone cancer, which as you well know is scary due to its aggressive nature and rarity.  I feel very glad that I am working with a Team (oncology gyn surgeon, gyn oncologist and gyn radiation oncologist) affiliated with a teaching/research hospital.  I was also able to get a second opinion of the pathology from a cancer center.  Still, because there is so little data and research, it's difficult to feel comletely confident that anyone knows from any substantial experience whether what they're recommending and I'm experiencing is that effective.  Yet, it's all I can do so I've decided to get on board and follow instructions.  My team has been good at listening to what I have to say and making adjustrments to reduce noxious side effects as much as possible.  I am impressed with my Radiation Oncologist because of her thorough eplanations and warm, encouraging manner.  I'm less enthusiastic about her recommendation for 6 brachytherapy  treatments as it seems like many people get only three.  I'll cross that bridge when I come to it!  Mary Ann

Fridays Child said:

Lots of Doctors!

Originally I had surgery by a gyn oncologist, followed by radiation managed by a radiation oncologist.  In the ensuing years my surgeon left and I was followed by another gyn/onc until being released.  Subsequently I was diagnosed with a recurrence/metastasis, and my chemo was managed my a medical oncologist and radiation by the radiation oncologist again. I am also monitored by the gyn oncologist,, although no more surgery.  Oh, and the interventional radiologist who did the biopsy for the recurrence.  I really liked him.

You had adenocarcinoma stage 1, grade 1, had radiation and then seven years later you had a recurrence? I have a friend who had that and was not given any treatment. Do you mind telling me where was your recurrence?

mamlicsw said:

Feeling relatively confident in my Team.

I also have Grade 3, undifferentiated, low hormone cancer, which as you well know is scary due to its aggressive nature and rarity.  I feel very glad that I am working with a Team (oncology gyn surgeon, gyn oncologist and gyn radiation oncologist) affiliated with a teaching/research hospital.  I was also able to get a second opinion of the pathology from a cancer center.  Still, because there is so little data and research, it's difficult to feel comletely confident that anyone knows from any substantial experience whether what they're recommending and I'm experiencing is that effective.  Yet, it's all I can do so I've decided to get on board and follow instructions.  My team has been good at listening to what I have to say and making adjustrments to reduce noxious side effects as much as possible.  I am impressed with my Radiation Oncologist because of her thorough eplanations and warm, encouraging manner.  I'm less enthusiastic about her recommendation for 6 brachytherapy  treatments as it seems like many people get only three.  I'll cross that bridge when I come to it!  Mary Ann

Mary Ann, I got 5 brachy treatments. They were a lower dose than the standard 3 to reduce any damage to my vaginal tissue. You may want to ask them if that is the reason for the 6. I can tell you it has been 3.5 years since my treatment and I haven't had any issues. I stopped using the dialator about a year ago and so far, so good. I'm still sexually active but not nearly as often as we used to be... Hope this helps!

Love and Hugs,

Cindi