How much does it matter where you have your radiation therapy?

There might be more diferences than you realize - the equipment, the planning process, the procedure, the follow-up, etc.  All things being equal I would have preferred the short drive to my local hospital, but the hospital I chose (a one hour drive one way) is one of the top rated hospitals in the US.  I had no idea what I was getting into since I didn't find this site until after I finished treatments, so I think I made the right choice.

From my experience, it might make a big difference. I'm 10 years and 4 months down the recovery road. I was treated at a local Regional Cancer Center, which was the first in the Quad Cities (population 320-K+), and believe the Technicians did just what the Dr.s ordered. From what they said, I was under the impression they had talked to the U of Iowa...But I was wrong. Couple years ago they announced they finally were! And I don't see how you can go wrong with at least getting a 2nd opinion from a Major C Center on the Rad tx regiment. Your team of Dr.s- ENT, Chemo and Rad- are in charge. Mine was a bit of a joke in that for every negative symptom the Chemo Dr. blamed the Rad, and the Rad blamed the Chemo! So, I guess they really weren't working as a team- though right across the hall from one another in the same building. If I had it to do over- I would have made the drive to Iowa City and gotten a 2nd opinion from them. I'm now on a FT for the rest of my life due to Rad damage, and have been treated for years by a Neurologist for the Rad damage done to both sides of my neck.

I know we're not to talk of negatives, but...Had an ex-coworker who had H&N of unknown variety and was treated at the same place in 2006. The C came back within 2 years and he went to the U of Iowa. They told him his first tx in the Quad Cities had not been done as it should have, without pulling any punches. He ended-up going thru a 15-hour Op. in Iowa City that got him a new tongue, a long emergency Op. overnight, there, when a complication developed, and a very long recovery. And, changed him for the worse, mentally: divorce, then a couple years later arrested for rape and found guilty. And to know him before his bout w/C- no way. Just my opinion, but I think his 1st local tx that was wrong turned him into a bitter man because of the physical impact the 2nd bout at the U of Iowa had left him.

That said, I think the most important thing is to get a tx regiment plan established by the most competent "C-team" possible in your area. Wish I had taken that route.

Where you get treated can make a difference I believe best recommendation is to go to cancer specialty facility hospital - I went to University of Miami Slyvestor Cancer Center and teaching hospitals are good I have heard others mention that too.  Keep the faith and God will see you thru. 

I went to a local cancer center. To me, what I liked the most was how conveneient they made it. I did 7:30am treatments daily because I drove myself to them and then straight to work. Getting up first thing with somehwere to go and something to do made a huge difference.

I also complained when they rotateed out my techs on about the 25 visit. I told their boss that as a patient I looked forwarrd to the known routine. I had enough stress without new techs learning my norms. They promptly put the old tteam back in place.

johnsonbl said:

If you have the option....

You should try and receive all your care at the highest level cancer center you can (academic medical center, NCI cancer center, large private multidisciplinary center)...  However, not all of us live convenient to such an institution (I work at one so I just walked down the hall for my treatments).

If it is truly a hardship to travel for daily treatments for 6-8 weeks then have your rad onc refer you to a center more convenient for you.  They will give you a good recommendation.  My Rad Oncs know who is out there and what their capabilities are.  They'll also be honest if your cancer is tricky enough that you should stay with them.  If it means you'll be compliant with your treatment plan that's the most important thing.

I've said it before, head and neck cancer in the grand scheme of things is a pretty rare cancer type.  In Iowa, it's only 3.6% of new cancers each year.  This means that at smaller centers where they treat say 400 new cancer patients every year only 14 of those would be head and neck patients.  So your rad onc is treating all kinds of patients and is likely good at all cancer types but maybe excellent at none.

At a larger center like an NCI cancer center (University of Iowa) we treat upwards of 3500 new cancers every year...so around 125 head and neck cases per year.  We have Otolaryngologists, Medical Oncologists and Radiation Oncologists that ONLY TREAT head and neck cancer.  They are EXPERTS at that type of disease.

So, if you can...get your treatment at the most robust program you can...  But if you have to receive care locally, it can be done... your docs can help you find the best place.

Best of luck,

Brandon

You have no idea how much I wish I had been one of your 125/year H&Ns. I did make a drive to Iowa City using an alternative route than 80 and actually walked into your C center. Did so because at the time with my Insurance would have approved a 2nd tx w/C there. The head Dental Dr. down the hall from the ENT Center is the one I went to for an explanation on my teeth problems. Did you know you/U of Iowa is ranked #3 in H&N C?

Go please, I so wish I had.  I had Stage 2, HPV+, No lymph involved, small leasion on left tonsil skins .   They pushed Me so fast locally to jump on Treatments immediately since I had had it for 3 yrs traveling Europe, any Dr I saw I would ask, they said it was nothing till I went to an ENT at one office for allergies.  He suspected it was something & did a biopsy, Came back Cancer.  Sent Me to a Chemo Dr another place & a Rad Dr at another place locally.  Said they would do a Team Approach.  Boy he was wrong.  Rad Dr was not the nicest & My first treatment when I saw the machine had a bad feeling, looked old & it did break down probably 3 times during My Treatmen.  Rad Dr didn’t really confer with Chemo or ENT so forget Team Approach.  I am almost certain he over radiated & too big an area.  Almost 4 yrs later at this moment Cancer free won’t know till next Month for next check-up with Chemo Dr But......NO Saliva already had to go to Baton Rouge to have dilation surgery to open damaged ducts.  They have since shut down again & looks like the glands are probably fried.  Thyroid is shot.  So yes, I’m angry at Myself for not putting the brakes on till I went somewhere like Mayo or MD Anderson for their opinion.  They have better machines & a real Team.  It’s worth going.  No Saliva & desert dry mouth 24/7 is really horrible, Thyroid is a mess, please think about a second opinion & trust your gut where you feel more confident at.  Your the one that has to pay the price Not them so go for the best so you can live a quality of life.  Trust Us that admit to making a mistake, now I have to live like this in pain, so very uncomfortable, many new medical conditions due to the treatment, for possibly the rest of My life which I wish would just end.  Going to Mayo In Jacksonvill,Fl next week to see if they can help with some answers or treatments.  Fla Local Drs In My area are the worse I have ever had from New ENT ( old one left & moved up North), to a Endo, Kidney, GI, won’t ever speak to Rad Dr again he was so insensitive, Internist.  Money grabbing, pill pushers & Not very competent.