Picking the doctor....

It's a very individual decision. I have a surgeon, oncologist, rad onc and ortho doc. Plus, I do my own research so I go in expecting what I know I want to hear.
I was diagnosed 6/00 with breast cancer followed by bone mets 8/01.
My brother has hodgekin's lymphoma, diagnosed 10/03 and wants to be treated only by MDAnderson Hospital.
Very different approach with in the same family. Personal opinion, they are in the business of treating cancer not patients, my brother feels more comfortable with that. One just has to go with what feels right.
God bless. Hope this helps.
hummingbyrd

Hi joanf:

I went to 3 different facilities for my treatment.
None were close to the other's or affiliated in any way.

My surgeon, who specializes in diseases and conditions of the breast, has a private practice in a shore town about an hour from where I live. He is also the director of the breast care center at a large hospital in the same town. My surgery was done in that hospital.

My oncologist office is in a building, adjacent to yet another large hospital, about 30 minutes from my home, in the opposite direction. (This building is the State Cancer Institute) Any tests, etc, which I should need can be done right there as well. Scans, CXR's, etc. This new building has beautiful gardens, etc. with a huge chemo treatment wing, upper body massages included during infusion, full meals included, individual tv's with headphones, music, etc.. A nutritionist and cancer social workers are also on staff and available.

At the time of my treatments, the closest facility for me to have rads was in yet another large hospital, in another direction and also about 30 minutes from my home. I didn't like the rad onc. or the facility much but unless I wanted to double my daily driving time, that was it. About 6 months after finishing rads, a new facility was completed nearer to me and I began going there for my rad follow up care. The rad onc is wonderful and the level of care there is far superior to the facility where I had my rads.

All this considered, it was not complicated. My surgeon acted as the coordinator, which made things much simpler for me. Although none of my other docs were people he knew and there was no affiliation or association between them, he took charge, so that the left hand knew what the right hand was doing, so to speak. He even rang the rad onc when I was preparing for rads and wasn't getting specific answers about a few aspects of it. He reiterated my concerns to the rad doc, got specifics and rang me back, etc.. For me, that was key...having one member of my treatment team who was the anchor, communicating with everyone else involved.

When I sought 2nd opinions re adjuvant treatment, (at Memorial Sloan Kettering and Fox Chase) I took copies of everything to my surgeon, which also facilitated our being able to discuss different aspects of those opinions, including the pathological review of my original slides, at those facilities.

I currently see my surgeon every 6 months, as well as seeing the rad onc and oncologist every 6 months. Each doc does a complete physical examination at each visit and reviews my mammo film. The onc. does counts, tumor markers and chemistry profile at each visit. Each doc also receives a full mammo report from the facility where I have them but they all prefer to actually see the films too.

Obviously, I have utmost confidence in my surgeon. He is on top of everything that's going on in the field, not just the surgery, so his role was a tremendous one for me.

I'd suggest that you ask on of your physician's with whom you're very comfortable, to perhaps serve as your coordinator as this can really simplify many aspects of the treatment process.
It certainly worked well for me. With general surgeon's this is likely not possible because they have no special interestes in breast cancer and really aren't involved in research, treatment options, etc.. Sometimes, the oncologist may assume the coordinator role. It depends upon your needs and whether the doc you prefer is willing. But keep in mind that if you prefer "one stop shopping", you may not really like every doc you may need to see, under one roof. Just have to decide what's going to work best for your particular needs. Hope this may help some.

Take heart and trust your instincts as they are probably correct. None of us wants to go through this treatment process. It's a very nervous time. However, having doctor's we trust, can rely upon and communicate well with, is of major importance and it's a bonus when we can get just the right docs from the outset.

Good luck and please let us know what you decide.

Love, light and laughter,
Ink

I am in NYC also and I finished treatment in March 2003. I had most of my treatment at Memorial Sloan-Kettering, which is one of the country's top cancer centers, and am also going there for my follow-ups. I saw three different doctors there - a breast surgeon, my oncologist and a surgical oncologist who removed both ovaries. The primary doctor in my case is the oncologist and I see him every 4 months. Everyone there was/is fabulous and I found the support, nursing care, and chemo treatment facilities all to be excellent. I also had several diagnostic tests done there as well - MRI, CT scans, and genetic counseling - and go annually for my mammogram and breast ultrasound. That being said, Sloan-Kettering is very expensive and isn't in most health insurance networks. For all of that, I'm glad I went there. It made everything much less complicated for me (at a time when life was extremely complicated). The only thing I didn't have done there was radiation, which I had at NY Presbyterian. With my Sloan-Kettering oncologist's blessing, I saw the head of NY Presbyterian's radiology department, who happened to be in my network. There are many fine hospitals in NY City and I'm sure you can find excellent care here. The main thing is for you to feel comfortable and have trust in your doctors and treatment. It's a difficult enough process without having those additional worries. Good luck!