ENT doctor question
My dad had an appointment to go back to the ENT two weeks ago to schedule the surgery, but I postponed because he had just started treatment. He now has on for June 7th. Does it make more since to go after treatment to determine if he needs the surgery. I don't want my dad to go and get the poor outlook attitude when he is doing so good with treament and finally has a good outlook and is feeling better.
Do you guys think my dad should get a second opinion from another ENT? Please give me your honest opinion
Comments
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ENT
Hi Puma, I remember seeing my ENT after chemo & radiation monthly. I had cancer in my neck. (lymph nodes) It was my oncologist who decided whether to do neck dissection, or not.
I myself, definately would get a second opinion. Your Dad is going to have an ongoing relationship with his ENT, and if he is not informative on the first visit, well that does not bode well. I had to get scoped each month, so if I did not like my ENT, I think I would have hit him! Lol!
I changed my chemo doctor halfway thru treatment because he was rude, cold, and held me by the shoulders leading me out of his office, because I was asking too many questions! It was the right move. Trust your instincts Puma and God bless you for being a caretaker, and your Dad's advocate. He is very lucky to have you!0 -
type of treatment
Depending on your diagnosis you may consider no surgery at all. There is a study that says the overall survival rate and rate of re-occurence are basically the same for surgery vs no surgery on patiens with advanced SCC. I dont know if its true but I will find out as that is the method that was used on me. I have confidence it will be a good choice. I have noticed most folks do get surgery before radiation and chemo and I am not sure if it is because the method I am referring to is new or what. I am somewhat confused but like I said I have faith and time will tell. I have not had any post scans yet but will have next month. Also my tumor was partially in base of tongue as well as tonsil so surgery would likely have been brutal. Good luck in your decision and I will keep you in my prayers. Here is the link to a blurb on the study.
http://www.ncbi.nlm.nih.gov/pubmed/16475199?dopt=Abstract&otool=stanford0 -
Pattyannpattyanny said:ENT
Hi Puma, I remember seeing my ENT after chemo & radiation monthly. I had cancer in my neck. (lymph nodes) It was my oncologist who decided whether to do neck dissection, or not.
I myself, definately would get a second opinion. Your Dad is going to have an ongoing relationship with his ENT, and if he is not informative on the first visit, well that does not bode well. I had to get scoped each month, so if I did not like my ENT, I think I would have hit him! Lol!
I changed my chemo doctor halfway thru treatment because he was rude, cold, and held me by the shoulders leading me out of his office, because I was asking too many questions! It was the right move. Trust your instincts Puma and God bless you for being a caretaker, and your Dad's advocate. He is very lucky to have you!
I agree with you that my dad needs to feel comfortable. He does with the whole team of cancer doctors and nurses. I think I might also talk with the other doctors. I do not want to put him through something that is not necessary at this time. I am not sure what seeing him in the middle of treatment will do. The rad doctor said that there would not be any difference in the tumor until week 4 (my dad says he thinks most of his has gone away at week 3). I am glad to know that other have the same opinion that I have. I do not think my dad would have said anything about changing unless I did.0 -
Ent VisitsMGC said:type of treatment
Depending on your diagnosis you may consider no surgery at all. There is a study that says the overall survival rate and rate of re-occurence are basically the same for surgery vs no surgery on patiens with advanced SCC. I dont know if its true but I will find out as that is the method that was used on me. I have confidence it will be a good choice. I have noticed most folks do get surgery before radiation and chemo and I am not sure if it is because the method I am referring to is new or what. I am somewhat confused but like I said I have faith and time will tell. I have not had any post scans yet but will have next month. Also my tumor was partially in base of tongue as well as tonsil so surgery would likely have been brutal. Good luck in your decision and I will keep you in my prayers. Here is the link to a blurb on the study.
http://www.ncbi.nlm.nih.gov/pubmed/16475199?dopt=Abstract&otool=stanford
Puma
I saw my ENT twice prior to treatment and when she removed a spot from the base of my tongue. I am now seeing her every three months post treatment. My care was coordinated thru all three docs. So not seeing her during my treatment does not me she was not involved
Best Wishes & Prayers
Dave0 -
Good Doctor - bad personMGC said:type of treatment
Depending on your diagnosis you may consider no surgery at all. There is a study that says the overall survival rate and rate of re-occurence are basically the same for surgery vs no surgery on patiens with advanced SCC. I dont know if its true but I will find out as that is the method that was used on me. I have confidence it will be a good choice. I have noticed most folks do get surgery before radiation and chemo and I am not sure if it is because the method I am referring to is new or what. I am somewhat confused but like I said I have faith and time will tell. I have not had any post scans yet but will have next month. Also my tumor was partially in base of tongue as well as tonsil so surgery would likely have been brutal. Good luck in your decision and I will keep you in my prayers. Here is the link to a blurb on the study.
http://www.ncbi.nlm.nih.gov/pubmed/16475199?dopt=Abstract&otool=stanford
Tough one Pumma. Just because he is an ****, doesn't make him a bad Doctor. He sounds to have bad manners. You do however need to be happy with your Doctor so if not, change him out.
My ENT is superb. He was the one who diagnosed me and assisted with the other 2 doctors in decision making. He performed the Surgery first, then checked me a couple of times Post surgery then occasionally during treatment. i now see him every few months for a check and scope. If this ENT upsets you, I would change him unless you can confront him and find some common ground and mend the fence.
Scam0 -
ENT Main Man...
My ENT is my lead professional...
He is the one that I initially saw, he made the diagnosis, performed the tonsilectomy, arranged and over saw my chemo and radiation doctors.
I also see him every 6 - 8 weeks and have since the original diagnosis 2 January 2009. I see hime tomorrow as a matter of fact. I'll probably see him again in 6 - 8 weeks and if all remains good, my visits will probably stretch out to every six months there after....
John0 -
ENTScambuster said:Good Doctor - bad person
Tough one Pumma. Just because he is an ****, doesn't make him a bad Doctor. He sounds to have bad manners. You do however need to be happy with your Doctor so if not, change him out.
My ENT is superb. He was the one who diagnosed me and assisted with the other 2 doctors in decision making. He performed the Surgery first, then checked me a couple of times Post surgery then occasionally during treatment. i now see him every few months for a check and scope. If this ENT upsets you, I would change him unless you can confront him and find some common ground and mend the fence.
Scam
My Husband was Diagnosed by his ENT...he went to see hime maybe 3 or 4 times until now...he is Cured! He will be following up with ENT from now on as well as his Rad Dr..who he cancelled appt for twice and was told she is part of the Team and u must reschedule. He has and will be seeing her next week. The ENT did the Surgery on his Tognue las Monday and another Dr did the masses on his Lung's...but the ENT is doing most all of the follow up..he must go back in 6 month's for PET Scan, but will be seeing him and the Swallow Dr until he can truly eat. If you are not comfortable with your Dad's ENT or get a bad feeling or what ever DO get another opinion! You need Dr's you can comunicate with and that treat your Father with RESPECT! Like Scambuster said confront and get some common ground and maybe you guy;s will think differently. These people have bad day's too..not as bad as the Patient who has CANCER..but maybe he was having a bad day (Just a Thought) Like they say Don't LOOSE YOUR SWALLOW.....remind your Dad of this, as my Bob lost his and is so thin his stomach curves inward
( he is nothing but bones....BUT HE IS CURED! There is HOPE and this Board gave me hope..to pass on to my Husband..I honestly thought I was going to loose him..now it's a NEW GOOD WORLD...!!!
Hoping everything works out for your Father and yes he is very LUCKY to have you as an advocate.0 -
ENT
I was diagnosed a year ago this month with NSCLC in my left lung by my PCP who referred me to my cancer team. After the PET scan they found that I also had SCC of the larynx and I was then referred to my ENT who performed the biopsy.
Neither of my cancers are operable so I only met with my ENT a few times during chemo and radiation. I DID NOT like my ENT after my first consultation and still wasn't keen on his bedside manner after the biopsy. After my treatments were finished I had to see my ENT every month for the "dreaded" scope ;-) About 3 months post treatment he said he was still concerned because of swelling on the left side of my larynx and he decided to do another biopsy to make sure the cancer hadn't invaded the tissue of my larynx. Needless to say this had me terrified as I knew that I would have to have my larynx removed if they found more cancer in the tissue. I still wasn't 100% happy with my ENT but stayed with him anyway. The day I met with him to get the biopsy results I changed my mind completely. This man was genuinely concerned and affected by my results, this I know because his eyes were misty when he gave me the results. I was CLEAN!!! He told me that he saw me sitting in the waiting room with my husband and he had wanted to rush out and tell me the good news but didn't think it would be professional to give me the biopsy results while surrounded by other patients. I have finally realized that this man is a great and caring doctor.
I now see him every month for the first year post treatment and then will continue to see him every 2 months for another year. I have come to respect this doctor more than I ever thought I would.
Sorry for the long post, I guess what I am trying to say is you may not always like your doctor after the first couple of visits as he may be the type who is too professional with little warmth for the patient. Naturally, if he is causing your father too much stress and concern by his gloomy attitude you may want to consider getting another opinion. Post treatment is when your dad will be seeing his ENT more often than any of the other doctors in his cancer team. With any head and neck cancer he is a very important part of your team.
My best to you and your dad.
Glenna0 -
I dumped mineGlenna M said:ENT
I was diagnosed a year ago this month with NSCLC in my left lung by my PCP who referred me to my cancer team. After the PET scan they found that I also had SCC of the larynx and I was then referred to my ENT who performed the biopsy.
Neither of my cancers are operable so I only met with my ENT a few times during chemo and radiation. I DID NOT like my ENT after my first consultation and still wasn't keen on his bedside manner after the biopsy. After my treatments were finished I had to see my ENT every month for the "dreaded" scope ;-) About 3 months post treatment he said he was still concerned because of swelling on the left side of my larynx and he decided to do another biopsy to make sure the cancer hadn't invaded the tissue of my larynx. Needless to say this had me terrified as I knew that I would have to have my larynx removed if they found more cancer in the tissue. I still wasn't 100% happy with my ENT but stayed with him anyway. The day I met with him to get the biopsy results I changed my mind completely. This man was genuinely concerned and affected by my results, this I know because his eyes were misty when he gave me the results. I was CLEAN!!! He told me that he saw me sitting in the waiting room with my husband and he had wanted to rush out and tell me the good news but didn't think it would be professional to give me the biopsy results while surrounded by other patients. I have finally realized that this man is a great and caring doctor.
I now see him every month for the first year post treatment and then will continue to see him every 2 months for another year. I have come to respect this doctor more than I ever thought I would.
Sorry for the long post, I guess what I am trying to say is you may not always like your doctor after the first couple of visits as he may be the type who is too professional with little warmth for the patient. Naturally, if he is causing your father too much stress and concern by his gloomy attitude you may want to consider getting another opinion. Post treatment is when your dad will be seeing his ENT more often than any of the other doctors in his cancer team. With any head and neck cancer he is a very important part of your team.
My best to you and your dad.
Glenna
Mine was an **** and I quickly found a new one. That said they are all surgeons and surgeons like to operate. They also don't get to the top of their profession without a certain amount of high brow personality. It dosen't matter, as all you want is a good surgeon who has done hundreds of whatever procedure is being done. You must also ask, if in a teaching hospital, who is doing the actual cutting
and demand it be the one you hired. Read that again, You hired him!
Any team member can be the lead guy/girl. Currently my ONCOMAN is in charge. A second opnion is always a good idea and he should not only encourage you but provide recomendations. Ask him who he would have operate on his mother? Put all that loyalty crap to the side as you are fighting for your Dads life and shopping for the best. Doctors are obligated to only recommend practitioners in the hospitals they are on staff on. That isn't what you want. You want the best in your area.
Last time I researched my data the chance of spread with a diagnosis that is already in the lymphatic system is around 22% without a neck disection. 1 out of 4 is not a chance I personally would take. The operation is normally done prior to chemo/radiation but can also be done post TX and have just as good results. Keep asking questions.0 -
2nd Opionionratface said:I dumped mine
Mine was an **** and I quickly found a new one. That said they are all surgeons and surgeons like to operate. They also don't get to the top of their profession without a certain amount of high brow personality. It dosen't matter, as all you want is a good surgeon who has done hundreds of whatever procedure is being done. You must also ask, if in a teaching hospital, who is doing the actual cutting
and demand it be the one you hired. Read that again, You hired him!
Any team member can be the lead guy/girl. Currently my ONCOMAN is in charge. A second opnion is always a good idea and he should not only encourage you but provide recomendations. Ask him who he would have operate on his mother? Put all that loyalty crap to the side as you are fighting for your Dads life and shopping for the best. Doctors are obligated to only recommend practitioners in the hospitals they are on staff on. That isn't what you want. You want the best in your area.
Last time I researched my data the chance of spread with a diagnosis that is already in the lymphatic system is around 22% without a neck disection. 1 out of 4 is not a chance I personally would take. The operation is normally done prior to chemo/radiation but can also be done post TX and have just as good results. Keep asking questions.
I would always opt for 2nd opionion. A friend of mine who is a doc told me even if he knew who the best surgeon around was, he would still talk to 3 different ones to make sure they had the same philosophy as him and was someone he trusted. I "interviewed" several. The one I picked ended up being the leading surgeon for this in my area, but what sold me on him was he works as a team with the ONC and Rad. ENT is the lead but he confers with the others on all decisions. I've been scheduled to see him every 4 weeks and now that treatment is done, every 6 weeks.
I agree with ratface also. My team of doc's keep their own set of statistics and they showed a 20% increase in postive outcomes when they did a neck dissection versus not doing one on patients where it was an option.
Good luck to you and your dad!0 -
PumaGreg53 said:2nd Opionion
I would always opt for 2nd opionion. A friend of mine who is a doc told me even if he knew who the best surgeon around was, he would still talk to 3 different ones to make sure they had the same philosophy as him and was someone he trusted. I "interviewed" several. The one I picked ended up being the leading surgeon for this in my area, but what sold me on him was he works as a team with the ONC and Rad. ENT is the lead but he confers with the others on all decisions. I've been scheduled to see him every 4 weeks and now that treatment is done, every 6 weeks.
I agree with ratface also. My team of doc's keep their own set of statistics and they showed a 20% increase in postive outcomes when they did a neck dissection versus not doing one on patients where it was an option.
Good luck to you and your dad!
Saw my ENT: first, for evaluation and needle biopsy; second, for biopsy results and set-up for surgical biopsy; third, for that surgery; fourth, for results and set-up of Pet Scan; fifth, results, and basics of the Chemo and Rad, and answering any questions; sixth, last-minute appointment for another biopsy (ordered by the Rad); and the seventh time, for the second surgical biopsy. Did not actually see the ENT even once during the C&R treatment. And, first post-treatment visit came about a month after my last rad. With the treatment I got- nothing to be gained with a visit during the actual C&R.
If you ask him to explain, for instance, why he has chosen a treatment plan, or of the specifics of your Dad's C, and he acts like he doesn't wanna give you any answers- that doesn't seem right. You and your Folks are as much part of the "team" as the ENT, Onco and Rad. A simple question, like- "What can we expect, going forward thru treatment, and then post-treatment," should get your ENT to speaking with you on friendly terms.
kcass0 -
Thank youKent Cass said:Puma
Saw my ENT: first, for evaluation and needle biopsy; second, for biopsy results and set-up for surgical biopsy; third, for that surgery; fourth, for results and set-up of Pet Scan; fifth, results, and basics of the Chemo and Rad, and answering any questions; sixth, last-minute appointment for another biopsy (ordered by the Rad); and the seventh time, for the second surgical biopsy. Did not actually see the ENT even once during the C&R treatment. And, first post-treatment visit came about a month after my last rad. With the treatment I got- nothing to be gained with a visit during the actual C&R.
If you ask him to explain, for instance, why he has chosen a treatment plan, or of the specifics of your Dad's C, and he acts like he doesn't wanna give you any answers- that doesn't seem right. You and your Folks are as much part of the "team" as the ENT, Onco and Rad. A simple question, like- "What can we expect, going forward thru treatment, and then post-treatment," should get your ENT to speaking with you on friendly terms.
kcass
Kent,
I talked with the Rad office today and they told me that dad did not have to see him until treatment is complete. I also talked about a second opinion and they said they could refer him. We did ask the ENT some quesitons but got the response that Rad/Chemo will take care of all of that. He made us think that there was something on the CT scan that caused us to have the PET (I now know better).
I think we might go back again and then see what happens from there. He did not tell us much about any thing. The oral surgeon that did my dad biopsy told us more then the ENT.
I don't know any one in the area that has dealing with any ENT. I guess you just have to trust how you feel. I know that with my dad being older he will not speak up to a doctor and that leaves it up to me to do it, but I can tell when he is uncomfortable with someone.
I wish that we could find someone that is a good to as the Rad doctor has been.0 -
Hi KittyPumakitty said:Thank you
Kent,
I talked with the Rad office today and they told me that dad did not have to see him until treatment is complete. I also talked about a second opinion and they said they could refer him. We did ask the ENT some quesitons but got the response that Rad/Chemo will take care of all of that. He made us think that there was something on the CT scan that caused us to have the PET (I now know better).
I think we might go back again and then see what happens from there. He did not tell us much about any thing. The oral surgeon that did my dad biopsy told us more then the ENT.
I don't know any one in the area that has dealing with any ENT. I guess you just have to trust how you feel. I know that with my dad being older he will not speak up to a doctor and that leaves it up to me to do it, but I can tell when he is uncomfortable with someone.
I wish that we could find someone that is a good to as the Rad doctor has been.
Same here my Cancer was in the nasal passageway and in the right side of the neck, my oncal doc said he was going to treat the one in the neck with rad and chemo only for now and wait and see, after treatment I had no sign of anymore C in the neck. A little lump is still there but it is all scar tissue
I did not put a lot of faith in my first ENT, so I have a new one now that talks to me when I see him.
All the best to you0 -
Quality Matters
My partner was diagnosed by his primary family physician and he was sent to a local ENT. We live outside of Philadelphia with 3 NCI (National Cancer Institute) Hospitals. I said, let's go to the best. It was the best move we could have made. While the local ENT could treat Mark, he also takes out kids tonsils. We wanted someone who does Head and Neck oncology surgery ALL the time. So just something to consider...if you already are not liking the current guy (although I agree with Scam, just because he has a poor bed side manner doesn't mean he's a bad doc)and you have a bigger hospital with doctors that specialize, get a second opinion. It is worth the communte time to get to doctors who do just this...the commute can be a hassle, but it really for a short period relatively, and the results can be dramatic. Good luck...and don't be afraid to stand up to these doctors. The person who is looking out for your dad the most...is YOU.0
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