Choosing Your Doctors

I was talking with a friend the other day (when am I NOT talking with friends, but anyway), and something she said made me realize that most people don't realize that when you are in cancer treatment your doctors do not have to all be at the same cancer center.

Depending on what kind of cancer you have, and the treatment(s) you are contemplating, you could easily have three or four oncologists of different types, plus a talk therapist, physical therapist, massage therapist, and more.

When I was first diagnosed with breast cancer, for example, I sat down for a conference with a breast cancer surgeon, a medical oncologist, and a radiation oncologist. If I had been considering breast reconstruction, a plastic surgeon would have joined us.

As it turned out, I only needed the surgeon and the medical oncologist for my first round of treatment, which was a mastectomy followed by chemotherapy. But when my cancer returned a few months later (I had a local recurrence), I saw my medical oncologist and a radiation oncologist. That time I was treated with chemo and radiation.

I had chosen this team carefully, and they were all at the same hospital, the University of Washington Medical Center.

But now, I have a team of three doctors and they are not even all in the same state. The doctors who care for me are Dr. Livingston, who left Seattle for Tucson about a year ago. He is the doctor who had been my medical oncologist from the beginning, and I see him in Tucson twice a year and communicate with him by e-mail in between.

When Dr. L left, there was not a breast cancer oncologist at the UW or SCCA (a new facility that had opened during the time I was under Dr. L's care) I would trust my life to, so I jumped over to Swedish and saw a doctor there briefly before landing with Dr. Lee at Northwest Hospital, also in Seattle.

Dr. Lee is the doctor I see most often, as he is my new medical oncologist.

But last winter I needed radiation therapy again, and I chose Dr. Eulau at Swedish. He is still my radiation oncologist. And I'll be having treatment with him again over the next month or so, more on that later.

So I have two doctors in Seattle at two different cancer centers, and one doctor consulting from afar in Arizona. And it works seamlessly.

The biggest benefit is that I have the doctors I want. Doctors I trust. Doctors who seem to "get" me, and who like me.

My point is, anyone can do this. Cancer centers don't advertise it, for obvious reasons, but you are the patient, and you are free to choose the doctors you want and ask them to work together.

And they will. They usually know each other anyway, cancer medicine is a surprisingly small world.

@ Jeanne Sather 2007.

Comments

[Lisa]

I am so sorry that you will be needing radiation again soon. I was hoping that no news on that front meant good news. Ick.

More on topic, My doctors are spread out in 3 institutions (2 sarcoma centers), and my main surgeon is 3000 miles away, but I totally trust her and would go anywhere to have someone I trust. I think having a physician who you trust is so important, of course I feel lucky to have been able to swing this.

[Amy]

My husband's doctor (hematologist/oncologist) described himself at one point as a "broker" who could help us figure out what all the researchers and lymphoma specialists were really up to. Meaning, help us decide what cutting-edge approaches might be good, versus who wanted him as a guinea pig. It was interesting to us that he saw himself not just as the main cancer doctor but also as an advocate. It could be, however, that he is a control freak!

[jeanne]

Amy--but how do you (the two of you) read him? As a control freak, or as an advocate? That's what matters, I suppose.

I think we all need advocates. My best one is my therapist. She doesn't go out and make phone calls on my behalf, but she talks things through with me, and always comes up with things I haven't thought of, and then she points me in the right direction and gives me a loving shove.

And she never tells me what to do, although she has strong opinions, sometimes, and isn't shy about expressing them to me. And since she's been my therapist so long, nine years, I trust her.

Jeanne