dr. opinion disparities

peeps1111

Hi;

Wondering if anyone else gets mystified or discouraged by the wide disparity of dr. recommendations in almost everything.  For example, a simple question as to whether chemo patients should get a flu shot yielded several different answers.  I mean shouldn't this be a known fact to all oncologists at this point? 

Radiation is another story. Some drs. strictly limit which cream to use.  Also some recommend "airing" out the radiated breast.  I talked to two women who both had radiation last year and neither one of them ever heard of it or did it.  Those type of things are things I'd really like to know next month when I start radiation but it's all so confusing.

I know everyone is diferent here as far as type of breast cancer,  quality of life issues, side effects from chemo, hormone therapy, etc. and I appreciate the advice and experience from everyone who has been through treatments.  But it seems to me that the drs. should be on the same page as far as basic recommendations.  Anyone else find this a little maddening?

So I guess what to do is sift through everything here, listen to what my drs. have to say, do a lot of research, then trust my gut. 

Peeps 

Beesie

Peeps, I think the problem is that there are just so many variables related to breast cancer treatment - too many to test.  Some things have been tested but other things haven't been.  And some doctors are up-to-date and others are less up-to-date.

Basic treatment protocols are well documented ( http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf ) but even there, you get different opinions from different doctors.  That certainly shouldn't happen.  But once you go beyond the basic treatments, it's all up for grabs.  While there are dozens of smaller studies done here and there by individual doctors and hospitals, I suspect that there are few if any large definitive studies on most of the types of things that you mention - airing out a radiated breast, which cream to use, flu shots and chemo, etc.  And if the only studies that have been done are smaller ones, it means that most doctors probably don't hear about the results and/or or different studies may have different results.  Another problem with breast cancer treatment protocols is that in some cases it may be years and years before we know the affect of a treatment or understand how the results of those treated one way differ from those treated another way.  So in the meantime, doctors make their own judgements.  They make their recommendations based on their own experience, what they've happened to have read most recently, what they've happened to have heard at the last conference they attended, what they heard from their fellow doctors, etc.  The result for us is that treatment protocols are all over the map. 

I had reconstruction and it's amazing the differences in what PSs do.  Some put in implants that are smaller than the expander, some put in implants that are larger than the expander, some put the implant in as soon as the expander is full, others insist on waiting 2-4 months before putting the implant in - and they all say that the way they do it is best. It's so frustrating!