After lumpectomy...?

Kitchenwitch

OK, I've had lumpectomy and though I'm still waiting for results, I'd like to start my next moves. I need a radiation oncologist and a regular oncologist, right? Does anyone think all these people have to be at the same inst. as my BS? I know there are advantages to that but a lot depends on location. (Hosp. has a couple of locations and I can't keep going to the farther away one.) 

Does it matter, or can I just choose hospital (esp for having rads) that is convenient to me?

Figure even though I'll need the report from my surgery I can make appointments now and will likely have them in time.

Any other suggestions or advice welcome! 

dsj

The first breast surgeon I saw referred me to a radiation oncologist and I naively thought I needed to work with whatever team he assembled.  However, my PCP wanted me to see a medical oncologist before going any further, which I did. The medical oncologist then referred me to another radiation oncologist, who I eventually saw and liked much better.  Upshot is that I am using doctors in 3 institutions  I live in a fairly small city and they all know each other, so I don't foresee any problems coordinating. 

The medical oncologist referred me to the second radiation oncologist because she has what he called "state of the art technology," and with radiation, he also said "it all about the technology."  But I was also very impressed with her personally.  When I saw her for the first consult, I brought my mammogram films, but she told me she had already gone to where I had the mammogram and looked at the originals.  I thought that was pretty impressive.   So I want her to do the radiation, even though it means a longer drive. 

 I guess to answer your question , in my case I assembled the "team," with the help of my PCP. 

Kitchenwitch

Hey, thanks, DSJ, good answer. I guess I'll see what the NY group recommends - I like the recommendation for state of the art tech. I think that definitely is the key to good rads!

ruthbru

I don't know, I'm thinking that radiation is radiation; and I'd do the one closest to my home. I had to drive 100 miles each way for mine; and I know if I could have done it in my own town, it would have made the whole experience a LOT easier, and that is what I would have picked if I had had the choice. Good Luck! Ruth

redsox

For DCIS they treat the whole breast but no nodal fields.  It is pretty straightforward radiation treatment.  You should make sure any facility has a modern linear accelerator, CT simulator, and other standard equipment but you don't need super high tech equipment or technology.  I would ask for recommendations from your surgeon and ask about the facility that is most convenient.  In the end I think the most important factor is your assessment of the rad onc. How thorough in checking your history, reports, test results?  How good at explaining and answering questions?

In the end I went to a facility that was not a convenient location because the doctor had the best reputation. My experience with him showed that the reputation was well deserved.

sweatyspice

Kitch - I haven't been through it yet so you might want to check with the others in the NY group, but even when I thought I'd be Feldman's, I told them I was unwilling to do rads at that location and they were fine with it.  I'd do rads wherever I was most comfortable.

Scheduled to do it at NYU, which is the most conveneient for me (after Beth Israel, which I will not go back to).  All I can say about NYU is that they're keen on doing rads while you lie on your stomach, and they're doing a clinical trial w/shorter but more intense rads for DCIS.

IronJawedBCAngel

I don't think all radiation treatment centers are created equally and it is worth checking around.  Depending on the center, they may normally use external beam or IMRT.  You may be interested in and be a candidate for brachytherapy, it was still being developed when I was diagnosed and wasn't available in the town I had my treatment in.  I had moved before being diagnosed and my insurance was limited to my original city about 3 hours away from where  I live. For six weeks, I had to go stay at my daughter's during the week, and then I drove home for the weekends.  In the time since I have been grateful for those circumstances as I hear alot about bad burns and other complications at my local rads center. I want the best facility possible directing those rads.  I want rid of the cancer but I also need my heart and lungs functioning well afterwards and some facilities do better than others.  I have found that asking at some of the support groups can bring some really good information from women who have actually experienced the treatment at the various centers. Hope you find an onc and a rads center that is a very good fit for you.