Help Need Toronto Oncologist and Surgeon

bluesky

I'm from NYC and was treated there, I am in Toronto temporarily, today I met with an Oncologist at Princess Margaret Hospital for a check-up and I'm so upset about the check-up procedures here;

1st-He will not perscribe a bi-lateral breast MRI and ultrasound which is what I have done in NYC once a year as mammos are too painful for me and when I had BC it did not detect it.  He said I can I only have a mammo, if I want MRI I have to pay for it.  He said that MRI's do not pick up anything extra that a mammo wouldn't.  This is the opposite from what my NYC doctor told me who is one of the best in NYC.

2nd-He said that surgeons do not do follow up visits so he could not recommend one.

3rd-He would not do the tumor marker test, and I had this done twice a year in NYC, while I know they are not completely reliable, they were my safety check.

4th-He said that he will only see me once a year and that it's up to me to do my own examines and if I don't feel well to be in touch with him.

He kept saying that they only do all these tests in NYC for the money and that they are not beneficial they are not finding anything at check-ups that I wouldn't find myself.   My visits were reassuring for me and I felt very cared for, I do not feel cared for here, they are just doing the bare minimums because it's government funded. Frankly I'm Outraged at the moment with the lack of care that I heard about today.

I need help, I am looking for a very good Oncologist and Surgeon? Is this the norm here?? 

Sugar77

I'm from Mississauga (a Toronto suburb). I've had absolutely wonderful care at Carlo Fidani Regional Cancer Centre, which is at Credit Valley Hospital in Mississauga. My surgeon does follow up appointments and will do so for a couple of years until he turms me back to my family doctor (who is also involved...just saw her last week).  The surgeon referred me to both a medical oncologist and a radiation oncologist and they were both great. I will continue to see all of them on a rotating basis. I will have clinical examinations every three months and one annual mammogram.  I do not in any way feel that they are doing the minimum because it's goverment funded.  I have been given exceptional care and I'm sure that will continue. Rest assured there are a lot of really good doctors here in Canada and I hope you find one that you are comfortable with during your stay,  All the best to you!

crazy4carrots

bluesky:  I think the onc you saw was being much too "cavalier" with you.  I live in a small city in Ontario and, even though I'm Stage 1, my onc would arrange an MRI for the remaining breast if I ask her to (government-funded!).  But, as it is, my breast is not dense and a yearly digital mammo and U/S are keeping a close watch.  (BTW, the digital mammo is quicker and much more comfortable.)  My onc agrees that tumour markers do not provide useful info and does not order them.

I suggest you post on the Stage III thread with your query.  I know that one gal, KerryMac, is a patient at Sunnybrook.  You might ask her opinion.

There are many concerns about the over-use of scans and other expensive tests that often are ordered as a doctor's CYA.  However, a patient's dx, history and especially her emotional concerns should always be the primary consideration, IMO.

Good luck in your search for the onc who is right for you.

Luah

Bluesky:  I'm sorry you were upset by the oncologist at PMH - and frankly surprised if their practices are much different than the U.S. PMH is known to be one of North America's 5 leading cancer centres.  I have also noticed many U.S.-based women posting on these boards that their docs only scan if symptoms present themselves. Studies have shown routine scanning makes no difference to survival. Like me, you may find this counter-intuitive, but nonetheless health care resources are allocated based on clinical evidence. Is this more true in Canada where we don't "purchase" our health care services? I'm not sure.

If you're not happy, I would seek a second opinion. If your path or personal/family history warrants, you may very well get a different outcome. For example, I have some family history (though not BRCA +) and my tumour was an aggressive trip neg type, which never showed up on a mammo. My onc said I can get both an annual mammo and an MRI. 

Luah

Just as an addendum:  My BS follows up for 5 years (annually I think).  Right now, I have 4-month vists with onc, but that will move to 6 months after a year, then presumably annually after a couple of years. I have an annual physical with GP, who also does a breast exam.   

bluesky

Thanks all for your advice, I am seeing my family doctor in two weeks and will get her to recommend another oncologist and surgeon and am also going to ask her to request the MRI and US.