How important is the radiation facility?

JSwan

I am getting ahead of myself because I haven't had surgery yet (doing neoadjuvant hormone therapy) but was wondering how important the facility is to the success or side effects of radiation therapy.  I live in Montana and was planning on having any chemo and radiation done at the local cancer center even though I am having the surgery out of state (no breast surgeons here).  People have told me that, while it would be ok to do the chemo locally, I should think about having the radiation out of state as well because it really matters where it is done.  I hate the thought of being away from home for the long duration of the treatment.  Any thoughts or experiences? 

redsox

Everybody should go to a radiation oncology facility with modern and relatively new linear accelerators, but most breast cancer patients do not need esoteric or unusual equipment.  I do think the quality of the radiation oncologist is very important and I would check that person's qualifications and experience in treating breast cancer thoroughly.  If you are going to a major cancer center for surgery you could ask them.  If the rad onc is well qualified most likely the rest of the staff is good but you can ask about that as well.

JSwan

redsox -- thank you very much for your response.  I guess I have some research to do before deciding.  The problem is I'm not sure I will get the real story from the local center because they seem to try hard to keep things in-house and discourage people from getting treatment elsewhere. 

toomuch

JSWAN-You may want to ask if the local facility has the ability to do IMRT. Radiation to your other organs, lung & heart if tumor left sided, can be better controlled with this method. I think that it's important to get several opinions, one at your local facility, and one elsewhere so that you can compare treatment plans.

Claire_in_Seattle

I would do local unless a major red flag not to.  Radiation therapy for breast cancer is a very common procedure.  So check out the radiation oncologist and equpiment, and if all OK, it should be a go.

Even major cancer treatment centers often have local facilities for delivery of treatment beyond surgery.

Radiation is an every day event for six weeks (normally).  This would mean that you would need to stay near the facility, or do punishing commutes.  You wil most likely be tired towards the end.

Personally, I would want my own bed and not to have to drive very far.  Which is why I would try to do local if possible.  However, if I thought that the radiation oncologist was not the best or if the equipment was sub par, I would be willing to make the sacrifice.

JSwan

toomuch and Claire_in_Seattle -- thank you for your advice.  I plan to get opinions from the local center and the one in Colorado where I will be having the surgery but would like to do the radiation locally if possible.  The radiation oncologist here seems to be well qualified although I have not met with him yet.  According to their websites both centers offer IMRT although I don't know the extent to which it is done for breast cancer.  I will ask about it but am not sure I would qualify for it anyway.  Plus, my cancer is on the right side.   

GabbyCal

Good luck as you work through this decision. I'd rely heavily on advice from the people in Colorado who are doing your surgery. I think they would be able to advise you on whether or not the local center has current equipment and staff who are able to deliver.

Some insurance companies have coverage for travel should you need to get treatment away from home so if you haven't checked into that yet, I encourage you to do so. They also may have other services to help patients who don't have access to the treatment they need locally. 

JSwan

GabbyCal -- thanks for your suggestions.  I briefly met with the radiation oncologist in Colorado (a friend of a friend) when I was first diagnosed and would trust his judgment.  I will also check into the options you mentioned.