Doctors Leaving Practice During and After Treatment

mary625

I was treated at a major cancer center offering all practice areas in one place.  I just learned yesterday that my breast surgeon is leaving the practice.  I hope to be able to track her down if she's continuing in practice, although she could be leaving for family reasons.  When I was on about my 6th out of 8 chemos, my oncologist left the practice and moved across country for a drug development job.  I got a new oncologist, actually head of the practice thankfully.  I did not use the rads onc at this cancer center, and the one I used at the local hospital came into my case when I was nearly done with neoadjuvant chemo.  With the loss of the breast surgeon, this means that I won't have anyone on my team who was there at my at my diagnosis.  I'm upset about that and wondering just how important this could be.  Like all of us in Stage III, my situation was complicated and disease was "extensive" to quote the breast surgeon.  Any thoughts?  Reassurances? 

Edited to add:  I had BMX and while I realize that one can never be sure that all breast tissue has been removed, I'm wondering how important or not it is to have a surgeon on my ongoing care team since it's more likely that I need to watch out for mets rather than a second primary or recurrence at the same site.

kathleen1966

Hello!  I found that my oncologist generally didn't want to deal with anything related to the mastectomy performed by my surgeon, and that this area was "her responsibility".  So for this reason, unless you really like your oncologist and you don't get this impression from the person, I would try to find another surgeon for the team.  They might know more about what to look for. But, I too think that a local recurrence is not our biggest worry.

MaxineO

I guess I would ask what originally brought you to the cancer center, the surgeon? or the center's reputation?  While I think we develop a strong attachment to our doctors, large centers do operate under a 'standard of care' umbrella, meaning your treatment/followup, etc. will likely be similar no matter what docs you have.  That said, the importance of confidence in your individual doctor is critical, so if you don't find a new BS in that office, you may want to look elsewhere.

One thing I have unfortunately learned along this journey is the feeling that the docs really don't have much invested in any individual, as awful as that sounds. I believe they hurt for us and care for us, but at these large centers, they deal with so many people, I don't even know if they remember me!  The truth is, we must be our own advocates for our health, and that includes choosing doctors and cancer centers...whatever is involved in that choice.

I switched centers, after my diagnosis, to a large hospital with an excellent reputation. In some ways, I felt bad jumping ship, but my confidence in being in a 'teaching hospital' outweighed that...as did my feeling that it was absolutely my responsibility to myself to feel confident in my treatment.

Finally, followups with your MO are probably the most important, but continuing to see the BS on that schedule (probably less frequently) is good for peace of mind and to deal with issues with scarring, etc.

Best to you. Take care of you and be your own advocate.

Outfield

Mary, I've had two MO's leave, but neither during treatment.  It does suck a little seeing a new one because my treatment didn't go smoothly except I didn't miss any days of chemo or radiation.  Keeping it on schedule was the only thing that went right - I have a ton of problems as a result and it's a hassle acquainting each doc with them.  Lymphedema, chronic neutropenia, things like that.  

If you really liked the breast surgeon, contact her and see who she recommends.  If she's a good doctor, she'll be able to steer away from the party line she's supposed to say when leaving a group, "I'm sure they'll replace me with someone excellent."  Also, if you have a good relationship with any of your other docs, like your RO, ask them who they would recommend.  Same thing - they may talk to you honestly.  I have had three honest converssations with providers and gotten good info, and one useless one.  You just have gto try.