Has anyone changed MO after chemo has started?

puncturedbicycle

Not sure even how to word the subject line.

My mom (IDC/DCIS) has been receiving treatment at NYU and has been happy there but is now worried that her upcoming chemo is going to make the travel too hard (she lives about two hours away and will need to be there once every three weeks). She is supposed to be starting CMF in the next 10-14 days. I guess my question is what should she do if she starts treatment and finds the travel too hard? Can she just continue to look for an alternative MO closer to home and if they're in agreement with the first doctor's plan just pick up where she left off? The nurse practitioner in the NYU MO's office says she has to decide now, but surely if she's unable to carry on there she will be entitled to change - ? I want to suggest something to her to take the pressure off, because she is thinking in such absolute terms right now - 'I will get sick and be unable to travel' - it would be good to present a plan B.

We don't want to delay treatment (she has already had surgery, rads a month later and now a gap of a month before chemo starts) while we try to find a doctor closer to home, and my mom likes the NYU MO. I don't think the CMF is a controversial choice of treatment (second opinion at MSKCC confirmed they would follow the same protocol) so I expect it to be straightforward finding an MO who will agree, but is it going to be a logistical nightmare to get everything swapped over?

I thought we'd be able to get the chemo prescribed by the NYU MO and administered at an infusion center closer to home, but it seems like this isn't an option.

Not sure how clearly this is coming across - we have had a real head-beating day chasing an appointment with an MO at Rutgers - but I'm going to stop re-writing it and click submit. :-)

treelilac

Both NYU and MSKCC should be able to refer you to a different doctor near your location. They should at least have the compassion to help you. What about your mom's PCP? Can he/she recommend anyone?

puncturedbicycle

Hi treelilac. Thanks for your reply.

They had no objection to my mom seeing someone else but neither MO knew anyone in NJ.

MO #1 actually suggested my mom get appts w three different docs at teaching institutions and find one she liked and MO would work with them. How long would it take to get all your slides and reports trundled around from doc to doc three more times never mind the six week waits for appts?? I thought that was kind of a bonkers suggestion when you consider the sheer heavy lifting it takes to organize these appointments, esp after you've had upteen procedures with all the accompanying paperwork. So in the end we're seeing an MO at Rutgers to see if she concurs w MOs #1 and #2 and hopefully we can work out the details in good time.

MO asked my mom specifically to find someone at a teaching hospital and that does not fit anyone down here near my mom's PCP. When my mom was first diagnosed he did recommend a local surgeon but in the midst of all the cancer hubub and worry at the time we felt more secure seeing the NYC bigwigs. :-) (For what it's worth.)

Partly I'm just having a wigout because of all the time everything is taking, although I don't know if there is any rush on the chemo. She has already had surgery and rads and they're giving her time to heal up after rads before chemo starts. I should probably stop panicking.

april25

This is late, but I changed MOs after I started Chemo.

I had chemo before surgery, so that was the start of my treatment. I switched from my original MO because I went for a 2nd Opinion and liked that MO better (he was an hour away in west Los Angeles, but my sister lived out there and I could stay with her). As there was Open Enrollment, I also switched insurance (first doctor was at an all-inclusive HMO thing). I didn't want to delay treatment, so made sure the first guy was giving me what the 2nd MO suggested (first MO agreed after getting a letter from the 2nd). I also had to go to the ER and was hospitalized during that first cycle at the old hospital. But managed to switch everything, doctors, insurance, etc., by the time of my 2nd cycle!

So it's possible. Probably not recommended, but most doctors follow similar protocols, and at the very least, the doctors can recommend others closer to where you want to be. I could have been treated closer to my home, but my sister wanted me up where she could keep an eye on me, so I'm still going an hour away up to L.A. for treatment and doctors, and staying with her when I need to. The people up in L.A. kept saying they would recommend me to doctors and places down here if I needed that.

I hope you and your mother found a workable solution!