Where would you go????

Hissyfit33

ASAP. PLEASE. I am scheduled to be seen at Mayo on June 6th for evaluation and treatment Mayo was ranked 3rd in US for Cancer Hospitals but now found that Mercy a Hospital in Des Moines was rated very high for Breast Cancer.im only 30 minutes from Mercy and Mayo is 5 hours away.

They said it was IDC and very small .5

Also my family doctor said I didn't even need to see an oncologist until after surgery. That a general surgery I house could do it

Now I can't decid if I should just stick close to home. Anybody have an advice for me???

Artista928

A general surgeon who has done many bc pts did my surgery along with a good ps he uses for recon. If the place near you is that good then why would you want to go further out? I love that my mo, bs, ps, pcp, infusion center, radiation center is all 10 minutes away. Unless you have something going that's complex, which with IDC there really isn't, I wouldn't go further than the good one nearby. IDC is supposedly the better type of bc. ILC and IBC are tricker from what I've read here.

And don't go by what a fam doc says. Everyone who has bc should have an onc. You probably don't need chemo with that size, but that's for an onc to decide and not a fam doc, imo.

cp418

I agree it is reasonable to go the nearby hospital with a small non-complicated dx. All follow-up should be with an oncologist and not family doctor.

Denise-G

I believe it is ALWAYS best to get a second opinion from a NCI Designated Hospital - that has a tumor board of cancer experts. Then a decision can be made if you want to stay locally. The reason I say this is from my own experiences - myself, my mom, and sister were all diagnosed with BC within 3 years.

http://www.cancer.gov/research/nci-role/cancer-cen...

huntersd74

Wow he really said not to see an oncologist until after your surgery? For my peace of mind I would want to talk to the oncologist first. They can give you a lot more information. I love here in Ohio and the place where my oncologist is had peoold there who can answer all my questions and help me figure out a plan. This is a scary time and things can be very confusing. Also do some research about Mercy and see if you can find others who have been there. My tumor was rather large at 9cm but I think whether it's .5cm or larger this is a time when you need answers because you have so much going through your head. Another thing to keep in mind, depending on the type of treatment you will need it can take a lot out of you and being that far away from home could be an issue. I feel for you at this time....let me know how tho 's go and what you decide....Prayers

Octobergirl

I'd go to Mayo and hire the best surgeon possible. After surgery and pathology report is back, I'd ask questions, research and listen to recommendations to make further treatment decisions. If chemo and radiation are on the table, it may make sense to do those locally in consultation with Mayo. I was in the same situation in 2009 and opted to go to Duke...a 6 hour drive...for surgery. The peliminary MRI showed tumor less than 2 cm and no suspicious nodes. Turned out, shockingly, that I was stage 3A. I had 4!!! positive nodes, 1 with extracapsular extension and my tumor was closer to the skin than expected. Boy, was I glad I went into that surgery with a top notch highly skilled breast surgeon, though going to Duke was a bit inconvenient! While cancer is always a crapshoot, I believe a lot of the credit for my remission of 7+ yrs. goes to careful and thorough surgery and follow up. Remember, nobody really knows what the surgeon will find...so I decided to hope for the best and prepare for the worst. Best of luck to you and keep us posted as you move through your process. Hoping for an easy surgery and recovery for you!

Blessings2011

Hissyfit33 - just to be clear: did they say your tumor was .5 centimeters or .5 millimeters?

Here is my PERSONAL opinion.... yes, while it's true there can be surprises during surgery (especially with node involvement), most of the time a good Radiologist and a series of diagnostic tests can predict fairly accurately the size and location of your tumor(s).

If it were me, I would choose the facility close to home. Traveling is stressful, and a three hour commute (one-way) for a 15 minute post-op, or a quick look at a possible complication, or to receive treatment, would wear me out. If I had confidence in my local facility I would definitely go there.

But I knew in advance that my tumors were detected very early, and that they were very small. (1.5 mm and .5 mm) I did not need chemo OR radiation. Others, however, with a different dx, may feel very differently about where they are treated.

By the way, I was never assigned an Oncologist until AFTER my BMX, and the final Path report was in.

GoodbyeGirl

I agree with Blessing: Local for treatment. But distant for a second opinion is always a best idea.

HuskerFan

I'm receiving all of my care at Mayo in Rochester.....just had my BMX last week and my first appt with an oncologist isn't until June 8.

Obxflygirl1

Seeing an oncologist after surgery is important. Even if chemo is ruled out, there are other drugs that usually need to be taken to reduce the recurrence rate. Breast cancer is not curable. There's always a risk of distant recurrence.

exbrnxgrl

No advice on the facility, but it is quite common to not see an oncologist until after surgery. An oncologist will make tx reccommendations based on the post surgical pathology report. Yes, second opinions are always good. My second opinion was at an NCI designated facility. They concurred with my primary mo on a tx plan, so I traveled only 15 minutes vs. 30. Best of luck to you.

Carlsoda

• I would keep Mayo in your back pocket. Get the tumor out asap and go from there. I know someone who was treated at Mayo for BC and had an amazing experience but it is 5 hours away. I live bout 2 hours from Mayo but decided to have my treatment close to home. But I always know they are close by!

BarredOwl

Hi Hissyfit33:

As you may know, the Mayo Clinic is an NCI-designated cancer center:

http://www.cancer.gov/research/nci-role/cancer-cen...

If your appointment at Mayo is for evaluation and is already scheduled in six days, then I would keep the appointment at Mayo to get that additional expert evaluation (essentially a second opinion). With a second opinion, one is not obligated to seek treatment there. It will give you an opportunity to see the facility, get a sense of its capabilities, meet another breast surgeon perhaps, and then you have more info to help compare and gauge whether you may want to be treated at Mayo (in whole or in part), despite the distance.

For example, you might choose to have surgery at Mayo, and after surgery, consult with Mayo professionals (Radiologist, Medical Oncologist) about any further interventions, but then have the interventions with a team closer to home (e.g., radiation). A number of members here travel to an NCI-designated cancer center for selected aspects of their care.

BarredOwl

Beatmon

I have traveled 3 times in the last months with my daughter in law for a completely different disease to the Mayo in Rochester. I can tell you as a nurse I was very impressed with every thing that I saw there. Nothing wrong with being seen there and then having the remainder of care closer to home, working in tandem with the Drs. At Mayo. Incredible research is being done there. It is huge. We stay at the Marriott and walk through the tunnels and never have to go outside into the snow or heat...which ever is occurring at the moment. There are volunteers everywhere to help if you decide to start there. The only problem we have had is that they want to make appointments when we are not there....we fly in a week at a time! Problematic.

Good luck and please feel comfortable with whichever you decide.

Brenda E

gardengypsy

Hissyfit33

My second opinion was at Dana Farber, and it is a four-hour drive away. It turned out that, in my case, their expertise was absolutely essential. I had a 5.5 cm tumor! Pathology revealed that the cancer had just begun to spread (micrometastisis).

Although they were in a major teaching university, my local oncologist had been absolutely incorrect about my diagnosis and course of treatment.

I had surgery and chemotherapy at Dana Farber because I trusted them completely. I was fortunate, however, to have a place to stay in Boston to recover from treatment. I would not have been able to do this without my friends' generosity. The driving was rough. I had help with that, too.

I am feeling confident that I can do the rads close to home. This will be 2.5 hours driving each day for 5 weeks. I will continue to do my follow up in Boston.

After getting your second opinion, you will get a sense of what is best for you.

~gardengyspsy

ChiSandy

This is not a job for a general surgeon or even a general radiologist. For diagnosis & surgery, you want someone who does breasts (preferably breast cancer) and nothing but. Most patients meet with an oncologist after surgery, because the final surgical path report will often dictate the course of adjuvant (chemo, radiation, oral-meda or any or all of these) therapy--and if the report raises more questions, there are tests that can and should be ordered to determine the advisability of chemo. And getting your initial radiation consult at NCI breast cancer center in a major teaching hospital might inform you of latest developments in treatment that could shorten your treatment and minimize side effects. (Local hospitals are prone to one-size-fits-all “because this is how we’ve always done it” modalities) My RO was part of a study at teaching hospitals that concluded a shorter, stronger targeted course of radiation had the same success as conventional radiation in women over 60 with early node-negative tumors. Had I gone to a smaller hospital I might never have known about that. Once you have your post-surgical treatment plan in place, your local doctors can then administer it, consulting the major center’s specialists when necessary.

Mayo is a long way off, but you probably won’t be making more than two or three trips there--after surgery and oncology consults, you can do everything else in Des Moines. I’m lucky in that I have several NCI breast cancer centers within half an hour of me--I chose the closest (U of Chi. Med. School system teaching hospital and Mayo-affiliated) with the easiest & cheapest parking. (For radiation, which requires going every day M-F for 16-33 sessions, you want to stay close to home). But if I’d had to go to Mayo, M.D. Anderson, Duke, MSK, the Hutch or Dana Farber for my surgery and initial MO and RO consults, I would have.

Hissyfit33

thank you so much to everybody that gave me advice. The report says its IDC. Nottingham grade I. Size is at least 0.6 cmand its Estrogen Receptive 99% positive. DCIS Nuclear Grade: Intermediate

This is still all Greek to me. I'm still trying to decide since I'm horribly indecisive.

Hissyfit33

Kay.... Thanks so much for looking that up for me. I've posted the specifics of my Pathology Report in case that makes a difference.

I still can't decide since my general dr just talked to me like a optimistic mortician in hushed tones.

Hissyfit33

Kay? Where were you able to see where they did their fellowships? I was on HealthGrades but couldn't find it.

Thanks again everybody

dtad

Ive said it before and I'll say it again...where you get treated is a huge factor in fighting this disease. Best bet for most is a major university teaching hospital. For those lucky enough to get to the Mayo Clinic even better! Good luck to all.

Hissyfit33

thank you

labelle

I grew up in MN. Over the years we've had many friends and family members treated at the Mayo Clinic (although none for BC). Everyone who has ever spoken about their care at the Mayo Clinic, has been so pleased, including my cousin who was written off by other hospitals as having an inoperable and fatal brain tumor. His life was literally saved at the Mayo Clinic. If my insurance would have allowed it, I would have flown up there from TN and stayed there with family to have my treatments. It is top notch. With a small uncomplicated tumor your biggest problem would probably be the potential for over treatment and the problems that can come with that. I'm sure the Mayo Clinic is up on the latest recommendations. Even if you don't go to Mayo for treatment, finding out what they have to say would IMO be worth driving a long ways for.

As others wrote, you can mix and match treatments. Having daily radiation so far from home would not be practical, but surgery and onco care, definitely doable IMO.

Brutersmom

I would at least get a second opinion from Mayo clinic. I drove an hour and 1/2 to see the DR at a teaching hospital. It was the best decision I made. I would drive five for that second opinion if I needed to. I had a good surgeon locally but I am not a fan of the oncology Dr's locally. The physician I saw for the 2nd opinion felt I could be followed by the local hospital. He was familiar with practices etc. The 2nd opinion gave me piece of mind and with a cancer diagnosis you need that.

KBeee

I am near Des Moines. My care is at Iowa Methodist (Unity Point). I have been up to Mayo for second opinions and my docs worked very well with them. Feel free to PM me for any info on my docs in Des Moines, or any other questions about local info.I love my team of docs.

dlb823

I'm in the "at least get a second opinion at the Mayo" camp, then you'll have something to compare, and probably learn some helpful information I'm the process. I started out locally and my bio page details what can go wrong when a general oncological surgeon thinks they know what they'll find. I eventually ended up at UCLA... had tx both there and locally w/at least one doc (my rad onc) who had trained at UCLA and was recommended by them... and now have both a UCLA oncologist who is always on the leading edge of what's new, as well as a local oncologist for in between follow up. And I can cite at least 5 times when UCLA's tx recommendations were different and well ahead of the tx I would have received if I had gone with what was recommended locally. So, by all means, get that second opinion before deciding how to proceed. (((Hugs))) Deanna

Editing to add... Since you had mentioned it being rated very high for breast cancer, I took the time this a.m. to look up the on-line reviews and ratings for Mercy Hospital, and you may want to as well.

https://www.google.com/search?q=mercy+hospital+des...:1,lf_ui:3&rflfq=1&rlha=0&rllag=41597841,-93624424,140&tbm=lcl&rlfi=hd:;si:10427166132595134720

http://www.hospitalsafetyscore.org/