Deciding on an oncologist in DC area

Asmont

Hello,

I’m recently diagnosed with either a Stage 1 or Stage 3 invasive ductal carcinoma. Apparently it’s not clear since the size of the cancerous area is not confirmed and waiting to get a PET to confirm not metastasized.

It’s definitely HER2+ and seems big enough that I need to start with chemo. I’ve met with two oncologists who recommend the same treatment plan, and I’m having trouble deciding between them.

The first is Dr. Denduluri at Virginia Hospital Center. She seems to get mostly great reviews and definitely seems smart and on top of things. Her office is super organized and lined everything up for me. The only drawback was that I found her manner while seeming to be caring to maybe be a bit insincere. But I was impressed she wrote down her email address for me as I feel like I have to go to through nurses every other doctor I’ve met. Other pro is that VHC is super close to my home.

Then I met Dr. Karen Smith at Sibley, associated with John Hopkins. I felt like I “clicked” more with her. I also liked the infusion center which is brand new and has nice individual rooms for each patient. It’s not terribly far from my home, about 15 minutes if no traffic. But the group doesn’t seem as organized, taking care of things for the patient, although maybe that’s because a lot of appointments/procedure were already scheduled.

So, basically my questions are 1) any thoughts on how to decide which doctor is right? Meaning are there aspects that should “hold more weight” when deciding? 2) would welcome any feedback positive or negative from anyone who’s worked with either of these doctors.

Thanks so much for any guidance! I’m feeling overwhelmed and pressured - need to get chemo started ASAP

Moderators

Hi Asmont-

Welcome to the community! We're so very sorry you find yourself here, but we hope you find these boards to be a source of support and information as you continue down this road. You might want to check out or post in our Recommend Your Resources forum, lots of members share doctor experiences there, and someone might be able to chime in on your choices: https://community.breastcancer.org/forum/26

The Mods

Peacetoallcuzweneedit

What does your gut tell you to do? Any online reviews to check? Insurance acceptance the same? Are they part of same group as other cancer team members for communication? I did not connect immediately with my plastic surgeon and sometimes I still don't...I mean I like him, but he is vague. I am a discusser, need recommendations with guidelines, and then let's discuss those as well. He is like, "sure you could do that" or "try and see"..BUT what he does do well is plastic surgery...and all is well. My BS is awesome....but she is direct...to the point. I have set all my second opinions up at City of Hope...and will continue that way for the long haul. I have loved all my interactions with City of Hope - connected to most providers I have met there.

Hopefully other ladies will chime in here.

MTwoman

Asmont, how we each weigh what we value in our team seems to be a highly personalized process, so I can't help there. What I will say is that you should remember that you'll be working with your MO for a long time (years) as he/she will be the one to continue prescribing hormonal treatment for you. So anyone that you don't want to continue seeing for the foreseeable future, or who you don't feel like you'd be comfortable calling (at some point in the future) if you become worried about something (it happens to quite a few of us) that's NOT the MO for you. He/she is the person you'll work the closest with over the longest period of time. Hope that helps you in your decision making. Good luck!

star2017

Hi Asmont,

I'm also in the area. I met doctors at both Georgetown and Hopkins. While I haven't met either of the doctors you mentioned, the oncologist at Hopkins spoke very highly of Dr. Karen Smith because he had worked with her. I didn't end up seeing her because at that point I was exhausted from meeting so many doctors, and the doctors were (thankfully) all recommending the same protocol, but I wanted to let you know about his recommendation. I didn't end up going with Hopkins because Georgetown is much closer for us and the Hopkins doctor himself said proximity is important when you're sick and dealing with frequent visits/treatments. I hope this little bit of information helps you to decide. Best wishes.

SpecialK

Something to consider, which is often overlooked when in the throes of deciding on treatment, is how often you will be seen and how you will be followed post-treatment. Many patients express dissatisfaction with their surveillance after chemo, so determining in advance whether your oncologist will routinely scan or do tumor markers or other blood work at intervals becomes important. Also, trying to get a sense of accessibility of oncologist and staff in the event of chemo or hormonal therapy side effect assistance is important, and may tip the scale toward one or the other.

I did a clinical trial at Sibley and found the facility and personnel to be very nice and things were well organized - easy to park if you drive, or if you access by metro they have a hospital shuttle that arrives outside the Tenleytown station, or the M4 bus from the same spot and they go right to the hospital. I lived in NOVA for ten years so was familiar with the area, but because I flew in for this trial sometimes I rented a car, sometimes I didn't depending on where I was staying

JKL2017

Asmont, I'm being seen at VHC & Dr. Denduluri is my MO. I didn't need chemo so I haven't had to see her often but I've been pleased with her efficiency & accessibility. She struck me as more business-like than warm & fuzzy but I got the impression she was very good at what she does & that was good enough for me.

I had another cancer doctor (that I really liked!) whose office was an administrative nightmare. Their inefficiency has been so bad it almost cancels out the skills & warmth of the doctor!

Even though I haven't needed a lot of appointments, it really helps to be close to your hospital & providers. All that said, you need to be comfortable with your medical team. And Sibley seems to have more lymphedema expertise than VHC & that could prove important to you later. In the end, I'd suggest following your instincts. Treatment can get emotional & you need to do everything you can to be comfortable.

If I can answer any specific questions, please feel free to private message me. I've gotten so much assistance & support on this Board I'd love to pay back a little of it. Whatever you decide, best of luck!

Asmont

Thank you all so much for your thoughts! I’m a horrible decision maker in general...like picking where to go out to dinner stresses me out ...so this felt imposssible. Although how lucky I am to have more than one excellent option! I made a decision yesterday and am feeling good about it and getting started with treatment. Really appreciate all the feedback

Reader425

Asmont, glad to see you are heading a direction you feel comfortable with. I have seen Dr. Smith for three years and have felt comfortable/confident in the care I receive although I did not need chemo. From reading about her she sits on the standards committee for BC care so thats reassuring. Also i found her warm and caring but direct. Can be tough to be both.

I too am thankful to live in a place where there are multiple good options. All the best to you!

gonegirl

I am hoping folks are still around on this thread. I just left my oncologist at George Washington University MFA because the cancer center doesn't have nurse practitioners, and that meant I couldn't get answers when I started having reactions to my treatment.

I moved to Dr. Denduluri at Virginia Cancer Specialist. She is clearly very good at what she does but I am feeling like my desires aren't being listened to. I had a reaction to my first treatment with Herceptin/Perjeta (I became nauseous and got the chills) and was given steroids, which I hate. I made an appt with the doctor after to talk about what happens next based on the reaction. Was hoping could do the slow the infusion down and given anti nausea meds before. Doctor immediately went for the steroids again and when I said I'd prefer to try other things first, she simply talked through what I was saying. Oy. She did agree to cut the dose on steroid. I feel so strongly about the need to be heard that I emailed her, asking if we could at least wait until I start a reaction before giving the treatment. Nope. She's insisting on the steroids.

I know this might sound like a small detail, but I was so frustrated that now I'm a bit panicky about continuing to work with this doctor. Anyone else had experience with Dr. Denduluri on this type of thing? She is clearly very skilled and was recommended by my first oncologist, along with Dr. Karen Smith at Sibley. Trying to figure out what to do next. I have metastatic breast cancer and have had the very good luck of responding well to treatment - I'm knocking on wood that this is what will happen with Herceptin/Perjeta. For me an oncologist is a longer relationship than just a few months. Any feedback?

JKL2017

Gonegirl, I sent you a PM.

adymaria

Did you all find an oncologist that you're happy with? I'm disappointed by the lack of communication with my doctor and thinking about switching. The only time I can speak to my doctor is by appointment. She will not answer questions over the phone. I can only speak to one her nurses if I have followup questions after my appointment. Is that normal with all oncologists?

I can understand that oncologists are busy, but I think at the very minimum, they should be available to do a follow up call after your initial diagnosis. It's a lot of information to take in and it should be expected that a newly diagnosed patient will have a lot of follow up questions. And unfortunately I feel like I received a lot of conflicting information from the nurses.

I also doubt whether I'm getting the best treatment. I know my doctor is smart, but my gut tells me that she is always too busy and is not proactive about future plans/giving advice. For example, I started researching online if cancer patients should get a flu shot and read that a flu/pneumonia shot is highly recommended for cancer patients because complications from the flu are more serious even deadly for us. Shouldn't my oncologist have told me this, instead of me discovering it myself?

I also see that breast cancer patients on this site commonly talk about things that my doctor has never discussed with me. Such as tumor markers, hormone testing, bone density testing, how many lymph nodes are positive. When I ask her about these things she usually says those tests are not reliable. But again I get contradicting information later on. When I was first diagnosed, I asked whether I should take hormone testing to make sure I was menopausal before taking a letrozole. She told me it was not a reliable test. But 3 months later her office orders the test for me. If not reliable why was this test done at all?

It's all these things that make me doubt whether I'm getting the best treatment. Of all the doctors we could go to in our lifetime, we should have the best relationship with the doctor who is working on saving our life.

If you have a doctor you're happy with, please let me know. I'm from NOVA as well. Thank you.

star2017

I've been very happy with my care at Medstar Georgetown University hospital. I know a couple other people treated there as well. My MO, BS, and PS have all been kind, thoughtful, and incredibly professional.

Let me know If you’d like more information.

gonegirl

Star: Do you mind sharing the name of your medical oncologist? Do you feel like she or he listens to you when you express your wishes about treatment? I really appreciate it.

Susan

star2017

Dr. Robert Warren. He listens and offers advice from years of experience. He also seems to consider my specific experience and symptoms. I never feel rushed or ignored

gonegirl

ok. At this point I think I may have to move. The doctor has her own rigidity but it's turning out the system as a whole is rigid. Today I asked to be given the 250 ml of Iv saline solution that was already hung and was told no, doctor had to order that. I pushed and finally was given saline (extra hydration helps me with side effects). I'm tired of having push to be heard or for simple things so time to explore other options. Does Georgetown have whacky rules like this?

Georgia1

Hi there Gonegirl. I didn't have chemo so I can't answer that specific question. But I would definitely recommend Dr Smith or Dr Nunes at Sibley. The facility is lovely and I found the staff super organized during my radiation treatments.

Georgetown is undergoing renovation so parking is a mess and the logistics of treatment may be too much to handle. Just my two cents.