How do you choose your oncologist?

Maya12

It looks like everyone here (unlike me) knows what they are doing! I am somewhat lost :(How do you choose where to go for treatment? How do you choose an oncologist? Do I go to an oncologist first? Or a surgeon? Or are there navigators who could help point me in the right direction? Who do you call first after getting diagnosed?

flashlight

Hi Maya12, I think everyone feels lost and overwhelmed throughout this journey. After my biopsy results came back positive my radiologist called my primary doctor and they both agreed on what surgeon I should see. Usually you have to have a follow up with the radiologist to get the results, but she ended up calling me. My primary called me that evening. I went with their suggestion. When I had my follow up with the surgeon she told me who I would see for an oncologist and for radiation. I didn't question it because I thought that was how it worked!! I found out later that you usually meet with the whole team so you can understand the plan of treatment. My surgeon didn't set it up so it didn't happen and I met with the other doctors separately. It was all so confusing and frustrating at times. Is there anyone you know who has been through this in your area that might give you some advice? I think once you find your surgeon you will receive recommendations for the other doctors. Thinking of you......

Spookiesmom

My PCP gave me the news the first time in his office. Then asked me what surgeon I wanted. I had no idea, so asked him where he would send his wife. I got the best guy around here. He called the shots for tests, etc. Then my case went to tumor board, chemo came first, so met MO. Then surgery, then met RO for rads.

I’m now with my 4th MO, because of insurance, stupidity, and retirement. This guy is a keeper, glad the last one retired.

I was ok with the way everything went the first time. I never even considered second opinions. If you are comfortable with everything stay with. If you aren’t, by all means find someone else. You’ll be seeing them a lot.

AngieB92

I had a friend who was diagnosed with cancer last year. She was diagnosed at the same breast center I went to but sought a second opinion from our big university medical center about an hour away. She was very happy with her treatment so I moved all of my files to that hospital right after diagnosis. My oncologist is amazing! My breast surgeon is amazing!

ksusan

My radiologist gave me my biopsy results by phone and said the next step was to pick a surgeon. He gave me a list of several suggestions. I was researching them when my PCP suggested a surgeon not on the list because her office worked with him a lot and thought he did good work. After looking him up, I went with him because of this positive relationship. At our first meeting, I made sure his hands didn't tremble and that he was listening to me. I also fired the radiologist and his whole group because what he described was a lumpectomy, which was clearly revealed to be a huge error on his part as soon as any other medical professional looked at the biopsy results. The surgeon recommended an oncologist, who I went to. He seemed okay at our first meeting, but after some issues with his lab tech and a second meeting at which he said, "I don't have time to answer your questions, but trust me" as well as several other problematic or incorrect statements, I was distraught. I lay down for a nap and when I got up, my spouse had found an oncogist with a breast cancer specialization at a teaching hospital. I made an appointment with her and fired the first one. After chemo, the radiation oncologist at the teaching hospital recommended a couple of RO's whose work she liked closer to where I lived. I compared them and chose the one I felt best about.

At this point, 4 1/2 years out of surgery, my oncologist is the only one of these cancer specialists I still see. I expect I'll see her forever. It's your life, so ask people you trust for referrals, pick who you feel best about if you have choices, and fire people who aren't working for you if you're able to in your medical system.

Spookiesmom

This second time around, my MO who retired Feb 1, ordered the PET/ct days before he retired. He also sold his practice to a large group. It happened, but took a month for the new ppl to make all changes, from appointments to new computer system. Nerve wracking. I went back to original BS. When he discharged me, I told him he’s a nice guy, but I never wanted to see him again.

Previous RO had retired too, so had a younger one. He’s also affiliated with Moffitt that was reassuring.

I haven’t deleted their phone #s off my phone, just in case. Hope I never have to call either again, but will if necessary. I liked them that much.

gb2115

There are nurse navigators...if you have access to one definitely get in touch. Mine was extremely helpful.

I went with personal referrals from my doctors, kind of in a chain reaction. My GYN was the one who found the lump and sent me for testing. Radiologist called me with results. I had a call from the nurse navigator within an hour of that, telling me that the GYN recommended a particular surgeon. I trust her, so I went with it. My surgeon is awesome, so when she personally recommended an oncologist (and somehow got the oncologist to meet with me in the office on her vacation), I went with it. She's great too. My least favorite was the radiation oncologist, who I chose based on proximity to my job. She was just ok, but I think I got good treatment, I just didn't like the way some things were handled.

I would see if you have a navigator through whoever did the biopsy...start there. If not, I would say a breast surgeon. Many times the first step is surgery, and sometimes they want to do extra testing first, like MRI or genetic testing. I didn't get sent to oncology until after surgery, but my tumor was clearly an operate first kind of thing. Sometimes it's chemo first though, depending on your tumor type.

Yeah, definitely nurse navigator, they can help you sort this. Mine even made some of my appointments!

Maya12

Thank you so much ladies - all your responses and experiences have been super helpful!

Unfortunately, I haven’t had a chance to speak to my referring obgyn yet, and it looks like I will have to initiate my own search for a surgeon. Hoping to locate a nurse navigator who can guide me through the process.

Thank you so much

Sjacobs146

Maya, it may help to Choose your hospital first to narrow down your choices for surgeon. After my diagnosis, I met with my PCP. He told me that he could refer me to Dana Farber, but I had "garden variety breast cancer" so he recommended staying with the hospital where I had my mammogram. Mt. Auburn has a dedicated breast center with a FT social worker. It turned out to be a great decision for me. I went with the surgeon, MO, and RO recommended by the Breast Center, and they are all wonderful.

AliceBastable

I went for a long-delayed mammogram at a breast center that's attached to a local hospital. They called me back for an ultrasound, and I had the biopsy right afterwards. There are two surgeons in that breast center, so I used one of them. Everybody there was terrific. I had already been referred to an oncologist/hematologist by my PCP for an unrelated (or not?) issue, and she was the same oncologist the breast surgeon recommended. Except for that coincidence, my PCP was completely out of the loop, other than her office grudgingly supplying the written referrals I needed throughout the whole process. The radiologist for the radiation treatment after surgery was the one who is in charge of the department at the hospital. It was all very seamless as I was turned over to the next doctor by the previous one. Luckily, I liked them all (well, the radiologist and I butted heads once, but I liked the technicians who did the actual treatment); I'm not sure what I'd have done if any of them had been people I didn't want to deal with. I didn't use the nurse navigator; she was on vacation when I had my first appointment with the surgeon, and I never really needed any extra help getting through it all.

edj3

Agree with others, do ask around. Where I live, we have two major teaching hospitals with well-developed breast/breast cancer centers and both have excellence reputations. Since my PCP is part of one of them, I get pretty much all care through them. And it's worked well for me.

St. Luke's has a care team approach and I met with all three doctors in one mega appointment the week I was dx'd with cancer: breast surgeon, medical oncologist, radiology oncologist. I also officially met my nurse navigator there and then a couple of weeks later attended an all day workshop on all the services available through St. Luke's plus what all the treatments entailed. It was comprehensive and I'm so very glad I went before my surgery.

Ingerp

Where I live there are two hospitals—a large public teaching hospital and a smaller private one. I’ve done all of my breast care through the private one. It’s considered a little more personal, with a little better bedside manner. For early stage cancers, your treatment and outcome will likely be the same regardless of who you go to. And most of us start with the BS, then MO and/or RO if necessary. You’re GYN probably has a breast care group she recommend

Maya12

Thank you, i would definitely consider a smaller hospital. I am a little taken aback by all the negative reviews for MD Andersen - many complained that they felt they were just a medical record number not a person.

Honestly, will probably go where they can take me as soon as po

ML1209

I think everyone is different which makes it even more confusing. I found my lump and called my obgyn. She ordered my mammogram and ultrasound. When it was determined that I needed a bx, she referred me to the breast surgeon oncologist. He did the bx, all of the testing, breast MRI, etc. Once we knew I needed chemo first based on my tumor, he referred me to a medical oncologist.

ML1209

I think everyone is different which makes it even more confusing. I found my lump and called my obgyn. She ordered my mammogram and ultrasound. When it was determined that I needed a bx, she referred me to the breast surgeon oncologist. He did the bx, all of the testing, breast MRI, etc. Once we knew I needed chemo first based on my tumor, he referred me to a medical oncologist.

WC3

I didn't. I chose the place and was assigned a medical team but I have been very happy with my doctors.

OnTarget

My gynecologist, PCP, etc are all part of a large teaching hospital, which is an NCI cancer center.

I have enjoyed the ease of having everything in one place. The radiologist told me to call a surgeon, and I called the new breast cancer patient line at the hospital and everything has just worked perfectly from there. All of my records are fully visible to each person, so I don't have to do any extra work. I can do labs at various locations, which really made things faster as I was willing to drive to get the many tests I needed at the first available place.

I was in a bit of a rush to get things moving, and I had no particular idea one way or the other of who to pick for doctors so I just let the receptionist put me with the first available person for my BS, PS, and MO. My BS (who was great) did have PS recommendations which I didn't end up taking because I felt that the timing of my surgery was the most important thing and I didn't want to be delayed while waiting for a more popular PS. I've been happy so far.

My suggestion is to go somewhere that has an integrated system between the various doctors. I would also look for a hospital with a breast cancer program. I don't know where you live, but I would opt for an NCI cancer center if it is possible.

Anonymous

My surgeon recommended my MO. I called a friend who did research at Mayo in Scottsdale and he confirmed she was rated pretty highly. A friend of mine who had her own b.c. history also recommended my MO since she had chosen her for her own b.c. care.

I also met with another oncologist at MD Anderson for a second opinion and could compare the two. They both recommended the same course of tx, so I went with the one I liked (she was closer to where I lived, too).

Claire in AZ

Runrcrb

Maya, there are always more negative reviews than positive as unhappy people post more. 😀

As mentioned, you OBGYN probably has a recommendation for surgeon and starting there is usually good. But, always make sure YOU are comfortable with the doctor you’re seeing. You need to be able to ask questions and get answers you understand. Assuming you are just post biopsy, you probably don’t have all of the answers even for surgery. An MRI ordered by my breast surgeon resulted in a change from lumpectomy to mastectomy.

My PCP recommended my BS and got me in quickly.

My BS recommended the Radiation Oncologist, the medical oncologist and the Plastic Surgeon. I met with each of these women individually. Since the PS doesn’t do the surgery I wanted, she referred me to another PS. As mentioned, it helps when all of your doctors are in the same hospital system if you have more than one to choose from. I had three in my hometown, two private, one public teaching hospital. I stayed with a private system as my PCP is there and the doctors I used were too. Makes sharing medical updates easy between drs.

You are in the phase where it feels like everything must happen immediately. If your biopsy results didn’t drive someone to immediately connect you with a surgeon or oncologist, my guess is that you have some time to gather referrals, facts and plans. I was once told that while a breast cancer diagnosis is an emotional crisis, it’s rarely a medical crisis.

As also mentioned, I see my PCP and my medical oncologist. Haven’t seen my breast surgeon or radiation oncologist since 2017.

bella2013

I am fortunate enough to have MD Anderson here in my city. My gynecologist found my lump and set up the diagnostic mammo, which then included a sonogram, and the the biopsy. My case was in front of the tumor board at MD Anderson at the same time I was receiving confirmation from my gynecologist that I did have Stage I BC. I was provided a nurse navigator. I chose my breast surgeon and my surgeon recommended me to my PS. I didn’t know a MO or a RO so I went with the team. Loved my team except for my MO. I gave it 9 months and we just didn’t click. I didn’t feel confident that I was being cared for. She was not a MD Anderson Oncologist. She was with another practice. I know people who go to that Oncology practice and are pleased. She and I were not a good fit. I sent an email to my nurse navigator. I had already let her know that I might be looking for another oncologist. She took the reins, had my records transferred to the new oncologist, made the appointment for me and went with me to the appointment. Love my new oncologist. Love her staff, PA and nurses.

There is a difference between my Chick-Fillet and my McDonalds. They are both fast food...they sell similar products. It’s the service that leads me to my Chick-Fillet...even if there is a double line wrapped around the building for the drive thru. Their training, efficiency and expertise in providing an excellent product allows me to get through the double drive thru line faster than I can get through the McDonalds drive thru with just a few cars ahead of me. Chick-Fillet employees enjoy working for the company and they enjoy providing good service. I find the same quality providers at MD Anderson

The same principle applies when you are choosing your cancer team. This process will go so much smoother if you are comfortable with your team and you have complete confidence in your team. You can receive chemo and rads anywhere. It’s the diagnostic process, the surgery, plastic surgery and the recommended chemo plan that is important to receive from a hospital that has a cancer specialty.

I am sorry that someone has had a bad experience at MD Anderson. That has not been my experience at all.

Sending prayers and good thoughts as you make your decisions about your plan of care.

Bella

hapa

Maya - I did radiation at MD Anderson in Houston. I thought it was a pretty good place. The doctors were amazing and all the staff was pretty good at what they did. However, getting appointments in a timely manner can be difficult. A few times my RO wound up making appointments for me because I could get nowhere with scheduling on my own. Treatment, once you get the ball rolling, is excellent and I felt they offered a lot of emotional support. There are so many patients in your same boat that just sitting in the waiting room is like group therapy, lol! I think that was my favorite thing about going there, actually. But it can be kind of stressful and chaotic to go through treatment there, especially if you're driving in from the suburbs every day. And it did seem a little crowded and messy, just due to how busy they are.

I did the rest of my treatment at Mayo in Phoenix and I have to say that being a patient there was so stress-free. If I needed a follow up appointment or referral to a different specialist or anything at all, Mayo would set it up and all I had to do was show up. Some people might find that annoying but I was glad I didn't have to take any initiative to set up appointments or make sure things got done. Once I got in the system, everything was fast and efficient, and even if I didn't have an appointment with him for months, my MO was keeping on top of all my test results, etc. That place is like a machine. However, they offered very little in the way of support groups or emotional support. Those things were available, they just weren't very big or even really well advertised. Also, the "machine" thing and automatic scheduling may not be as comforting for other people as it was for me.

All of this to say: I would choose an doctor in a cancer center instead of a private office. It is just more efficient in terms of getting appointments, and you won't be responsible for making sure the treatments and results from one doctor make it to your other doctors, that is all handled for you. Plus, the doctors can discuss your case at their tumor board, should they need to. Most cancer centers will make at least some effort to schedule multiple appointments on the same day, which sure beats driving all over town to get exams/imaging/treatments/consults all the time.

I would also look for doctors who specialize in breast cancer. They will be more up to date with all the newest treatments and protocols. Stuff is changing fast in cancer treatment.

I got into both MD Anderson and Mayo by calling a number on their website. I did not get referrals to go to either one. You don't need one for MD Anderson, but I hear it can get you an appointment quicker.

Good luck!

Askmissa

I highly recommend searching to see which hospitals near are top rated in your state- https://health.usnews.com/best-hospitals/area

I also recommend seeing if any medical school hospitals are in your network. Those doctors do clinical studies, lecture, and teach the next generation of doctors. They are up on the latest and greatest.

Look at where doctors went to medical school and looking at reviews online.

You deserve the best! See who the best is in your network

Maya12

OP here

I managed to set up two appointments- one with a recommended breast surgeon who also has great reviews online, she is with a large hospital (they will see me in two days) and another appointment with MD Anderson - first available physician, the appointment is in a week (initially, they offered two weeks out but once their navigator got involved they found earlier availability). I just hope I will be able to make the right choice between the two

hapa

Maya - excellent, it sounds like you've got the ball rolling. These decisions are never easy. I hope if you have difficulty choosing it is because both doctors are so great you can't decide which is better!