Timing to switch to a new MO during her2 treatment

michelle816

Hi, I would like some suggestions on when to switch to a new MO.

I'm right now having 6 cycles of chemo. Then will have surgery followed by radiation. Right after chemo, will continue 9 months of immunotherapy, herceptin/perjeta orTDM1, depending on surgery result. (My MO is local while surgeon is in MSK, will choose a radiologist also in MSK)

At first, I was thinking not to switch until the end if 1 year immunotherapy. After I realize MO is the real lead of the whole treatment, I'm considering to switch to a more experienced MO sooner; at least I would like to have MO and surgeon in the same system.

Not sure about the timing. Is it better switch after chemo but before surgery? Or after surgery? After radiation?

Any thought will be appreciated!

ElaineTherese

Is there something you don't like about your current MO? Too inexperienced, I guess? I also did treatment for HER2+ cancer, but chose a local oncologist and that was fine. (I'm eight years out, no recurrence.) The standard for treating HER2+ cancer is pretty much the same everywhere, so I'm not sure what is gained by being treated by a Super Oncologist unless there is something unusual about your case.

My neighbor, for example, is BRCA2+ and just finished treatment for her second bout of HER2+ cancer. She sees someone at an NCI-approved cancer center, though she still gets her treatment locally. Her case is far more challenging than mine, and I understand her wish for more experience and different treatment options like proton therapy. (Has a heart condition and needed radiation to stay far far away from her heart.)

Good luck, whatever you decide!

michelle816

Hi elainetherese,

Thanks very much for your reply!

Mainly two reasons:

1. Currenty MO is not able to answer my questions/concerns sometimes. In the beginning, I wasn't thinking too much, because I was told it's a standard receipe.

2. My understanding is I will follow up both MO and breast surgeon for a few years? Not sure if it's easy to have them in two different systems.

ElaineTherese

Oh, OK. Yeah, it helps to have an MO who is willing to take the time to answer your questions and address your concerns. Yes, you may end up having a very long relationship with your MO, so yes, it is a good thing to feel comfortable with this doctor and know you can trust them.

RE: follow-up -- I haven't seen my surgeon in years; I do no follow up with him. I was seeing MO every three months at first, then every six months, and now once a year. Since I was (am?) premenopausal and she recommended Zoladex so I could take an AI, MO oversees my Zoladex. Since Zoladex + AI have given me osteoporosis, MO also oversees my Prolia. She reviews my bloodwork, and orders my mammograms (yearly) and dexa scans (checks bone density every two years). So, I really only follow up with MO at this point.