Choice of treatment center

Ira ~  Those in the medical community will tell you that there is a difference between NCI-designated hospitals and everything else.  That difference is based on 2 things. (1) They see a lot more breast cancer than other facilities; and (2) They teach it, so have to stay totally up on what is happening, and are often at the forefront of research themselves.

http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html

When I was dx'd with bc, I started out at a very fine, very convenient local hospital with a highly esteemed breast surgeon.  But when my diagnosis suddenly became a bit complex, I went to UCLA (3 hrs. away) for a second opinion, and was rather shocked to see how much more thorough they were about evaluating my individual situation.  They contradicted some of the treatment plans that had already been recommended for me earlier, and they had far superior reconstruction options to what I could have had locally.

So, based on my personal experience -- which may vary greatly from someone else's -- I am very high on using an NCI-rated facility such as MSK.  Also, although I had a second surgery @ UCLA, I had chemo and radiation locally, guided by UCLA's recommendations.  In fact, UCLA wanted me to be close to home for both of those elements of my treatment, and they went above and beyond to work with my local doctors.

I would think your relative should consider at least getting a second opinion at MSK. That way she will have their input and can decide for herself where she prefers to have treatment. 

Good luck to her!    Deanna

Ira ~  I would suggest that she sets up appointments at both facilities.  Usually if you go to the NCI-designated facility for a second opinion, that will give you a pretty good idea if your first choice facility (Maimonides in this case) is on target with their recommended treatment plan.  If they are, then she can use Maimonides with peace of mind that they're doing exactly what MSK would do.  If there is a discrepency in recommendations, she can decide which facility/doctors she prefers.

I'm sure women who have been treated either wholly or in part at MSK can weigh in on exactly how they work, but from what I know about other NCI-designated facilities, they're the experts docs at smaller hospitals call to consult with when they have questions.  But I think that also depends very much on the doctor(s), so best to ask them how they would feel about input from MSK if she should want it at any point in her treatment.  My situation wasn't exactly like your relatives.  I had a major surgery and followup appointments with oncology and radiation oncology @ UCLA but chose to do chemo and rads closer to home because of logistics/distance.  That's not quite the same scenario as your relative would have if she opts for Miamonides from the start.    Deanna

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Ira, I was treated at Dana Farber Cancer Insitute in Boston, MA. Their website had all the info about the doctors who practice there. Here is an interesting website that might help in deciding on a specific doc. Some of the docs do not have complete profiles, but I picked for myself the chief of breast cancer surgery dept. And it was a good choice. In this website, the docs need to be looked up by State. www.docboard.org/docfinder.html

Good luck. Sue

I started at a large local hospital with a highly esteemed breast surgeon in private practice - had a rotten experience both with the hospital and the surgeon, who seemed very distracted and overbooked - and not very concerned about anything.  Went for a 2nd opinion a the local teaching hospital (UT Southwestern) and was blown away by the difference.  My friend that suggested I go there said "it's like the doctors at "Fancy Hospital" are trying to make their Ferrari payments, and the UT doctors are trying to cure cancer".  After having experienced both I whole heartedly agree!  So thorough and caring, never rushed, eager to answer questions even if the answer requires research.  And all of my docs work TOGETHER - radiologist, breast surgeon, medical oncologist and radiation oncologist.  They actually speak to each other about me, share my medical records (which are online - it's AWESOME).  I now feel like I have a great team of healers working to cure me and keep me cured.

Although I had a good attitude, I had a very bad outcome at Weill Cornell/NY Presbyterian Hospital,  Memorial Sloan Kettering picked up the pieces. I would highly recommend a hospital that had the best surgeons and current information on treatment. Go with a NCI facility like Memorial Sloan.

me1ani -

Your story is similar to what happened to me at Weill Cornell.  Among my many medical complications, I was left with significant limitations regarding future plastic surgery.

The most important negative issue regarding my experience at W-C  and yours at MSKCC is the lack of compassion and humanity in the staff members that we've encountered, from some doctors down to some auxiliary personnel.  Although the hospital staff is supposed to be part of the edifice of healing, they have been sadistic on occasion, dismissive, tried to disassociate themselves from their mistakes and seem to be unable to empathize with the terror of our diagnosis and treatment.

I have to believe there is a special place in the afterlife for them 

Me1ani

You have to be an advocate for yourself.  You will put one foot in front of the other and ask for an oncologist, a fitter for a prothesis and on and on.  Let things fall in place as best you can.  The people you are dealing with don't get it.  Maybe you should tell your doctor when she returns, that you need more compassionate committed care.  Maybe you should tell her that unless you get it from her, you will leave her practice.  Hang in there.

By the way, my diagnosis was given to me by a nurse who first said "all is well,"  and then said "oops..." The doctor who was to give me the path report was surprisingly "away."  What do these people have where their heart is supposed to be? 

You will survive and persevere through all this.  I did. 

where can I find updated posts on this topic?

I am not sure how to navigate through this website.