How to pick a medical oncologist?

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dense
dense Member Posts: 48
edited June 2014 in Stage I Breast Cancer

I have been given a couple of names.  I understand that the treatment in many ways is algorithmic, for this size tumor, this grade, this Oncotype DX score, we do X.    I also understand that the art is in  figuring out the dosages and in how to deal with side effects?  Is this right?  What are the good questions to ask to decide who to go with?

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited October 2011

    Jerome Groopman, MD just wrote a book, Your Medical Mind which discusses precisely what you are asking.  How do people choose their doctors and how do they choose their treatment plans.  Most people will say, you choose your doctor based on recommendations from other doctors and/or friends.  Likewise, you choose a doctor based on your comfort zone.  That's where the book is informative because you can visit three doctors and get SLIGHTLY or COMPLETELY different opinions when it comes to treatment and depending on "Your Medical Mind," you decide.

    Good luck.

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  • cp418
    cp418 Member Posts: 7,079
    edited October 2011

    Totally agree that you should feel comfortable and trust your oncologist.  Good communication is critical and you should feel you can ask questions and be satisfied with the response. 

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited October 2011

    Yes, different MOs may make different recommendations. I agree you should find someone you are comfortable with and who communicates well and respectfully.  After my Dx, I found a team of docs (BS,RO,MO) that worked together. (I like docs with a lot of relevant experience in cases like mine so I chose a BS who is a BC oncologist;  the RO was the head of the dept and even had a sense of humor). I didn't hit it off with the MO so I asked my BS for a referral and like my new MO.  I believe most insurance companies will pay for a 2nd opinion (or maybe even third) so it doesn't hurt to shop around. The MO is the one you'll be seeing for the longest time, so you'll want to like them.  I'm not sure where you are in treatment, but you may want to see one MO, wait to get the results of the oncotype and his/her recommendations, and then meet with the other MOs when you have that data. (so you can shop for their opinion and also the personality match at the same time)

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  • NatsFan
    NatsFan Member Posts: 3,745
    edited October 2011

    Schedule initial consults with some of the doctors who have been recommended to you and see how you feel.  Write down all your questions ahead of time.  Take someone with you whose job it is to take notes and at the end when the doctor says, "Any questions?" that person can also make sure all your questions have been answered. 

    Note how the doctor treats you and responds to questions - some doctors have that old-fashioned "doctor as god" complex and do not work well with patients who ask a lot of questions and ask the doctor to give reasons for his/her recommendations.  Other doctors welcome involved patients.  Some people want a more passive role and want to let the doctor make decisions - they'd be more comfortable with the first type.  Other patients welcome an active role and need the second type.  

    Personality is important - you are putting your life in this person's hands and will be seeing them for a long time.  It's important to feel comfortable with your onc.

    Visit a few oncs, then go with your gut feeling about who is right for you.

    Good luck!

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  • Susie123
    Susie123 Member Posts: 804
    edited October 2011

    Make sure they follow NCCN protocol. My nurse case manager was a wealth of information and I learned how that's a biggie. That means they're up to date on the latest cancer treatment protocol which is constantly evolving.

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  • Racy
    Racy Member Posts: 2,651
    edited October 2011

    My onc has a special interest in breast cancer, is involved in research with a lot of papers published, as well as having links with several bc research/support groups, has a friendly manner and sense of humour.

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  • dense
    dense Member Posts: 48
    edited November 2011

    Still waiting for an appointment with an oncologist. I find the wait very frustrating.  I did not want to meet until my Oncotype test came in, but it ended up being sent out almost 3 weeks after my surgery.  And now I cannot get the appointment with an oncologist for another 3 weeks. 

    I also find it frustrating not having information ahead of time.  When I met with one of the oncologists before the surgery, I asked about what appointments I should set up for after the surgery.  No help there.  Now I am getting information in bits and pieces.  My BS recommended that I get a flu shot because I might need chemo.  An insurance nurse recommended that I schedule my teeth cleaning before chemo too. I had a regular ob/gyn appt this week and emailed the oncologist to see if there is anything I need to ask ob/gyn about -- no answer. But I read here that people have US and get their endometrial lining measured. 

    When the insurance nurse called, she introduced herself and told me she could help me with info  and be my advocate.  I asked her if she could help get the onco appointment scheduled sooner, well no can do.  Next I asked her if the insurance company had any info on the two centers/docs that I was considering -- well, both are good, you can look up the stats on our website.  I don't even have any idea what stats to look up.   Someone told me that the number of patients that finish chemo is important, because it shows how well the doc/center manage side effects.  But I am not sure that is even reported anywhere.

    Anyway, I am not impressed with the process.  Seems like lots of women are going through this and there should be a checklist and someone should be able to go through a checklist of what is needed before the next decision making step.  My first appointment with an oncologist to discuss whether BMX is a reasonable decision cost $500, and I am not impressed with what I got for it.

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  • PLJ
    PLJ Member Posts: 373
    edited February 2012
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  • Racy
    Racy Member Posts: 2,651
    edited November 2011

    dense, yes unfortunately you will probably find that you have to be your own case manager. I had a dental checkup and even had three problem teeth removed (two wisdom teeth), had a skin check recommended by my GP and had a pelvic ultrasound due to a thickened uterus identified on my CT scan.

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  • Miles2Go
    Miles2Go Member Posts: 120
    edited November 2011

    Denise,  Choosing an oncologist.  1)  My best surgeon recommendations came from a nurse and an office and another time from my radiologist following biopsy.  Listen to your gut; we make a first impression within a matter of seconds and so do others.  Listen to physician for skill, knowledge, and ability; kind, thoughtful, and consideration, all of which came across during 1st office visit.   If there ANY reservations about a doctor, look for another doctor under the guise of "getting a 2d opinion.'  2)  Be ahead of the curve in making follow-up appointments.  I made an appointment even before my surgery w/my oncologist; discovered an OncotypeDX had yet to be ordered and ordered it.   3)  Do your own research on net by Source, Published Date, crediblity--if you get 3 sources with like information, that's a trend (much more reliable than a single source).  THE ART is making choices that are appropriate for you, then monitoring and verifying choice results, deciding if you want to stay with your original choice, modify it, or discard it.  Miles2go

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