Is it crazy to do this drive?

I travel to a cancer center that is an hour away; my MO, my BS, my PS, and my clinical trial are all there. For my rads, I chose someplace closer. I would have been too tired and burned out to travel that far for my six weeks of rads. Good luck with your decision.

Do what is going to give you peace of mind for the future. I think many of us second guess decisions that we have made along the way, as we are forced to make so many decisions so very quickly. Six weeks is a short length of time, versus wishing forever that you had made another choice.

I'm confused. You have multiple sources saying the local hospital is not very good, and there's a top-rated cancer center an hour away? I'm definitely in the camp of driving for the right doctors. In fact, having grown up in a small town (where we had to drive 1/2 hour to do anything) I'm grateful that I have access to great care that's within driving distance. Some people fly to other states. In HI some patients move from Kauai to Oahu for cancer Tx. It's your decision but just an FYI on the range of patient experiences.

I’ve been thinking about this more. It reminded me that I’d had a freak-out in the days before I started rads. (in my case, I was having “buyer’s remorse” about the lumpectomy. Should I have had a Mx instead??? Arg) I can joke now but I was really stressed-out and finally called the cancer support center, who put me in touch with a counselor and she helped a lot. (do you have that option? Our center provided three free sessions) She recommended writing in a journal. One option is to write a list of the pros and cons of the two centers. Or just write your concerns, no matter how small. Seeing them on paper can help you relax a bit and settle your mind.

I’ve been wondering if there is any objective information to help you decide. (when my FIL was choosing a surgeon for open-heart surgery, we were able to find data on surgeons: experience level, frequency of doing that procedure, and outcomes.)  Sloan-Kettering says there is a database that lists outcomes. 

http://www.mskcc.org/cancer-care/hospital-information/survival-outcomes

I did a google search and found articles that said that large top-rated cancer centers had better outcomes than local ones (the articles said it can be hard to choose between the top-rated centers; not your concern). Sometimes the difference isn’t huge but it is consistent; no article said the local community hospitals did the same or better.

I think the quality of the rads technician (and equipment) does matter, and my understanding that the doctors set the tone and level of professionalism. Like most aspects of medicine there is some level of judgment when doing rads. When I had my “simulation,” the RO came in a couple times, reviewed the images and made changes. The goal was to get good coverage but reduce the exposure to my rib cage.  So I think it’s important to get a well-qualified RO who works with good technicians. I don’t want to freak you out, but there was a front-page story in the news 5-10 years ago that one cancer center hadn’t calibrated their equipment right, so there is always the question of human error. (my DH grilled the RO on their calibration procedure and training of their rad techs. The RO took these questions seriously).

If you choose the center an hour away, maybe you can ask a few friends to help drive, especially the last two weeks, when you may feel fatigue. When people ask, “What can I do to help?” you could ask if they’d be willing to drive you, maybe just once. (get a few people lined up.). It might be hard for them to take a ½ day off from work, but you never know if you don’t ask. They might want to help (or…want an excuse to miss work.

Also, it sounds like you have a few questions about the procedures offered at the top-rated center. So maybe the decision right now is whether to go back for another appointment to get those questions answered. Having that info (and another visit and another chance to drive) might help you decide.

FWIW, when I spoke to that counselor I initially had concerns about rads, but as we talked a lot of other concerns surfaced about my BC Dx and Tx. (I guess they were bottled up). The counselor said it’s not uncommon for patients to have a lot of anxiety before taking the next step in Tx or even when ending Tx.  Each transition point can be a challenge. She said the goal in making a good decision in the face of uncertainty, is to be comfortable no matter what the outcome. So in this case, there are four possible outcomes: 1) you’re treated locally and are fine, both short- and long-term; 2) you’re treated locally and have complications (either short- or long-term). 3 & 4 are those outcomes at the top-rated place.  Maybe ask yourself, how would you feel in each of these scenarios? I know decision making can be hard and no one can you what’s the right. But trust that whatever you decide with be the right answer for you. (((hugs)))

Sophia we are in the same situation.  I have an appointment Tues with a RO 30 miutes from home.  I met on Friday with an RO 1 hour from home.  The center 1 hour from home has the most up to date equipment, in fact she is trying to get approval to use the newest one on me.  I would be able to do 5 weeks with no scar boosts with it.  I don't know if the same can be done at the center closer to me.

I would make those appointments and see what is available and how you feel about your treatment at each center.  I was very impressed with the center on Friday.  The staff was very nice, organized, informative and ready to answer every question I had.  The center I visit on Tuesday even though closer to me will have a big challenge impressing me.  I will drive to the one I feel the most comfortable with.  I will bite the bullet.

I challenge you to start before me.  You need to get a move on.

Good luck in choosing the best course for yourself.

SophiaMarie - I drove myself an hour and half to radiation every day for six weeks last fall. It was very doable. I arranged to have my session at 11:30 am so I would have plenty of time to get there without rushing out of the house each morning. Nearer the end I was getting a bit tired so I would take my sweet time going home. I'd stop for lunch, stop to poke around stores, take a scenic route and look at towns and villages I hadn't been to before. It was a lovely "me" time.

I highly recommend making the choice to go to the better hospital. I did.

Glad you made the call!  Lots of us start a little later than we'd hoped just because the decision making process with this disease is so blinking complicated.  Others delay because of scheduling issues.  Others need to wait for their incisions to heal or an infection to clear.  Your decision making took exactly the time it needed, so, from that point of view, you're right on time. 

Me too!  Just could not wait for surgery. I dreaded radiation and tried very hard to convince myself that as my margins were clear and my mitosis rate was in the lowest category, it wouldn't be all that effective for me.  Of course, you can't ignore statistics, so I didn't.  Now I'm extremely glad I "did" rads, even gladder that it's in the past, and gladder still that arimidex is starving any leftover cells.

Little change.  There was some swelling, which has since disappeared, scar tissue formation, which nicely replaced most of the bulk I'd lost from surgery, and the scars got a tiny bit indented, but still look fine.  I'm told my skin is thicker, but I can't tell.