How important is your oncologist? (and NOLA)

no, they don't all do the same thing. Seems in fact, they all do everything different. You can tell on here, seems no two treatments are the same.

The oncologist is very important. I agree with nottoday and other posters. As with all of this there are docs who are on top of thing, read the literature and offer you the latest and the best. Than there are does that aren't. Not getting a good cosmetic result with reconstruction is bad. Not getting good cancer treatment is worse. Go with the oncologist you feel is is the best and try to make sure there is a good match in terms of personality and communication. You will have a long term relationship with your oncologist.

for me, the doc who had ordered my mamo (my reg primary care doc) gave me the first referral to a BS who just happened to turn out to be one of the best in the state. but when she started talking about rads and me needing an MO, I got two opinions,  They were originally names the surgeon suggested.  Got second opinions for each and chose my second.  I will say that being in NJ the MO I ended up chosing while at a dif hospital than my BS, knew my BS and they worked well together.

not sure how it works with NOLA

Trvler-If you are not finding local medical oncologists, radiation oncologists etc that you feel comfortable with - perhaps you can work the recommendations in the other direction. Ask Dr. Stolier and/or the NOLA plastic surgeons (Dr. Massey who works in Chicago as well as NOLA) who they would recommend in your area- possibly they may come up with a few names. (You would still need to check the recommendations out yourself very carefully). In addition possibly look at the closest NCI designated cancer center. Just some ideas.....

Your MO is an important player, so it does need to be someone you are comfortable with. However, location is also important because when your feeling like crap and need to see the doc or need some extra fluids at the infusion center, you won't want to be traveling hours to get there.

I'm sure there is a standard protocal of chemo for your dx. and most MO's are going to offer you that. What are others on this board with dx similar to you getting? That is likely what you will get and if not ask why.

While you don't want to make a hasty choice, you can't take too long to decide either. I only met with one MO. I liked his personality, he was offering me the same treatment others on here were getting and his office and the infusion center were conveniently located. Once chemo is over, if you don't like your MO's approach to follow up care and scans, you can search for a new one at that time.

Did NOLA say why they wanted chemo first? Did they think chemo would compromise the recon? Do they want the size of the tumor reduced before surgery? Or does it have more to do with timing, perhaps they want you receiving some type of treatment now to stop its growth, realizing its going to take time to schedule surgery.

Good luck to you. I know you are really researching your options and going into this as informed as you can be. These decisions are so difficult to make and as hard as we search, there just is no "right" answer.

I don't know what chemo cocktail you get with ILC. Most get tx every 3 weeks, but some get taxol weekly. You will likely  get bloodwork 2 days before chemo, which can be done at a lab close to home. Usually your mo wants to see you the day before or the day of chemo. 24 hours after chemo you get a neulasta shot at the infusion center. I know of some who lived far and had this shot mailed to their home and self administered. Chemo times can vary based on what your getting and how things are done at your center. I was usually there about 3 hours, although expect the first time to be longer.

I had issues with dehydration and needed extra fluids on day 4 following every tx, so that was another trip back to the infusion center, plus I had other concerns like oral thrush and had to be seen by the MO between treatments. I spent more time at my center than I expected to. Fortunately it was less than 30 minutes from my house, which was particularly appreciated after tx when I just wanted to get home to bed. Perhaps if your MO is farther away you can see your family doctor if anything arises between tx. 

With an MX, getting clean margins near your chest wall is important or they are going to recommend rads too. So if they looked at the location of your tumor and recommended chemo first then its probably a good idea.

are you near chicago

Dr block is there

he wrote life over cancer

I've seen him

he has vegan encouragement, nutrition classes

hes very good

You should be able to have a local MO and get opinions elsewhere. I got rid of my local MO last summer and went up to Mayo. I was diagnosed with a recurrence recently and needed someone local. I have a new MO locally, who knows I am also seen at Mayo, and he and my Mayo doc e-mail back and forth and talk when needed. He said another set of eyes to look at things is always good. Any good doc will respect you getting a second opinion and not tell you you're on your own if you go there. I had surgery consults at mayo as well and they gave me good questions to ask my surgeons here which did lead them to do things differently (and ultimately led them to find a second tumor). I am so grateful I have had multiple opinions, but keep most of my care local. Best of luck; it is not an easy decision.

NOLA is the Center for Restorative Breast Surgery in New Orleans. Many travel to here for top notch, innovative options in breast reconstruction. Not me personally, but I've seen many on here refer to it. Their website, however, is a good resouce for anyone considering flap reconstruction because it gives good explanations of what the options are and include before/after photos. I had my recon done locally, would not have been able to afford travel costs, but I'm happy with the results

Ahh...thanks!

Well that is ironic, you can go out of state to come to his cancer center, but all PS's do it the same way, lol. I'm sorry he turned out to be a jerk, but I do agree with him that you would probably do the same two drugs no matter where you go, unless you were in some type of trial.

Trvler, It seems like you are on your own finding doctors. Is that your choice because you wanted second opinions or didn't the facility that gave you the dx refer you to anyone? For me, from the time my mammo came back questionable, everything was laid out for me, from biopsy, to BS, to MO, to PS, I was referred to who I should see. The appointments were even made for me and I was sent a calendar and scripts for blood work and scans that I needed. I was assigned a nurse navigator who I could contact if I had questions, plus she arranged things I asked for like genetic counseling, a nutritionist, and a mastectomy class. My MO also had me meet with his nurse for about an hour to answer all my questions . I think I called her with concerns after every treatment. She was wonderful!. For the post part, I liked who I was referred to and stayed with them, except for the PS. The one I was referred to was nice enough, but he did not do DIEP, but another in the same practice did.

When first dx I contemplated going to a bigger cancer center in Philadelphia, which would have been about a 2 hour drive for me, but then I decided the cancer center close to my home had a very good reputation and because I was early stage, the treatment would be the same wherever I went. When it came to reconstruction, I again wondered if I should go into Phila, but I then I met the one and only PS doing DIEP in my area, and although he is young and has less experience, he came highly recommended and I felt good with him.

Trvler, you are so right for seeking out doctors who listen to you and treat you respectfully. Cancer is difficult enough, you don't need doctors that add to your worries. The MO I was referred to is great. He had just moved to our area and I was his first patient at this practice. The day of my first appointment, I was actually his ONLY patient, lol, we talked for over 2 hours. Of course he now has more patients, but I never feel like he is hurrying me through an appointment. He listens to my concerns and is very good at "talking me down" when I'm feeling anxious. He has a deep calming voice and he looks you in the eye with much sincerity. When I first met him I immediately felt very safe. It's hard to explain, but I felt like I could let go of some of my fear and trust that he would do his best for me. He's easy to joke with too, which sometimes you need a little humor. Bedside manner is important, some have it while others don't. I hope you find someone you are comfortable with.

I wish you good luck with NOLA and keep us posted on what it is like. btw, which chemo cocktail will you be getting?