Would like your feedback: Patient - Doctor Relationships
Comments
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I really LIKE my MO, but I live in a rural area and there are no great oncology clinics within 100 miles. I am travelling to Dana Farber (my 2nd visit there next week) for reviews of my treatment here. It's 4 1/2 hours away. My MO seems to be content with the status quo of letrozole/Ibrance, which has been good this past year, but I feel like I'm just in a waiting game until my health spirals downhill again. When I look to the Oncology staff for nutrition advice, alternative therapies, support groups- I get blank stares. It would be nice to have some words of hope! So I am trying to decipher the science behind possible clinical trials, especially immunotherapy, on my own. Don't get cancer in the boondocks!!! Thank God for this website.
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I started out with a local oncology duo who ran an "everything but the kitchen sink" shop; they were recommended by the general surgeon who did my lumpectomy (at the recommendation of my primary doctor, who I trust completely). The surgeon was wonderful; as soon as he saw the lump on the films, he recommended taking it out - even though that's apparently not current practice anymore - which was exactly what I wanted. He did a terrific job, got everything out and left a very minimal scar.
That oncology team? Not so much. They were very solicitous until the PET scan showed metastasis to my spine - then they were so cold! The doctor literally told me that I was now incurable (not the cancer, me!), and that he could give me hormone pills to try to slow it down, but that was it. He knew I was ER+/PR+/HER2-, yet never mentioned Ibrance.
A quick call to my primary got me an appointment at Sloan Kettering here in NJ, where I met my salvation - Dr. Gabriella D'Andrea. She ONLY treats breast cancer patients, and also does research and clinical trials. From the very first day, she has been so supportive! She told me it was true that the cancer wasn't curable, but she likened it to diabetes - it's treatable and manageable. Of course she put me on Ibrance immediately, and due to my Stage IV status, I avoided chemo and radiation. I have had monthly monitoring, visits with Dr. D'Andrea, and a monthly Xgeva shot for my bones. I am now seven months in, and at my PET scan last month, there was NO uptake that they could see. The breast? Clear. The lymph nodes? Clear. The spine? Clear. The lesion on my spine? Healed!
The doctor's offices (I deal with two) are amazing - I have never felt unheard. They have an online portal that's monitored all the time - I've never gone more than an hour or two before getting an answer. On a few occasions, Dr. D'Andrea has called me herself, the rest of the time, it's been the same two nurses that I have a relationship with. I feel like I can ask them anything; we are never hurried during office visits or treatment - or even blood draws!
If I had to have cancer, I'm sure glad I have it here.
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1. Part of my challenge with every visit with my oncologist is time. She rushes in, talks with me, sometimes examines me, and then rushes out again. I keep a notebook to ensure I remember to ask her what I need to during every visit. She will stay and talk with me, but if I don’t have questions or indicate that I do, she is gone.
2. I had to talk to a social worker to ask how long I have. I tried to ask my onc this question, but she did not want to discuss it, until the social worker got involved.
3. Another question I have not been able to have her address is ‘What does the end look like’? I’m not obsessed with death, but I’d like to understand what issues I should tackle now when the end is near. She said we aren’t there yet and would not answer my question.
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Communication with my doctor was great at first but now that I’m stable she’s always in a hurry to get away. I spend more time with her assistants who are great. When I have an issue I just talk to them.
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Thank you all for your great feedback! We thought you might like to listen to the Podcast that was born of this thread. Thank you once again!
Doctor-Patient Communication for People With Metastatic Disease
March 26, 2018
Dr. Timothy Pluard is medical director at the Saint Luke's Cancer Institute and the Koontz Center for Advanced Breast Cancer in Kansas City, Missouri. A medical oncologist, Dr. Pluard specializes in offering comprehensive care, including treatments that use advanced genomics and immunotherapy to women diagnosed with metastatic breast cancer. He also incorporates nutrition planning, spiritual counseling, exercise physiology, massage, yoga, palliative care, and emotional support into patient care. He also advises patients on participating in clinical trials on leading-edge treatments for advanced-stage breast cancer. Many of Dr. Pluard's patients have praised his communication skills.
Listen to the podcast to hear Dr. Pluard discuss:
- how he tailors his communication to each individual patient and that person's unique situation
- how he talks to patients about disappointing news, such as cancer progression or a treatment that stops working
- what makes someone a good communicator
- his tips on how to make doctor-patient communication the best it can be
Running time: 18:47
Listen now or read the transcript.
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When i was going thru chemo i had asked my doctor about the best way to have protect my skin i am a black lady whose feet and some of my hands were turning really dark and peeling almost sheet fashion. She said that I could stop chemo when I asked what would then she told that would do test every 3/4 months, I was going into my 3rd treatment.
So when I finished my treatments we had conversation about what she said, she died me why I waited to say something to her because does not remember the conversation which I don't believe.
As far as my surgeon and the breast health clinic a number 10, they have been great.
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Jwb44, that is so frustrating. We are sorry you had that experience, but very happy to hear your positive experiences with your surgeon and clinic, in general.
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I have been fighting breast cancer since 2008. After having a left breast mastectomy I was told that the surgeon "got it all". He also told me that I was not a candidate for chemo or radiation therapy. I was tried on four different hormone therapy drugs, each causing terrible bone pain. My Oncologist at the time told me to "go home and live my life". In 2013 I experienced terrible, burning pain in my left chest wall and the left side of my neck. After testing I was told that the breast cancer cells had spread into my left chest wall and the lymph nodes in the left side of my neck. I went through 35 radiation treatments which shrunk the tumors, but was not put on any chemo therapy. I had another recurrence in 2015. The cancer had spread into the lymph nodes of both sides of my neck. I was tried on Ibrance which caused side affects and then on Venezio, again taken off due to side effects. I feel that my Oncologist does not care. He tries me on the most expensive treatments that haven't worked. The latest being Faslodex injections which I found so painful that I made the decision to stop. He has done nothing to ease my fears or to talk to me about any other treatments that may be available. I have been treated at the Northern Lights Cancer Center located in Brewer, Maine. I should have been given the options of chemo therapy and radiation after my mastectomy in 2008. I don't understand why I was and still are being treated so badly. I have good insurance.
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Hi there, Bonnierogan49-
We want to welcome you to our community here at BCO. We're so sorry that you've had such a frustrating experience, we know how important it is to have a good relationship with your doctor. Is there another doctor at the same cancer center you can consult with, or a doctor with a different group?
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