Five Things To Look For When Finding The Right Doctors For Your Breast Cancer Treatment
After a breast cancer diagnosis, one of the most important decisions youll make is choosing your treatment team. To get the best care, you need a team that includes specialists such as a breast surgeon, a medical oncologist, a radiation oncologist, a plastic surgeon, and a genetic counselor.
The process of researching and meeting with doctors might seem overwhelming and intimidating at first. You may feel tempted to rush into decisions so you can start treatment as soon as possible. But keep in mind that in most cases, you can take the time you need to carefully select the doctors that are right for you.
Here are five things to consider when selecting each of the key members of your treatment team:
Why Should I Choose Memorial Sloan Kettering For Breast Cancer Treatment
Were recognized internationally as a leader in pioneering new ways to treat breast cancer, resulting in optimal outcomes for the 4,500 new breast cancer patients who consult us each year. In fact, most of the effective treatments developed over the past decade were studied and tested by members of our breast cancer team. That means our patients have access to clinical trials with new treatment options that are not available at other hospitals and could turn out to be tomorrows cures.
MSK is also helping women with breast cancer avoid unnecessary treatments. Our experts recently played a leadership role in developing new national guidelines to help women with breast cancer avoid repeat surgeries after lumpectomy while still minimizing the risk that the cancer will return. Choose MSK because we offer:
Treatment In Any Hospital Using Private Health Insurance
If you use private health insurance to be treated in either a public hospital or a private hospital or clinic, you will be charged by the oncologist and by the hospital. You might also be charged for pathology tests, x-rays and other forms of imaging, and by other doctors you see, such as an anaesthetist. Your private health insurance will cover some of these costs
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What Are The Most Common Forms Of Cancer
Cancer may occur anywhere in the body. In women, breast cancer is one of the most common. In men, its prostate cancer. Lung cancer and colorectal cancer affect both men and women in high numbers.
There are five main categories of cancer:
- Carcinomas begin in the skin or tissues that line the internal organs.
- Sarcomas develop in the bone, cartilage, fat, muscle or other connective tissues.
- Leukemia begins in the blood and bone marrow.
- Lymphomas start in the immune system.
- Central nervous system cancers develop in the brain and spinal cord.
What Are The Side Effects Of Hormone Therapy
The side effects of hormone therapy depend largely on the specific drug or the type of treatment . The benefits and harms of taking hormone therapy should be carefully weighed for each person. A common switching strategy used for adjuvant therapy, in which patients take tamoxifen for 2 or 3 years, followed by an aromatase inhibitor for 2 or 3 years, may yield the best balance of benefits and harms of these two types of hormone therapy .
Hot flashes, night sweats, and vaginal dryness are common side effects of all hormone therapies. Hormone therapy also may disrupt the menstrual cycle in premenopausal women.
Less common but serious side effects of hormone therapy drugs are listed below.
Tamoxifen
- Breathing problems, including painful breathing, shortness of breath, and cough
- Loss of appetite
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What Are The Stages Of Breast Cancer
The stages of breast cancer are used to describe the extent of your cancer at the time of diagnosis. Your doctor will base the stage of your cancer on a physical exam and other diagnostic tests. This is known as clinical stage. The final, or pathologic, stage is determined after surgery when the size of the cancer is measured under a microscope and it is definitely known if there is cancer in the lymph nodes.
If you have breast cancer, knowing the stage helps guide your treatment plan. Breast cancer is typically staged with Roman numerals ranging from 0 to IV . Cancer stages are based on:
- whether the cancer is invasive or noninvasive
- the size of the tumor
- whether the cancer has spread to the lymph nodes, and if so, to how many of them
- whether the cancer has spread to other parts of the body, such as the lungs or liver
Questions To Ask About Your Health Care Team
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How many oncologists will be part of my cancer treatment team?
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If there is more than 1 doctor on my team, which doctor will lead my overall care?
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How will each type of recommended cancer treatment help me?
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Will my case be reviewed by a tumor board? When?
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When do I need to make a decision about my treatment planning?
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How often will I need to see each doctor during the treatment period? After treatment?
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Are my doctors all at the same hospital/center or at different locations?
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What is my health insurance coverage for different medical services? If I’m concerned with the costs of cancer care, who can help me?
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What other types of health care providers will be part of my cancer care team?
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If I experience a new side effect or a change in how I’m feeling, who should I tell?
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Is there one person I should contact with any questions I have? How can I get in touch with the different professionals on my team?
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What is the best way to get in touch with my cancer care team in an emergency?
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Who can help me cope with the stress and emotions of cancer?
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Which Treatment Is Right For Me
Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.
Sometimes people get an opinion from more than one cancer doctor. This is called a second opinion. Getting a second opinionexternal icon may help you choose the treatment that is right for you.
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Vitamins To Avoid During Radiation Therapy
Your radiation oncologist may tell you to avoid taking certain antioxidant vitamin supplements, such as vitamins C, A, D, and E, while you’re having radiation therapy. These vitamins might interfere with radiation’s ability to destroy cancer cells.This is because radiation works in part by creating free radicals highly energized molecules that damage cancer cells. Free radicals in the environment can damage all cells, but in the case of radiation treatment they are focused on the cancer cells. Antioxidants help keep free radicals from forming or neutralize them if they do form.
Because of the potential conflict between the goal of radiation therapy and the goal of antioxidants , it makes sense to stop taking any antioxidant supplements during radiation therapy. When radiation is finished, you can resume taking your supplements.
Throughout your treatment, do your best to eat a well-balanced diet that contains all of the vitamins you need. Vitamins that come naturally from food are unlikely to interfere with treatment.
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Determining The Right Breast Cancer Treatment For You
Many factors go into determining the right breast cancer treatment for your condition. These include the size of your tumor, the stage and type of breast cancer you have, an assessment of the genes that may be associated with your cancer, your age, whether cancer has spread to other parts of your body, and your risk for recurrence. Tests will determine if your breast cancer is hormone-receptor-positive, HER2-positive , or triple-negative.
The sequence of treatments is determined by your treatment team and can include a lumpectomy or mastectomy, medical treatment, and radiation treatment. Medical treatments can include chemotherapy, hormone therapy — which blocks hormones such as estrogen or progesterone that promote the growth of cancer cells — and targeted therapies, which tell the bodys immune system to target and destroy certain breast cancer cells.
Your medical oncologist will help you weigh the pros and cons of each treatment option to help guide your decision.
Roles Of Your Treatment Team
Treatment of breast cancer involves a team of many different specialists.
Surgical oncologist – This doctor performs surgery to remove cancerous tumors from the body. He or she also provides expertise on biopsy techniques, imaging guidance, and what role, if any, for surgery to aid in the treatment of more advanced disease.
Medical oncologist – This doctor is responsible for ordering tests to determine the grade and stage of the breast cancer. He or she also makes evidence-based decisions regarding type, and duration of chemotherapy, hormone therapy, and targeted biologic therapy to treat the cancer.
Radiation oncologist – This doctor applies radiation to treat cancer. Using an evidence-based approach, he or she is responsible for recommending, prescribing and supervising therapeutic radiation.
Nurses – Nurses provide cancer care to patients in a variety of settings, including the cancer treatment centre, hospitals and the community. They are the central point of contact for the patient throughout diagnosis and treatment, and they facilitate quality, timely care. The role of the nurse will be different at each cancer treatment centre and may include navigation, accompaniment, referrals, health education, and counselling. The role of the nurse is to understand the health needs of clients and make sure that they receive optimal care.
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Do You Want To Keep Looking For Another Doctor
Ultimately, your goal should be to get the best care — that provides the greatest benefit with the least side effects — right from the beginning of your treatment or moving forward from wherever you are now in your treatment.
Dont hesitate to get a second opinion if youre lacking confidence in a particular doctors treatment recommendations, expertise, or communication skills. Asking for opinions from other doctors can also help if you feel unsure that your diagnosis is correct or if you need more information to make decisions about your treatment.
In some cases, it might be worth switching doctors early on so you can feel comfortable with your care. You may also choose to switch doctors later on in your treatment because your needs change over time.
Finding the right doctors can be a challenge, but the rewards are worth it. When you work with doctors you can trust, reach, engage, and share decisions with, youll feel a lot better.
Complementary And Alternative Medicine
Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments, and alternative medicine is used instead of standard treatments. Meditation, yoga, and supplements like vitamins and herbs are some examples.
Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.
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Ask Your Doctor For A Survivorship Care Plan
Talk with your doctor about developing a survivorship care plan for you. This plan might include:
- A suggested schedule for follow-up exams and tests
- A schedule for other tests you might need in the future, such as early detection tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
- A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
- Diet, physical activity, and other lifestyle modification suggestions
Is It Ok To Tell Your Breast Cancer Doctor You Want A Second Opinion
Yes, it is OK to ask your breast cancer doctor for a second opinion. In fact, theyre likely expecting you to. Doctors expect patients to get a second opinion before starting treatment. You can also get a second opinion at any point during your treatment. Although you might feel awkward asking for a second opinion, its important that you feel you are making the best possible treatment decisions for your health. A second opinion can help increase your confidence in your treatment plan.
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Finding A Treatment Hospital
Often, it is helpful to start your search by considering the hospitals in your area rather than looking for a specific doctor. Your hospital search will be limited by geography, but if you have multiple hospitals near you, it can be worthwhile to drive a bit farther to a hospital that has a larger breast cancer treatment program.
The National Cancer Institute maintains a list of NCI-Designated Cancer Centers that offer outstanding treatment. If possible, try to be treated at one of these hospitals, which are at the forefront of cancer research and treatment. Some research suggests that patients treated at such comprehensive care facilities have slightly better survival outcomes than those treated in non-NCI-designated treatment centers.
If theres not a Cancer Center near you, consider a teaching hospital. These university-affiliated hospitals offer the most up-to-date treatment options and may run clinical trials. Many community hospitals also provide excellent breast cancer treatment.
What Can You Do To Manage The Side Effects Of Cancer Treatment
Supportive care services describe a broad range of therapies designed to combat side effects and maintain well-being. Treating cancer requires focusing on more than the disease alone it must also address the pain, fatigue, depression and other side effects that come with it.
Supportive care services include:
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Screening For Breast Cancer
The most common screening for breast cancer is the mammogram, which involves taking pictures of your breasts using special X-ray machines. There are different recommendations for when you should start having mammograms and how often they should be done. The American College of Radiology and the Society of Breast Imaging recommend women who are not considered at high risk for developing breast cancer begin yearly screenings at age 40.
If you are at high risk, maybe because you have a family history of breast cancer like me or you carry a genetic mutation known to be linked to breast cancer, you should start your exams at an earlier age. Talk to your doctor about when that should be. In some cases, the determination may be based on the age at which one of your close blood relatives developed breast cancer.
How do you find out more about your risk? The American Society of Breast Surgeons recommends undergoing a formal risk assessment for breast cancer as early as age 25.
Screening is all about early detection. A mammogram may detect a cancer that wasnt noticeable to the touch. We know that cancers that are caught early are more easily treated and have better outcomes. Thats why regular screening is importantand not just for breast cancer. Cancer screenings include having regular Pap smears to check for cervical cancer and colonoscopies for colorectal cancer.
Follow Up Care After Breast Cancer Treatment
Many women are relieved or excited to be finished with breast cancer treatment. But it can also be a time of worry, being concerned about the cancer coming back, or feeling lost without seeing their cancer care team as often.
For some women with advanced breast cancer, the cancer may never go away completely. These women may continue to get treatments such as chemotherapy, hormone therapy, or other treatments to help keep the breast cancer under control and to help relieve symptoms from it. Learning to live with breast cancer that doesnt go away can have its own type of uncertainty.
Even if you have completed breast cancer treatment, your doctors will want to watch you closely. Its very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems, and will probably examine you. Lab tests and imaging tests aren’t typically needed after treatment for most early stage breast cancers, but they might be done in some women to look for signs of cancer or treatment side effects.
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What Are The Types Of Breast Cancer
There are many types of breast cancer. Most cancers form in the milk ducts and are called ductal carcinoma. Others start in the breasts milk-producing lobules these types are referred to as lobular carcinoma. Rarely, cancer can start in the breasts connective tissue, a type known as sarcoma, or in the skin of the nipple, which is called Pagets disease.
Tumor samples are analyzed in a lab by pathologists who determine whether the tumors are sensitive to the hormones estrogen and progesterone, which can fuel breast cancer. Some genes and the proteins they create also affect cancer cell growth. One of those is HER2/neu. In some cases, the HER2 protein goes out of control and helps tumors grow.