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fauna13

major cancer centers vs regional centers

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Hello all,

My mother has a mass in her middle lobe.  Surgeon recommends no biopsy but moving straight to surgery, scheduled for 11/27.  He is fairly sure it is a lung cancer based on the CT.  I am trying to get a sense of whether we should feel comfortable with this surgeon's advice, or whether we should try to get a 2nd opinion at a major cancer center.  Hopkins happens to be 1 hour from my mom's house, but her last cancer (breast) was treated here and the outcome was exceptional.  How have you decided where to go for treatment?  How have you picked between a local/regional/not incredibly famous hospital and a major cancer center?  Did you go for a 2nd opinion prior to surgery or just prior to chemo/radiation?  

Thank you.   

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I live near a couple of local cancer centers, but chose to travel an hour away to Penn State Hershey's Cancer Center. I chose not get 2nd opinion. I had read several well respected articles, including Lungevity's. If you have not read it, I highly recommend it. Every test done & every procedure done was just like outlined. Typically if there is any reason they believe there is lymph node activity or any mestatisis, they will do biopsy 1st, then perhaps a bronchoscopy or a medianoscopy.  If they are moving straight to surgery, it could be a good thing. Tumor contained in 1 lobe, no lymph node involvement & no mestatisis - sounds to me like they are moving in the right direction.

But... If your mother chooses a 2nd opinion, encourage & support her in it.

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fauna,

How did I decide where to go for treatment?  I didn't; my GP chose my treatment team.  In my time of diagnosis, lung cancer treatment was standardized with treatment dominated by either surgery then chemotherapy or if not surgery, then radiation concurrent with chemotherapy.  Radiation and chemotherapy conformed to a national standard of care -- that is: almost everyone received the same treatment.  So it mattered little where one sought treatment because almost the same treatment was administered everywhere.

Now the lung cancer treatment world, with the explosion of new drugs and methods, is complex and large research lung cancer hospitals often have means and methods not available at local clinics.  But, this complexity and making this choice mostly arrives when in second line treatment.  That is after failure of a first line treatment method.

Retrospectively, what I now realized was important in my treatment was the skill and courage of my surgeon and the intuition of my medical oncologist. My treatment started down the path of first line with pre-surgical conventional radiation and weekly chemotherapy to shrink my tumor and allow surgery.  After a successful surgery, problems with sutures holding my bronchus stump emerged and my treatment became anything but normal.  After the surgical mayhem subsided and cancer mets appeared in my remaining lung, Taxol and Carboplatin chemotherapy in what was now my third line of treatment were the only weapons available.  After that failure, another course of the same recipe was administered to address a problem tumor that kept reappearing in my left lung. During that course of treatment, my oncologist learned that precision radiation in the form of SBRT had recently been approved by the FDA for lung cancer treatment.  He quickly referred me to treatment.  

I never went for a second opinion.  In choosing my medical team, my GP made a comment about surgery.  He said: "choose a place that does thousands of thoracic procedures a year". I wanted to have my surgery done in a local hospital, but his guidance revealed something important about surgery: it is a team activity and doctors and nurses who have many cycles of experience perform better than those who occasionally do complicated thoracic procedures.

Stay the course.

Tom

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Thank you all; this was very helpful.  Shelkay, can you tell me what Lungevity article you are referencing?  I've been reading a lot of the general info articles but would like you know which you found particularly helpful.

Thank you again.

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My cancer is adenocarcinoma, there is a link near the beginning of this where you can get this in a printable & easy to read format. If they have it for adenocarcinoma, I'm sure they have for other types too. Best wishes for your mom.

https://lungevity.org/for-patients-caregivers/lung-cancer-101/types-of-lung-cancer/lung-adenocarcinoma

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Hello Fauna,

My pulmonologist sent me to my first medical oncologist.  It just happened to be at a comprehensive cancer center (I learned later as I dove into researching everything about my lung cancer) and I went for 2nd opinion.  Not only that when the 2nd med onc contradicted what the 1st onc told me (first one said I could start with the targeted therapy given my gene mutation; the second one said no way, you need to start with regular chemo) AND my gut said (before, during and after the first chemo) this is not it, so I changed the doc so now I've been with my third med onc for the most of my journey.  

I think it's so very important that you advocate for yourself (for your mom in your case :) ) and your medical onc will be your "main guide" in this journey so you need to be comfortable with your med onc.

Sending you and your mom warm thoughts,

MB

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Hi, Fauna,

I’m glad to see that you’ve connected with some of our members already. This community is a great place to share your experience, ask questions, and connect. LUNGevity’s Lung Cancer 101 is a comprehensive website with information about how lung cancer develops and various treatment methods. Please let me know if you’d like additional information about LUNGevity’s education and support resources.

I’ll reach out to more of our members and ask them to weigh in on your original question about local cancer centers vs. large hospitals.

With gratitude,

Lauren

Digital Community Manager
LUNGevity Foundation

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