Your treatment.

[Robert A.]

I am curious to know if those here that have had or currently undergoing treatment having it done locally or are being treated at a major cancer center such as MD Anderson? It would be nice to be treated close to home.

[Rower Michelle]

Hi Robert,

I run The Living with Lung Cancer Support Group here in KC.  The majority of our members receive treatment locally because most lung cancer is very straightforward according the the NCCN guidelines. 
 

After the diagnostic process was completed some opted to go to Mayo or MD Anderson for a second opinion. In one case a member was referred to a late phase clinical trial for the first line of treatment.  Another member has the primary treatment plan dictated by MD Anderson and administered locally at Kansas University. 
 

I think it all boils down to your confidence in the local treatment team. It’s important to ask the oncologist how many other patients they’ve treated with a similar diagnosis.  Bigger isn’t always better.  In the local community there is the “Cheers Effect”  where everyone knows your name.  It all really depends on what the Stage and complexity of the sub type of cancer sub type.   Personally,   my treatment plan was not controversial and my oncologist had treated a number of patients like me so I didn’t seek a second opinion or treatment elsewhere.  Horrible answer I know: it all depends.  
 

Lungevity has a help line too to assist with navigating all of this.  The Go2 Foundation is another great resource. They have the Lung Cancer Living Room on YouTube which is very informative. 
 

You’ll know a little more after the PET scan and the initial pathology report in the next week.  It’s really frustrating to wait for all the results.  I hope the pearls are taking the edge off of your wife’s cough.  
 

Michelle 

[Tom Galli]

Robert,

I also support Michelle's view.

Most lung cancer diagnosis are straight forward.  A biopsy yields a type and a PET yields a stage. But some diagnosis can be difficult and when difficult, it is best handled at a sophisticated cancer treatment center. How do you know straight forward from difficult.  We can help by helping you understand what test reports and biopsy reports mean. So use this forum to ask questions about the biopsy or scan results you are receiving. But, once diagnosed, and a treatment plan is designed, treatment can be effectively administered at a local clinic.  If surgery is a suggested method, I'd pick a thoracic surgeon who practices at a large surgical hospital. You want to have a surgeon who does hundreds of lung cancer surgeries a year and a hospital where thousands a year are performed. Some precision radiation can be difficult to find at a small town local setting.  All my chemotherapy was administered at a small local clinic that had but 10 infusion chairs. This was an ideal setting compared to a hospital setting had up to 50 or more chairs. Smaller is better generally applies to conventional chemotherapy. 

I would encourage that you receive all of your diagnostic scans at the same treatment facility.  Results need to be interpreted and radiologists who have easy access to digital files of previous scans make better interpretations then those seeing imagery for the first time.

Where things get tricky is treatment plan development if cancer recurs after successful treatment or if the designed treatment does not arrest your cancer.  This is when I would seek out doctors at large National Cancer Institute affiliated hospitals.  Here is a link to National Cancer Institute Cancer Centers. They are listed by state, so look under Texas hospitals.

Stay the course.

Tom

[BridgetO]

I agree with Michel  and Tom on this. "It depends". It's really important to have confidence in your doctor(s).  My insurance is through an HMO that has its own doctors and hospitals, so no choice of where to go. My lung cancer treatment was extremely straightforward, so there was no problem. However I had two other unrelated primary cancers and one of them was a rare and aggressive type and the treatment  was not at all straightforward. I was't confident about what my HMO was recommending for chemo. The HMO wouldn't pay for an out-of-network second opinion, so I decided to pay for one myself. Fortunately, we have a National Cancer Institute designated Comprehensive Cancer Center locally and I was able to get my second opinion there from a specialist who had experience with the type of cancer  I had. I felt very confident about her expertise. I took her opinion back to my HMO doc, who fortunately was willing to follow it. The consultation surprised me by costing under $500 including reviewing my pathology slides. I thought it would cost a lot more. It was definitely worth it. If my HMO doc hadn't been willing to follow the other doc's opinion, I'm not sure what I would have done, because I couldn't have afforded out-of-network treatment. But it all went well and today I'm NED on all 3 cancers.

[Robert A.]

10 hours ago, Rower Michelle said:

Hi Robert,

I run The Living with Lung Cancer Support Group here in KC.  The majority of our members receive treatment locally because most lung cancer is very straightforward according the the NCCN guidelines. 
 

After the diagnostic process was completed some opted to go to Mayo or MD Anderson for a second opinion. In one case a member was referred to a late phase clinical trial for the first line of treatment.  Another member has the primary treatment plan dictated by MD Anderson and administered locally at Kansas University. 
 

I think it all boils down to your confidence in the local treatment team. It’s important to ask the oncologist how many other patients they’ve treated with a similar diagnosis.  Bigger isn’t always better.  In the local community there is the “Cheers Effect”  where everyone knows your name.  It all really depends on what the Stage and complexity of the sub type of cancer sub type.   Personally,   my treatment plan was not controversial and my oncologist had treated a number of patients like me so I didn’t seek a second opinion or treatment elsewhere.  Horrible answer I know: it all depends.  
 

Lungevity has a help line too to assist with navigating all of this.  The Go2 Foundation is another great resource. They have the Lung Cancer Living Room on YouTube which is very informative. 
 

You’ll know a little more after the PET scan and the initial pathology report in the next week.  It’s really frustrating to wait for all the results.  I hope the pearls are taking the edge off of your wife’s cough.  
 

Michelle 

Thanks Michelle, the Pulmonologist also gave her some Breo yesterday to try.

 

[Robert A.]

8 hours ago, Tom Galli said:

Robert,

I also support Michelle's view.

Most lung cancer diagnosis are straight forward.  A biopsy yields a type and a PET yields a stage. But some diagnosis can be difficult and when difficult, it is best handled at a sophisticated cancer treatment center. How do you know straight forward from difficult.  We can help by helping you understand what test reports and biopsy reports mean. So use this forum to ask questions about the biopsy or scan results you are receiving. But, once diagnosed, and a treatment plan is designed, treatment can be effectively administered at a local clinic.  If surgery is a suggested method, I'd pick a thoracic surgeon who practices at a large surgical hospital. You want to have a surgeon who does hundreds of lung cancer surgeries a year and a hospital where thousands a year are performed. Some precision radiation can be difficult to find at a small town local setting.  All my chemotherapy was administered at a small local clinic that had but 10 infusion chairs. This was an ideal setting compared to a hospital setting had up to 50 or more chairs. Smaller is better generally applies to conventional chemotherapy. 

I would encourage that you receive all of your diagnostic scans at the same treatment facility.  Results need to be interpreted and radiologists who have easy access to digital files of previous scans make better interpretations then those seeing imagery for the first time.

Where things get tricky is treatment plan development if cancer recurs after successful treatment or if the designed treatment does not arrest your cancer.  This is when I would seek out doctors at large National Cancer Institute affiliated hospitals.  Here is a link to National Cancer Institute Cancer Centers. They are listed by state, so look under Texas hospitals.

Stay the course.

Tom

Thank You Tom, I hope it can be handled locally but will keep all options open.