Sunday, August 8, 2010

When your DR & your Radioligist disagree about Breast cancer treatment

When your DR & your Radioligist disagree about Breast cancer treatment?
Put simply my mom has several doctors that have conflicting opinions. She has gotten 2nd opinions and none of the DR's agree on anything. No body even says what stage it is. After 3 mamograms we knew something was up, but they had never said they thought it was cancer. They sent her for a biopsy ( as in the past) but this was not a needle, this was with a scalpel. They did ultra sound, and MRI. She went to a radiologist who said he could not do 8 weeks treatment because it was close to the heart. So her oncologist recomends masectomy. She called the Radioloigist back and told him the recomendation, he said he would not do it if it was him. He said MRI can be wrong, they are so sensitive. He would rather risk heart damage down the road. Has anybody had to make the treatment decision on thier own, and should they tell her what stage she is in. The biopsy was positive on AUG 1. They say it might be 2 spots and might be in the lymh nodes.
Cancer - 10 Answers
Random Answers, Critics, Comments, Opinions :
1 :
Go with the oncologist and a mastectomy. The radiologist would enter late in the game, perhaps too late to avoid spread.
2 :
if its already in the lymph system she will also need a port, but if she has heart issues, only two medications will be used instead of three. as for the breast cancer, i would do whatever it takes....this is unfortunately one of those damned if you do damned if you dont kinda things.... (father had lymphoma to as well as renal carcinoma) good luck and prayers are with you! i dont know what else to tell you since it is now in the lymph system....but, since you cant treat two different kinds of cancer with different meds, i'd have them cut the tumor out of the breast and hop on the "port" meds for the lymphoma
3 :
I think that I would go to a well known teaching medical center and get tested again. I think that these placess have a much more modern up to date approach on all the new stuff and diagnostic equipment. I am a nurse and that is what I would do. I also like going to women physician......they are much more sensitive.
4 :
The only way to know if there is spread to the lymph nodes is to surgically remove the first tier of them and send them through pathology to check for spread of the primary cancer. Your mom should probably switch doctors and find one who will give her full disclosure of her condition so she can better make decisions about her treatment and care. A Radiology Oncologist is only going to recommend radiation because they don't work with or study up on the chemotherapies or surgeries, they are a specialty. Don't delay in finding a new oncologist because with every passing month things can progress if not treated.
5 :
You need to find out from the biopsy results if the cancer has spread anywhere in the body-mestastisized. If it has spread, usually a mastectomy will not be done since the cancer has already spread from there. Usually, staging is done first-the steps of biopsy, ultrasound etc -your mom has done that. From that info a decision should be made. Actually staging of the tumor-1A to 4C sometimes can't be determined until after surgery but the oncologist must have an idea from the biopsy report. The usual steps are biopsy, surgery, chemo. radiation for treating breast cancer. Since the cancer has spread to the lymph nodes, I would opt for a mastectomy followed by chemo and then radiation if necessary.
6 :
Only Radiologists And Oncologists Should Make Decisions About Cancer Patients It Is Important To Know That A G.P Has Limited Knowledge About Cancer So Get The Radiologist And Oncologist Working Together Cheers I Am A Doctor
7 :
The radiologist and oncologist have two different functions. Use their advice only for what they are specialized to do. That said, it is clear to me that the oncologist is more qualified in the area that the Radiologist is not. Breast cancer should be treated according to the oncologists advice. Perhaps she should see a breast cancer oncologist. There is a fantastic doctor in Marin County, California. Her name is Dr. Bobbie Head. You could call her office and see if she can help. But then not sure where you live. I am 47 and found two very small Ductoral carcinoma in situ. The positioning was such that I was advised to have a left breast mastectomy if I wanted to be really sure it was all out. I did not hesitate. Best thing I did because when they tested the mass and they found some was actually invasive and had not been detected earlier. I was so grateful I made that decision because three years later it is all gone and has not come back and nor is it likely to.. I had a tram flap reconstruction and I look very normal. I did not need radiation or chemo. BUT remember everyone is different. You should be very comfortable with your doctor and able to follow advice. At the same time it is imperative you do your own investigation so you can accomplish that level of comfort needed to move forward. Al the best. Tell your mom not be afraid, but to take "the bull by the horns."
8 :
Unfortunately in this day and age, the doctors want the patient to make the final decision. My sister, sister-in-law, and I are all breast cancer survivors. My sister had several suspicious spots, including two confirmed locations of malignancy in the same breast. She opted for mastectomy, as did my sister in law. I had a partial mastectomy, also known as a lumpectomy followed by chemo and radiation. Radiation isn't always necessary, nor is chemo, depending on the size of the tumor and if it has spread to the lymph nodes. Your mom should seek to have a sentinal node biopsy, which will let the doctors know if the cancer has spread to the lymph nodes. If the cancer hasn't spread, and as you say there are several spots, most doctors recommend a mastectomy followed by reconstruction, if your mom want's to go that route. My sugery left me a little lopsided but I opted not to go with any reconstruction. Good luck to your mom. Please feel free to contact me directly if you want. Please also check out Dr. Susan Love's website. It is full of lots of good, up to date information.
9 :
I wouldn't wait too long to make this decision, if I was your mom. Also, maybe you are confusing the terms "radiologist" and "radiation oncologist"? First, go see a breast surgeon and get this taken care of. They will do sentinel node biopsies and recommend mastectomy v. lumpectomy. Time is of the essence!
10 :
I hope u mean oncologist, but get a PET/CT scan. The oncologist should order this as a staging procedure. Stick to theperson who specializes in cancer- the oncologist.



Read more discussions :

Posted by at