[Mtngrl]

Tiffany,

I didn't talk directly to my former oncologist about why I wanted to be assigned to a new medical oncologist. The practice manager called me to ask about it, and I told her it was just not a good fit. That really is most of it. I think she's a good doctor, but she's just not used to having patients who are as proactive as I am, or as opinionated. She wasn't neglectful or incompetent. For the most part she gave me good medical advice.

My part is I may not have done enough to help her understand where I'm coming from in that regard. I also think I could have done more to help her understand my cancer history.

When I met with my new medical oncologist I brought her printouts of my three most recent blog posts and a copy of a running tally I've been keeping to summarize my scan results. I also talked to her about why I wanted a new doctor, though, again, I kept it at the level of, "we just didn't click." I told her I like having my emails answered. She said the emails are first read by staff, so it can take a day or two, but that she would answer them.

I also wonder about my former onc's treatment philosophy. I have spent very little time at anything like "NED," but I don't place a high priority on that. (Don't get me wrong. If we could find a way to put the cancer in remission permanently I'd be thrilled. I want to be StepN when I grow up.) My point is that, to me, the most important thing is quality of life. As long as I'm alive, and functioning fairly well, with a low cancer burden, I call that success. Looking back on my history, it seems important to balance the benefits of the harsher old-school chemos against their ill effects. I need antibody drugs all the time, but I need to take breaks from the big guns, and not just to let my hair grow back. I define "stable" as "no new lesions." That seems to work for me. By contrast, my former onc treated increased uptake anywhere as a sign of impending runaway progression. I had been taught by my first oncologist in Boston to "wait and see." So far that has been a good approach for me.

Amy