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Nguyen · 03-13-2019, 07:25 AM

In every single field of any discipline, there are bad, mediocre, excellent, and gifted performers. How can a patient or love ones get answer to below three questions before placing a patient's life in an oncologist hand?

1_ Discounting "bed side manner", how can one determines which category (bad, mediocre, excellent, and gifted) an oncologist belongs to? Note that reading online reviews (if available at all) do NOT help very much in this regard.

2_ For those of us who do in-depth research (not as career, but to care for love ones) with in-depth knowledge of the field, how does one determine an oncologist who does not have an ego that gets in the way of taking suggestions (backed by relevant data) from us (patients, relatives), since we are lay person in their eyes? Most (if not all) everyone in any field would answer yes when ask the question such as "are you open or willing to consider suggestion", whether this is the honest answer, who knows.

3_ How much time an oncologist is willing to spend thinking about a patient's case in determining treatment. Yes, there are some "easy" treatment decision, most requires some careful thought, particularly 2nd, 3rd, 4th lines with multiple difficult choices and ramification. This is where the "excellent" or "gifted" part comes in.

I think I am just venting, I am sorry, thanks for your thought.

Nguyen

Linda's treatment history

03-2019 - current: bone mets discovered, denosumab, will be in syd-985 trial
08-2018 – 03-2019: Xeloda and Herceptin, have to reduce Xeloda dose several times to 1000mg/day
04-2018 – 08-2018: restart T-Dm1
03-2018: biopsy of the lung: ER+, Her2+++, PR—(change from PR+)
03-2018: comprehensive genetic profiling by FoundationOne medicine, numerous genomic alterations

12-2017 – 04/2018: Pertuzumab + Herceptin
03/2017 – 12/2017: Herceptin + Fulvestrant (take a break from T-Dm1)
07/2014 – 03/2017: T-Dm1
02/2014 – 06/2014: Everolimus (5mg), Exemestane, Herceptin
08/2013 – 01/2014: Femara, Herceptin
12/2012 – 07/2013: 4mg estradiol, Herceptin
08/2012 - 12/2012: Fulvestran 500mg, exemestane, Herceptin (Stop everolimus due to mouthsores)
05/2012 - 08/2012: Everolimus (10mg), Exemestane, Herceptin, Zometa
08/2011 - 05/2012: Herceptin, Tykerb, Femara, Zometa
08/2010 - 08/2011: Herceptin, Femara, Zometa
09-2009 - 08/2010: Herceptin and estradiol (6mg)
09/2008 - 09/2009: Herceptin, Fulvestrant, Femara
03/2008 - 09/2008: Herceptin, Exemestane, Oophorectomy
01/2005 - 03/2008: Herceptin (readded) and Femara
07/2004: It returned again via several small nodules in the lung
10/2002: NED (via CT and CA27.29)!
10/2001 - 01/2005: Femara, (Fosamax)
12/2000 - 10/2001: Herceptin and Navelbine
12/2000: lung metastatic was diagnosed (a few small nodules)
02/1998 - 12/2000: Daily Tamoxifen
05/1997 - 04/1998: Modified Radical Mastectomy, many cycles of chemo regiments (CAF,Taxol, Carpoplatin, Thiotepa, Navelbine, Taxotere), high dose chemotherapy with autologous stem-cell s rescue, and radiation
05/1997: First diagnosed with BC stage 3A, ER+, PR+, HER2 +, poorly differentiated, nuclear grade 3.

03-13-2019, 07:25 AM	#1
Nguyen Senior Member Join Date: Nov 2005 Posts: 514	bad, mediocre, or gifted oncologists In every single field of any discipline, there are bad, mediocre, excellent, and gifted performers. How can a patient or love ones get answer to below three questions before placing a patient's life in an oncologist hand? 1_ Discounting "bed side manner", how can one determines which category (bad, mediocre, excellent, and gifted) an oncologist belongs to? Note that reading online reviews (if available at all) do NOT help very much in this regard. 2_ For those of us who do in-depth research (not as career, but to care for love ones) with in-depth knowledge of the field, how does one determine an oncologist who does not have an ego that gets in the way of taking suggestions (backed by relevant data) from us (patients, relatives), since we are lay person in their eyes? Most (if not all) everyone in any field would answer yes when ask the question such as "are you open or willing to consider suggestion", whether this is the honest answer, who knows. 3_ How much time an oncologist is willing to spend thinking about a patient's case in determining treatment. Yes, there are some "easy" treatment decision, most requires some careful thought, particularly 2nd, 3rd, 4th lines with multiple difficult choices and ramification. This is where the "excellent" or "gifted" part comes in. I think I am just venting, I am sorry, thanks for your thought. Nguyen Linda's treatment history 03-2019 - current: bone mets discovered, denosumab, will be in syd-985 trial 08-2018 – 03-2019: Xeloda and Herceptin, have to reduce Xeloda dose several times to 1000mg/day 04-2018 – 08-2018: restart T-Dm1 03-2018: biopsy of the lung: ER+, Her2+++, PR—(change from PR+) 03-2018: comprehensive genetic profiling by FoundationOne medicine, numerous genomic alterations 12-2017 – 04/2018: Pertuzumab + Herceptin 03/2017 – 12/2017: Herceptin + Fulvestrant (take a break from T-Dm1) 07/2014 – 03/2017: T-Dm1 02/2014 – 06/2014: Everolimus (5mg), Exemestane, Herceptin 08/2013 – 01/2014: Femara, Herceptin 12/2012 – 07/2013: 4mg estradiol, Herceptin 08/2012 - 12/2012: Fulvestran 500mg, exemestane, Herceptin (Stop everolimus due to mouthsores) 05/2012 - 08/2012: Everolimus (10mg), Exemestane, Herceptin, Zometa 08/2011 - 05/2012: Herceptin, Tykerb, Femara, Zometa 08/2010 - 08/2011: Herceptin, Femara, Zometa 09-2009 - 08/2010: Herceptin and estradiol (6mg) 09/2008 - 09/2009: Herceptin, Fulvestrant, Femara 03/2008 - 09/2008: Herceptin, Exemestane, Oophorectomy 01/2005 - 03/2008: Herceptin (readded) and Femara 07/2004: It returned again via several small nodules in the lung 10/2002: NED (via CT and CA27.29)! 10/2001 - 01/2005: Femara, (Fosamax) 12/2000 - 10/2001: Herceptin and Navelbine 12/2000: lung metastatic was diagnosed (a few small nodules) 02/1998 - 12/2000: Daily Tamoxifen 05/1997 - 04/1998: Modified Radical Mastectomy, many cycles of chemo regiments (CAF,Taxol, Carpoplatin, Thiotepa, Navelbine, Taxotere), high dose chemotherapy with autologous stem-cell s rescue, and radiation 05/1997: First diagnosed with BC stage 3A, ER+, PR+, HER2 +, poorly differentiated, nuclear grade 3.