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Janet,
Two oncs reccomended chemo to me, one at a major cancer center, and the onc I am treating with. Based on my research and what I thought was right for me, I declined. I chose my onc, who is in private practice, because he was willing to treat me with Herceptin without chemo. At the time I started my infusions, Herceptin was still only approved for use in metastatic bc patients, and the doctors affiliated with large hospitals or major cancer centers would only prescribe it in accordance with the protocols for the trials of Herceptin as adjuvant therapy in early stage patients, and all the protocols included chemo. He was not bound by any internal administrative rules, and my insurance covered it, so we went ahead.
My onc and his associates have one of the largest private practices I am aware of. Once a month, they have a lunch program in house, where they invite one or two of the oncs from local major cancer centers to do presentations to them and answer questions about treatment. So, I feel that they are as up to speed as any of the docs in the larger centers. Also, I am examined by the doctor every three weeks when I go for my infusions, and have the chance to discuss new drugs and therapies with him. I don't know if other patients get that much "face time" with their oncs.
I know this is a non-traditional path to follow, but my doctors were satisfied I had done good research and was making an informed decision. In the end, the choice has to be one we can live with. I am very satisfied with my treatment plan.
Hopeful
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