How To Find The Right Medical Oncologist For You
Start by asking your primary care doctor for suggestions. Or call a trusted hospital to see what medical oncologists work there and who might be a good fit for you. Choose one who treats the type of cancer you have and who takes your insurance. You can also:
- Talk to friends or family members whoâve had the same cancer. They can tell you which doctors took care of them and what the process was like.
- Ask the medical oncologist about their experience and credentials. They can tell you exactly how many years of experience they have and if they have any advanced or specialized training. For example, if the medical oncologist is board certified in oncology, that means they passed an intense, high-level test.
- Ask how to contact them after hours. Find out if your doctor is available on weekends and holidays.
- Meet the medical oncologist and staff. You can do this either in person or over the phone. Meeting the team can give you a sense of how theyâre going to help you with your treatment. This is also a good opportunity to make sure theyâre willing and ready to answer your questions.
What Type Of Breast Cancer Do I Have
The most common types of breast cancer are:
Invasive lobular carcinoma: This disease, accounting for one in 10 breast cancers, begins in the lobules, or the glands of the breast that make milk.
Invasive ductal carcinoma: This cancer, accounting for about eight in 10 breast cancers, begins in the breasts milk ducts, the thin tubes that carry milk from the lobules to the nipple.
A Radical Approach Isnt Necessarily Better Than A Conservative One
A mastectomy is not the only way to remove breast cancer. A lumpectomy is an option for many early-stage patients, Dr. Greenup says. The breast cancer itself is removed and the residual remaining breast tissue is treated with whole breast radiation, she explains. Increasingly, for older women with small, favorable breast cancer types, we can even consider foregoing radiation in some cases.
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Can Breast Cancer Be Prevented
At this time, there is no sure way to prevent breast cancer.
Some risk factors, such as your age and being female, cannot be controlled. But you may be able to do things to stay as healthy as you can, such as having a healthy diet and being active. Knowing your risk of getting breast cancer also can help you choose what steps to take.
Talk to your doctor about your risk. Find out when to start having mammograms and how often you need one. If your doctor confirms that you have a high or very high risk, ask about ways to reduce your risk, such as getting extra screening, taking medicine, or having surgery.
If you have a strong family history of breast cancer, ask your doctor about genetic testing. The test can check for gene changes that increase your risk for getting breast cancer and ovarian cancer.
Do You Want To Keep Looking For Another Doctor
Ultimately, your goal should be to get the best care — that provides the greatest benefit with the least side effects — right from the beginning of your treatment or moving forward from wherever you are now in your treatment.
Dont hesitate to get a second opinion if youre lacking confidence in a particular doctors treatment recommendations, expertise, or communication skills. Asking for opinions from other doctors can also help if you feel unsure that your diagnosis is correct or if you need more information to make decisions about your treatment.
In some cases, it might be worth switching doctors early on so you can feel comfortable with your care. You may also choose to switch doctors later on in your treatment because your needs change over time.
Finding the right doctors can be a challenge, but the rewards are worth it. When you work with doctors you can trust, reach, engage, and share decisions with, youll feel a lot better.
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Should I Have A Test To Find Out If I Carry The Breast Cancer Gene
The choice is up to you and your doctor. Your doctor can help you decide if a gene test might be useful to you. He or she can also discuss the pros and cons of taking the test. Talking with a genetic counselor might also be helpful.
Think about how you would feel if the test results show that you are at greater risk of getting breast cancer. Some people want to know if they have one of the mutated genes. Knowing instead of wondering helps them deal with the risk of breast cancer. It allows them and their doctors to watch more closely for early signs of cancer. But other people would rather not know they have the abnormal gene. They feel that it would be too hard to cope with. Talk with your doctor about your feelings. Remember, even if you have a mutated BRCA1 or BRCA2 gene, your chances of developing breast cancer are still very low.
Follow Up Care After Breast Cancer Treatment
Many women are relieved or excited to be finished with breast cancer treatment. But it can also be a time of worry, being concerned about the cancer coming back, or feeling lost without seeing their cancer care team as often.
For some women with advanced breast cancer, the cancer may never go away completely. These women may continue to get treatments such as chemotherapy, hormone therapy, or other treatments to help keep the breast cancer under control and to help relieve symptoms from it. Learning to live with breast cancer that doesnt go away can have its own type of uncertainty.
Even if you have completed breast cancer treatment, your doctors will want to watch you closely. Its very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems, and will probably examine you. Lab tests and imaging tests aren’t typically needed after treatment for most early stage breast cancers, but they might be done in some women to look for signs of cancer or treatment side effects.
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Top Risk Factors Linked To Breast Cancer
- Aging. Your breast cancer risk increases as you get older. By age group, breast cancer is diagnosed in:footnote 2
- 4 out of 1,000 women in their 30s.
- 15 out of 1,000 women in their 40s.
- 24 out of 1,000 women in their 50s.
- 36 out of 1,000 women in their 60s.
- 38 out of 1,000 women in their 70s.
How Do Your Cancer Cells Appear Under A Microscope
When a sample of your breast cancer is examined under a microscope, heres what the pathologist looks for:
- Cancer cells with unique appearances. Some subtypes of breast cancer are named for the way they appear under the microscope. Subtypes include tubular, mucinous, medullary and papillary. Your subtype gives your doctor some clues about your prognosis and how your cells may respond to treatment.
- The degree of difference between the cancer cells and normal cells. How different your cancer cells look from normal cells is called your cancers grade. Breast canc
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What Are The Limitations Of Ultrasound Imaging Of The Breast
- Ultrasound is one of the tools used in breast imaging, but it does not replace annual mammography.
- Many cancers are not visible on ultrasound. Many calcifications seen on mammography cannot be seen on ultrasound. Some early breast cancers only show up as calcifications on mammography. MRI findings that are due to cancer are not always seen with ultrasound.
- Biopsy may be recommended to determine if a suspicious abnormality is cancer or not.
- Most suspicious findings on ultrasound that require biopsy are not cancers.
- Many facilities do not offer ultrasound screening, even in women with dense breasts, and the procedure may not be covered by some insurance plans.
- It is important to choose a facility with expertise in breast ultrasound, preferably one where the radiologists specialize in breast imaging. Ultrasound depends on the abnormality being recognized at the time of the scan as it is a “real-time” examination. This requires experience and good equipment. One measure of a facility’s expertise in breast ultrasound can be found in its ACR accreditation status. Check the facilities in your area by searching the ACR-accredited facilities database.
Ask Your Doctor For A Survivorship Care Plan
Talk with your doctor about developing a survivorship care plan for you. This plan might include:
- A suggested schedule for follow-up exams and tests
- A schedule for other tests you might need in the future, such as early detection tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
- A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
- Diet, physical activity, and other lifestyle modification suggestions
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Additional Factors May Also Play A Role In Treatment Planning Including:
Genetics: Some breast cancers are related to mutations in the genes BRCA1 and BRCA2, or other genes. The results could impact the treatment recommendation and future cancer screening — not only for breast cancer, but for other types of cancer as well.
Fertility: Hormone therapy and chemotherapy can affect fertility and family planning, so for women of childbearing age, this is an important treatment-planning consideration, Morikawa says. Like so many aspects of diagnosis and treatment, this too can be overwhelming to consider. But I encourage women in this age group to at least meet with a fertility specialist on our team to discuss their options.
Clinical trials: Many patients, both soon after diagnosis or at some point in the future, may be candidates for experimental treatments available at top centers like Michigan Medicine, says Morikawa. We encourage patients to explore clinical trial options with their care team.
Morikawas advice to every newly diagnosed breast cancer patient: Ask, ask, ask. Every concern is legitimate and every question deserves an answer.
Learn more about breast cancer treatment and options:
Questions You Might Want To Ask Your Gp
- Do I need to see a specialist? Is it urgent?
- When will I see them?
- Where will I see them?
- Will I find out about my appointments by post or telephone?
- Do I need tests? What will they involve?
- How long should I expect to wait?
- Where can I find out more about tests?
- Do I have to do anything in preparation for this test?
- When will I get the results and who will tell me?
Your GP might not be able to answer all of your questions. They will tell you what they can at this point. Not knowing is difficult to cope with and can make you anxious.
Speaking to a friend or relative about how you feel might help.
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Cancer Treatment Is A Team Effort
One of the first things that can confuse a patient unfamiliar with cancer treatment is who does what, says Morikawa.
At the Rogel Cancer Center, cancer care is multidisciplinary. A team of specialists comes together in a forum called a tumor board to review each patients test results and background information and arrive at a consensus recommendation about treatment.
A patient is likely to interact with doctors from more than one specialty, including:
- Surgical oncology: Removing cancerous tumors and tissue
- Medical oncology: Treating cancer with medications such as chemotherapy or hormone therapy
- Radiation oncology: Treating cancer with radiation
Many times, a patient will meet with a surgeon first, before they meet with a medical oncologist like me, Morikawa says. The surgeon will focus on discussing the procedure to remove the tumor and will refer questions about follow-up chemotherapy to me .
In addition, each of these groups has nurse practitioners or physicians assistants who are part of the team, she notes. The multidisciplinary approach is proven to provide the most comprehensive care, but it takes some practice and patience to direct each question to the specialist best prepared to answer it.
What Kind Of Training Does A Medical Oncologist Have
Medical oncologists must first earn a bachelorâs degree. After college, theyâll go to medical school for about 4 years. This includes 2 years of studying in a classroom and 2 years of practice in a hospital setting.
Next, theyâll complete a 2- to 5-year residency where they get special training in a hospital. Finally, theyâll get certified and licensed in the state where they want to practice medical oncology.
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What To Expect At An Oncology Appointment
If itâs your first oncology appointment, it could last a few hours. The oncologist will spend time going over your medical history.
They might give you a physical exam, even if your primary care doctor did one recently. Thatâs because physical exams can show signs of cancer that doctors who donât treat it every day might miss. Your oncologist could also order more tests, like imaging tests , or they might take a sample of your blood or urine. You might need a biopsy, too.
During your appointment, the oncologist may give you a basic idea of how long treatment will take. They could also give you a prognosis, or an idea of how youâll respond to treatment. You might also meet other doctors on your treatment team. Theyâll explain things like costs and the insurance process, too.
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What Does It Mean When Your Nipples Burn
If you have sore or sensitive nipples, its not because there is something wrong with your body. It happens to everyone at some point in their lives and can be caused by many different things like tight clothes rashes that irritate the skin even more than usual due seexEcidedly painful breastfeeding sessions- any pain felt near these breast tissue will cause discomfort immediately!
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Why Choose Cleveland Clinic For Breast Cancer Care
Our Comprehensive Breast Cancer Program is one of the largest and most specialized in the nation. As part of the Case Comprehensive Cancer, we are one of only 41 comprehensive cancer centers in the nation designated by the National Cancer Institute. Cleveland Clinic has also achieved a Three Year Full Accreditation from the American College of Surgeons’ National Accreditation Program for Breast Centers . Cleveland Clinic is ranked as one of the nations top hospitals by U.S. News & World Report.
Our multidisciplinary physician team of breast surgeons, medical oncologists, radiation oncologists, radiologists, and plastic surgeons work together to provide customized, coordinated care for patients. We offer the highest-quality screening, diagnosis and treatment of breast cancer.
We are a national leader in intraoperative radiation therapy, novel targeted therapies and adjuvant therapies for breast cancer, and also in fertility preservation for cancer patients. We also participate in important clinical trials of brand new therapies and our patients have access to these trials for every stage of breast cancer. Our cancer specialists are pursuing many promising avenues of research including the development of a breast cancer vaccine to bring hope to future patients as well.
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Specialists And Board Certification
Specialists are doctors who have trained in a specific area of medicine. After finishing the training for their specialty, they must pass an exam given by the specialty board. Doctors who pass the national board exams become board-certified specialists. Doctors who have not completed the specialty board exam are “board-eligible” but are not specialists.
Board certification is a sign that a doctor is highly trained in their field. Several fields related to cancer care have national boards that set standards that doctors must meet in order to be certified.
But some of the specialties that are important in cancer treatment donât have board certifications. Doctors who practice in these specialties are board-certified in a broader field. For example, there is no board certification for breast cancer surgery. Surgeons performing breast cancer surgery should be board-certified in general surgery, which gives them the basic skills to perform breast surgery.
If doctors practice in specialties that do not have national boards, additional training such as fellowships and years of experience are usually good measures of their qualifications.
Some specialists can subspecialize by completing more training in a particular area. They can sometimes become board-certified in the subspecialty, too.
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Hereditary High Risk Clinic
Cleveland Clinic offers a unique, hereditary high risk clinic to help manage the risk for individuals with identified mutations and untested family members, or a strong family history of breast cancer.
Characteristics that may suggest a hereditary predisposition include:
- diagnosis of breast cancer before age 50
- triple negative breast cancer
- several family members on the same side with breast and/or ovarian cancer or pancreatic cancer
- male breast cancer
- and/or a known familial gene mutation.
Early identification of patients at increased risk due allows for a proactive approach to care, including genetic counseling, education about lifestyle changes, enhanced surveillance, chemoprevention, and risk-reduction surgery.
What Is Radiation Therapy
Radiation therapy uses targeted energy like X-rays to kill cancer cells. If a breast tumor is large or not easily removed by surgery, radiation therapy before surgery may be recommended to help shrink the tumor. When used for breast cancer treatment, radiation is delivered to the affected breast and, in some cases, to the lymph nodes under the arm or at the collarbone.
Radiation therapy is delivered in two main ways:
External beam radiation: This standard type of radiation therapy directs high-energy beams from a machine outside the body to cancerous cells within the body. Intensity modulated radiation therapy , intraoperative radiation therapy , TomoTherapy® and stereotactic radiosurgery are all forms of radiation therapy.
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