Finding the Right Oncologist to Treat Breast Cancer

Phyllis Johnson Health Guide
  • One of my colleagues at work stopped me in the hall right before Christmas break to tell me about her daughter’s breast cancer recurrence.  Her 34 year-old daughter is trying to decide what treatment option to take. Her daughter had worked for the oncologist for ten years before starting a new job.

    “She’s told the doctor he just needs to think of her as a patient he’s never known before.  He’s too close.  He keeps changing his mind about what to do,” said my colleague. “My daughter needs a plan, not all this uncertainty.”

    This story reminded me of another friend whose surgeon knew her personally.  He was sure he “got it all,” and on the strength of his certainty and her trust in his friendship, she never consulted an oncologist.   I don’t know what an oncologist would have recommended—very likely the same course she took.  But she did have a metastasis that eventually killed her and lots of second guesses about her decision not to get a second opinion.

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    My own doctors have varied from distant to friendly.  I’ve been fortunate that most of them were open to questions and good about explaining medical procedures to me.  But I noticed a definite change in their demeanor about three years after my inflammatory breast cancer (IBC) diagnosis.

                They were more relaxed and personal.  The change was subtle, but they seemed more open emotionally to me.  Maybe it was just the passage of time that deepened our relationship, but I think that they had been holding back just a little because I was a patient who was very likely to die on them.  Most IBC patients recur within two years, so at three years they seemed willing to risk a little more emotional closeness.

                Complaints about cold, uncaring doctors are common, but consider that some objectivity is in your best interest.  Our doctors’ decisions determine whether we will live or die.  They need a clear head.  Maybe they aren’t asking how your toddler is doing because thinking about the possibility of your adorable tot being left motherless is too painful.

                Does that mean you have to put up with rude treatment?  Of course not!  If you are considering changing doctors because of “bedside manner,” here are some things to consider.

                Does your doctor have a reputation in your community for technical competence?  Your surgeon needs to be good at cutting.  Your oncologist needs to know the latest research on drug dosages and side effects.  Your radiation oncologist needs to be a detail-oriented person who can measure to a millimeter.  Asking other doctors, nurses, and former patients can give you some insights into your doctor’s professional reputation.   If the doctor has an excellent medical reputation, you might decide you can do without charm.

                Is your doctor willing to answer questions?  Doctors are under pressure these days to see more patients in less time, so they will often appear rushed.  However, if you ask a question, they should take the time to answer it without brushing you off.  If you are the kind of patient who likes medical procedures explained, your doctors need to explain.

  •             Is your doctor open to second opinions?  Doctors should be confident, but not arrogant.  Doctors who act offended when you ask about the research studies that support their recommendations belong in the arrogant column.  So do doctors who seem reluctant for you to get a second opinion at any point in your treatment. 

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                Finding doctors who are a good match for you can be a challenge.   The size of your community and your insurance network may limit your choices.  But if you have options, don’t worry if your doctor’s attitude is not warm and fuzzy as long as he or she is competent, open to questions, and willing to collaborate with you and other doctors.  

Published On: January 02, 2009