Thursday, July 23, 2009 dora asks

Q: I have had a lumpectomy APril 8, 2009 and not yet simulated

I went to a teaching hospital in New York City. Did not have to do chemo cause oncotype score was 11, however, the radiation oncologist keeps delaying my simulation and radiation treatments for the simple reason that she refuses to sign a consent form and refuses to assure me that she will do the mapping. She states that being that it is a teaching hospital she will oversee the resident. The resident can sign the consent form. Is this proper? Should I fear that a resident is working on me? Should I also fear that radiation treatments may not be as effective since the lumpectomy was in APril 2009 and as of date I have not been simulated yet? Thank you for your responses.

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Answers (1)

PJ Hamel, Health Guide

7/23/09 6:10pm

Hi Dora - Not sure who's holding this up. The doctor, because she wants the resident to be in charge? You, because you don't want the resident in charge? I think at this point, 3 months post-lumpectomy, you're starting to get into sketchy territory. You need to get started with radiation, one way or another. If you're dead set against a resident overseeing your care (and I wouldn't be - I'd let the resident take over), then you should ask to have your treatment transferred to another hospital, a non-teaching hospital. So - either transfer to a new facility, or accept the resident, since it doesn't sound like the doctor is going to change her mind... looks like you're caught in the bureaucracy. Hope you get started soon - PJH

dora

7/28/09 5:18pm

Hi PJH

You were right-the doctor is not changing her mind and wants the resident to plan and simulate me on August 19th and start radiation 3 weeks after. My lumpectomy was April 8th and I do not believe I will get any benefit by starting at the end of August. A resident is not Board certified. WHy are they allowed to do this? If I will not receive any benefit by starting radiation at the end of August, why should I bother at all? Do u know why a woman that is 70 yo, no lymph node involvement, tumor less than 2 cm and her positive is allowed not to go for radiation therapy? What is the difference of being 70yo and 53yo? Why is radiation recommended for the 53yo and not the 70yo? I am so frustrated that a teaching hospital is acting in this manner by forcing me to have a non board certified resident work on me and starting radiation so late after April 8th. THanks for all your responses PJH

PJ Hamel, Health Guide

7/28/09 6:31pm

Hi - My advice is, if you can't go elsewehere, to go for the radiation at your current hospital. You'll still get the benefit. And the resident will be supervised. I assue you, radiation given at a somewhat late date is better than no radiation at all. I'm surprised the 70-year-old wasn't recommended to have radiation - it's the absolute standard of care, when you have a lumpectomy. Unless she has underlying serious health issues that would preclude radiation - I'd think she'd want to have it. Hope you can get something going soon - PJH

Flora

7/28/09 8:20pm

HI PJH,

The recommendations for 70yo are in the ACS booklet titled "You are not alone".

thanks