The decision to be treated locally or at a large research center can be a difficult one, but I am lucky enough to have both.
One of the hardest decisions cancer survivors can make is whether to have their treatments done locally or travel to a research center farther away. Unless, of course, they are fortunate enough to live close to a large center.
There are pros and cons to each one. Through my 12 years of survivorship, I have gone to two well-known research centers yet managed to get my treatments at the local hospital I have gone to my entire life.
My local hospital is important to me. I have had several surgeries there, tried to find doctors who use their insurance and have spent years with the Patient Advisory Council, which made suggestions for the new cancer center about to open soon. I have spent more hours than I care to count in the emergency department with my parents before they passed, and feel that overall, the doctors are knowledgeable and the nurses caring.
However, when I was diagnosed with cancer, a problem became apparent. Myelodysplastic syndrome (MDS) is so rare that only 10,000 people a year are diagnosed as compared to 250,000 with breast cancer in the United States, according to the American Society of Clinical Oncology. My local oncologist referred me to University Hospital, which is connected with the prestigious Case Western University in Cleveland and where she trained.
I liked the first doctor at University very much, but she left to take over a bone marrow transplant unit at another well-known research center. My local primary care physician told me that is often the case because doctors use the major clinics as stepping stones to go to other centers. The second doctor knew my local oncologist and told me she was excellent and sent me back to my local oncologist. She did tons of research on her own and kept me alive for 10 more years.
After I started getting funky (not a medical term but works for me) blood counts, she referred me to the Cleveland Clinic. I connected well with the competent doctor there who then left for the Mayo Clinic in Florida!
Then, the absolute worst happened. My local oncologist left after 18 years to go to a warmer climate and explore new possibilities. I was devastated and confused. I knew many of the nurses and staff by now at the local hospital because I went there every week for treatments, and they were like family to me.Every time I parked my car, I watched the new cancer center being built with wonderful anticipation.
My local oncologist knew people at both University and the Cleveland Clinic who were specialists in MDS. She told me it is time for me to go to one of those places with the most recent research and newest therapies. She referred me to a woman who is world-renowned at the Cleveland Clinic.
I met this new doctor and loved her. She suggested that I look for a cure for the cancer and get a bone marrow transplant. Immediately, the clinic set into action appointments to find donors, take swabs and join support groups. The problem was that the guaranteed of success rate was low, and the procedure very grueling. I had a terrible couple of months trying to make my decision on the bone marrow transplant. I went to University for another opinion, and they advised against it.
I decided not to have the transplant, but to remain under the care of the physician at the Cleveland Clinic who I connected with so well. A miraculous new drug had been approved for my type of cancer, and my new local oncologist agreed to work with the Cleveland Clinic so I could continue my treatments at the local hospital. Meanwhile I go to the Cleveland Clinic every three months and am under the supervision of the doctor there.
I have the best of both worlds. I have the excellent medical care and exposure to the newest information at a world-renowned research center, while I can have my treatments locally and am one of the patients to open the new beautiful cancer center.
Throughout my time writing articles for CURE, I have heard from people who go to the large centers for second opinions. They either choose to have the treatments there or go back home.Sometimes the patient needs to go for a second opinion and reassure themselves that they are on the track which is best for them.I always encourage a second opinion and a doctor who does not support that is not the one for you.
Like so much of life, there is no right or wrong answer that applies to everyone, and these decisions need to be made by each individual patient. The local centers are comfortable and closer, but the research centers are always up to date.And sometimes with a little luck and cooperation, you can have both.
This arrangement for me may not be permanent and I may eventually need to exclusively go to the Cleveland Clinic.However, for now, it is the best decision I can make for me.
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