Some of you will be saying, wait, what? I get to choose?

The answer to that likely depends on where you live. If you live in the US, have insurance which will cover it, and are able to find more than one provider within driving distance, YES!
Many people I talk to never considered the need to shop around for the oncologist they want to work with. I look at it this way: I shop around for produce. I shop around for shoes. Why wouldn't I shop around for a doctor when my life is on the line?
I have shared before how little I clicked with the first team I was "assigned," by my referring doctor. It wasn't their fault so much as it was an impersonal set up designed to give basic care to as many people as possible. There was no time to ask questions. There was no time for patient education. There was no nutritional or lifestyle guidance. You got the "gold standard" of care, which is actually the bare minimum. Not only that, my original oncologist, as sweet of a guy and as great of a surgeon as he was, had his hands firmly tied when it came to any supplements or off-labels which might give me an edge over this beast. In fact, I asked him about Metformin, a diabetes drug which has showed promise in the treatment of cancer. His response was a carefully worded, "Those drugs have been shown in studies to have efficacy against cancer, but because they are not oncology drugs, I cannot prescribe them."
I stuck with them for a bit longer, but that should have been a red flag to me. It wasn't that I necessarily wanted a prescription for Metformin. However, I did want a doctor who was able and willing to throw everything at this disease to give me the best chance at seeing my kids grow up!
In my quest to find a provider that met my needs, I realized there were some criteria that were essential for me. I ended up finding a place that met ALL of my requirements. The Block Center in Chicago is fantastic and I cannot recommend them highly enough. Whether I live or die from this, I feel that they are giving me the best possible care. So, I wanted to share with you some tips for choosing your team of doctors.
Is there at least one veteran on the team?
Look, I love research and I have learned a lot about cancer. I am a stay at home mom who spends her days reading textbooks on cancer. However, I will never have the expertise and education that someone with a lifetime of cancer care has. This doesn't necessarily mean that everyone on your team has years of experience, but there should be at least one consulting doctor who has been in the game for awhile.
Dr. Keith Block has been doing this for over 30 years. He's not an oncologist, but he's treated cancer patients for almost as long as I've been alive. He even wrote a book on cancer. Dr. Nimmagadda, my oncologist, though younger, is literally a genius. (I won't tell details of her personal and educational life, but if you ever meet her, you can ask her yourself.) Jen, my PA has also had many years of experience. The nurses at the Block Center have combined decades of oncology nursing experience. The best part is, they meet weekly to discuss each patient and their care, so they are truly collaborative.
What do others say about them?
This one is tricky because typically only angry people write reviews online. So, you might not find a good representation without some digging.
My best advice is to join some online groups and see what patients have to say. While there are some crazy reviews for The Block Center, I've never talked to a person who wasn't happy with them in the forums I visit.
Do they have good results?
This is tough, especially with integrative doctors. The truth is, most people don't seek out an integrative doctor until conventional medicine fails them. It's comparing apples to oranges to want someone who only sees stage 4 patients with someone who primarily sees stage 2 patients. Because cancer is so complex and we don't fully understand it, you can't expect any doctor to have a miracle 100% cure rate. However, it is helpful when comparing patients with similar staging and prognosis, to see how they stack up. If you can't find the data on that particular center, you should at least be able to find the data on the specific treatments offered compared to the "gold standard."
Is someone available to you when you need them?
When I decided that I'd either have integrative care or completely holistic care due to a really awful experience at my first oncologist, I reached out to The Block Center. I had reached out to multiple other doctors both during that time and prior. The Block Center assigned me a Patient Advocate from the get go. I actually spoke to the Patient Advocate every single day until I was scheduled for all of my first appointments with The Block Center. In fact, I spoke to her before I even spoke to my chemo nurse who was supposed to be scheduling me for actual treatment after a failed attempt at chemo the week prior!
At my previous onc, I would not have seen my doctor or oncology nurses on treatment days at all. I didn't even get a phone call to check on my status after surgery!
Dr. Block has taken my husband's phone calls on holiday weekends when I was having complications. There is always a provider available to meet with you and clear you for chemo the day of treatment. The nurses are fantastic. I was terrified that I would have anaphylaxis to my second chemo drug like I had my first, so my sweet nurse actually sat with me until we knew I wouldn't. (I was fortunate it was a slow day!)
That was a huge difference between my first hospital where I was vomiting uncontrollably and gasping for breath but my husband had to track down the infusion nurse!
Do they communicate clearly?
Informed consent cannot happen if you aren't given the option to be informed. Now, there are some people who will waive that right and that's okay. If you don't want to know about all the unlikely complications, I totally get that. (Okay, not really, because that's like a foreign concept to me, but I understand there are people like this!) However, they have to be willing to discuss them with you.
Doctors are in a precarious position with cancer treatment. They have seen first-hand what happens in different situations, so they cannot help but have an opinion on what is the best choice for you. However, as much as they have an opinion, it's still your body and you have to live with the consequences of your choices. If you can't have a frank conversation about the benefits and risks of treatments and procedures, that is a big red flag. You should never feel that you need to hide information from your doctors; it's not safe for you. Choose carefully so you have a doctor who will respect your choice if you don't agree but who you also trust enough to know they have your best interests in mind.
They don't need to be able to educate you to a doctorate level in any subject, but if you have specific questions that are making you anxious, it helps to have someone who will answer those for you.
Are they willing to think outside of the box for treatment?
This is a blog about integrative cancer treatment, so of course this is important to me. I think there are too many avenues of treatment that are under-explored in oncology. That being said, if you are not someone who sees the benefit on this, it might not be important to you.
It also may not seem important if you are in the die-hard holistic cancer camp. I know there is a big push in pop culture right now to heal cancer naturally. If this is you, it might not make a difference in how flexible the doctor is in treatment.
However, I still think someone who is able to approach cancer from different angles is your best bet for healing. Not only do I think there is plenty of research to support integratives, I also think a person who is not dogmatic in their approach will be most likely to adjust treatment when objectives aren't being met. That brings up another point...
Do you share the same philosophy on health?
I see illness as a result of unhealthy living. I think there is just too much research proving this to be true to look at an illness as something to be treated without seeing the biological mechanisms which allowed this disease to grow. We can't pretend that lifestyle has no impact on health. It just does.
However, I also see the statistics on holistic cancer care for ovarian cancer, and they aren't particularly promising, either. We get caught up in cancer staging, but the truth is that by the time we find cancer, it is pretty late in the game. By this point, it has already evaded the body's natural defenses. Can some people get their cancer under control by a holistic philosophy? Absolutely! Some people get it under control with a conventional philosophy, too. However, I see the benefit in both.
So, when I searched for a doctor, I realized I needed one who was on the same page.
Do you genuinely like them?
Sometimes we all work with people we don't like. This shouldn't be one of those times. It's important to at least respect your doctors. Cancer is hard. Don't make it harder on yourself by dreading your appointments due to personality conflicts. Who cares if they're at the best research hospital in the world if they make you stressed and miserable?
I genuinely like everyone on my team at The Block Center. I also genuinely like my family doctor, my regular integrative doctor, and my dentist. Because I like each of them and we "click," I don't dread my visits. It doesn't become this compartmentalized part of my life. I enjoy chatting with them during treatment. I know they'll tell me if I need to know something. Even though I am a compulsive researcher, it takes the stress off me to know that they've got my back.
So, those are my criteria for choosing an oncologist. Note that I didn't include being in a top researching hospital or having the best clinical trials. Many times we hear about how important it is for ovarian cancer patients to see a gynecological oncologist because studies show that they do better when they have one as their primary oncologist. I disagree with those studies for several reasons, the least of which is because comparing traditional oncologists who treat all manner of cancers from a conventional standpoint and an integrative oncologist who has more knowledge on that approach of treatment are quite different. While I'm certain that a general, conventional oncologist would have worse results than a gynecological oncologist, I don't know how you can possibly extrapolate and say integrative oncologists have worse outcomes than gynecological oncologists. (And in fact, I'm already getting actual medications for ovarian cancer which I would not have received had I stayed with my first gynecological oncologist!)
Secondly, you can still have a gynecological oncologist on your team. I do. I go to her for my checkups and we discuss what is happening with my treatment. However, she is not my primary onc. Why? Because we share different philosophies on medicine. I like her. She's great. But she sees little point in many of the things I am doing. So, there you have it: my tips for choosing your oncologist. I hope the post gave you some things to think about. Do you have any additional tips? If so, please share them!
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