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tinalove (@tinalove)

Concerned about the side effects of anastrozole

Breast Cancer | Last Active: Aug 1 10:50am | Replies (1725)

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my first suggestion is to read about the new specialist; their bio, anything that they have published, etc. My second suggestion is to ask friends, co workers, neighbors, support group members who have had breast cancer for their experiences with area specialists. That has been extremely helpful for me. Finally, I would ask the current doctor about the specialist – how they know the doctor, what their working relationship is, how many patients they have sent on to that doctor, etc. If you are working with a nurse navigator, ask that person as well.
Best of luck – I was fortunate to be referred to an amazing doctor for a second opinion.

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Replies to "my first suggestion is to read about the new specialist; their bio, anything that they have..."

@oilermama @colleenyoung A few thoughts about opinions and breast cancer.

When I first got the news about the possibility of breast cancer (immediately following a mammogram from the lab's radiologist), I was in shock. Following the succeeding core biopsy (where the Nottingham and FISH histologic grade scores disagreed…), I went directly to my GP who had several recommendations on surgeons and oncologists (translation: doctors who had good reputations). It took another month to get an appointment with the breast cancer surgeon I chose… another several weeks to get on her surgical schedule… another ten days to get on the schedule of the tumor board (a group of cancer specialists) which she had convened.

With the tumor board report in hand (saying radiation and AI is all that was needed for Stage 1, ER+, HER2+, Grade 2), I called one of the recommended oncologists (another 3 weeks to get on her schedule) who disagreed with the tumor board report and insisted that I begin with 12 weeks of chemo and 12 months of Herceptin infusions, followed by radiation at the conclusion of the chemo part and an AI. She gave me ten days to decide what I was going to do. Back to the surgeon for her recommendation on a second opinion oncologist who saw me two days before my decision was due. The whole time, my head is swimming. The second oncologist agreed with the first one on complying with those treatment standards because of my HER2 status… the first oncologist said it was due to the Grade 2 status of the tumor.

During chemo, a second radiology oncologist disagreed with the first radiology oncologist on whether radiation was recommended at my age.

In the meantime, I'm reading how the British National Health System had decided that 9 weeks of Herceptin infusions were as effective as the 12 months of infusions (recommended by the oncologist), resulting in fewer cardiac effects and lower costs. My oncologist disagreed. I stopped the Herceptin (concurrent with chemo) after the recommended 3 months of chemo. My surgeon agreed with my decision, my oncologist did not. Four months later, the American Society of Oncologists declared that six months of Herceptin is as effective as 12 months. My oncologist continues to opine that this group's conclusion does not comply with the established treatment standards….

Cancer is a harrowing swamp of opinions (locally, regionally, nationally, and internationally). I live in the San Francisco Bay Area with access to plenty of top-rated hospitals and physicians, and yet, in the end, YOU have to pick your way through the alligators… YOU have to decide between all the varying opinions and in a short period of time (and last I looked, I don't have a medical degree). I recently read that some researchers now believe that breast cancer is caused by a bacteria…? that recurrence increases once AI treatment ends? … on and on. The science of it all will continue to evolve and the physicians will continue to rely on treatment standards and be behind the curve as they wait for long-term trials to play out. In the meantime, breast cancer is effecting 1 in 7 women and, according to my surgeon, is predicted to effect 1 in 4 within 15-20 years… and each woman basically is on her own in her fight for survival.