by Marisa Weiss, M.D.
After a breast cancer diagnosis, one of the most important decisions you’ll make is choosing your treatment team. To get the best care, you need a team that includes specialists such as a breast surgeon, a medical oncologist, a radiation oncologist, a plastic surgeon, and a genetic counselor.
The process of researching and meeting with doctors might seem overwhelming and intimidating at first. You may feel tempted to rush into decisions so you can start treatment as soon as possible. But keep in mind that in most cases, you can take the time you need to carefully select the doctors that are right for you.
Here are five things to consider when selecting each of the key members of your treatment team:
1. Do they communicate well?
It’s essential that your doctor explains things in a way you can understand, listens to you, and takes your concerns seriously. You want your doctor to be open to your questions and not to act dismissive or threatened when you bring up treatment options you’ve researched. Ask yourself: Does this person enjoy practicing medicine, or do they seem overworked or even burned out?
If possible, bring a trusted friend or family member along to one of your appointments to help you form an impression of the doctor. When you’re anxious or upset, it’s hard to catch everything the doctor is saying and to judge the interaction. A friend or family member can bring a fresh perspective.
Also, remember that it may take more than one appointment to get a feel for whether you communicate well with a doctor. Sometimes a doctor squeezes you in for a first appointment on a very busy day and winds up having more time to talk at the second appointment.
2. Do they have the right expertise?
Make sure your doctor has the right training and experience. For example, choose a surgeon and an oncologist who specialize in breast cancer rather than in treating several kinds of cancer.
Ask questions during your appointment to see if your doctor is knowledgeable about the latest research advances and treatment approaches that are relevant to your situation. For instance, it’s worth asking: Are there any new medical advances I should know about that could influence my choice of treatment? Are there any clinical trials that I may be able to participate in? You can prepare for this conversation by doing some research on your diagnosis and treatment options using resources such as Breastcancer.org. Consider printing out the sections of Breastcancer.org that address your concerns or the treatments you’re interested in and sharing them with your doctor. Bringing this information to your appointment may give you more confidence to have this important discussion.
And don’t be afraid to bring up treatment approaches that your doctor hasn’t already mentioned. Your doctor should be aware of relevant advances in medicine and able to provide you with up-to-date care. It’s also ok if your doctor says, “Let’s explore that option you mentioned together and see if it’s right for you.”
3. Is their office staff responsive?
Pay attention to whether the doctor’s office staff is helpful, accessible, and returns your calls. If setting up appointments and getting your questions answered is too frustrating, that might be a deal breaker. However, try talking with your doctor about any problems you may have with the staff before you switch practices. You might find out that new staff is being trained and the problems are likely to be temporary or that you have the option of contacting the doctor directly through email, cell, or pager.
4. Could you stick with them over the long-term?
Your doctor might be working with you extra closely for a number of years -- particularly if you have metastatic breast cancer, are taking hormonal therapy on a long-term basis, or if you have an inherited gene mutation that increases your risk of breast cancer. For this reason, it’s best to choose a doctor who is going to be in practice for a long time and isn’t close to retiring.
Whether you’re seeing a doctor for a shorter period of time or more long-term, it’s good to make sure that he or she respects your priorities and your approach to your care since you’ll be making decisions about your treatment together.
If you have metastatic breast cancer, you’ll also want to know that your doctor can help you access clinical trials and new treatments that become available over time.
5. Do you want to keep looking for another doctor?
Ultimately, your goal should be to get the best care -- that provides the greatest benefit with the least side effects -- right from the beginning of your treatment or moving forward from wherever you are now in your treatment.
Don’t hesitate to get a second opinion if you’re lacking confidence in a particular doctor’s treatment recommendations, expertise, or communication skills. Asking for opinions from other doctors can also help if you feel unsure that your diagnosis is correct or if you need more information to make decisions about your treatment.
In some cases, it might be worth switching doctors early on so you can feel comfortable with your care. You may also choose to switch doctors later on in your treatment because your needs change over time.
Finding the right doctors can be a challenge, but the rewards are worth it. When you work with doctors you can trust, reach, engage, and share decisions with, you’ll feel a lot better.