By T.J. Sharpe, Melanoma survivor, Blogger & Cancer Advocate
One of the most difficult things for a cancer patient is making the final decision on a treatment team and plan. Selecting an oncologist isn’t like popping open your smart phone and pulling up an app to choose a trendy dinner spot. There are no US News-type rankings for individual oncologists; their “Best Hospitals” list is a good place to start for vetting cancer centers, but much like college rankings, its better used as a guide rather than an infallible hierarchical order. Choosing the right care, like the right college or right café, is an art that requires balance between treatment options, patient objectives, and personal preferences.
Many patients’ initial reactions to a diagnosis are similar – they may feel inclined to do what their first doctor says is the best course of action.1 While the suggested treatment MAY end up being the right one for you, it does no harm to verify that recommendation. Getting a second opinion can give added perspective and may provide potential alternate treatment options or plans. A good doctor will not be upset or “offended” if you seek the professional opinion of one of his or her colleagues; people get multiple quotes for auto insurance, refrigerator repair, or legal advice all the time. Why wouldn’t we do the same due diligence for our health care decisions?
Let’s be clear – the decision for treatment is (except for rare, imminently life-threatening cases, or when the patient is incapacitated) yours and yours alone. Doctors, even the top oncologists in the world, are at their core extremely smart professionals who are providing you with extremely important advice and service. That being said, as the patient you need to make the choice that you feel the most comfortable with.
During my initial diagnosis, I got the opinion of the very first oncologist I saw – a general oncologist, not a melanoma specialist. Unaware that melanoma was at the forefront of the immunotherapy wave taking off, he recommended standard of care chemotherapy, complete with its abysmal Stage IV survival rates.2 Had I taken his advice, I think there’s a strong chance I would not be alive today.
I met with a second doctor, regarded as one of the top oncologists in South Florida. He gave me several options, but ultimately suggested I see one of his colleagues across the state, explaining that they would have more treatment options, including clinical trials. THIS is the type of oncologist you want advising you. We ended up deciding to do my first trial with the doctor that was suggested to us for several reasons, but I would not hesitate to return to the local doctor for a consult or treatment. He had my best interest at heart AND helped us navigate the potential options.
The difference in care is striking, but there is no ill will towards that first oncologist. He was simply not in a place to know what was careening around the corner in the world of new treatment options. Fortunately, I was able to do my own research, and with the assistance of one of the melanoma advocacy groups, found not one but two clinical trials that have given me a second chance at life.
Making an informed choice can only happen when a patient and their team are aware of the options and have a clear goal in mind. Some, like me, wanted to recapture a significant part of life expectancy. Some people have different goals, like our family friend Bobbe, who wanted to have quality in her remaining years to enjoy watching her grandson grow up. Some, like those with a terminal diagnosis, may look for the option that can give them enough time to experience a life milestone – the birth of a child, a wedding, or their high school prom.
Each patient, each situation, each cancer is unique. Finding the treatment options and choosing the path that is right ultimately rests squarely on the shoulders of the patient, with the support of their loved ones and treatment team. Know what your options are. Understand each treatment’s possible outcomes. Make the choice you are most comfortable with.
This is the fourth installment in a series of blog posts authored by patient and advocate T.J. Sharpe for NovartisOncology.com. Be sure to check back regularly for new installments in this series by T.J. Sharpe. Learn more about T.J.’s story here.
*T.J. Sharpe is not a medical professional, but a patient currently undergoing care for advanced melanoma. He is being compensated by Novartis Oncology for sharing his story. All opinions are his own. Any and all information, tips, advice, etc. included throughout his series of blogs stem from his own personal experience as a patient. Patients should always consult their doctors when seeking medical advice.