One Stop Shopping: The Benefits of Care at a Comprehensive Cancer Center
There are two types of centers that treat cancer: community cancer centers, and comprehensive cancer centers. I recently had an experience that made it clear to me that if you can get yourself to a comprehensive cancer center, you will likely find that the additional travel and related expenses are worth it.
I began care at a community cancer center, the Richard E. Winter Cancer Center in Ogdensburg, NY. I love this center and my doctor there, and continue to have a relationship with it - that’s where I get my bi-monthly Xgeva shot. Community cancer centers are necessary and valuable, especially for standardized treatments, but they offer little access to clinical trials and highly specialized services. I need my local center, because if I need a standard chemo treatment, it’s crazy for me to travel 5 hours one-way for the same treatment I can have only an hour from home. My doctor there is very sharp and good at seeing me and my situation holistically, but she is a general oncologist treating all kinds of cancers, and there is no way that she can keep up with the literature for my particular type of cancer, especially when it’s one where there have been a lot of discoveries and new treatments over the past few years.
Once I decided to enter a clinical trial, that meant going to a comprehensive cancer center, because that’s where the trials generally are. I’m fortunate that there is a center “only” 5 hours from my home, Roswell Park Cancer Institute in Buffalo, NY. Logistically this is relatively easy for me, because I have family nearby in Rochester. We stay at my mother’s, and it’s a win-win - access to a top institution and more time with my mom.
What are the advantages of a comprehensive center besides access to clinical trials? I see a lung cancer specialist rather than a general oncologist, and she is completely up to date in her knowledge about new developments in research and treatment. All of the other staff in the thoracic center, nurses and mid-level practitioners, are very experienced with lung cancer patients and know what questions to ask. The CT scan reports are better, because the radiologists are also specialists.
I recently had a clinic experience that brought home another advantage: just about everything I need is accessible in one facility, and all of the departments work together to take care of patients with needs. I showed up at the clinic two weeks into my new prescription of Tagrisso, and I had a number of side effects that could have been signs of something serious. I had a nasty looking red rash on my legs and some edema, which could indicate that the drug was affecting my heart. I was also already scheduled for a MRI of my brain because I had had a pesky headache for a few weeks. When I saw my doctor in the morning, she issued orders and what was supposed to be a leisurely day became a busy one. By the end of the day, I had received: a full round of blood work, a doctor visit, EKGs, a trip to the dermatology department where the rash was biopsied, an echocardiogram, a brain MRI, and a follow-up with my doctor. Besides being able to get everything I needed in one place in one day, everyone everywhere was kind, calm, and professional, never indicating that squeezing me into their day caused inconvenience.
By the way, the echocardiogram was probably the most interesting test I’ve ever had. The technician was a very warm and friendly woman, and she enjoyed showing me my heart in action, saying things like, “And here is the miracle of all four ventricles visible at once!”
By the time I left, I had good indications that my heart is not being affected by the Tagrisso. Whew! A call the next day let me know that my brain is free of metastasis, and the dermatologist called the next week to say no big problems were found in the skin biopsy.
While I continue my relationship with my community cancer center, I cannot imagine discontinuing travel to Roswell Park now that the clinical trial is over for me.
Here is a map of institutions that are members of the National Comprehensive Cancer Network (NCCN). Source: http://www.nccn.org/members/network.aspx