In the immediate aftermath of hearing that you have breast cancer, you may find it is difficult to think clearly and make the choices that will influence the rest of your treatment. You may be completely satisfied with the doctor or hospital where you heard the diagnosis, or you may wish to consider other possibilities. There are a few things to remember in your selection of a treatment center. While it is usually easiest to have all your care coordinated in one facility, it is also possible to have different parts of your treatment at different places. You should consider carefully both the need for the best care you can get and the logistics of your life as you move through the months of active treatment.
This period is the very hardest time emotionally. You will feel better after all the medical information has been gathered, after you have met with all of your doctors, and after the treatment decisions have been made. If you are managing to get through your day now, you are doing fine, and you can count on feeling stronger, saner, and less out of control in the future.
Do take someone with you to all of your consultations. You will not remember most of what is said to you, and your companion’s ears and memory will be extremely valuable. Prepare ahead! Take written questions with you and have your companion take notes during the consultation. Some doctors are glad to have you tape your meeting; some object to this practice.
In our system of health care, some decisions will likely be made for you based on your medical insurance. Most policies, especially most managed care plans, limit the number of doctors you can see. They may also limit their coverage to doctors who are on their list of approved specialists. If there is a specialist in your area whom you especially want to consult and who is not covered under your plan, it is worth a call to ask if a special referral/exception may be made for a second opinion visit. If the answer is no, it might still be worth it to you to pay out of pocket for a single visit. If you decide to do so, inquire at the physician’s office whether there are ways to minimize the bill. For example, you can avoid having any blood work or other laboratory tests done there; if those results are part of the consultation, they can always be sent to the specialist from your usual health care provider at a later date.
After talking with your doctors, you may decide that you want to get a second opinion. Most insurance companies will pay for this. Occasionally it even makes sense to seek a third opinion; this situation would most likely arise if each of two physicians recommends a different course of treatment and you wish to find a “tiebreaker.” In any case, you should prepare yourself both mentally and emotionally to become actively involved in the process of choosing your treatment.
Cancer care is delivered in several different kinds of settings, and you may feel more comfortable in one than in the others. With the exception of certain clinical trials, which are available only at participating cancer programs, you can receive the same treatment at each place, and your decision may be based on other factors.
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