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Expert Q&A: Getting the Best Breast Cancer Treatment

An interview with Duke University Surgeon Lee Gravatt Wilke, MD

Q: I’m overwhelmed with all the information I’m getting about my cancer and possible treatments. How do I remember it all?

Many of my patients bring either a family member or friend to act as a second set of ears or to write everything down. If a patient doesn’t have someone with them, bringing a tape recorder is not a bad idea. And a patient can ask the doctor to write down key points, if they aren’t doing this already.

Q: Should I join a cancer support group?

That depends. If a patient feels it would be beneficial, then support groups are great. But I have patients who have actually been made to feel guilty because they don't want to join one. People who aren’t particularly social to begin with aren’t going to become social after learning they have cancer. These patients may be more comfortable gathering the information they need and digesting it on their own.

Q: How do I find the right doctor or treatment center for me?

Again, if you don’t feel comfortable with the doctor you are referred to, get a second opinion. The Commission on Cancer is a good place to go for information on top surgical centers. A joint consortium of health organizations including the American College of Surgeons and the American Cancer Society, the Commission has accredited more than 1,400 cancer programs in the U.S. and Puerto Rico.

Q: When should I consider traveling for treatment?

That’s a tough one. If there are complexities with the cancer, such as a strong family history or a large tumor, a patient may want to consider traveling if they don’t live near a treatment center that has been accredited by the Commission on Cancer (CoC). The National Cancer Institute also designates cancer centers and comprehensive cancer centers of excellence. A list of these centers can be found on the NCI web site.

Q: When should I consider a clinical trial?

The only way we are going to identify the best and most effective therapies is with clinical trials, so it is important to consider joining one. Usually a hospital’s web site will list the trials that are available. Another good source is the clinical trials web site of the National Institutes of Health.

Certainly, the majority of women with metastatic disease are entered into clinical trials. And many women who are candidates for neoadjuvant therapy, which may include either chemotherapy or endocrine therapy prior to surgery, are placed in clinical trials.

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