When seeking out a new doctor, there's still no substitute for the old-fashioned method of asking people you know and trustin the case of breast cancer, starting with your gynecologist, internist, family care physician, the radiologist who did your mammograms, and the nurses you've met along the way. Take it from a nurse of 15 years: "What other staff say about doctors is pretty important," says Georgette Williams, 44, of Elysburg, Pa., who was herself diagnosed with stage IIB breast cancer in September 2007.
Here's what else you should look for in a doctor:
Choose doctors with significant experience treating breast cancer. (This assumes, of course, that your geographical, financial, and insurance situations allow you to be choosy). Your physician should also ideally be a member of the American Society of Clinical Oncology (check out ASCO's excellent site for patients, Cancer.net) and in good standing with your local/state medical board or society. (There is no subspecialty within the field of medical oncology for board certification in breast oncology, however.) Your doctor should be on staff at a quality hospital accredited by the Joint Commission, though you don't necessarily need to be seen at a comprehensive cancer center to get excellent care and advice. (For a list of National Cancer Institute–designated cancer centers and comprehensive cancer centers, go to cancercenters.cancer.gov.)
You and your doctor don't need to be best friends, but if you don't get along, your care may sufferespecially if he or she doesn't listen to your concerns. Your doctor or doctors should also be open to your getting a second opinion; this is standard, not an insult.
Perhaps most important, you want a doctor whom you can count on to discuss your optionsincluding all the potential risks, benefits, and side effects of each course of treatment based on your diagnosis, preferences, health, age, and lifestyle. "A physician should take the time to really study the case, read the records, look at the films, review the pathology report, talk to the patient, and not be too rushed to figure out what the issues are," says Edward M. Wolin, MD, a medical oncologist at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center in Los Angeles. "It's a little bit of a red flag if someone says, 'You have breast cancer and my nurse will come in to teach you about chemotherapy,' and they go on to the next case. That would be scary."
Overall, while it's crucial to be able to communicate well with your doctor, there may be limits to the amounts of information you can absorb. "You can participate, but it shouldn't be your burden to evaluate every risk and treatment" that may be part of your care, says Julia A. Smith, MD, director of the NYU Cancer Institute's breast cancer screening and prevention program and director of the Lynne Cohen breast cancer preventive care program at NYU in New York City.
And, adds Dr. Smith, with a potentially life-threatening disease, "sometimes there is a choice [of treatments], but sometimes there isn't." For those cases, you want to be in the hands of a doctor you know you can trust and rely on to make the appropriate medical decisions.