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Heather Shaff's avatar

Excellent, measured advice, thank you!

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RJ's avatar

Thank you for this.

I obtained more than one opinion in addition to the initial opinion. I actually obtained 7 opinions. Although all agreed on the recommended chemo, there were other issues that were important in my selection: yes or no radiation after chemo, field radiation or image guided radiation, comfort with radiation oncologist and medical oncologist, consider other major medical diagnoses in dosing chemo or not, continue working as physician or close my practice, general comfort with the doctor and office staff, how the office responds to patient calls and needs, how the doctors respond to my questions, will I be seen by my physician oncologist or by lesser trained mid level providers. I was surprised at the complexity of this set of choices.

In the end, I was able to choose a pair of oncologists (medical and radiation) at a local hospital, I thought my care was very good, and I have never regretted getting more opinions. It gave me peace of mind that, regardless of outcome, I had the right care for my situation.

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Jane's avatar

Wish I’d read this before I had treatment. I was so blindsided I just went with the flow. After treatment I had a second opinion and was informed that I had probably been over treated but iv just put it behind me. I guess I never would have been interested in reading a Substack article on cancer - The irony !

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Daniel Flora, MD, PharmD's avatar

I’m sure you’re not alone. Hopefully we can guide others in the right direction.

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Kendra Rubin's avatar

Important information! Thank you for sharing. What is a molecular profiling report?

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Daniel Flora, MD, PharmD's avatar

During the diagnosis and workup for many cancers, we are now testing for specific mutations within the cancer that could help with designing a treatment plan. This is sometimes referred to as next generation sequencing (NGS) or molecular profiling. Many advanced cancers can benefit from this type of testing.

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May 22
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Daniel Flora, MD, PharmD's avatar

Not that I am aware of. He supports the Mesoamerica Health Initiative which does a lot of cervical cancer screening programs in Honduras. His Foundation is involved in a lot of startups using DNA sequencing technology.

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May 22
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Daniel Flora, MD, PharmD's avatar

That’s the hope. We are using genetically engineered T-cells already to help treat certain types of lymphoma. This is called “off the shelf” CAR-T.

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