Medical care is uneven. Even if hospitals offer the same treatment, by no means does this mean that this treatment is interchangeable. Do yourself a huge favor and do your due diligence: Make sure you are getting treatment at an excellent center, from an expert radiation oncologist and team.
Patient volume matters. First, says Johns Hopkins radiation oncologist Phuoc Tran, M.D., Ph.D., look at the numbers. (In fact, he recently co-authored an editorial on a study correlating patient volume with improved outcomes in radiation treatment for prostate cancer and other forms of cancer.) “Find out how many cases of prostate cancer they have managed,” he says. “The more, the better.” Ask how many patients with prostate cancer the center treats each day. Radiation therapy, done properly, is technically difficult; precision is essential. “For the most part, your best bet is to look for a high-volume center that treats a lot of men with prostate cancer – at least 30 to 40 patients a day – with IG-IMRT.”
How do you find a high-volume center? Here are two websites, one from the National Cancer Institute, http://www.cancer.gov/research/nci-role/cancer-centers/find and one from the National Comprehensive Cancer Network, https://www.nccn.org/patients/about/member_institutions/qualities.aspx
Look for a center where different specialties work together. The very best centers offer a multidisciplinary approach – this means that you get expert opinions from a pathologist, medical oncologist, radiation oncologist, and urologist. Adam Dicker, M.D., Ph.D., Chairman of Radiation Oncology at the Sidney Kimmel Cancer Center at Thomas Jefferson University, describes it this way: “We’ve been doing this for over 20 years; the patient stays in the same room, and doctors from different disciplines go in and out. We think that provides the ultimate service to a patient.” This teamwork promotes a more thoughtful and thorough approach to treatment decision-making.
Ask your doctor about his or her success rate. The best cancer doctors, in any specialty, follow their patients for many years. How many patients have remained cancer-free? What percentage have had long-term side effects?
Ask to talk to some patients. Many doctors have a list of their patients who are willing to talk to other patients and share their experiences. If your doctor doesn’t provide such a list, look for prostate cancer support groups and talk to men who have undergone radiation therapy from this doctor.
Keep your antennae up. It should raise a red flag, says Tran, if your doctor seems hesitant for you to get a second opinion, or “seems overly concerned with getting you to start treatment fairly quickly without addressing all your concerns.” Remember, your cancer took years to grow. You can afford to take a few weeks to find the right doctor to treat it. Also, be leery if a doctor is pushing a specific treatment; it may be that the hospital just spent millions on a new machine and needs to pay for it.
Don’t trust reviews on the internet. They are unreliable, in large part because it’s not clear exactly who is writing them.
Don’t trust hype, either. Hospital websites and ads can promise a lot of things. Whether they can actually deliver them is a different matter.