Questions...

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Hi TC,

Happy twenty ten. I hope this is a better year for you.

My daughter has been diagnosed with breast cancer. I wonder if you can share information you feel may be helpful for her.

The preliminary report was that it is the most common type of breast cancer they see (whatever that means) and she was told it was encapsulated. She is able to see her test results on-line, and said she saw that it was the aggressive type. She hasn't seen the surgeon yet, so this is all I know to date. BTW, she is 44 years old. Anything you can share will be greatly appreciated.

Thanks in advance.


Response (I am not so arrogant as to believe I have any answers):

First, I am so sorry that you are being so touched by b.c. It sounds like it is ductal carcinoma. She needs to research, research, research! She should not make any decisions from a position of fear (or emotionally bullying) by the medical professionals. Cancer is typically indolent, and if it has been detected in an early stage she need not feel pressured to opt for any course of action immediately before she fully explores all of her options.

My own cancer is Invasive Lobular Carcinoma -- less common, but generally: DCIS is encapsulated within the milk ducts and there are different types - Comedo happens to be the more aggressive type in that of the types of DCIS - it would spread more quickly than the other types. Having said that it is a very early form of breast cancer, and is still classified as stage -0-.

She should pay the $500 and have her diagnostic records sent to Dr. Michael Lagios in the Bay Area. I know she is out-of-state, but he does phone consults. He will go over her diagnosis and fully advise her as to a course of action, in addition to re-evaluating her diagnosis. I found Lagios to be informed, sensitive, a “non-cookie cutter" doc who was integral in my own research and exploration.



Breast Cancer Consultation Service
Michael D. Lagios, M.D. • (415) 789-0965 http://www.breastcancerconsultdr.com/ - The Breast Cancer Consultation Service.

A Little Further Down the Rabbit Hole (or am I now tripping down the Yellow Brick Road???): PART I

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After my last free fall with the radiation onc (refer back to September 24, 2009) I decided to follow her advice. I went forward in pursuit of the 3rd and 4th consults. Heck, why not? I think I am turning into a med-pro junkie. My tete-a-tetes with the med pros have opened my eyes in so many ways that I just can't get enough of them. I just need to know what they will say and do (or not do) next.

So off I went.

The first adventure began with trying to get the appointment with the first recommended 3rd medical onc. Radio onc encouraged me to meet with the famous Dr. Jeffrey Isaacs, because "he has a brilliant mind." I recalled the name - he had been referred to me by a medical malpractice attorney friend. I had actually called his office during my initial investigations, and was told that he would not see new patients prior to surgery. Consequently, I had drawn a line through his name back in July.

Radio onc warned me about Isaacs' front office staff's personality deficits. (Yes, I begin recalling a prior surly encounter.) She advised me to "smile and nod" because meeting with him was so worth the frustration..."He's got a brilliant mind for tough cases!" And she assured me that her personal nurse would help get me an appointment. Yeah right! I don't think I had ever seen a 50-something, salt n' peppered lady roll her eyes until then.

To that "instruction" radio onc's personal nurse sighed heavily and said, "you call first and see what you can do, if you can't get an appointment let me know." Thanks personal nurse, Beverly.

But, I was intrigued (not by the eye-rolling, mind you). So I called Dr. Isaacs office, again. . . .

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"Have you consulted with, been seen by, or started treatment with any other oncologist?"

Umm, I tried to consult with Dr. Isaacs previously, but I could not get an appointment pre-surgery.
"Have you consulted with, been seen by, or started treatment with any other oncologist?"

Umm, I have been meeting with another oncologist, but I am not pursuing treatment with him. My radiation onc...[insert name]...highly encouraged me to discuss my case with Dr. Isaacs.

"Dr. Isaacs will not meet with anyone who has consulted with or has been seen by any other oncologist."

But, radio onc is the one who referred me to Dr. Isaacs. You see, I have this high-risk complex situation.

"Honey (oh you so did not just say that?), you and everyone else. Dr. Issacs is a very busy and sought after specialist. He only sees new patients that have not consulted with, been seen by or started treatment with any other oncologist. He is selective." (Who anointed this guy the "Great Oz"?)

Oh, then why would radio onc insist I meet with him?

HUGE SIGH...SILENCE..."Ask radio onc to fax over your file. Dr. Isaacs will review it and will determine whether or not he will meet with you."

TIGHTLY GRIPPING THE COFFEE COUNTER...Thank you, may I have the fax number?

"Radio onc's office will have it. The records must come from her office. Someone will call you in a couple of days with Dr. Isaac's decision." ~CLICK~

Beverly? T.C., I just had an interesting conversation with Dr. Isaac's office...blah...blah...blah

"So, you are asking me to fax over your records?"

At the least. Do you think you can call, as radio onc offered previously? See if you have better luck?

"They asked that the records be faxed?"

Yes...
"So you are asking me to fax the records over?"

Umm, yes, but would you also call?

"They asked for the records, I can fax the records if that is what you are asking of me."

MY KNUCKLES HAVE LOST ALL BLOOD FLOW AT THIS POINT.... If that is all you will do to assist me, then yes, Beverly, do fax the records.

"I will fax them shortly." ~CLICK~

If I had not been in a public coffee house I think I would have had my second cry since this odyssey began.

Dr. Isaacs' office did call -- four hours later. The Great Oz deigned to offer me an audience. Yipee Skipee!

"Make sure you bring a CD of your PetScan. He will look at films too, but prefers a CD."

Of course he does . . .

. . . .to be continued