› Forums › General Melanoma Community › Surgical Oncologist vs. Colorectal Surgeon
- This topic has 21 replies, 6 voices, and was last updated 9 years, 5 months ago by
jennunicorn.
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- September 25, 2016 at 5:51 pm
I was wondering if anyone could give us advice as to whether to have a surgical oncologist or colorectal surgeon perform my mother's surgery. She will most likely need an APR resection and inguinal lymph node removal. We have an appointment with a colorectal surgeon (who has great credentials and used to be chief of surgery) this Tuesday, September 27, but we cannot meet with a surgical oncologist until October 4 (he has a packed schedule because he is in demand).
Because we are currently inclined to take the earliest surgery possible, does anyone have any insight as to whether we should hold out for the surgical oncologist or vice versa?
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- September 25, 2016 at 7:43 pm
Hi Cindy,
I doubt I am qualified to answer your question definitively, but I would suggest to take a good look at Jenn's (jenniunicorn) response in your prior thread. She nailed what everyone on this board can see. Your current doctors are in way over their head on this one, and you need to take control of your Mom's care and get her out of the Kaiser system if need be. The fact they are not treating her pain, when the opioid side-effects can generally be managed effectively amounts to cruel and unusual punishment. They are operating like a socialized medicine state who would prefer patients die, than support expensive treatments. (sorry but this just really ticks me off). I would suggest waiting the extra week if it means better care, and remember a surgeon sees all solutions through surgery, whereas a melanoma specialist will consider a wide range of options. Best to you and Mom in the battle.
Gary
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- September 25, 2016 at 7:43 pm
Hi Cindy,
I doubt I am qualified to answer your question definitively, but I would suggest to take a good look at Jenn's (jenniunicorn) response in your prior thread. She nailed what everyone on this board can see. Your current doctors are in way over their head on this one, and you need to take control of your Mom's care and get her out of the Kaiser system if need be. The fact they are not treating her pain, when the opioid side-effects can generally be managed effectively amounts to cruel and unusual punishment. They are operating like a socialized medicine state who would prefer patients die, than support expensive treatments. (sorry but this just really ticks me off). I would suggest waiting the extra week if it means better care, and remember a surgeon sees all solutions through surgery, whereas a melanoma specialist will consider a wide range of options. Best to you and Mom in the battle.
Gary
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- September 25, 2016 at 7:43 pm
Hi Cindy,
I doubt I am qualified to answer your question definitively, but I would suggest to take a good look at Jenn's (jenniunicorn) response in your prior thread. She nailed what everyone on this board can see. Your current doctors are in way over their head on this one, and you need to take control of your Mom's care and get her out of the Kaiser system if need be. The fact they are not treating her pain, when the opioid side-effects can generally be managed effectively amounts to cruel and unusual punishment. They are operating like a socialized medicine state who would prefer patients die, than support expensive treatments. (sorry but this just really ticks me off). I would suggest waiting the extra week if it means better care, and remember a surgeon sees all solutions through surgery, whereas a melanoma specialist will consider a wide range of options. Best to you and Mom in the battle.
Gary
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- September 25, 2016 at 10:07 pm
Hi Cindy,
I had a colorectal surgeon and a melanoma specialist plastic surgeon do my combined inguinal and pelvic node clearance. I believe this kind of combination of expertise id not uncommon in the specialist melanoma centres. I was also considered for radiation post surgery but was advised this was not appropriate as the 3cm tumour in my lymph node was still encapsulated.
The pelvic surgery was endoscopic, the inguinal clearance was an open surgery. Only the 3cmtumour was detected on the pet scan but a further positive node not microscopic was found in my pelvis.
The experienced melanoma teams often have multi disciplinary discussions and may consider systemic targeted or surgical treatments or a combination of the above with or without radiation.
I did swap from the local specialist centre to a regional centre of excellence who conducts clinical research and is on tnbe cutting edge of deve!opments. The swap meant my surgery was 11 days later than the first centre had offered but am absolutely convinced that the delay was not to my detriment overall as the clinical judgements and surgical skills of the new team were much superior.
Hope this helps. In the UK we can buy stools of softeners over the counter at the pharmacy.
Docusate / dulcolax or similar might be useful plus drinking lots of water..
Your choices re surgery may not be as binary it first appears. A specialist centre might also advise immunotherapy prior to surgery as a fast response may make things easier for both you mum and the surgeon.
These are dark difficult days but it will get easier when you are convinced the med team are giving the best possible advice.
All the best
Deb
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- September 25, 2016 at 10:07 pm
Hi Cindy,
I had a colorectal surgeon and a melanoma specialist plastic surgeon do my combined inguinal and pelvic node clearance. I believe this kind of combination of expertise id not uncommon in the specialist melanoma centres. I was also considered for radiation post surgery but was advised this was not appropriate as the 3cm tumour in my lymph node was still encapsulated.
The pelvic surgery was endoscopic, the inguinal clearance was an open surgery. Only the 3cmtumour was detected on the pet scan but a further positive node not microscopic was found in my pelvis.
The experienced melanoma teams often have multi disciplinary discussions and may consider systemic targeted or surgical treatments or a combination of the above with or without radiation.
I did swap from the local specialist centre to a regional centre of excellence who conducts clinical research and is on tnbe cutting edge of deve!opments. The swap meant my surgery was 11 days later than the first centre had offered but am absolutely convinced that the delay was not to my detriment overall as the clinical judgements and surgical skills of the new team were much superior.
Hope this helps. In the UK we can buy stools of softeners over the counter at the pharmacy.
Docusate / dulcolax or similar might be useful plus drinking lots of water..
Your choices re surgery may not be as binary it first appears. A specialist centre might also advise immunotherapy prior to surgery as a fast response may make things easier for both you mum and the surgeon.
These are dark difficult days but it will get easier when you are convinced the med team are giving the best possible advice.
All the best
Deb
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- September 25, 2016 at 10:07 pm
Hi Cindy,
I had a colorectal surgeon and a melanoma specialist plastic surgeon do my combined inguinal and pelvic node clearance. I believe this kind of combination of expertise id not uncommon in the specialist melanoma centres. I was also considered for radiation post surgery but was advised this was not appropriate as the 3cm tumour in my lymph node was still encapsulated.
The pelvic surgery was endoscopic, the inguinal clearance was an open surgery. Only the 3cmtumour was detected on the pet scan but a further positive node not microscopic was found in my pelvis.
The experienced melanoma teams often have multi disciplinary discussions and may consider systemic targeted or surgical treatments or a combination of the above with or without radiation.
I did swap from the local specialist centre to a regional centre of excellence who conducts clinical research and is on tnbe cutting edge of deve!opments. The swap meant my surgery was 11 days later than the first centre had offered but am absolutely convinced that the delay was not to my detriment overall as the clinical judgements and surgical skills of the new team were much superior.
Hope this helps. In the UK we can buy stools of softeners over the counter at the pharmacy.
Docusate / dulcolax or similar might be useful plus drinking lots of water..
Your choices re surgery may not be as binary it first appears. A specialist centre might also advise immunotherapy prior to surgery as a fast response may make things easier for both you mum and the surgeon.
These are dark difficult days but it will get easier when you are convinced the med team are giving the best possible advice.
All the best
Deb
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- September 26, 2016 at 2:40 am
Cindy,
Is there a way that your mom can switch insurances? We are coming up on open season and I believe it would definitely be worth it to get her out of the Kaiser system so that she could avail herself of the Melanoma Centers of Excellence.
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- September 26, 2016 at 2:40 am
Cindy,
Is there a way that your mom can switch insurances? We are coming up on open season and I believe it would definitely be worth it to get her out of the Kaiser system so that she could avail herself of the Melanoma Centers of Excellence.
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- September 26, 2016 at 2:40 am
Cindy,
Is there a way that your mom can switch insurances? We are coming up on open season and I believe it would definitely be worth it to get her out of the Kaiser system so that she could avail herself of the Melanoma Centers of Excellence.
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- September 26, 2016 at 3:10 am
Hi Cindy,
Is the colorectal surgeon on the melanoma team? Your mom's case is very rare so maybe this hospital hasn't treated many in her condition before, and that's probably who you want to get her in front of – a surgeon who has successfully treated anal melanoma. Plus her tumor is particularly large so you really want someone very skilled at colorectal cancers. Bigger cancer centers are likely your best bet, if at all possible.
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- September 26, 2016 at 3:10 am
Hi Cindy,
Is the colorectal surgeon on the melanoma team? Your mom's case is very rare so maybe this hospital hasn't treated many in her condition before, and that's probably who you want to get her in front of – a surgeon who has successfully treated anal melanoma. Plus her tumor is particularly large so you really want someone very skilled at colorectal cancers. Bigger cancer centers are likely your best bet, if at all possible.
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- September 26, 2016 at 3:10 am
Hi Cindy,
Is the colorectal surgeon on the melanoma team? Your mom's case is very rare so maybe this hospital hasn't treated many in her condition before, and that's probably who you want to get her in front of – a surgeon who has successfully treated anal melanoma. Plus her tumor is particularly large so you really want someone very skilled at colorectal cancers. Bigger cancer centers are likely your best bet, if at all possible.
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- September 26, 2016 at 3:17 am
If you let us know what area you're in, we can chime in to give great suggestions for a melanoma specialist near you. Your mom needs this, there's just no other way to get the best care. I wish Kaiser had that ability, they just don't, and come November when it's time to switch insurance, I highly suggest your mom switch to a PPO like I did, I was exhausted with the couple of months of fighting with Kaiser after my diagnosis and am so much more relaxed and reassured knowing I have nothing but the best doctors and minds when it comes to my care.
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- September 26, 2016 at 3:17 am
If you let us know what area you're in, we can chime in to give great suggestions for a melanoma specialist near you. Your mom needs this, there's just no other way to get the best care. I wish Kaiser had that ability, they just don't, and come November when it's time to switch insurance, I highly suggest your mom switch to a PPO like I did, I was exhausted with the couple of months of fighting with Kaiser after my diagnosis and am so much more relaxed and reassured knowing I have nothing but the best doctors and minds when it comes to my care.
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- September 26, 2016 at 3:17 am
If you let us know what area you're in, we can chime in to give great suggestions for a melanoma specialist near you. Your mom needs this, there's just no other way to get the best care. I wish Kaiser had that ability, they just don't, and come November when it's time to switch insurance, I highly suggest your mom switch to a PPO like I did, I was exhausted with the couple of months of fighting with Kaiser after my diagnosis and am so much more relaxed and reassured knowing I have nothing but the best doctors and minds when it comes to my care.
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- September 26, 2016 at 6:39 am
We are based in Orange County CA, but willing to take her anywhere in Southern California for treatment. It's currently open enrollment at her work, but the new coverage would not kick in until January. We are looking into secondary insurance options as well, if anyone has any information about that. We have been in the process of trying to get Kaiser to allow us to go out of network for a second opinion since last week, but I'm not sure if that will go anywhere. To the best of my current knowledge, Kaiser does not have a melanoma team in Orange County. I just found out that Kaiser has a melanoma center in Los Angeles and another in Riverside, and it baffles me that nobody mentioned this to us sooner.
Unfortunately, we are afraid of putting my mom's surgery on hold with all further administrative delays. Because we want to get the surgery as soon as possible due to the size of the mass and the potential of spread to other parts of the body, we may be forced to do the surgery through Kaiser for now and start treatment until January when the PPO kicks in and we can switch to a specialist.
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- September 26, 2016 at 4:07 pm
I've heard others on here mention UCLA and some great melanoma specialists there, so that may be one of the best options for a specialist in the SoCal area.
I would recommend writing a formal letter to all of your mom's doctors and to whoever is the head of that Kaiser stating that your mom's case is in need of a specialist in melanoma that has dealt with mucosal melanoma specifically and needs an authorization for a second opinion outside of Kaiser. A family member of mine wrote a couple of these types of letters to my Kaiser doctors before they gave in and let me see a specialist at UCSF. I hate that Kaiser is such a pain in the you know what about things like this. I very muched liked them for 10 years I had them…. when I was healthy! The minute I had a serious problem, it was like they could care less and moved like molasses. Very frusterating.
I had my WLE and SLNB surgery at Kaiser and even had my first 2 infusions of Yervoy (that's the treatment I am on) at Kaiser, because my new insurance did not kick in until January. But, I was still able to see the UCSF oncologist and had the Kaiser oncologist correspond with the UCSF oncologist to make sure everyone was on the same page for the time that I had to still go to Kaiser. Now I only go to UCSF and I am so glad I am done with Kaiser.
Your mom's surgery is more complicated than what I had done… but, I do know that Kaiser has some great surgeons. A lot of their surgeons, at least ones up in NorCal, trained at excellent schools such as Stanford and UCSF. It's likely similar down there, and you can research on the Kaiser website for a surgeon that will be the best fit for your mom. Wish these things were easier and didn't require so much of the patient and patient's family's time and energy just to get the best care.
Keeping you and your mom in my thoughts.
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- September 26, 2016 at 4:07 pm
I've heard others on here mention UCLA and some great melanoma specialists there, so that may be one of the best options for a specialist in the SoCal area.
I would recommend writing a formal letter to all of your mom's doctors and to whoever is the head of that Kaiser stating that your mom's case is in need of a specialist in melanoma that has dealt with mucosal melanoma specifically and needs an authorization for a second opinion outside of Kaiser. A family member of mine wrote a couple of these types of letters to my Kaiser doctors before they gave in and let me see a specialist at UCSF. I hate that Kaiser is such a pain in the you know what about things like this. I very muched liked them for 10 years I had them…. when I was healthy! The minute I had a serious problem, it was like they could care less and moved like molasses. Very frusterating.
I had my WLE and SLNB surgery at Kaiser and even had my first 2 infusions of Yervoy (that's the treatment I am on) at Kaiser, because my new insurance did not kick in until January. But, I was still able to see the UCSF oncologist and had the Kaiser oncologist correspond with the UCSF oncologist to make sure everyone was on the same page for the time that I had to still go to Kaiser. Now I only go to UCSF and I am so glad I am done with Kaiser.
Your mom's surgery is more complicated than what I had done… but, I do know that Kaiser has some great surgeons. A lot of their surgeons, at least ones up in NorCal, trained at excellent schools such as Stanford and UCSF. It's likely similar down there, and you can research on the Kaiser website for a surgeon that will be the best fit for your mom. Wish these things were easier and didn't require so much of the patient and patient's family's time and energy just to get the best care.
Keeping you and your mom in my thoughts.
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- September 26, 2016 at 4:07 pm
I've heard others on here mention UCLA and some great melanoma specialists there, so that may be one of the best options for a specialist in the SoCal area.
I would recommend writing a formal letter to all of your mom's doctors and to whoever is the head of that Kaiser stating that your mom's case is in need of a specialist in melanoma that has dealt with mucosal melanoma specifically and needs an authorization for a second opinion outside of Kaiser. A family member of mine wrote a couple of these types of letters to my Kaiser doctors before they gave in and let me see a specialist at UCSF. I hate that Kaiser is such a pain in the you know what about things like this. I very muched liked them for 10 years I had them…. when I was healthy! The minute I had a serious problem, it was like they could care less and moved like molasses. Very frusterating.
I had my WLE and SLNB surgery at Kaiser and even had my first 2 infusions of Yervoy (that's the treatment I am on) at Kaiser, because my new insurance did not kick in until January. But, I was still able to see the UCSF oncologist and had the Kaiser oncologist correspond with the UCSF oncologist to make sure everyone was on the same page for the time that I had to still go to Kaiser. Now I only go to UCSF and I am so glad I am done with Kaiser.
Your mom's surgery is more complicated than what I had done… but, I do know that Kaiser has some great surgeons. A lot of their surgeons, at least ones up in NorCal, trained at excellent schools such as Stanford and UCSF. It's likely similar down there, and you can research on the Kaiser website for a surgeon that will be the best fit for your mom. Wish these things were easier and didn't require so much of the patient and patient's family's time and energy just to get the best care.
Keeping you and your mom in my thoughts.
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- September 26, 2016 at 6:39 am
We are based in Orange County CA, but willing to take her anywhere in Southern California for treatment. It's currently open enrollment at her work, but the new coverage would not kick in until January. We are looking into secondary insurance options as well, if anyone has any information about that. We have been in the process of trying to get Kaiser to allow us to go out of network for a second opinion since last week, but I'm not sure if that will go anywhere. To the best of my current knowledge, Kaiser does not have a melanoma team in Orange County. I just found out that Kaiser has a melanoma center in Los Angeles and another in Riverside, and it baffles me that nobody mentioned this to us sooner.
Unfortunately, we are afraid of putting my mom's surgery on hold with all further administrative delays. Because we want to get the surgery as soon as possible due to the size of the mass and the potential of spread to other parts of the body, we may be forced to do the surgery through Kaiser for now and start treatment until January when the PPO kicks in and we can switch to a specialist.
-
- September 26, 2016 at 6:39 am
We are based in Orange County CA, but willing to take her anywhere in Southern California for treatment. It's currently open enrollment at her work, but the new coverage would not kick in until January. We are looking into secondary insurance options as well, if anyone has any information about that. We have been in the process of trying to get Kaiser to allow us to go out of network for a second opinion since last week, but I'm not sure if that will go anywhere. To the best of my current knowledge, Kaiser does not have a melanoma team in Orange County. I just found out that Kaiser has a melanoma center in Los Angeles and another in Riverside, and it baffles me that nobody mentioned this to us sooner.
Unfortunately, we are afraid of putting my mom's surgery on hold with all further administrative delays. Because we want to get the surgery as soon as possible due to the size of the mass and the potential of spread to other parts of the body, we may be forced to do the surgery through Kaiser for now and start treatment until January when the PPO kicks in and we can switch to a specialist.
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