How to select an institution

I receive numerous calls from cancer patients around the country asking where the best place to treat their cancer would be. That is a much more complex subject than it appears on the surface. First of all, their motivation and how serious their cancer is statistically must be considered.

The fundamental factor is to be certain the patient has a strong desire to win and that they have made a commitment to themselves to do everything in their power to win. If this is not present, the balance of the conversation would be a waste of time.

If they have a disease that is easy to treat with standard treatments and usually successful, such as early stage breast or prostate cancer in an older individual, I always recommend they seek treatment locally from a board certified physician. There is no need to travel anywhere. It can be treated as well locally.

From there on, it is not quite as easy. If the patient has an extremely rare and serious condition, it is best to go to a center that is accustomed to seeing a volume of that specific type of cancer to have the best chances of winning. If the prognosis is extremely poor, there are individual physicians somewhere who are generally having better success than most. Clinical trials are an excellent resource showing who is specializing in a specific disease.

Assuming experience is equal, how do you choose between institutions? Recently I received a telephone call from a major hospital saying they wanted my suggestions in trying to design a “user friendly” cancer center. I was thrilled at the prospect that they were thinking of the patient first. That started me thinking about grading institutions. Second to experience, I would rate as the most important single factor the status of the patient. If an institution places the welfare of the patient above all other considerations, it has to be a good place to be treated.

If politics, money, ego, doctors, time off, etc. outranks the welfare of patients, generally the experience will not be a pleasant one. If the patient’s welfare is placed first, the institution will run like a well oiled machine and the results will probably be superior. How do you tell how the patient rates at a particular institution? Generally admission time will be fairly indicative.

Cancer is never as treatable as it is right now. If an institution schedules you for tests this week and again next week before placing you on treatment the following week, you know the patient does not come first. If they give you the tests today and tomorrow and the following day get you on treatment, they care about you.

Another way is to see how promptly and completely your questions are answered. Even the manner in which your telephone calls are handled can indicate if the institution regards the patient as its reason for being or an interruption. Search for the institution that is anxious to treat you, help you and get you well.