Choosing the Right Oncologist for Metastatic Breast Cancer Treatment

Choosing the oncologist who will spearhead your treatment for metastatic breast cancer (MBC) plays a big role in feeling safe and secure as you get care. While you don’t want to feel rushed into making a decision, you also don’t want to delay your treatment too long. “I tell patients, ‘Once we know there is metastatic cancer, let’s try and get you on treatment within the next two to three weeks,’” says Shilpi Gupta, MD, a breast medical oncologist at Atlantic Health System in Morristown, New Jersey.

Although it doesn’t sound like much, it does give you enough time to look for an oncologist and interview a few before deciding on one. “The most important thing is having trust in your doctor and feeling comfortable that you are getting the care that you need,” says Christina Annunziata, MD, PhD, senior vice president of extramural discovery science for the American Cancer Society who’s based in McLean, Virginia.

The Importance of Trusting Your Doctor

Having an open, transparent relationship with the oncologist and their team is crucial. It can also affect treatment — the better the relationship, the more successful the outcome for people with advanced cancer, a study in Spain found. It’s no wonder that when people have a negative experience, they’re ready to go elsewhere. In fact, 80 percent of people said they wouldn’t go back to the same healthcare provider if they had an experience where they lost trust, according to a 2021 article.

The relationship is also crucial because you’re going to see this oncologist throughout your treatment, unless you switch to a different provider. “It is very important for every patient to understand that having metastatic breast cancer does not mean that the doctors don’t have treatment options. But, it does mean that the doctors will not be able to cure you,” says Dr. Gupta. “So, the treatment goal is to try and control the cancer as much as possible.” While every case of MBC is different, you may be in treatment for many years.

Questions to Ask Any Potential Oncologist

When you meet with an oncologist, it’s important to ask questions to get to know them better and understand their approach to treatment. “You should also consider your own goals of care and communicate these to your doctor,” says Dr. Annunziata. “These can affect your treatment recommendations and your own satisfaction with the results.” Here are some questions you might want to ask:

1. What does a doctor/patient relationship look like to you?
2. What, in your opinion, is the most important aspect of treatment?
3. How would we work together to form a treatment plan and scheduling?
4. How will you handle and treat my current pain?
5. What are the short-term and long-term goals for my treatment? How will I be monitored during this treatment?
6. How long does it take to get an appointment with you outside of regular treatment and checkups?
7. Can I bring a loved one/friend to appointments?
8. Do you have a nurse practitioner or physician assistant that works with you?
9. If the treatment does not go as planned, what happens next?
10. How do you communicate with patients? Do you use electronic medical records? Do I get in touch with you through your nurse or nurse practitioner?
11. How will your team handle my treatment side effects?
12. What clinical trials are available to me, through you or your affiliations?

“These questions will open up the conversation to understand what to expect from this doctor, and they will also help the doctor to understand your expectations as well,” says Annunziata.

How to Choose the Right Oncologist for Your MBC Treatment

There are several ways you can look for an oncologist who’ll be the best fit. Consider the following:

• Ask for referrals. These can come from friends, family, and area hospitals. “This can be useful if friends have a similar diagnosis and have had personal interactions with a particular oncologist,” says Annunziata. Your primary care doctor may have recommendations, as well. You can also ask a local cancer navigator for recommendations or reach out to one through the American Cancer Society. Check that a potential oncologist takes your health insurance, but this shouldn’t be your only criterion.
• Find an oncologist who specializes in treating breast cancer and MBC. “These doctors should have the most up-to-date information on treatment recommendations,” says Annunziata. And, because they have experience prescribing the drugs, they can anticipate any side effects you might have. Go to an oncologist’s online profile and see if they have a video introducing themselves and explaining their approach before deciding to meet with them, Gupta suggests.
• Meet with more than one doctor. Getting a second or third opinion about your initial diagnosis is always a good idea. It also gives you the chance to get to know another oncologist or two. “You should not feel bad about meeting and talking with more than one doctor throughout the course of your MBC treatment journey. But, it is best if the doctors are communicating with each other and one is taking the lead in managing your treatment, to ensure your own safety,” says Annunziata. Gupta agrees. “I feel very strongly about a potential patient going for a second opinion, either because I want to refer them to a tertiary care center for a clinical trial evaluation or because I sense an anxiety in the patient,” she says. “I feel that if they speak with another oncologist — hopefully, who will come up with the same recommendations — they’ll feel a little bit more reassured and comfortable.”
• Find someone with a similar background, if that’s important to you. You may be more comfortable with someone who has a shared background or culture. “I’m from India, and oftentimes I’ll have a patient of Indian background in my office who is more comfortable speaking in our native language,” says Gupta.
• Look for a personality match. Your oncologist doesn’t have to be your best friend, but you should feel like you can talk openly with them. It’s also important to feel that your oncologist hears you when you have a concern. “It’s very important that you and your physician can talk about things besides cancer at a human level,” says Gupta. “It’s important that you’re able to smile and even laugh together, if possible, and that you feel comfortable sharing.”

Remember that there will be ongoing conversations as your cancer continues, so you’ll want to keep the lines of communication open. “As treatments progress, as more information comes in with response to treatment with side effects, it’s important to be able to discuss and sometimes reidentify the priorities, plan, and the goals,” says Gupta.

That’s why it’s so important to find a doctor who will be able to do that, at your first visit and beyond.