[Nan]

Consultation with a myeloma specialist - how does it work?

by Nan on Mon Feb 10, 2014 2:56 am

Hi:

My family member has primary plasma cell leukemia (very aggressive myeloma) and is battling pneumonia in the hospital after renal failure. He is seeing a well-recommended and competent oncologist in a large city, but the doctor is not a myeloma specialist and the patient is not hospitalized in a hospital in a city with a myeloma program.

The oncologist says he is consulting with a myeloma specialist, but we never have spoken to that specialist and it is unclear how often the oncologist and specialist speak and how involved that specialist is in the care of my family member. Patient has received two weekly chemo treatments so far, but it is not clear what the protocol is.

We would like to have direct access to the myeloma specialist, but we understand that this usually involves transferring the patient to the specialist's facility and care, and he is too weak at this point to travel hundreds of miles.

Does anyone have experience with how consultations work? Are there myeloma specialists who are willing to work directly with the patient (and local doctor) remotely, or must the consultation always be doctor-to-doctor, with the patient only having indirect access to the specialist?

Any advice?

Thanks,

Nan.

[JBarnes]

Re: Consultation with a myeloma specialist - how does it wor

by JBarnes on Mon Feb 10, 2014 1:43 pm

I have a local oncologist who is not a specialist. I also have a myeloma specialist located in Denver which is roughly 40 miles from my home. In my case I call for a consult or go in for a consult every three months to review my treatment plan. Prior to my visit I send my latest blood work results to the specialist for them to review. The specialist then reviews the latest results, talks to me and sends a note to the local oncologist with his recommendations for treatment. My local oncologist and I review the recommendations and decide what course of action to take.

There has been several times over the last 1.5 years where the specialist has disagreed with the treatment plan layed out by the local doc. My local doc is very supportive of the information received from the specialist and alters the treatment plan in accordance with the specialists plan.

I would call the specialist that is the closes to you and get a list of the blood work, urine samples etc. that they will require prior to doing a consult. Typically they will want a biopsy and a FISH analysis done for new paitients.

I've really seen the benefit of having the specialist to consult with. My local oncologist tended to over treat me which as I have learned can lead to more side effects and the possibility of running out of treatment plans as the cancer relapses.

Good luck to you, Jerry.

[torimooney]

Re: Consultation with a myeloma specialist - how does it wor

by torimooney on Mon Feb 10, 2014 9:49 pm

I say ditto to Nan's comment. My two oncologists (local and specialist) work together like Nan's.