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American Medicine

After a woman gets a diagnosis of breast cancer, she has anxiety, depression and fear until she gets her treatment plan from her doctors, and begins therapy (surgery possibly followed by radiation, chemotherapy and/or hormonal treatment). This delay from diagnosis to treatment with surgery has been growing  (according to Dr. Richard Bleicher and coauthors, J. Clin. Oncol. 30: 4485, 2013). The delay averaging 21 days in 1992 has grown to 32 days in 2005 (the last year they studied, it’s probably longer now).

Worse, waits of over 60 days (10% of women) were associated with an 85% increase in breast cancer deaths. That study by Dr. John McLaughlin (J.Clin. Oncol. 30: 4493, 2013) was from data on patients in 2000 to 2002. Waits may be longer today with problems in authorizations, coordination of care, need for special preoperative tests, and shortages of doctors (expected to be worse as the Affordable Care Act is implemented in 2013 and 2014).

Get your doctor to order your treatment quicklyoperativeoperative

Here are my tips to avoid long waits and get more effective treatment:

• After you get a diagnosis of breast cancer, immediately ask for a second pathology opinion to confirm the diagnosis and request special pathology tests for hormone status (estrogen and progesterone receptors) and Her-2 gene status to help develop the treatment plan.
• Show this blog information to the physician and ask how treatment can begin as soon as possible to increase your cure rate.
• Ask the doctor to coordinate your necessary tests and consultations so you can proceed with surgery or other treatments as soon as possible.
• If the doctor is reluctant to expedite your care, get a second opinion urgently.

You can see more tips on communicating more effectively with your doctor and getting second opinions in Chapters 7 and 15 of my book Surviving American Medicine available at booksellers and at Amazon.com, Barnesandnoble.com, and iUniverse.com and booksellers across America. It has received the 2013 International Book Award as the best book on health.