在之前的一篇文章中
我怎样才能确定自己得到了正确的对待? - I explained the advantages getting a second opinion may afford. A person with a new cancer diagnosis does not always have to travel outside the immediate area to obtain a second opinion—often another care provider in the same field practices in the same community—but frequently people seek such consultation at a regional or national cancer center. 生活在大西洋中部, we have readily available to us several such excellent facilities, most of which have National Cancer Institute (NCI) designation as research centers. The health care practitioners who work and provide cancer care at these institutions typically possess specialized expertise and can impart a definitive assessment and recommendations as to the best ways to handle a specific cancer diagnosis. 就像我之前写的, even if a person with cancer chooses not to receive her care at a more distant cancer center, by obtaining a second opinion she gains confidence that the treatment she receives locally comports with the current standard of care. She enjoys the best of both worlds: expert care delivered in a familiar environment, 离家近, with all the supports that home and community afford.
为什么有人会, despite the availability of quality cancer care in one’s own local community, seek such care at a more distant large cancer center? Are there circumstances where the advantages outweigh the benefits of staying local? Despite my own strong advocacy for remaining local whenever possible, I have practiced in both settings and know well when going to a large center is a wise decision despite some of the logistical and practical disadvantages.
Many large cancer centers have developed specialized clinics dedicated to the treatment of a specific disease. Often these are diseases in which a number of different disciplines become involved in the care of an individual patient. Calvert 健康 has one such specialized clinic in our Sheldon E. Goldberg乳腺癌中心由Dr. Theodore Tsangaris, a leading expert in the surgical management of breast disease. 在未来, we hope to develop several such specialized clinics that offer coordinated care informed by diverse expertise, all of which come together to form a solid plan that combines with optimal effectiveness all the appropriate interventions to produce the best possible outcomes. 直到我们找到, 然而, 癌症病人可以选择在医院接受治疗, 例如, a melanoma treatment center or a dedicated sarcoma service. Such specialized clinics frequently develop through concentration of cases over time deeper knowledge and experience in the management of such cases that greatly exceed that of more generalized cancer care facilities.
沿着类似的路线, a large center can often offer care for unusual types of cancer, the sorts of diagnoses rarely encountered in community oncology practices. For example, several of the cancers that occur in the brain and spinal cord are very uncommon. 同样的, 骨骼的恶性肿瘤, 肌肉, 肌腱, 以及身体的其他支持结构, 通常被称为肉瘤, can be unusual enough and tricky enough to treat that receiving care in a sarcoma expertise facility makes a great deal of sense.
There are some aggressive forms of cancer that present with serious symptoms, 常常使人衰弱, and require intensive treatment delivered to someone who is already unwell. The acute leukemias form the most common clinical scenarios for such dangerous cases. Due to the complex nature of the required treatment and the need for far more support, 包括人员和设备, 比社区中心所能提供的还要多, someone with a new diagnosis such as this can and should expect to receive at least his initial treatment at a specialized facility. Often after stabilization it is possible to return home and continue treatment locally; some次 the nature of the disease requires ongoing care delivery at the larger center.
最后, 一个很好的理由去一个更大的中心, typically one affiliated with a teaching hospital and medical school, is to participate in a clinical or investigational trial, treatment that has not yet become standard but may offer a better result than more conventional or standard options, 尤其是如果后者已经耗尽. Calvert 健康 plans to develop local availability of some clinical trials in the near future. 现在, 然而, persons interested in such treatment will need to travel to a larger center to receive such care.
The ideal for any person with a challenging cancer diagnosis is a partnership between local caregivers and more distant expertise. The whole can be greater than the sum of the parts.