Yesterday I had my first visit with my new doctor. He was a likeable enough, but I didn't like a few things he told me. He said that Dr. Rivkin did things a little bit different- something which was evident from the first time I met him. First of all, he doesn't order routine PET scans. He quoted research that found that they didn't improve survival in the long run. That could be true, but I do think that the results can determine that treatment plan. If a scan located an isolated tumor within my uterus, wouldn't the better treatment be surgery to remove the tumor, rather than start a new round of generalized chemotherapy? Why cause unnecessary damage to the rest of my body? I also think that it's important to have peace of mind knowing that I had a clean scan. In any case, he ordered one...this time.
When I mentioned the PET, he also asked how I paid for the last ones. I told him that my insurance paid initially, and charity care covered the rest. By questioning my finances, does this mean that he will possibly withhold expensive treatments in the future? On my very first visit, Dr. Rivkin told me that money would never be a reason to forgo needed treatments. I definitely need to advocate for myself if this becomes an issue.
Finally, he questioned Dr. Rivkin's use of Avastin. He said that using that drug isn't normally done. I told him that other chemo regimen didn't work, and that I switched doctors because I didn't want to restart a cycle with a similar drug. At the first appointment Dr. Rivkin was pushing for me to start Avastin. This doctor didn't seem convinced, which is a bit concerning. Avastin is a legitimate treatment option for ovarian cancer- it just isn't indicated or recommended by the FDA for my type of cancer. It seems like this doctor's decision-making is only based on statistics and FDA standards of care. The recommended treatments work in theory, but not all cases are the same. My cancer has behaved differently in every way, and so the treatment standards no longer apply. With a recurrence it's time to bring out the big guns, regardless of whether they are cost effective or result in only a small reduction in mortality. I want someone who will fight for me and find me the most promising treatments out there. If he won't then I'm going to find someone who will.
I left my appointment clearly missing Dr. Rivkin. I believe that it was his patience and dedication towards my case that perhaps saved my life. I hope he's enjoying his retirement, because he sure earned it :)
