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Chemo in local and surgery MSK ?

michelle816 Member Posts: 8


I'm recently diagnosed with ER-/HR-/Her2+, ki-67 20%; grade3, almost 4cm with 1 node. I need chemo first then surgery.

Local oncologist recommends TCHP. I went to MSK for second opinion. I was told MSK don't do TCHP much, and they normally do AC-THP.

However, the oncologist kind of push me to enter a trial (removing AC from the AC-THP recipe, leaving ONLY THP, in order to approve less chemo still working fine), The trial is in phrase 2.

I really want to stay with MSK, but I'm not comfortable with the trial. and I can tell the oncologist is not happy that I refused the trial.

So my options are

- go back to my local oncologist with TCHP, and back to MSK for surgery;


- stay with MSK from chemo to surgery, refusing trial, so most likely they will give me AC-THP.

I dont know how important is it to do chemo in a top hospital? Is it normal to do chemo in a local place and surgery in a top hospital?

I appreciate your advice. Thank you!


  • moderators
    moderators Posts: 8,287
    edited April 2022


    That is indeed a dilemma, and we're sorry you find yourself here. It's really important that you do what you think is best for you. If that means stay at MSK but not do the trial, then that's what you should do. And if necessary for you to feel comfortable with your decision, though a lot of work, you may want to even get a third opinion.

    We hope that others chime in, but just keep advocating for what you need.

    We're all here for you!

    The Mods

  • ratherbesailing
    ratherbesailing Member Posts: 129
    edited April 2022

    Michelle, I think the moderators' advice is wise. A trial is just that - a trial. It my benefit many women years down the road, but not necessarily benefit you (although it could, in the end, prove to be a better regimen for you as well.)

    You are in treatment to be cured, not help MSK publish. And you should never, ever feel pressured to participate in a trial. I would go for a third opinion, and try to obtain an understanding of why different protocols are recommended. Do stats show better cancer-free outcome for your particular tumor profile? Or perhaps fewer side effects?

    Once you decide on chemo, that will guide where you go for it. The chemo formula itself will be the same - what you are looking for then is an oncologist who knows their research, and will keep track of you during the process and pay attention when you have questions or possible issues. That is not necessarily a "big name" hospital (and I say that from experience.) If you do stay at MSK but don't want to do the trial, then tell them that with no fear of being a "bad patient." The oncologist will likely understand and respect your opinion.

    I might add, there are also plenty of fine surgeons in many places. Just look for one that has significant experience with breast cancer. If you need cosmetic surgery after that will be a plastic surgeon in addition to the breast surgeon.

    Wishing you all the best.

  • jrnj
    jrnj Member Posts: 407
    edited April 2022


    Where are you? MSK has a few facilities throughout NJ. My non MSK team is "local" and I am not thrilled with a lot of things. I have long wondered if I made a mistake not going to MSK, the #2 cancer center in the country. Their Middletown facility is close to me, but my concern was the difficulty going into the city for surgeries. I had a second opinion on chemo there and loved the oncologist, but my local oncologist agreed to do her recommendation so I stayed with my local drs. out of convenience. Chem, radiation, dmx, deip flap. I especially regret doing diep with a local dr instead of a cancer center. I understand what you are saying, you want to be aggressive. I had the opposite problem, Rutgers Dr. and local said no chemo, and Sloan said yes and I wanted to do the chemo. I'm surprised to hear about the pressure they put on you and my cancer is totally different than yours. But my chemo was less toxic, CMF. So that is a really hard decision because the "A" is the one that could cause heart damage. I would go for a third opinion, that is what I did when I didn't feel comfortable with the first two. A tie breaker. I was confused that I thought my team all needed to be in the same place. But they really don't if you aren't comfortable with what you are hearing.