Equipment v Team

[mesafinn]

Just speculating....

I'm wavering between going "in-network" and working with folks who have done GK for only a few years or going "out of network" to UPittsburgh and working with experts who've been doing GK for decades.

My question:  since money matters to most of us (financial realities):  do you think the access to GK is what's of most importance or do you think the individuals performing the GK are equally, if not more, important?

Just curious on opinions.  I continue to think you are all the best!

[Jim Scott]

Mesafinn ~

The recommendation of the ANA is to seek out doctors who have extensive experience treating acoustic neuroma patients.   If it were me, I would opt for experience over convenience or cost.

Jim   

[arizonajack]

I'm wavering between going "in-network" and working with folks who have done GK for only a few years or going "out of network" to UPittsburgh and working with experts who've been doing GK for decades.

I think you need a lot more information than just that.

1 - What equipment do they have? Old? New?
2 - How many GKs have they done in the past "few years"? If they've done one a day for the past few years their experience might be comparable to those that have done one a month for decades.
3 - What's their track record with patients who are a year or two post GK?
4 - Where and with whom did they train?
5 - How many years experience in brain surgery do they have? If they know their way around in there, they ought to be able to properly pinpoint the tumor for setting the coordinates on the machine.

I'm not advocating one side or the other but it's entirely possible that you might get just as good a result from either.

And above all, how comfortable are you with who you pick after doing all your research?

[Mickey]

I would think both.... Optimum is to get the best equiptment with the best experience. Shop around.. Best wishes, Mickey

[leapyrtwins]

I'm with Mickey.  Jim and Jack both have valid points, but since both factors are important don't just settle for one being the best.

It may or may not be true, but I'd imagine that the best docs insist on the best equipment. 

Jan

[MDemisay]

Dear mesafinn,

I tend to concur with Jim here.  It has been my experience from interviewing 14 docs that experience trumps equipment. This is precisely what helped me to relax as I went into surgery. I wouldn't have been able to tolerate less. In 1974, 2004 and 2012 this has proved to be the case. I am fortunate that I went with Columbia Presbyterian every time. Which is not to say each time that there was some considerable indecision on my part. -----I was lucky that I had the best docs and the best (latest) equipment.-----

My theory being this:

 Best doc + best hospital = best outcome!

In my book, choice of doc is the most important.

This decision is THE  most important! Never settle!

 Many years from now, you'll catch yourself saying did I give it my best, did I give it my best shot?

You owe yourself more than--" I think I'll go with this guy or gal just because he/she was cheaper." This is your brain! The master controller here. Some would say the very seat of your soul.

Choose wisely!

Good Luck,

Mike

[mesafinn]

Thanks for your insights, all.

I had a consult with a doctor yesterday who seemed to minimize the team who approached the GK.  He said "a proton is a proton is a proton" and that the procedure was mostly computerized and so the access to the machinery meant more than the specialists treating it.

At first that made some sense but as I've thought about it, that kind of mentality actually concerned me more.  I don't just want access to the equipment--I want someone with extensive knowledge of that equipment, treatment of ANs, and respectable patient care.

[mk]

Equipment is pretty much standard, as well as procedures. But treatment planning is also important, choice of dose depending on the size location etc., so that's where the human factor and experience count. This may be more important in complicated cases (larger tumors, proximity to brain stem, etc). I think that the procedures/dosages are pretty standard for smaller tumors. In some centres planning/dose is done by a radiation oncologist, in collaboration with a neurosurgeon, so you get the benefit of the combined experience of both.

There is a lot of good input in this thread, one thing that I wanted to add is post treatment follow-up, which is very important, especially post radiation, where you need follow up MRIs etc. This may be a bit problematic if you seek treatment further away, or not at all, depending on the facility/doctor. I know that some people have found it frustrating when problems cropped up and they couldn't get in touch with their doctors who did the treatment. So you should have a good understanding with your treatment team about who is responsible for the follow up, including assistance in case of problems (for example if a course of steroids is needed).

Marianna