Our physicians have many patients, some with urgent needs, and that the day is short. So, it can help to be respectful of your doctor's time. Ask if it's a good time to ask questions ...
Think like a corporation: Produce a concise executive summary that describes your history and main objectives. Have ready the chronology of tests, treatments, lab results, and outcomes that show the trends.
Doctors
Last update: 01/17/2019
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TOPICS Patient-Recommended Lymphoma Oncologists United States: Northeast | Midwest | South/Southeast | West/Southwest
Countries: Canada | United Kingdom | Spain | Germany
Cancer Centers | Second Opinions | Find Doctor | Finding Specialists - TIPS |
Find Specialty Oncologists | CLL | Find Surgeon?
Complaints? | Communicate with Doctors | Optimizing Doctor Visits |
Pathology - Getting a Second Evaluation | Research News
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Find Doctor /
Second Opinion
Does the oncologist you are considering or consulting:
- have experience in the treatment of your specific cancer?
- conduct clinical trials (is a clinical trial investigator)?
- actively participate in professional organizations dedicated to continuing education and professional development in the field?
- shows compassion and the ability to communicate and partner with you?
OTHER TIPS:
Adapted from NYT article on how to find good medical care
nytimes.com
* Find out which doctors your closest friends really like, ...ask trusted friends, neighbors and colleagues whom they see and feel comfortable with."
... "I cannot emphasize enough how important it is for every patient to have a trustworthy primary care physician who can help them navigate our challenging, but potentially excellent, health care system," said Dr. David T. Tayloe
* Stressed the importance of patients doing research and becoming active part of the medical team.
... "becoming more active and knowledgeable can only improve your care." ... "This is a shared responsibility between the physician and the patient
for the patient's health," said Dr. Ted Epperly
* Exercise caution when going through information from commercial or industry Web sites.
... "The Web can be a good place but also a dangerous place," Dr. Epperly said. "It's important to find sites that aren't biased and that provide evidence-based information."
* Ask prospective doctor questions like how much experience he or she has with a specific condition or operation
* Make sure you feel part of a shared decision-making process and comfortable saying how you feel, or that you don't understand or that you respectfully disagree.
* Identifying high quality medical groups or hospitals that "carefully monitor the quality of the clinicians affiliated with them" and that provide "decision support, continuous quality improvement and continuing education to keep their clinicians functioning well."
* Contact the national professional society for that doctor's specialty. (for lymphoma: ASCO / ASH)
... a plus: membership in the national professional society of a specialty - often referred to as being a "fellow" in the organization, as in Fellow of the American College of Surgeons, or F.A.C.S. - requires board certification and a certain degree of clinical experience.
...look for: M.D., F.A.C.P."
* Ask about participation in clinical trials.
* Caveats... bedside manner is only one of many concerns. "While excellent quality health care integrates caring with doing the right thing medically," she said, "a caring attitude can mask poor quality medicine."
* Most critical - part of deciding on any physician is the quality of the first appointment.
... arm yourself with the right questions [in writing - and a summary of your medical issues and treatments]
* Seeking a surgical oncologist?
... ask surgeon about the number of times annually she or he performs the specific operation needed,
... ask also about the hospitals in which those operations are performed. (research has shown that hospital mortality rates are lower when those operations are performed frequently.)
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Getting an accurate diagnosis and finding an expert you can communicate with are critical to receiving optimal care.
Regarding Second Opinions:
Second opinions will raise the level of the care you receive from your primary oncologist, because it set's up a kind of peer review.
... In addition it provides a valuable perspective on how to manage or treat the lymphoma.
Consulting an expert provides an excellent opportunity to inquire about the many promising clinical trials that may be appropriate for your clinical circumstance.
The expert you consult can also work with your treating oncologist to come up with a good plan.
Finding and Choosing a Qualified Oncologist
Leads on Finding Lymphoma and CLL specialists:
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NCI Lymphoma Steering Committee roster: NCI
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NCI Leukemia / CLL Steering Committee roster: NCI
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CLL experts cll.ucsd.edu
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CLL.acor.org list PDF
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Find Cancer Centers by specialty and excellence
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UK Resources
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Royal College of Pathologists http://www.rcpath.org/
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What pathologists do with the tissue
http://www.rcpath.org/Resources/RCPa...sion2aug10.pdf
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Guidelines for tests to figure out which type of lymphoma (technical)
http://www.bcshguidelines.com/docume...csh_042010.pdf
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British Committee for Standards in Haemotology Contact
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British Lymphoma Pathology Group http://www.blpg.org.uk/
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Return to top
Communicating with your doctor
On Optimizing Office Visits:
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Prepare in writing: your main questions first ...
and a list of the medications, events, and allergies you may have.
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Provide a summary of your goals. Provide information on the clinical trials you think worth discussing.
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And sometimes just in the making of your report and questions, new ideas will arise.
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Be concise -- avoid handing your doctor a 20 page report - adding one stack to another.
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To assist you in your mission, we provide patient support tools here
Return to top
Find a Specialty Oncologist Near You
Return to top
Questions To Ask Your Radiation Oncologist
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RTAnswers.org
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Return to top
Tips for Finding Specialists
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Tips - Science-Based Medicine: How to Chose a Doctor
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How To Find a Doctor or Treatment Facility If You Have Cancer cancer.gov
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Choosing a Doctor ahrq.gov/
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Finding a New Doctor cancer.net
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“America’s Top Doctors” (Fifth Edition)
The Best in American Medicine: America’s
Top Doctors and Hospitals childrenshospitalla.org
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American Board of Medical Specialties abms.org
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Licensing, background, and disciplinary information on physicians docboard.org
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Return to top
Centers and Oncologists
that Specialize in CLL PAL
Return to top
Resources FOR Physicians PAL
Return to top
Complaints About Doctors?
We believe that the overwhelming majority of physicians and their staff are dedicated to meeting the needs of their patients. However, there are sometimes unfortunate exceptions.
What should you do in such cases? When "the duty was not acted upon ... the provider failed to provide the standard of care."
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We recommend that you first write your doctor directly regarding your concerns - describing what happened concisely but in detail.
Next, if necessary, copy the State Medial Board ... if the problems you cite are not addressed or recognized.
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To locate the Medical Board in your State:
Go to: http://www.fsmb.org/directory_smb.html
Then select the letter for your state.
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In the meantime, use the resources on this page to help locate and choose another physician, or ask neighbors, friends, support groups, ... for referrals.
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Return to top
Finding a Competent Surgeon / Hospital
Signals of Excellence
Adapted from Medical Matters Consumer Reports (subscription required)
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Volume counts: How often surgeons and hospitals perform the procedure - which can be especially important for unusually complicated procedures.
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Complication rates: Volume is not a perfect indicator of excellence, so too are issues that arise after surgery, which can be due to the medications prescribed, and the quality of follow up care.
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Questions for the surgeon:
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Is your Board Certification up to date?
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How many operations of this type have you done in the last year?
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What is your success, failure and complication rate?
A competent surgeon will be happy to provide this information.
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Does the hospital follow "best practices"?
See ratings - consumer Reports
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See Hospital Compare A quality tool provided by Medicare http://bit.ly/cE6Bwo
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Click "Find and Compare Hospitals"
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Select "Find a hospital within a certain distance of a ZIP Code"
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Enter Zip code and distance.
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Check at least two hospitals in region.
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Click Compare button.
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Return to top
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Patient-Recommended Lymphoma Specialists
United States: Northeast | Midwest | South/Southeast | West/Southwest
Countries: Canada | United Kingdom | Spain | Germany
Return to top
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How to recommend your doctor?
First review our criteria, what you should provide, and the limitations of recommendations of this kind:
1) your oncologist is respected by his or her peers, and has demonstrated a willingness to be a partner in your care:
2) that he or she communicates about the full range of treatment options (standard and investigational) - providing the rationale for each choice.
We reserve the right to exclude referrals when the physician promotes unconventional therapies or diagnostic tests that have not been validated by clinical research.
NOTE: Because we cannot verify all the recommendation received, please consider this list to be only a starting point in your search.
Please send your referral in
this format:
STATE, CITY,
CENTER, ADDRESS
NAME, Phone, Web/Email
You can send an email referral by clicking
PI means that this physician also conducts lymphoma-specific clinical research.
The information presented on Lymphomation.org is not intended to be a substitute for professional medical advice or to replace your relationship with a physician. For all medical concerns, you should always consult your doctor. Patients Against Lymphoma, Copyright © 2004,
All Rights Reserved.
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LIMITATIONS:
The list is based on submission by patients, and therefore excellent oncologists may not be included simply because patients haven't yet taken the time to tell us.
Submissions are not science-based - for example, are subject to patient bias, such as chance interpersonal chemistry.
See sidebar for our recommended criteria.
KEYS:
PI = primary investigator - does clinical research.
ES = Expert Status (See also Experts)
NORTHEAST UNITED STATES
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CT, New Haven
Yale Cancer Center, New Haven
Francine M. Foss, MD (PI / ES)
Cutaneous T-cell Lymphomas | Web Profile
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CT, The Whittingham Cancer Center
24 Stevens Street, Norwalk, CT 06856
Dr. Richard Frank, (203) 845-4899,
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MA, Boston
Dana Farber Cancer Institute, 800- 320-0022
Dr. Arnold S. Freedman (PI / ES) (617) 632-3441 Web Profile
Dr. Lee Nadler (PI / ES) (617) 632-3331
George Canellos (PI/ ES) , M.D. (617) 632-3470
Dr. Ann LaCasce (PI/ ES)
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MA, Boston
Beth Israel Deaconess Medical Center, 617-667-5864
330 Brookline Avenue
Boston, MA 02215
Robin M. Joyce, MD (PI/ES), 617-667-9920
Director, Research Operations
Hematologic Malignancy and BMT Program
BIDMC is a teaching hospital of Harvard Medical School. They are clinically affiliated with Dana-Farber, but unlike Mass General and Brigham & Women's, they are not managed by Partners Healthcare. So- they are research partners but competitors. All of these hospitals, as a group, are approved as 1 entity as an NCI approved center, under the DFCI flag. They also do all the different types of SCT's, as independent BMT programs.... so there is some competition within Partners as well.
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DC, Washington
Dr. Jeffery Vacirca
1101 Pennsylvania Ave., NW
Suite 700
Washington, DC 20004
(202) 756-2258
www.communityoncology.org
Georgetown University Medical Center -
Lombardi Comprehensive Cancer Center, 3800 Reservoir Road, NW Washington, DC 20007,
Head of Hematology, and Director of Hematology Research
Dr. Cheson is Professor of Medicine (PI / ES) (202) 444-2223
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MD, Bethesda
Wyndham Wilson, M.D., Ph.D. (PI / ES)
Head, Lymphoma Therapeutics Section
Senior Investigator
National Cancer Institute
Building 10 CRC, Room 4
10 Center Drive
Bethesda, MD 20892-1203
Phone: 301-435-2415
Fax: 301-480-3444
http://ccr.cancer.gov/staff/staff.asp?profileid=5829
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ME, Scarborough,
Dr. Kurt S Ebrahim DO
Maine Center For Cancer Medcn
100 Campus Dr
Unit 108
Scarborough, ME 04074
http://www.vitals.com
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NJ, Forked River
Hematology Oncology Associates of Ocean County
Dr. Sara Jane McGee (609) 693-2000)
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NJ, New Brunswick
Robert Wood Johnson Hospital,
The Cancer Center of NJ
Dr. James Salwitz
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NJ, Morristown
Carol G Simon Cancer Ctr
PO Box 1089 100 Madison Ave Morristown, NJ 07962-1089
Dr. Charles Farber
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NJ, Hackensack
Dr. Andre Goy
John Theurer Cancer Center at
Hackensack University Medical Center
Web
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NY, Buffalo
Roswell Park Cancer Institute"
Myron S Czuczman 1-800-767-9355 (PI / ES)
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NY, New York,
Columbia University Medical Center
Kara Kelly, MD
Academic Title(s):
Professor of Clinical Pediatrics
Director Integrative Therapies Program for Children with Cancer
Director Leukemia/Lymphoma Program
Contact Information:
Tel: (212) 305-9770 Press 1, then 1
Fax: (212) 305-5848
Email: WEB
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NY, New York
Center for Lymphoma and Myeloma, Weill Cornell Medical College, The New York Presbyterian Hospital,
Dr. Richard Furman (PI / ES) (212) 746-2932
Specialty: CLL
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NY, New York
NY Presbyterian Hospital Weil Medical College,
Dr. Rebecca Elstrom (PI / ES) web
Dr. Peter Martin, 646-962-2068
Dr. Morton Coleman (PI / ES) (212) 517-5900
Dr. John Leonard (PI / ES) 646-962-2068 (fixed)
Specialty: antibody-based research
Owen A. O'Connor, MD, PHD, (is rumored to be at Weil now)
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NY, New York,
Memorial Sloan-Sloan Kettering Cancer Center
Steven M. Horwitz, MD (PI /ES) (specialty: t-cell lymphomas)
Dr. Carol Portlock (PI /ES)
Dr. Zelenetz (PI /ES)
Dr. Anas Younes (PI /ES) https://www.facebook.com/DrAnasYounes
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NY, New York,
NYU Langone Medical Center (NYU-LMC)
Owen A. O'Connor, MD, PHD, (PI / ES) toll free number, 888-7-NYU-MED (888-769-8633) | Web
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NY, NY, Queens
Mount Sinai Medical Center
Dr. Joshua Brody (PI / ES)
ASSISTANT PROFESSOR Medicine, Hematology and Medical Oncology
Web Profile mountsinai.org
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NY, Staten Island
St Vincent's
Dr. Thomas Forlenza (718) 816-4949
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PA, Philadelphia
University of Pennsylvania, 15 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104.
Dr. Stephen Schuster (PI / ES) (215) 614-1846
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PA, Philadelphia
Hospital of the University of Pennsylvania
Abramson Cancer Center
Dr. Sunita Nasta (PI) 215-615-5858
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PA, Pittsburgh
Retina Vitreous Consultants, 412-683-5300
Dr. Louis Lobes, MD,
Specialty: orbital lymphomas
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PA, Pittsburgh
University of Pittsburgh Physicians, Department of Neurology, Hillman Cancer Center 5115 Centre Avenue Pittsburgh, PA 15232 Phone: 412-692-4724
Frank Scott Lieberman, MD,
Specialty: Neuro-Oncology (PI)
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Return to Patient-Recommended Doctors
WEST / SOUTHWEST UNITED STATES
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CA, Duarte (near LA), City of Hope - Lymphoma Team
Specialized Program of Research Excellence (SPORE).
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CA, Campbell
Southbay Oncology Hematology Partners,
50 E. Hamilton Ave. Ste. 200, Campbell, 95008
Martin Rubenstein M.D., F.A.C.P. (PI) (408) 376-2300
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CA, La Jolla
University of California, San Diego
Hematology/Oncology, Cancer Center & Department of Medicine,
Peter R. Holman, M.D., (PI) (858) 657-6790
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CA, San Francisco
Division of Hematology/Oncology, 400 Parnassus Avenue Suite A502 San Francisco, Ca. 94143-0324, Tel: (415) 353-2421, Fax: (415) 353-2467
Dr. Karin Gaensler
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CA, Santa Barbara
Cancer Center of Santa Barbara (805) 563-5800 http://www.ccsb.org
Daniel Greenwald, M.D.
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CA, Palo Alto
Stanford Cancer Center, Lymphoma Clinic
875 Blake Wilbur Dr., Clinic
Dr. Ronald Levy (PI /E) (650) 723-7621 | Web Profile
Specialty: immunotherapy-based research
Dr. Sandra Horning (PI /E) (650) 725-6456 | Web Profile
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CA, Santa Monica
Dr. Sven DeVos, M.D., PhD. (PE, PI)
Associate Professor of Medicine
UCLA Lymphoma Program / Division of Hematology/Oncology
2020 Santa Monica Blvd.
Santa Monica, CA 90404
Office: (310) 829-5471
Fax: (310) 582-6391
Web profile
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CA, Whittier,
Hematology/Oncology,
Dr. Glenn Tisman (562) 789-8822
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CO, Denver
Colorado blood cancer institute
1719 east 19th Ave suite 300
Denver co 80218
Phone 720-754-4800 |
Dr. Jeffrey Matous (PI /E)
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OR, Portland,
OHSU Knight Cancer Institute
Richard T. Maziarz, M.D.
Medical Director, Adult Stem Cell Transplantation Program & Center for Hematologic Malignancies
Web profile: http://www.ohsu.edu/
To Schedule an appt: 503 494-5058
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OR, Springfield
Dr. Jeff Sharman, M.D. (PI / ES)
RiverBend Campus
3377 Riverbend Dr.
Springfield, Oregon 97477
Profile on web:
http://oregoncancer.com/physicians/profile/jeff-sharman-m.d/
Blog: http://www.cll-nhl.com/
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TX, Dallas, Oncology/Hematology, Sammons Cancer Institute,
Baylor School of Medicine
Mark Walberg, M.D., Ph.D (214) 370-1000
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TX, Houston, The University of Texas MD Anderson Cancer Center
Dr. Nathan Fowler (PI/ES)
Web bio: http://faculty.mdanderson.org/Nathan_Fowler/
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TX, San Antonio, TX, Hematology/Hematologic Malignancy, Cancer Care Centers of South Texas, (210) 595-5300.
Roger Lyons, M.D., F.A.C.P. (PI)
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UT, Methodist Richardson Cancer Center
Dr. Sam Bibawi.
He is at Methodist Richardson Cancer Center (located at George Bush & Renner). I have only had positive experiences with him (and everyone there).
He is a Medical Oncologist/Hematologist and used to work at M.D. Anderson. The Methodist Richardson Cancer Center is affiliated with UT Southwestern Medical Center
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WA
Univ. of Washington
Dr. Maloney, (PI / ES) (206) 288-7400 | WebProfile
Specialty: antibody-based research
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WA
Seattle Cancer Care Alliance 825 Eastlake Ave E, G3-200
Seattle, WA 98109-1023
Dr. Oliver Press (PI / ES)
(206) 288-SCCA (7222) Fax: (206) 288-1025 Web profile Specialty: Radioimmunotherapy-based research
Dr. Gopal (PI / ES)
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WI, MADISON, WI 53705
Dr. BRAD S KAHL (PI / E)
ASSOC PROFESSOR
4059 WIMR 1111 HIGHLAND AVE
Phone Number
(608) 263-1836
Website: wisc.edu
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WI
Minocqua, Lakeland Center
Dr Weiss
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Return to Patient-Recommended Doctors
SOUTHEAST UNITED STATES
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FL, Ft. Lauderdale
North Broward Medical Center Cancer Center Pompano Beach,
Dr. Mayda Arias (954) 786-6460
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FL, Fort Walton Beach
Emerald Coast Oncology And Hematology Associates
1024 Mar Walt Dr
Fort Walton Beach, FL 32547
(850) 863-3148
Henry Hsiang, MD
Harvey Hsiang, MD
Ming Chang, MD
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FL, Tampa
Moffitt Cancer Center
Dr. Sotomayor Web
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FL, St. Petersburg, FL 33705
Florida Cancer Specialists
1201 5th Avenue North, Suite 505
St. Petersburg, FL 33705
(727) 821-0017
Joseph R. Mace, M.D. (RIT accredited)
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MS, Jackson
Oncology Associates PLLC Dr. 1815 Hospital Drive, Jackson, MS 39204
Dr Tammy Young (601) 373-4421 (800) 776-2378
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NC, Asheville
Asheville Hematology and Oncology Associates, P. A
Dr. James Puckett (828) 254-8232
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NC, Durham
Danielle Brander
CLL specialist at Duke University
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SC, Spartanburg
Gibbs Cancer Center at Spartanburg Regional Hospital
Dr. Shamilla Mehta Web
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SC, Charleston
Hollings Cancer Center
A National Cancer Institute Designated Cancer Center, 96
Jonathon Lucas St. P.O.Box 250635, 903 CSB Charleston, SC 29425
Robert K. Stuart, MD 843-792-4271
Professor of Medicine, Hematology/Oncology
Director, Hematological Malignancies and BMT Programs
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Return to Patient-Recommended Doctors
MIDWEST UNITED STATES
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IA, Iowa City
University of Iowa Hospitals and Clinics,
Dr. Brian Link (PI / ES) (319) 356-8508
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IL, Chicago, Northwestern University,
The Feinberg School of Medicine,
Dr. Leo Gordon (PI / ES) (312) 695-4546
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IL, Chicago
The Rush Cancer Institute
Dr. Gregory (PI / ES)
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IL, Chicago
University of Chicago Medical Center
Dr. Sonali Smith
Associate Professor of Medicine
Center for Advanced Medicine
5758 S. Maryland Avenue
Chicago, IL 60637
Website
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IL, Chicago
Lurie Cancer Center of Northwestern University Medical Center,
Dr. Steven Rosen (312) 908-5250
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IL, Chicago
M.D. Rush Medical Center
Dr. Stephanie Ann Gregory
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IN, South Bend
Michiana Hematologist/Oncologist Center, in South Bend,
Dr. Rafat Ansari (574) 234-5123
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IN, Indianapolis
Hematology-Oncology, Clarian Health-Methodist Hospital, 1704 N. Capital Ave. Indianapolis, IN 46202 (317) 962-9000
Sumeet Bhatia, MD
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IN, Indianapolis
Associated Vitreoretinal and Uveitis Consultants, 8704 N Meridian St. Indianapolis, IN 46260
Ramana S. Moorthy, MD (317) 571-1501
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MI, Ann Arbor
University Michigan Comprehensive Cancer
Dr. Mark Kaminski (PI / ES)
734-647-8901
Specialty: Radioimmunotherapy-based research
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MN, Minneapolis
Vicki Morrison, M.D. (PI / ES)
Professor of Medicine
VA Medical Center
Hematology/Oncology (111E)
One Veterans Dr
Minneapolis, MN 55417
Phone: (612) 725-2000
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MN, Minneapolis
University of Minnesota Hospitals, (612) 625-5411
Dr. Bruce Peterson (PI)
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MN, Rochester
Mayo Clinic, (507) 284-2511
Dr. Thomas Haberman (PI)
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MN, Rochester
Mayo Clinic, (507) 284-2511
Dr. Stephen Ansell (PI)
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MN, Rochester
Mayo Clinic, (507) 284-2511
Dr. David Inwards (PI)
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MN, Rochester
Mayo Clinic, (507) 284-2511
Dr. Thomas E. Witzig (PI)
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MO, Joplin
Hematology/Oncology. Freeman Cancer Institute
3415 Macintosh Circle Drive
P.O. Box 2644, Joplin Missouri 64803-2644
Dr. Tracy L. Coe, MD | (417) 782-6630 / (888) 234-3737
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MO, St Louis
Alvin J. Siteman Cancer Center
4921 Parkview Place, Suite B, Floor 7, St. Louis, MO 63110
Dr. Bartlett, Nancy Lee (PI)
(314) 747-9281 Fax: (314) 362-1608
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NE, Omaha
University of Nebraska Medical Center
Dr. James Armitage (PI / ES) (402)-559-7290, Web
Dr. Julie Vose (PI / ES) (402) 559-3848
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OH, Cleveland NEW
Cleveland Clinic Main Campus
Mail Code R32
9500 Euclid Avenue
Cleveland, OH 44195
Dr. Brian Bolwell Web profile
Dr. Hien Doung
Mitchell R. Smith MD (NEW arrival)
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OH, Columbus
Arthur James Cancer Hospital at OSU
Dr. Eric Kraut (614) 293-8606
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OH, Columbus
Ohio State University
John C Byrd MD (CLL expert)
Web profile: http://cancer.osu.edu
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OH, Canton
Dr. James Schmotzer
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OK, Tulsa,
Dr. Peter Aran - Chief medical Officer of St. Francis Hospital
Dr. Joseph P Lynch,
Internal Medicine and Hematology & Oncology and Medical Oncology.
Oklahoma Oncology
6585 S Yale Ave Ste 701
Tulsa, OK
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Return to Patient-Recommended Doctors
CANADA
|
Canada, Vancouver
BC Cancer Agency
BCCA, 600 West 10th Avenue, Rm 3225
Vancouver, BC V5Z 4E6
Dr. Joseph M. Connors (PI) (604) 877-6000
Randy Gascoyne, B.Sc., M.D. (PI / ES)
Specialty: biospecimen-based research
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Canada, Montreal, Quebec,
Jewish General Hospital
Pav E, 3755 Côte-Ste-Catherine Road,
Montreal, Quebec, CanadaH3T 1E2
Dr.Stephen N. Caplan, MD, FRCP 514-340-8222 ext. 8248
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Canada
McGill University
Dr. Pierre Laneuville (PI)
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Canada
Maisonneuve
Dr. Jean Roy
practices out of hospital)
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Return to Patient-Recommended Doctors
OTHER COUNTRIES
Germany
|
University Hospital of Cologne
Prof. Dr. Peter Borchmann
Studiensekretär GHSG
Universität zu Köln
Kerpener Straße 62
D-50924 Köln
Telefon: (0221) 478-5933
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UK
|
The Royal Marsden
Chelsea, London
The Royal Marsden
Fulham Road
London SW3 6JJ
Tel 020 7352 8171
http://www.royalmarsden.nhs.uk
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Nottingham UK, Consultant Haematologist,
Nottingham City Hospital, 0115 9691169
Dr. Andy Haynes
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Barts Cancer Institute
Professor John Gribben
Web profile: http://www.bci.qmul.ac.uk
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University College London Hospital
Prof David C. Linch
Tel: 020 3447 9443
Fax: 020 3447 9911
Email:
Contact info: uclh.org/
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Spain
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Spain, Pamplona
Lab of Immunotherapy Cell Therapy Area Clínica Universitaria, University of Navarra
Avda. Pio XII, 36 31008 Pamplona, Spain
Maurizio Bendandi, M.D., Ph.D. (PI / ES)
Phone (+34 606 002 087)
Fax: +34 948 296 500 | email: [email protected]
Specialty: immunotherapy-based research
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|
Pathology: Getting a Second Evaluation
of the Tumor Sample at Diagnosis
Return to top
|
Pathology - getting
a second evaluation
Related Topics
Diagnosis & Pathology
Getting a Second Pathology Evaluation
Prognostic indicators
Performance Standards
Diagnostic Tests
Disease Direction Indicators
|
So how necessary is a second evaluation of the tissue sample?
An accurate diagnosis is a key to receiving the the best treatment. We have received a good number of reports from patients on the support lists of incorrect or missed diagnosis. Unfortunately, it is more common than we would like to think.
Please know that your pathologist can send the slides out to the center you indicate for a nominal fee. Insurance reimbursement is also likely. No matter. If you can find a way to have this done, we think you ought to.
Here's one report on this question from a fairly large study: Comparison of Referring and Final Pathology for Patients With NHL in the National Comprehensive Cancer Network
From this report see table showing findings by subtype:
Referral and Final Pathologic Diagnoses for Patients With Non-Hodgkin's Lymphoma (n = 731)
A survivor writes: "I want people to be aware of the importance of a second opinion. For almost eight years I have been treated for Mantle cell lymphoma. I was sent to a radiologist for evaluation of treatment and he questioned my diagnosis as Mantle cell is very aggressive and if I have had it for 8 years and I look so healthy, he said he has treated many patients with mantle cell I did not fit the diagnosis. He had previous biopsies sent to an entirely different hospital and have been diagnosed with low grade indolent lymphoma."
DR LEONARD writes: ..." it is easy to ascertain a pathologic second opinion — it’s simply a matter of sending the slides; the patient doesn’t have to go. Generally, pathologists will discuss it with you over the phone, even if you’re at another institution. It’s not a big deal to do, and the pathology is key. I believe a pathologic second opinion is more important than another lymphoma subspecialist’s opinion. We re-evaluate a situation based on our pathologist giving us information that the primary oncologist didn’t have; therefore, I encourage patients to ascertain a pathologic second opinion. It is a relatively easy thing to do, and it gives the patients some reassurance.
I think all patients diagnosed with mantle cell lymphoma should also have a second pathology opinion. That’s a hard diagnosis to make and the implications, as far as the prognosis, are enormous. Additionally, if the disease is acting like one type of lymphoma, but the pathologist is telling you it’s another type of lymphoma, maybe that’s a red flag that you ought to have it evaluated by someone else.
Finally, gray areas exist when you see follicular and diffuse lymphomas, and you are trying to decide if transformation has occurred and whether you need to use an anthracycline — this is an area in which I would encourage a second opinion from the pathological standpoint."
Source: meettheprofessors.com
Centers Experienced with Pathology Evaluations
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DISCONTINUED: Armed Forces Institute of Pathology offers expert pathology consultation for both military personnel and civilian cases afip.org
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CA - UCLA, Dr. Said healthcare.ucla.edu
1-800-UCLA-MD1 (1-800-825-2631).
or email
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CA - Stanford University - Pathology Dept Stanford
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MA - Dana Farber (866) 408-DFCI (3324) dana-farber
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MD - NCI: Elaine S. Jaffe, M.D. Cancer.gov
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NY - NY Weil Cornell Medical Center NYCornell.org
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NY - Pre-Appointment Pathology Submissions Memorial Sloan Kettering
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TX - MD Anderson Cancer Center - Outside consultation services MDACC
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Other Country:
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Canada, Vancouver
BC Cancer Agency
Randy Gascoyne, B.Sc., M.D. | Website |
Criteria
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University Teaching Hospitals
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National reputations
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Evaluate lymphoma specimens often
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In the News & Related articles
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2017: Impact of Expert Pathologic Review of Lymphoma Diagnosis:
Study of Patients From the French Lymphopath Network
full text: http://bit.ly/2oViQO7
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Fine-Needle Aspiration Cytology in the Diagnosis of Lymphoma The Next Step
Linda M. Sandhaus, MD http://bit.ly/1aNXroh
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The Armed Forces Institute of Pathology (AFIP), which is the top-listed referral site for pathology second opinions on the Lymphomation list, regrettably is no more.
Although it was by far the world's largest repository of esoteric pathology specimens and slides, it was axed several years ago in one of the never-ending rounds of federal government downsizing.
So it needs to be removed from the web page.
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Diagnosis - Annals of Oncology: Expert second-opinion pathology review of lymphoma in the era of the WHO classification
"Given the potential harm from misdiagnosis, expert hematopathology review should be considered the standard of care"
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Common misdiagnoses in lymphomas and avoidance strategies PAL parsing
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Pathology the Gold Standard A Retrospective Analysis of Discordant Second-Opinion Lymphoma Pathology and Its Impact on Patient Care
The most common reasons for discordance were:
malignant non-malignant - 27 cases,
Non-Hodgkins Hodgkins - 14 cases,
lymphoma solid tumour - 18 cases and
more or less aggressive lymphoma - 47 cases.
Conclusions: (1) a discordance (one pathology finding not matching a second) rate of 16% was similar to previous studies and this high rate maybe improved through centralization of lymphoma pathology;
2) these types of patients are clearly at risk for harm, as best exemplified by patients who were felt to have a benign pathology that was actually malignant;
3) Discordant pathology has clear clinical implications including serial biopsies, invasive testing and treatment delays.
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Pitfalls in diagnostic hematopathology - Part II full text
The overlapping features of malignant lymphomas create a diagnostic "grey zone" , and lead to the invention of "grey zone lymphomas".
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Comparison of Lymphoid Neoplasm Classification:
A Blinded Study Between a Community and an Academic Setting Medscape (free login req.)
Am J Clin Pathol 115(5), 2001
Summary:
188 cases evaluated
167 cases were concordant (correctly diagnosed) - 88.8%
21 cases were discordant (incorrectly diagnosed) - 12.2 %
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Research News
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Research News
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How Doctors Think NPR.org
This question, not surprisingly, spawned others: Do different doctors think differently? Are different forms of thinking more or less prevalent among the different specialties? In other words, do surgeons think differently from internists, who think differently from pediatricians? Is there one "best" way to think, or are there multiple, alternative styles that can reach a correct diagnosis and choose the most effective treatment? How does a doctor think when he is forced to improvise, when confronted with a problem for which there is little or no precedent?
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Patient-Support Tools Medscape General Medicine [TM]
Future Directions: As limited and unsatisfying as information technology for patients has been, Blumenthal points out that the transformative potential is great. The fundamental premise of the practice and economics of medicine is a wide asymmetry of information.
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