› Forums › General Melanoma Community › What training/residencies/fellowships do I want my melanoma docs to have?
- This topic has 24 replies, 4 voices, and was last updated 13 years, 6 months ago by
runnergirl.
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- February 27, 2012 at 3:44 am
Hi all,
Hi all,
I'm 33 and have had 2 primary melanomas in the past 2.5 years, one stage 1A and one in situ. I have had two great dermatologists in different health systems both listed as melanoma centers of excellence – both of whom have left practice in Arizona for one reason or another. I am now looking for a new team and am wondering – what training do I want my doc to have? Banner MD Anderson just opened here, but the docs listed on their website as their "melanoma specialists" were trained in hem/oncology, internal medicine and surgery. No mention of dermatology. I assume training above and beyond what is offered in medical school is important – but maybe I'm wrong? What training is required for a good melanoma specalist? Has anyone been treated at the new AZ Banner/MD Anderson? I'd love to hear people's thoughts and experiences.
- Replies
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- February 27, 2012 at 3:56 am
Are you looking for an oncologist or a dermatologist? It seems the doctors you are listing are probably medical oncologists or surgical oncologists. These would treat mostly stage III and stage IV patients. Not a lot a melanoma oncologist is going to do for you at your early stage. I'd personally want someone trained in dermatology who can help you stay on top of your moles. You're more likely to have a new primary than a metastasis from your current ones. Maybe look for a cutaneous oncologist as their specialty is skin cancers and not metastases. That's the type of doctor I see (3 primaries, stage IB). Otherwise, I'd find a good dermatologist that you can work with as they are truly more suited to watching the skin than a medical oncologist would be. Can you contact either of the doctors who left and ask for their recommendation?
Best wishes,
Janner
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- February 27, 2012 at 3:56 am
Are you looking for an oncologist or a dermatologist? It seems the doctors you are listing are probably medical oncologists or surgical oncologists. These would treat mostly stage III and stage IV patients. Not a lot a melanoma oncologist is going to do for you at your early stage. I'd personally want someone trained in dermatology who can help you stay on top of your moles. You're more likely to have a new primary than a metastasis from your current ones. Maybe look for a cutaneous oncologist as their specialty is skin cancers and not metastases. That's the type of doctor I see (3 primaries, stage IB). Otherwise, I'd find a good dermatologist that you can work with as they are truly more suited to watching the skin than a medical oncologist would be. Can you contact either of the doctors who left and ask for their recommendation?
Best wishes,
Janner
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- February 27, 2012 at 4:04 am
Thanks for the information! I do have a reccomendation from one of my former providers, but the person is about 2 hours away. Don't get me wrong, I'll drive it if needed; but I'm trying to figure out if there is someone or some center closer to me that might be well suited. To clarify, I am looking for someone to do my skin checks on an ongoing basis, so I suppose I am looking for a dermatologist. I have many, many moles (atypical mole syndrome), and I am an octopus with my mole map photos. They ALL look abnormal to me, because most of them are! I have had derms who want to biopsy everything because so much of it is dysplastic – but then we're getting in to taking off all my skin, basically. Thus the question – I don't know if those other specalities I mentioned are trained to work with a dermascope and mole maps, etc. The issue I seem to be running in to is many derms in my area (Arizona) are practicing cosmetic dermatology and I want to make sure whoever I see has the right training to deal with my history and risk.
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- February 27, 2012 at 4:04 am
Thanks for the information! I do have a reccomendation from one of my former providers, but the person is about 2 hours away. Don't get me wrong, I'll drive it if needed; but I'm trying to figure out if there is someone or some center closer to me that might be well suited. To clarify, I am looking for someone to do my skin checks on an ongoing basis, so I suppose I am looking for a dermatologist. I have many, many moles (atypical mole syndrome), and I am an octopus with my mole map photos. They ALL look abnormal to me, because most of them are! I have had derms who want to biopsy everything because so much of it is dysplastic – but then we're getting in to taking off all my skin, basically. Thus the question – I don't know if those other specalities I mentioned are trained to work with a dermascope and mole maps, etc. The issue I seem to be running in to is many derms in my area (Arizona) are practicing cosmetic dermatology and I want to make sure whoever I see has the right training to deal with my history and risk.
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- February 27, 2012 at 4:12 am
I would see if there is anyone who is a cutaneous oncologist. Or again as you said, someone who is versed in mole mapping or who at least uses pictures as part of their practice. Call around. I've found that the most important characteristic is someone who will work WITH me and is willing to discuss each mole/biopsy and ask my gut feeling too. Watching the moles for change and feeling comfortable with the doctor are key issues and it may take trying out more than one doctor. My doctor requires photos as he doesn't want to try to remember what your moles looked like at the last visit.
Your neighbor to the north in Utah,
Janner
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- February 27, 2012 at 4:12 am
I would see if there is anyone who is a cutaneous oncologist. Or again as you said, someone who is versed in mole mapping or who at least uses pictures as part of their practice. Call around. I've found that the most important characteristic is someone who will work WITH me and is willing to discuss each mole/biopsy and ask my gut feeling too. Watching the moles for change and feeling comfortable with the doctor are key issues and it may take trying out more than one doctor. My doctor requires photos as he doesn't want to try to remember what your moles looked like at the last visit.
Your neighbor to the north in Utah,
Janner
-
- February 27, 2012 at 4:12 am
I would see if there is anyone who is a cutaneous oncologist. Or again as you said, someone who is versed in mole mapping or who at least uses pictures as part of their practice. Call around. I've found that the most important characteristic is someone who will work WITH me and is willing to discuss each mole/biopsy and ask my gut feeling too. Watching the moles for change and feeling comfortable with the doctor are key issues and it may take trying out more than one doctor. My doctor requires photos as he doesn't want to try to remember what your moles looked like at the last visit.
Your neighbor to the north in Utah,
Janner
-
- February 27, 2012 at 4:04 am
Thanks for the information! I do have a reccomendation from one of my former providers, but the person is about 2 hours away. Don't get me wrong, I'll drive it if needed; but I'm trying to figure out if there is someone or some center closer to me that might be well suited. To clarify, I am looking for someone to do my skin checks on an ongoing basis, so I suppose I am looking for a dermatologist. I have many, many moles (atypical mole syndrome), and I am an octopus with my mole map photos. They ALL look abnormal to me, because most of them are! I have had derms who want to biopsy everything because so much of it is dysplastic – but then we're getting in to taking off all my skin, basically. Thus the question – I don't know if those other specalities I mentioned are trained to work with a dermascope and mole maps, etc. The issue I seem to be running in to is many derms in my area (Arizona) are practicing cosmetic dermatology and I want to make sure whoever I see has the right training to deal with my history and risk.
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- February 27, 2012 at 3:56 am
Are you looking for an oncologist or a dermatologist? It seems the doctors you are listing are probably medical oncologists or surgical oncologists. These would treat mostly stage III and stage IV patients. Not a lot a melanoma oncologist is going to do for you at your early stage. I'd personally want someone trained in dermatology who can help you stay on top of your moles. You're more likely to have a new primary than a metastasis from your current ones. Maybe look for a cutaneous oncologist as their specialty is skin cancers and not metastases. That's the type of doctor I see (3 primaries, stage IB). Otherwise, I'd find a good dermatologist that you can work with as they are truly more suited to watching the skin than a medical oncologist would be. Can you contact either of the doctors who left and ask for their recommendation?
Best wishes,
Janner
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- February 27, 2012 at 6:25 pm
You are 2 hrs away from one of the BEST cancer centers; we are 4 hrs away, but it seems like 4 mins when considering the confidence we have in the AZ Cancer Center (Univ. of AZ). We see Dr. Werneke who is a melanoma specialist; then Dr. Hersch, an oncologist. The entire center is awesome in the way patients are treated. My husband has stage IV with mets to lung and bone. At one visit, he was huddled around the computer with 3 doctors discussing strategies. He has had 3 surgeries at UMC and radiation in Sedona. The Tucson doc talks to the Sedona docs—real teamwork. We previously went to Mayo PHX and the plastic surgeon there really was a turn off. The guy in Flag was really nice, but not a specialist. If necessary, we will go to MD Anderson in Houston. The MD Anderson PHX site is a new startup.
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- February 27, 2012 at 6:25 pm
You are 2 hrs away from one of the BEST cancer centers; we are 4 hrs away, but it seems like 4 mins when considering the confidence we have in the AZ Cancer Center (Univ. of AZ). We see Dr. Werneke who is a melanoma specialist; then Dr. Hersch, an oncologist. The entire center is awesome in the way patients are treated. My husband has stage IV with mets to lung and bone. At one visit, he was huddled around the computer with 3 doctors discussing strategies. He has had 3 surgeries at UMC and radiation in Sedona. The Tucson doc talks to the Sedona docs—real teamwork. We previously went to Mayo PHX and the plastic surgeon there really was a turn off. The guy in Flag was really nice, but not a specialist. If necessary, we will go to MD Anderson in Houston. The MD Anderson PHX site is a new startup.
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- February 27, 2012 at 9:10 pm
Thanks for your response and glad to hear you're having a good experience with U of A. I didn't have problems with Mayo's care; but had very big problems with Mayo's billing – so they are not an option. I will say, of the 5 WLE's I've had for melanomas and dysplastic nevi that needed reexcision, the only one that didn't keloid over, look terrible and be painful now is the one their plastics person did, for what that's worth (I'm sure other variables, area of body, etc. may have played in to that).
I have been to U of A as well, like them a lot, and will probably keep going there. My derm there is leaving and so I'm considering if there is somewhere/someone else of if I should keep going there. I know my provider there was about as much of an expert as one can be, which is basically the reason for my question about what training makes someone qualified.
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- February 27, 2012 at 9:10 pm
Thanks for your response and glad to hear you're having a good experience with U of A. I didn't have problems with Mayo's care; but had very big problems with Mayo's billing – so they are not an option. I will say, of the 5 WLE's I've had for melanomas and dysplastic nevi that needed reexcision, the only one that didn't keloid over, look terrible and be painful now is the one their plastics person did, for what that's worth (I'm sure other variables, area of body, etc. may have played in to that).
I have been to U of A as well, like them a lot, and will probably keep going there. My derm there is leaving and so I'm considering if there is somewhere/someone else of if I should keep going there. I know my provider there was about as much of an expert as one can be, which is basically the reason for my question about what training makes someone qualified.
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- February 28, 2012 at 12:13 am
Surely there is someone is PHX who can take care of you. I am a keloider, too, and that is a really unfortunate consequence of a simple procedure. Mayo's billing is simply dysfunctional although I know people who use them and are quite happy. At the Ariz Ca Ctr, I would recommend you see Dr. Werneke and have him refer you if that is what you need. My husband called Dr. David Alperts, who is the director of the center, to get his recommendation. You can do that, too. Dave has a home in Sedona nearby. He is VERY personable and answers all calls. There will soon be a PHX branch of the center, but I can't say anything about it, because i don't know. You are so young, and this disease is such a beast. You're smart to stay really on top of it.
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- February 28, 2012 at 12:13 am
Surely there is someone is PHX who can take care of you. I am a keloider, too, and that is a really unfortunate consequence of a simple procedure. Mayo's billing is simply dysfunctional although I know people who use them and are quite happy. At the Ariz Ca Ctr, I would recommend you see Dr. Werneke and have him refer you if that is what you need. My husband called Dr. David Alperts, who is the director of the center, to get his recommendation. You can do that, too. Dave has a home in Sedona nearby. He is VERY personable and answers all calls. There will soon be a PHX branch of the center, but I can't say anything about it, because i don't know. You are so young, and this disease is such a beast. You're smart to stay really on top of it.
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- February 28, 2012 at 12:13 am
Surely there is someone is PHX who can take care of you. I am a keloider, too, and that is a really unfortunate consequence of a simple procedure. Mayo's billing is simply dysfunctional although I know people who use them and are quite happy. At the Ariz Ca Ctr, I would recommend you see Dr. Werneke and have him refer you if that is what you need. My husband called Dr. David Alperts, who is the director of the center, to get his recommendation. You can do that, too. Dave has a home in Sedona nearby. He is VERY personable and answers all calls. There will soon be a PHX branch of the center, but I can't say anything about it, because i don't know. You are so young, and this disease is such a beast. You're smart to stay really on top of it.
-
- February 27, 2012 at 9:10 pm
Thanks for your response and glad to hear you're having a good experience with U of A. I didn't have problems with Mayo's care; but had very big problems with Mayo's billing – so they are not an option. I will say, of the 5 WLE's I've had for melanomas and dysplastic nevi that needed reexcision, the only one that didn't keloid over, look terrible and be painful now is the one their plastics person did, for what that's worth (I'm sure other variables, area of body, etc. may have played in to that).
I have been to U of A as well, like them a lot, and will probably keep going there. My derm there is leaving and so I'm considering if there is somewhere/someone else of if I should keep going there. I know my provider there was about as much of an expert as one can be, which is basically the reason for my question about what training makes someone qualified.
-
- February 27, 2012 at 6:25 pm
You are 2 hrs away from one of the BEST cancer centers; we are 4 hrs away, but it seems like 4 mins when considering the confidence we have in the AZ Cancer Center (Univ. of AZ). We see Dr. Werneke who is a melanoma specialist; then Dr. Hersch, an oncologist. The entire center is awesome in the way patients are treated. My husband has stage IV with mets to lung and bone. At one visit, he was huddled around the computer with 3 doctors discussing strategies. He has had 3 surgeries at UMC and radiation in Sedona. The Tucson doc talks to the Sedona docs—real teamwork. We previously went to Mayo PHX and the plastic surgeon there really was a turn off. The guy in Flag was really nice, but not a specialist. If necessary, we will go to MD Anderson in Houston. The MD Anderson PHX site is a new startup.
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- February 27, 2012 at 8:39 pm
If i had it to do all over again…i would have gone to one of the following:
1.Sloane-Kettering
2. Md anderson, period
3. Moffitt
4.Dana-Farber
5.NCI
true, non of these places i can get to without hopping on a plane, but, in the end…it is better to get to the top notch mel places and not waste precious time anywhere else
boots
y dda cymraeg
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- February 27, 2012 at 8:39 pm
If i had it to do all over again…i would have gone to one of the following:
1.Sloane-Kettering
2. Md anderson, period
3. Moffitt
4.Dana-Farber
5.NCI
true, non of these places i can get to without hopping on a plane, but, in the end…it is better to get to the top notch mel places and not waste precious time anywhere else
boots
y dda cymraeg
-
- February 27, 2012 at 8:48 pm
That makes sense when you're actively fighting disease, but she is stage IA. She is worried about new primaries, not a recurrence or treatment. There is a time and a place for action. I am stage IB and no way am I going to travel to MD Anderson. They probably wouldn't even accept me out of network given my stage. Nor would my insurance likely pay for a skin check visit that far away. She needs someone to monitor her skin and even a good local dermatologist with an open mind can do that. Stage I is a different beast than stage III or stage IV when it comes to followup care. Mole mapping and skin checks are her best friend at this point and she needs to find someone local who can do both for her.
Best wishes,
Janner
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- February 27, 2012 at 8:48 pm
That makes sense when you're actively fighting disease, but she is stage IA. She is worried about new primaries, not a recurrence or treatment. There is a time and a place for action. I am stage IB and no way am I going to travel to MD Anderson. They probably wouldn't even accept me out of network given my stage. Nor would my insurance likely pay for a skin check visit that far away. She needs someone to monitor her skin and even a good local dermatologist with an open mind can do that. Stage I is a different beast than stage III or stage IV when it comes to followup care. Mole mapping and skin checks are her best friend at this point and she needs to find someone local who can do both for her.
Best wishes,
Janner
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- February 27, 2012 at 8:48 pm
That makes sense when you're actively fighting disease, but she is stage IA. She is worried about new primaries, not a recurrence or treatment. There is a time and a place for action. I am stage IB and no way am I going to travel to MD Anderson. They probably wouldn't even accept me out of network given my stage. Nor would my insurance likely pay for a skin check visit that far away. She needs someone to monitor her skin and even a good local dermatologist with an open mind can do that. Stage I is a different beast than stage III or stage IV when it comes to followup care. Mole mapping and skin checks are her best friend at this point and she needs to find someone local who can do both for her.
Best wishes,
Janner
-
- February 27, 2012 at 8:39 pm
If i had it to do all over again…i would have gone to one of the following:
1.Sloane-Kettering
2. Md anderson, period
3. Moffitt
4.Dana-Farber
5.NCI
true, non of these places i can get to without hopping on a plane, but, in the end…it is better to get to the top notch mel places and not waste precious time anywhere else
boots
y dda cymraeg
-
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