Best US-based medical oncologist - Signet Ring Cell CRC?

[Snapfish]

So we had a bit of a setback today when my dad heard from 2 of the 3 HIPEC surgeons we have been consulting. Though my dad's medical oncologist says he is "confident it is working" and points to an apparent (to him; we can't see the difference) shrinkage of the tumors on his most recent PET scans, the surgeons do not agree, saying that they do not see that the chemo is working. "No objective improvement" is a quote from one of the surgeons.

My dad has completed 10 FOLFOX infusions and is now switching (due to neuropathy) to FOLFIRI so the surgeons are looking at 3 sets of CT and PET scans. One of the consulting surgeons, Dr. Bartlett at UPitt, did say that he would like to schedule a laparoscopic exam sooner rather than later so he can have a better idea if my dad is a candidate for HIPEC. The other is Dr. Levine in NC, and he also encouraged the laparoscopic exam. Still not sure if we'd want to do HIPEC if it were an option, but we're not ready to close the door yet.

All of this is to say that we are now looking at getting a second opinion on the course of treatment. Yes, I know we are doing the standard treatments, but hearing two surgeons say something that is the opposite of what the oncologist says is unnerving to say the least. And don't even get me started on the fact the we STILL don't have biomarker info yet.

So we are ready to find the best and brightest medical oncologist for CRC in the USA, whether for a consult or for actual treatment. Given that my dad has stage IV adenocarcinoma with Signet Ring features, we need *the* guru.

Who is the best? I will stalk them (nicely, possibly involving homemade pound cake) to get an appointment if I have to. I will also Google, but I thought I would ask you guys as well.

Many, many thanks!

Snapfish

[janklo]

What area do you live in? I am familiar with doctors who treat SRC in Texas and Nebraska,but I can't say who is the best. Just which ones we tried, at the time.

I would recommend the laparoscopy to take a look and see if the chemo is working.

[Snapfish]

Oh shoot. I should have mentioned that. My father is in Texas and receives treatment at an MDA satellite office in a suburb of Houston. His oncologist is a generalist and not a CRC guy. At this point, we can travel anywhere needed, though we'd rather keep the travel domestic.

-Snapfish

[janklo]

There is a doctor at Baylor in Dallas--Dr Jeff Lamont who might be one to check out. He did an exploratory lap for my daughter and scheduled Hipec. This was after another surgeon declined to do that. He's with Texas oncology, or he was in 2012.

[lpas]

I'd suggest Nancy Kemeny at Memorial Sloan Kettering in NY or John Marshall at Georgetown in DC.

https://www.mskcc.org/cancer-care/doctors/nancy-kemeny
http://explore.georgetown.edu/people/marshalj/

[Snapfish]

Thanks, @Janklo. I will definitely look into Dr. Lamont, though I think he might be a surgical oncologist and not a medical oncologist? For now, we are just looking into medical oncologists, but I will check into him for sure.

And @lpas, thank you as well! I know it sounds crazy, but I thought Dr. K at MSKCC would be focused only on CRC patients with liver mets. My sister is a Hodgkins Lymphoma survivor thanks to the great care she received from the team at MSKCC so -- while it would be depressing to be back -- it is a great place to be when you have cancer. I will reach out to Dr. Kemeny tomorrow. And I am in the DC area and didn't even think of Georgetown. I will look into Dr. Marshall as well.

Keep the suggestions coming!

[H is for Hawk]

Dr. Leonard Saltz is considered the "best" colo-rectal medical oncologist at Memorial Sloan Kettering Cancer Center; it may be difficult to get a timely appointment with him.

[Snapfish]

Thanks, H is for Hawk! We haven't had much luck yet (mainly due to matching up my dad's treatment cycle fatigue with Drs. Schedules), but I will see what we can do to wrangle an appt at MSKCC that works.

Worst case scenario, we will get him in to Dr. Kopetz at the main MD Anderson campus. My dad's motivation for travel has never been strong, and chemo has made him more of a home body even though he has thankfully not had to deal with some of the more awful side effects thus far.

-snapfish