The singular most important first step after being diagnosed with cancer  is building a team of health care professionals to assist you with your treatment . This team should include not only your oncologist, possibly a surgeon, depending on your type and stage of cancer as well as a psychologist or psychatryist and potentially others.

When I was first diagnosed with cancer I was at a word class hospital in NYC, I trusted my oncologist, and team of medical professionals largely because I did not know any better. The hospital after all was a world class hospital, my Drs.  all had advanced medical degrees and I was lulled into a false sense of security.  Although  there were some warning signs I ignored them- thinking they were aberrations and still blinded by the reputation of the hospital. Mind you, not  all of the Dr.s  on my team were bad- some were and are excellent, but there were enough warning signs that made me eventually change hospitals.

My first meeting with Dr. K, (one of the surgeons who was going to do the nephrectomy,  removal of my cancerous kidney), was less than comforting. I was ushered into his office and waited for him to enter. When he did he slipped behind his desk and asked " and why are you here today". He seriously had no idea not only who  I was or even why I was there. After I realized he was was not kidding, he honestly had no idea why I was there I suggested in my own not too subtle manner that he that he look in the computer and spend five minutes reviewing my chart, my medical records  and then we should speak. He did review the file and the balance of the first meeting went off reasonably well.

Mind you, at this point in my career I had been in business for 25 years and had 1000's of  business meetings  with potential clients and clients. Not once did I walk into a client meeting and start off with " OK gentlemen, why are we here". If I ever had I wold have been thrown out unceremoniously  and not invited back,  and rightfully so.

If how well Dr. K prepared for our initial  meeting was any indication of how well he was going to prepare for my surgery I was screwed. I am a firm believer proper preparation prevents piss poor performance.  Especially when it comes to a Dr. with a scalpel cutting into my abdomen. Fortunately the primary surgeon is a wonderful  Dr.- surgeon  whose attention to detail was flawless - but I will write more about her later, she deserves her own paragraph if not her own separate posting- I believe she is in fact an angel-  one of them anyway.

Unfortunatley due to my insurance plan I was not afforded access to the best oncologists at hospital A. With  the exception of my first oncologist, Dr. Kevin Becker, an amazing oncologist and human  being- one who I trusted implicitly. However  he left the hospital  only six weeks after my surgeryfor a new post  at a different hospital. I stayed at the hospital for another eight months, ten it total, during that time I had three  different oncologists each one worse than the last. My last oncologist Dr. L.  was the worst. On one occasion I went in for an appointment, sat down and asked a question, his response was " interesting question", got up and left  the room and only to  come back five minutes later with the answer.  Because of the nature of the questioning I had a follow up question, again I asked a question, he said "interesting question"  and he left the room again and came five minutes later  with the answer.  On one visit this happened  three consecutive times with three different questions. I honestly did not know whether Dr. L. was checking Google or asking another Dr.  either way I knew it was time to find a different hospital, one that the level of care was not dependent on my insurance plan.

Living in NYC has many advantages, one of them it has many of the best hospitals in the  world and I moved my care to Memorial Sloan Kettering Hospital in NYC and one of the three best  cancer hospitals not only in the US but in the world. It was not until I transferred  to Sloan Kettering that I found out that my first hospital misdiagnosed my cancer. Sloan Kettering insisted on doing their own pathology. Sloan Kettering informed me that I still had stage 4 kidn cancer, I was-and still am terminal, but rather than having papillary kidney cancer, the most aggressive form of kidney cancer with a prognosis of 2.5 years to live, I in fact have clear cell kidney cancer, a less agressive form,I am still terminal but rather than 2.5 years to live I my new Dr.s  have given me 3.25 years from date of initial diagnosis.  To adaquatley  atempt to  explain how I felt and still do,  would require a tirade of  four letter words that would take an entire paragraph and shock even the most seasoned sailor- suffice to say I was pissed.

If you look  at the two different type of cancer cells, papillary and clear cell they are as different as night and day,  how a seasoned professional pathologist  can make such an egregious error is beyond me, and this was from a world class hospital. What made matters worse it took an additional three months to finally meet with an oncologist from hospital A and then their only response, their only admission was yes we misdiagnosed you. No, "I am so sorry", no apology- nothing.

Fortunately the misdiagnosis did not have a negative impact on my treatment, my new oncologist at Sloan Kettering said he would have done nothing differently based on the new diagnosis- but I was very, very lucky. I can not stress the importance of finding and building a team of health care professionals you trust. Having cancer, being diagnosed with cancer is very serious business- choosing the right team can mean the difference between life and death or it can mean adding potentially months if not years to your life.

The three top cancer hospitals in the United States are Sloan Kettering in NYC, MDAnderson in Huston Tx. and Dana Farber Cancer Institute in Boston- I cannot impress enough on my audience the importance if at all possible of getting an initial proper diagnosis. If you are fortunate enough to live within a reasonable distance of any of these hospitals they should be your first choice. If not choose a hospital that specializes in cancer treatment.

If for what ever reason you are uncomfortable with any of your Dr.s whether it be an Internist, a surgeon, an oncologist or psychologist or psychatryist  do not hesitate to speak up. However you decide to address the issue make sure you are 100% comfortable with your entire team of Dr.s.

My next segment will  focus on my team.....