Saws,
As many of us have learned - and I learned it from this site almost 3 years ago - there is a hierarchy of cancer care. Most of us seem to start with a local urologist, some move on to a Urologist with a specialty of urothelial/renal carcinoma at a regional medical center. Many - especially if there is an unclear diagnosis, rare or an advance in grade, stage or metastasis - wind up seeking an opinion (and perhaps treatment) at a National Cancer Institute Designated Cancer Center.
From my experience, the level of services provided at the NCI-CCs is practically unobtainable at the local or regional level. I (and others here) have expressed the benefit from being seen at a place where "the tough cases" are the order of the day. I may have benefitted if I had made the decision earlier.
I continue to be treated by my Uro at the regional center 5 hours from my remote ranch, but I am followed and seen if needed by MY TEAM at the NCI-CC, which is a full day away, longer in rain or snow.
Everyone involved in my care is comfortable with this arraignment - me, my Uro at Regional, and the NCI-CC team.
I mean no disrespect to ANY caregiver or to their commitment to their patients. I have found that timely delivery of less-common and more-intensive services are available only at the higher tier of care.
A list and description of NCI-DCC is linked below.
NCI-Designated Cancer Centers
www.cancer.gov/research/nci-role/cancer-centers
None of us here are doctors. We are just patients working our way through the medical system and reporting on our experiences. We hope to learn from the words of those ahead of us and hope our stories assist those following us.
Best,
Jack