Regional hospitals are quite nice at what they do, but if you are faced with a life-threatening illness, choosing the best hospital is really the only right option in my opinion. I speak from experience: a regional hospital did not routinely perform an MRI for my breast cancer. At the Antoni van Leeuwenhoek in Amsterdam it was discovered that there was also a lymph node near my breastbone that was full of cancer. It can make the difference between dying and living.

The difference between a specialized cancer hospital and a regional hospital

The differences between a specialized cancer hospital and a regional hospital are often large. Of course it varies per hospital, but most regional hospitals simply do not have oncology as their only specialty. This means that cancer patients are included. In my case it also meant that I had to wait weeks for the results of all the tests. At the Antoni van Leeuwenhoek in Amsterdam, you go to the hospital in the morning if you suspect breast cancer and you know half a day later whether you have cancer or not. For me it took weeks. In addition, follow-up examinations can be scheduled and arranged very quickly. Because with cancer it is very important to know whether there are metastases. In the case of breast cancer, the following will be examined:

1. Metastases in the bones through a bone scan with radioactive material
2. A liver ultrasound to see whether there are metastases in the liver
3. A chest x-ray to see if there are also metastases in the lungs.

The MRI for breast cancer

Not every regional hospital allows an MRI to be performed for breast cancer, as my research has shown. For many people, only lobular (located in a mammary gland) breast cancer is examined. I myself had breast cancer that is referred to as ductal (located in the milk duct) and for which MRI is not done in many regional hospitals. A huge missed opportunity, because at the Antoni van Leeuwenhoek it soon became apparent that there was also a damaged lymph node near the breastbone. This was never discovered in the regional hospital in Sneek and the long-term consequences are often disastrous, because the cancer can then continue to run its course while the woman in question thinks she has been treated and is therefore healthy. The affected lymph node near my sternum is now being treated with chemo (before the operation) and after the operation with radiation.The entire body is mapped using an MRI (and radioactive material injected into the veins). If there are metastases anywhere, they will be noticed immediately. At the Antoni van Leeuwenhoek I also participated in a study in which radioactive markers were inserted into the tumor of the breast and that of the affected lymph node under my arm. By introducing glucose into the body (for this you must first fast for 6 hours so that the body contains little glucose. Before the examination, the patient is given a Valium tablet to ensure that there is as little activity as possible in the body, because this can blur the picture) it is possible to see exactly where tumors can be found. Cancer loves sugar and where the injected glucose goes, there are tumor cells. Everything is captured on camera and continuously compared to see if there are any changes.

Treatment in a specialized cancer hospital versus that in a regional hospital

In addition to the diagnosis and the speed of diagnosis, treatment in a specialized cancer hospital is often very different from that in a regional hospital. A research hospital conducts research and has much more experience with various treatment methods than a regional hospital that normally removes an appendix more often than treats cancer. In my case, the treatment plan was completely different at the Antoni van Leeuwenhoek than at the regional hospital in Sneek. In Sneek they first recommended breast-conserving surgery and the removal of the lymph nodes (which they skipped because they did not know it was there), then radiation and possibly chemotherapy. They weren’t sure about the latter either. In the Antoni van Leeuwenhoek the plan was immediately different: first give a big blow to the existing cancer with chemo once every two weeks. Then surgery and then radiation.

Chemo before breast cancer surgery

Research has shown that in many cases chemotherapy before surgery gives better chances of healing and/or survival. In the Antoni van Leeuwenhoek they therefore do this almost as standard in cases where this is possible. In my case there were of course already metastases in the lymph and that is why they immediately want to deal a hard blow to the disease by giving chemo in advance. In technical terms, this is called neoadjuvant treatment. Neoadjuvant treatment can also consist of radiotherapy (irradiation) beforehand.

Cancer treatment methods

Basically there are 4 methods for treating all types of cancer. These are:

1. Curative treatment. Is aimed at healing a patient.
2. Adjuvant treatment. This is an additional treatment and in many cases is given after curative treatment. This means, for example, chemotherapy or radiotherapy after surgery.
3. Neoadjuvant treatment. This is given before the operation and can consist of radiotherapy or chemotherapy. In regional hospitals this is often done to shrink a tumor, but in the Antoni van Leeuwenhoek it has another reason and that is to see whether the chemo is working at all. Women often receive chemotherapy after their surgery, but it does not always mean that the chemo actually works. So a lot of poison is poured in, which will certainly make someone sick, but the effect will then be nil. At the Antoni van Leeuwenhoek they evaluate with an MRI after 3 cycles to see whether the tumors respond to the chemo. If this is not the case, we will switch to another treatment. That is also a big difference with a regional hospital.
4. Palliative treatment. Aims at inhibiting the diseases and reducing the complaints. This does mean that the disease can no longer be cured.

Other methods for cancer

In addition to surgery, chemo and radiotherapy, immunotherapy can also be given. This is a treatment with agents that strengthen the activity of your own immune system. Hormonal therapy is also often given for breast cancer. If research into the tumor(s) has shown that the tumors are hormonally determined, women must take medication for years to, as it were, shut down this system.

Can you go to another hospital if you have cancer?

Cancer is about one thing and that is healing. As a cancer patient, you must ensure that you find the best practitioner. So yes, go to another hospital if you want the best treatment. Go to a specialized hospital where they can do everything for you, have the latest insights and research comes first. They know more, they can help you much better and they do not hesitate to use every means possible. Getting to such a specialized hospital is not always easy: it is a matter of perseverance. If you are already in the research phase at another hospital and you cannot get involved at a specialized hospital, go for a second opinion. That is possible in all those hospitals. They must already have the treatment plan from your own hospital and therefore the results of all your tests. That is very annoying, because in many hospitals it takes a very long time. That means waiting, even though you already know that you have cancer and want to hurry. Your own hospital must also cooperate, because it must send all the images and pathological data. Constantly being on top of things is what you have to do to try to save your own body if the hospital does not cooperate.If you are in an earlier phase (for example, your GP does not trust it yet) then make an appointment immediately in a specialized hospital. You will be diagnosed much earlier, you will immediately be at the right place and it will save you a lot of calls and hassle. Because regional hospitals also want to retain their customers. Simply because they get money for it. However, always keep in mind that it is your life. Cancer can mean the end of your life if it is not treated correctly (and provided you catch it in time, of course). But even if the cancer is already in a much more advanced stage, in my opinion you are much better suited in a specialized hospital. They still have methods there that ensure more time and better quality of your life.

A specialized cancer hospital is often much further away: keep that in mind

It makes quite a difference whether you have to go to a local hospital around the corner for every examination or whether you have to drive for hours every time (and go through traffic jams). This can be a problem, especially if you are ill and don’t have the most energy. I have also experienced that as difficult, because you sometimes have to spend whole days on the road for a consultation or treatment. In case of breast cancer radiation, you also have to go to your treatment center 5 days a week for 7 weeks. That is an attack on your fitness (which you do not have anyway). You may have dear friends or family nearby who can relieve you for an evening by sleeping with them.

Taxi transport for cancer or travel expenses reimbursement for cancer treatment

In addition, your health insurer may qualify you for taxi transport for oncological treatments. The hospital must then complete a declaration and after you have paid a deductible of over 90 euros (in 2012), you can take the taxi to the hospital every day. If there are people in your area who want to drive with you (because with chemo and radiation hours away from your place of residence, you really cannot do that yourself), you can also receive compensation per kilometer so that you do not have to pay a cent after the treatment period. your bank account.

Personal blog about breast cancer

In my personal blog about breast cancer I describe all stages of research and treatment of my own breast cancer and provide tips and advice. The blog can be found at: I have breast cancer