Change of Consultant stage 4 renal cell Carcinoma

Yes.   Or sort of.  

Started with oncology in Dec 2021 and met my named consultant.  After all the crap that goes with diagnosis (NHS staff expecting you to cry constantly and be a wreck) it was an absolute joy to be treated like a normal adult again with a functioning brain, able to make rational decisions about the treatment pathway that met my needs.   

I started treatment in Jan 22 and had check-ins with my consultant in Feb and March, and maybe a few more phone calls.  I got to the point where I felt comfortable with him and had built up a trusting relationship.  

Then he told me he was moving to a new role and his clinic time was being reduced.  Therefore he would be handing me over to AN Other at some point.   I was totally unimpressed and not happy.  I came to oncology after meeting with every staff member of the NHS (exaggeration!) and this consultant was the final one to the End Game.  I felt dumped!  He told me lots of things about the new incumbent like "he's really nice"; Me: "yeah, of course he is", "He'll be here for a long time" blah blah.  I would retain my current consultant as he'll still be in the dept.  

Then in May I experienced some adverse side effects and went in to oncology on one of those unscheduled appointments.  The new oncologist was running the clinic that day.  I've seen him ever since.  We've built up the same trusting relationship as I had with my onco 1, but it's even better.  We have great feedback sessions and we chat about normal stuff too.  We have Banter!   He's slightly better for me than onco 1 because he knows when to shut-up.  I don't know whether his approach is patient-specific or if he's been listening carefully to me explaining how I cope with having cancer, or perhaps he's just read me well.  I think onco 1 may have had too much lecturing time at uni.  He articulates a point very well, but it ain't brief!

It's probably a bit unfair of me to compare my onco's like this as we are all individuals with our own style.  But by 2-3 months I felt comfortable with the new one.  It's probably got a deeper foundation now than number one, because of the difficulties with my treatment when we first met.  Plus I've seen him for a year now.  It's funny you raise this question, because I am going to see onco 1 about a trial I'm applying for on Wednesday.  

Totally agree - you need to have a good trusting relationship with your consultant.  I've written my PoA and only these two consultants (or myself) are authorised to trigger it.  I don't trust anyone else that I can name right now and I wasn't prepared to include a generic clause.  

Thanks. That’s encouraging. I think the reason I have been un-nerved is that this change has come just as my disease has decided to go on growth spurt. It didn’t help much that  when after just one appointment with him he referred me to a Macmilan Nurse. I thought blimey is he saying I need palliative end of life care. The nurse when she came to see me explained that this isn’t the case moreover the referral had been sent because the new Fellow thought I needed some additional support as I was truthfully feeling very low. 
Perhaps if he’d explained this at the time we might have got  off to a better start. 
I will be seeing him in 3 weeks time and will attend in more of a mind to develop some trust. 

Yes, it's all in the "how" isn't it.  When my new onco invited a student to "observe" and the scene was set and subsequently explained to me, I was not happy and weeks later fed back how Drs arrange the outcome they want without checking in advance or giving enough thinking time.  Having a student waiting for you in the meeting room makes it more difficult to say no, and the question is not presented in an open-minded way, and the eviction becomes awkward for everyone.  Now we've cleared the air, we had a laugh about it afterwards, and now he asks me in advance on the walk to the room.  And I now know if it's bad news he wouldn't use that approach. 

I think sometimes consultants just don't realise what it's like for us on the other side.  And we're all different, too.  One approach doesn't suit  everyone.  

By the way, 14 years with a consultant is very impressive.  It's not a small step to start afresh after that.  

Forgot to say, I'm stage 4 RCC too.  

Hi Rojan,

I know exactly what you are saying and had the same feelings even though I only knew my oncologist for 2 years. I was accepted onto a trial purely down to him constantly searching for a suitable trial and then persuading them to accept me as I had the added complication of Leptomeningeal disease.

I’m convinced my extended time has a lot to do with the confidence he gave me. He simply knew everything!! And would tell me all the pro’s and con’s of any new treatment.

I now have a number of people who I see, originally on a weekly basis and it’s so difficult for me to trust them, whatever they say, I’m thinking is that what my guy would say, or more often than not…. That’s not what he would say!!

To answer your question it’s been 5 months now and I’ve managed to find someone who “gets me” and even though I sometimes get seen by another member of the trials team, I can usually bring the other person into the conversation or at worse see them the next time I’m there.

Hope this helps?

Hi Rohan,

 I am sorry to hear your news about changing consultant after so long, I understand where you are coming from I have a great relationship with my oncologist and I don’t know what I would do if he left, but as Mmum and Davethedog said it will take time to get used to another consultant I hope it happens soon for you Sandy