Getting a Second Opinion

Cancer is a complex disease with different potential treatments—if you ask
August 27, 2019 Updated: September 12, 2019

Cancer is one of the most common diseases of our age, and yet those who face it rarely know what’s about to happen to them beyond the broadest terms. “Cancer up Close” is an open recount of Michele Goncalves’s cancer journey from pre-diagnosis to life after treatment.

I remember my first contact with the Cancer Treatment Centers of America (CTCA) as if it were yesterday.

It was a few days before the Christmas holiday. I was trying to get into the spirit of the season, but I was frightened and overwhelmed as the seriousness of my situation sunk in.

On Dec. 20, 2017, six days after I was diagnosed with cancer, I was alone in my house reading their website at the suggestion of my functional medicine doctor. I decided to start a chat with them via text because I really didn’t want to talk to anyone on the phone.

My goal was to learn their protocol for treating stage 3 rectal cancer. I questioned why the New Jersey surgeon whom I met a week earlier wanted to do radiation and chemotherapy before surgery, which didn’t sound right to me. I wanted this tumor cut out ASAP.

The person texting me couldn’t answer my questions so I ended up on the phone with a sales representative. He asked me about my illness, and I got very emotional and cried while we talked. He offered comforting words that were welcome and sounded genuine.

He then launched into a sales pitch about how CTCA had at least 10 options in radiation treatments and cutting-edge approaches to cancer. He described a three-day new patient orientation, where I’d be given a full protocol as to what they thought I should do and a team of doctors who would be assigned to my case.

I thought he was laying it on a bit thick, but the thought of having so many treatment options and a team of doctors to offer me a treatment plan in three days sounded really good. I gave him my insurance information so he could check my coverage before we continued.

The insurance screening actually took a few days. He told me that my insurance carrier considered CTCA as out of network, but CTCA would offer me financial assistance. I thought they were joking. “Haven’t they seen my salary?” I thought. I make a good living and never dreamed of qualifying for any assistance.

But my salary didn’t exclude me from financial help at CTCA. I don’t remember the particulars of the deal he offered, but I remember thinking it sounded too good to be true. My auditor antennas quickly went up!

I told him I wanted something in writing before committing. While he didn’t put it in writing, he convinced me the three-day orientation would not be too pricey since it was only doctor’s fees, and that the radiation, chemotherapy, and surgeries that were the costly part of cancer treatment.

Their scheduling department could only get me in for their three-day orientation on Jan. 9 through 11. I had existing appointments for a CT scan on Dec. 28 and an MRI for Jan. 2. Merry Christmas and Happy New Year to me.

On Jan. 3, I had a long phone call with the CTCA “nurse navigator” who would manage my case throughout my treatment. She asked for my medical history, cancer diagnosis, names and doses of all the vitamins and supplements I was on, and what tests I had completed thus far. This information would help determine if I needed any other appointments during the orientation. I thought this was proactive and great.

In the week following, I had an absolute roller coaster ride trying to get my CT scan and MRI results before my CTCA visit. Everyone was out for the holiday season and the New Jersey doctor who wrote my prescription for these tests was on vacation. I was in agony, waiting to know the status of my cancer.
I remember anxiously driving 40 minutes to MRI facility, desperate for the results of my test.

When I finally had the report in my hands, I prayed before I took it out of the envelope and started reading. It was a cold but sunny day as I sat in the parking lot, ready to see my fate.

The MRI showed some concerns about the surrounding tissue. Then, as if God was finally easing my misery, the doctor’s office called on my drive home with the results of my CT scan.

The nurse told me in a sweet voice, “You’re good. The results look good. There are no signs that it has spread.” I was relieved and started to weep. I could barely get the words “thank you” out. She sounded emotional, too, based on my reaction, and wished me well.

With this good news, some of my fear was lifted. Jan. 9 quickly arrived and it was time to visit CTCA.

My brother and I drove to Philadelphia the night before and stayed at a nearby hotel where CTCA clients got a special $25 per night rate. My brother’s room was $96 per night.
They had sent my schedule in advance so I could see exactly what was planned.

Day 1:
8:45 a.m. – Orientation and tour
9:00 a.m. – Check in, get processed in system
9:45 a.m. – Meet nurse, get vitals taken
10:00 a.m. – Meet general practitioner, review medical history
10:45 a.m. – Meet oncologist
11:30 a.m. – Meet nurse navigator

Day 2:
9:30 a.m. – Meet naturopathic doctor
10:00 a.m. – Mind-body medicine introduction
10:30 a.m. – Pastoral patient care
11:30 a.m. – Blood tests
2:00 p.m. – Sleep screening
3:00 p.m. – Meet gastroenterologist

Day 3:
9:30 a.m. – Free car pick-up
10:15 a.m. – Meet with colorectal surgeon
12:45 p.m. – Vitals taken
1:00 p.m. – Regroup with oncologist
1:30 p.m. – Regroup with nurse navigator
2:00 p.m. – Vitals taken in radiology department
2:30 p.m. – Consultation with radiologist
3:15 p.m. – Talk to financial counselor
3:30 p.m. – Regroup with naturopath
4:00 p.m. – Consultation with a nutritionist

As I recall the orientation, memories and emotions flood back to me. I remember feeling happy to see naturopaths, mind-body medicine, and spiritual care included in my itinerary. This really appealed to me and aligned much more with my way of healing than just getting hooked up to a bag of chemotherapy and being pushed out the door.

I wish I could write 50 pages and take you into each appointment I had during that three-day visit. Suffice to say, my experience was good—really good. Their facility didn’t look like a cancer center. It was warm, and reminded me of a hotel. I really liked that.

However, the visit was emotionally and physically draining. I was so freshly diagnosed, and sobbing at almost every appointment, especially on day one. The emotional toll of being labeled a “cancer patient” was hitting me hard.

And the third day was so jam-packed, my brother and I didn’t even have time to eat lunch and had a very late dinner. Fortunately, I always carry nuts and water in my purse.

Between appointments, I saw the reality of what was in store for me. In waiting rooms, I saw women with no hair due to chemotherapy, people so weak and thin they were stuck in wheelchairs, and others barely able to walk, their severe pain plain to see. Nobody prepares you for the sights, sounds, and smells that cancer brings. It was so depressing. All I thought was, “How long before I look like this, too?”

Despite the strain and aggressive schedule, I knew that at the end of it I was going to get a full assessment. I was on a mission to get answers, and they were about to be delivered.

So, what was CTCA’s assessment you wonder? Come back next week to find out.

Until then, breathe deep, be kind, and take it one day at a time.

Michele Goncalves is a financial compliance and fraud auditor for a Fortune 500 company by day and a passionate pursuer of holistic and functional medicine knowledge by night. She is also the author of the column The Consummate Traveler.