My mother took treatment for breast cancer for around 1 year 9 months, under Dr. Shekar Patil and unfortunately she is not with us today, and hence I want to help others to choose their oncologist wisely. Over the periodMy mother took treatment for breast cancer for around 1 year 9 months, under Dr. Shekar Patil and unfortunately she is not with us today, and hence I want to help others to choose their oncologist wisely. Over the period, there have been multiple incidents which raised doubts on either the team's interest in the case or their expertise.**** ******** * **** ** *** ****** *** *** *** **** ********** *** *** **** ******** ** ** ****** **** ** **** *** **** **** ********* ** **** **** ******** ****** *** ***** **** ************ and doesn't have time to explain and discuss ** **** *** ***** ******* ** ***** *** ********* **** ** *** ***** ***** Hence, I would recommend you to choose the oncologist who has at least time to talk to you and who can give attention to your case. ********* ** **** ** ****** ** *** * ****** ****** ***** ** ****** *** ********* *** **** ** *** ******* *** *** ***** ** *** **** **** *** *** ********* Based on my experience, in hindsight, I would recommend ******** *** ***** *** *** to remain far away from Dr. Shekar ** ******* ******** *******
I am writing some exact incidents when Dr. Shekar himself, or the overall team had contradictory answers among themselves, as well as some incidents when the treatment plan was not on lines with other second opinions.
1) Initial diagnosis happened in a city near our hometown, confirming metastatic breast cancer. The oncologist told that drug (chemotherapy or hormonal therapy) will be decided based on biopsy report. Since it was the deadly cancer, we brought my mother to Bangalore in a hope of better treatment, and based on reviews went to Dr. Shekar Patil. Seeing the reports, **he immediately recommended Chemotherapy** and pressurized us to take the call soon. However, based on our information from earlier oncologist, we asked him to wait till biopsy report is received. On this, he started saying that first line of chemotherapy can be given irrespective of biopsy report and drugs will be altered from second line based on biopsy report. We still insisted to wait for the biopsy reports. A few days later, biopsy report was received and it showed hormonal receptor positive cancer. Then Dr. Shekar prescribed hormonal therapy and said chemotherapy might not have been effective. **** *** **** *** ** ** **** ***** ** **** ************* ******** ******** ******* ***** *** ***** ************ ****** *** ** ** ******** ******* ** **************** Later the dosage was changed from 125mg to 100mg. *** ****** *** ******** ** ** *********** ****** ** ********* ** *** *** ***** **** ** ***** ****** ** ***** ** ******* ** *** *** ******* ****** *** ********* ** ******** ********** ********** **** *** *** *** **** ******** ** ******** * **** ******* ******
2) After 11 months of reducing to no-pain duration, the patient complained again for pain. At this time, one of Dr. Shekar’s team’s doctor Dr. Sateesh prescribed MRI of the pain area. MRI confirmed metastases. *** ******* ** ********** **** ** * *********** ******* * **** **** ** ****** ****** ****** **** ********* ******* ** ****** ** ****** *** ******* ************ **** Dr. Shekar had a little time to even discuss about it, and just said that metastases will be there, it won't disappear suddenly and just returned us. ** **** *** *** ***** **** *** ******* ****** **** **** **** *** **** ********** *** *** ***** **** *** ***** **** ****** ****** ****** ** *********** ** **** ** **** *** * ********* ******* **** *** *** *** **** **** ***********
*** ****** *** *** **** ****** ** ******** ** *** *** *** **** ** **** * ******* I had to ask that should we prepone the PET scan from another 9 months to just 3 months, on which he said yes.
** ***** *** **** ******* **** ********* ** ** ****** **** we ourselves went for PET scan before due date. And unfortunately, cancer had progressed and met liver. At this point, Dr. Shekar said that immediately chemotherapy needs to be given otherwise if patient catches jaundice then we will be left with no treatment options. All scared, we just proceeded as he said. **He did not even discuss what drug(s) will be given and why is he making that choice?** *** **** **** ** *** *** **** **** **** * **** ********** ********* ***** **** ***** He gave three drugs (FAC regimen) as part of chemotherapy.
Meanwhile, I sent the reports to an abroad oncologist for second opinion - the response from there used to take around 4-5 days. The exact sentence from the second opinion response is "If possible, and this has to be judged clinically and with the blood values of the patient, we would prefer to give a monochemotherapy (only 1 drug, for example a taxane with or without the addition of bevacizumab) instead of 3 as proposed.”
In this duration, my mother responded very poorly *** ********* ******** ********* *** ** ******** ** ************* She remained hospitalized for 12 days due to alarmingly low blood counts. Dr. Shekar, now started saying that he is not thinking of giving another chemotherapy and will start second line of hormonal therapy after patient recovers.
**** *** *** ****** **** ******** ** **** ********* *** **** ***** **** **** *********** ************* *** **** **** * ****** ******* ********** ***** ****** **** **** ****** **** ****** **** **** ****** ******* **** ******* **** ******* *** ******* ******* ******* ** * ****** **** ***** **** *** ****** *** ******* ** ******* ********* **** **** * ********** *********** ****** ** ** ***** ****** *** ***** ****** ** ****** I took a third opinion too from an oncologist in Hyderabad and he also suggested taxane/paclitaxel alone for chemotherapy drug.
During the time my mother was hospitalized, I asked one of Dr. Shekhar’s team's doctor Dr. Shashidhara if at least risk of jaundice has gone down or not, for which his answer was No - nothing changes in one cycle. Later I asked the same question to Dr. Shekar just to start the discussion for plan to reduce the risk of jaundice, *** ** ** ********* Dr. Shekar said Yes, it would have reduced the risk of jaundice. *** **** *** ***** ** *** *** ******* **** ****** *** **** ************* ****** *** ******* ** **** *****
4) After getting discharged, we met Dr. Shekar after a week. He immediately said we will start second line of hormonal therapy only and that he is not in favor of another chemotherapy at all based on last reaction. ** *** *** ******* *** ***** **** ** **** Then I showed the two second opinion reports *** **** **** ***** ******* *** ********** ********** ************* ** ******** **** * ****** *** said yes this chemotherapy with paclitaxel is more beneficial, and if you are willing to take risk of low blood values, I would suggest to go with that. He started chemotherapy again with paclitaxel.
***** *** ***** ****** ****** *** ** ** ** ****** ***** ***** *** ********* **** ** ***** ***** PET scan done after two months showed good results with tumor size gone down and cancer activity being nill. *** **** *** ** ** *** *** **** ** **** ** ****** ** *** ****** *** *** ** *** **** **** **** ******* ** ** ***** ********* **** ************ **** **** ***** *** ******** *** ********* **** ******
** ** ******** ******* ********* **** ******* ** ************* ***** *** ****** *********** ** ******** *** ************ ****** *** **** ********* He said that we will give the drug on wider time gap in order to make it tolerable.
At this time, I went to cytecare for another opinion *** ******* ***** **** ********* **** ** ******* *** ******** **** ** ****** ** ********** ****** ***** ** ** ***** *** ******* ** ********** ****** ** *** *** ******** ** **** **** *** ** ******* ******* *** ** **** ******* ** ******** ******** *** ****** *** ****** *** *** *** *** ** ****** *** ****** **** *** *********** Moreover, I thought that this time opinions are correlating and put my faith that Dr. Shekar will be able to assess it properly, which he was probably, but we lost the opportunity to change the doctor).
Just immediately after one week Dr. Shekar stopped chemotherapy saying that side effects are more, but I can tell that in one week complaints as well as physical condition had not changed. And anyways the plan was to give the drug on wider time gap; ** *** ******** *** ******* ************** Dr. Shekar started second line of hormonal therapy.
6) After less than 2 months, on 1st April, my mother was feeling discomfort in abdomen, for which we admitted her in hospital. Her bilirubin was 2.5 (normal is till 1). Dr. Shekar just suspected that it could be due to cancer progression or due to hormonal therapy drug. ** ********** **** ** * *********** ****** * ***** **** *********** ***** *** * ** **** ** ***** ** ** ** *** ** ****** ************ **** *** ****** *** **** *** *** ** *** **** ** **** ***** *** **** *** *** **** ***** ** * ******************* *** I myself took the patient to visit one gastroenterologist for abdomen issues.
On 3rd November, her bilirubin was 3.4. Meanwhile, I sent the reports again for second opinion to abroad doctor.
On 4th April, CT scan was done which confirmed cancer progression, after which it seemed as Dr. Shekar and team was not even interested in the case. Report had shown that minor portal vein was also blocked by clot, *** ***** **** *** *** **** *** ***** ******** They just discharged the patient with give-up answers to us, not even clarifying the actual situation properly. They did not even prepare us for what is coming, and what should be our action on any condition.
Now we changed the doctor ** ****** ******** ************* but it was very very late by now. B** ** *** ** **** **** * **** ********** ****** ** ***** *** ****** **** **** ****** ******** ** ******* ****** **** ********* **** ***** ****** *** ****** ** ******** *** **** ******** the doctor explained three options and pro-cons of all three and then thoughtfully decided one along with a thoughtful discussion around dosage. He prepared us by telling the actual situation in very upfront way and told what should we do if patient collapses. Now, we were just remorsing that why did we not change the doctor earlier? We should have taken someone who could have remembered the case *** ***** **** ***** ********* ** *** ***** A day later, the bilirubin was also 16.5. So, we had no choice at all apart from remorsing. Consequently, my mother left us forever.
Finally, second opinion report from the abroad doctor came and the exact sentence was - "Considering that the patient still has acceptable liver tests (bili less than 5x the norm, ASL/ALT less than 10 x the norm) I would suggest to restart quickly with a chemotherapy, before coming to the point where it can no longer be administered. I would start again with NabPaclitaxel or Capecitabine or low dose weekly epirubicin or vinorelbine (with a strict control of hematology and liver tests).” *** ***** ** **** ******** *** ****** *** **** *** **** **** **** *** ****** **** ********* *** **** ** ***** ************* **** **** ** ** *** **** ** ****** *** ** *** **** ********** **** **** *** *** **** *** **** ********* ******* ******* ***** ******* *** ***** ** ******* ****** **** ********* *** *** ****** ** **** *** **** ** ********* ****** *********** *** ******* *** **** ***** **** ***** ** **** *** ********
It could be possible that they took the decision based on some other factors, but at least they did not communicate that to us, *** **** ** **** ****** ****** ** ** **** **** ******* ****** ******** *** ******* **** *** *** *** ***** ** **** ** *******
Apart from these major contradictory incidents, there were minor ones too like:
- one doctor saying that chemo administration should not immediately follow blood transfusion and another saying that it does not matter.
- For chemotherapy's neurology related side effects, patient kept on complaining for pain *** ******* *** ********** ** ** *** *** ******** ** ** *** ******* Once, we ourselves took the patient to a neurologist, and showed the prescription to Dr. Shekar for which he said yeah this medicine should be given. **** *** ****** *** **** ********** ** *** **** ******* ** ********* ***** ** ***** ** ***** ***** *** ** ********* ***** **** **** **** *** ***** ****** **** ****** **** **** ** ********** ***** *** **** *** **** ****** *** ****** ******* ******* **** ** ******* **** ** ******** **** ******** * ******** *** **** ********* *** ** ** *********** ******** **** *** ** ********* ** ****** *** ******** ** ******* * ******
******** * ***** ***** *** **** *** ****** ***** ** * **** ****** *** ***** ** *** ******* ******* *** *** **** ********* ** *** ****, I don't recommend him ** ******* ****** ** *****
One good thing about him is that he remains available on calls and is overall soft spoken, but not all other doctors in his team are alike soft spoken or available.
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