Table 1.

Diagnosis to Treatment Timeline

June 29Appointment with family nurse practitioner for chest wall pain
July 5Bone X-rays series
July 6Phone call from PCC reporting abnormalities in ribs and pelvis. Recommended CT scan.
July 12CT scan
July 13Appointment with PCC. Results of CT scan show rib fractures and metastatic breast cancer in ribs, pelvis, and cervico-thoracic spine. Phone call from general oncologist recommending bone scan and follow-up appointment.
July 15Told brother and daughter
Week of July 16Told key colleagues at work, 2 close friends and other 2 brothers
July 18Bone scan
July 25Appointment with general oncologist. Recommended seeing his colleague, an oncologist who specializes in breast cancer.
July 2First appointment with physical therapist
July 27Told mother
July 31Bone biopsy
Week of August 6Began to tell more extended family members
AugustBrain MRI for recurrent headaches
AugustFirst appointment with breast cancer oncologist. Recommends molecular profiling of cancer cells from bone biopsy and starting Zometa to prevent further “bone events.”
August 17Dental evaluation before starting Zometa
August 28First infusion of Zometa
August 30Scheduled follow-up appointment with breast cancer oncologist, but canceled and rescheduled (after several phone calls) to next day because molecular profiling results not back
August 31Follow-up appointment with breast cancer oncologist. Decision to start carboplatin after reviewing lots of treatment options. Also met with genetic counselor.
Week of September 3Informed faculty and staff in my units. Informed college deans/directors. Also told colleagues in the community, eg, hospital board members.
September 7Pre-op appointment with surgeon for port placement
September 10Port placement
September 11Chemotherapy education with pharmacist
September 12First chemotherapy

  • CT = computed tomography; PCC = primary care clinician; MRI = magnetic resonance imaging.