Health Care and Medical Treatment for Cancer (Honolulu, Hilo: transplants, health insurance)

[lepatriinu]

Hi Friends!

My family is planning a move to Hawaii in the next year. The biggest question for us is making sure that my parents (who are in their late 70's) can continue to receive the same or better quality treatment for cancer that they are currently receiving, particularly my father who is in stage IV of prostate cancer. I noticed that there seem to be cancer centers in Maui and Oahu, but what about the Big Island??

Currently my dad sees his doctor monthly, and these visits always include review & discussion of any new treatments that have become (or are soon to become) available. Taking monthly trips to another island would not work for us.

Does anyone have any experience or might be able to shed some light on such cancer treatment options on the Big Island? Or any island, really. What have your experiences with the medical system been there?

Thank you all very much!

[tweez]

Hello!

I do not have personal experience but have been doing a lot of island research myself and it sounds like for most serious medical concerns, Oahu is your best bet. I have not looked specifically at prostate cancer (since I don't have a prostate), but it is likely that some travel to Oahu would be needed if you move to any of the other islands. As far as new treatment discussions, that would be really dependent on the specific oncologist and whether they keep up with such things.

Good luck!

[OpenD]

I love the Big island, but one of the serious drawbacks is that there is a long-standing Doctor shortage in the state, and it's worse in Hawai'i County than it is on Oahu. One effect of that is that it can be very difficult to find a personal physician, particularly a specialist, who is accepting new patients. And yes, for specialty treatment you may need to fly to Honolulu, which will easily run $200 - 300 per trip.

Sad to say, one of the common reasons long time island residents give for returning to the mainland is due to chronic health challenges that are not as easily addressed in Hawai'i.

[oregonwoodsmoke]

OP, if your father has a good doctor that he trusts and is getting good treatment, this not a good time for him to be moving.

Good doctors are not all that common and moving is a huge stress, so not the best plan for anyone who is already stressed by serious illness.

[Dreaming of Hawaii]

I totally agree with OpenD. We usually leave the island if we need a specialist. Bringing someone here in their 70's with a pre-existing condition that needs specialized care is just wrong.

Who is your father's health insurance through? We are with Kaiser, so we are able to get accepted at the clinic. However, I've heard that there are a lot of physicians who are not accepting new patients, and especially those with Medicare. And, even with Kaiser, they do not have specialists who are here full-time. My husband's cancer follow-up (after having treatment in Colorado) doctor is here on the BI one day a week, and sometimes we have to wait as long as six weeks to get an appointment. So either you try to get in to see a doctor with limited availability, or you fly over to Honolulu.

Sorry, but that's real life on the Big Island of Hawaii.

[whtviper1]

Depending on the cancer - Oahu might not even be an option.

[lepatriinu]

Thank you all for your thoughts! We've got a lot to consider.

We called the Hilo Hospital yesterday and it looks like they do all the same treatments however they have just ONE medical oncologist so it doesn't too sound promising. (what if he takes time off or retires, and does he have a chance to collaborate with colleagues, etc)

We also called the University of Hawai'i Cancer Center and they said they have oncologists who often fly to the other islands.

Everyone we talked to was of course unbelievably nice and supportive on the phone.

Ultimately it's my father's decision but we need to be convinced it wouldn't be a mistake. We feel comfortable so far with Maui or Oahu but it looks like the Big Island is not a great option. Improving quality of life also comes into consideration.

thank you all again!

[Galactastica]

lepatriinu, I am a Patient Navigator for cancer patients with American Cancer Society for the Hawaiian Islands. I can guarantee you that most patients will have to fly from the neighboring islands multiple times when diagnosed and receiving treatment. The treatments/doctors are VERY limited on neighboring islands. I would not ever suggest someone move there if they are already diagnosed and seeking ongoing treatment. I may not even suggest a move to O'ahu depending on their specific needs. It will require a lot of money and less access to care in general. I say this not to poo-poo the islands, because I love them with my whole heart, more than anywhere else on the planet, but knowing the hardship that patients go through when needing treatments and check ups, I just can't say it's a good idea with a clear conscience. There are some people who have to go to O'ahu for every follow up with an oncologist, 6-8 weeks of radiation, almost always for surgeries, and the list goes on. If it's something you're family feels like they must do, O'ahu is going to be your best and only real possible option for someone who is an ongoing patient. If you are absolutely made of money my opinion may change, but you did say that flights to/from wouldn't work, so I'll assume that's not the case. If it's a case where one of them needs transplants of any kind it's guaranteed they'll have to go back to the mainland. It it's clinical trials they are interested in, it's a 99% chance they'll be told the same thing. This is a very, very serious decision for someone to make in their situation, I wish you the best of luck!

[smarino]

I think the above post summed it up for you quite eloquently. As someone that has recently seen some of our family go through cancer treatments, I would not think it would be a good move to go to Hawaii either. We lived on the Big Island many years, and the medical services are not very good for even ordinary problems, not in our experience anyway. Your parents would be leaving the friends that they have, the doctors that they know, and entering a different culture where it is not easy to make new friends. A support network is vital to anyone in medical need. Sometimes the people that care for us, and care about us, can offer more healing and peace than a host of strange doctors, so don't forget to make this a priority in your parents remaining years.

[SFBayBoomer]

For your father's sake, please don't make this move now.