Your Cancer Care Team

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Dr. G: Communicating with your Health Care Team
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Factors When Choosing Your Team

Consider these factors when choosing your health care team:

  • Past relationships. If you had cancer before, would you like to see the same doctors? Do they listen and take your needs and concerns into account? Do you trust them? If you aren’t sure, it’s a good idea to meet with someone else, or more than one doctor, as a comparison. Even after meeting with other doctors, you can choose to continue with your original doctor.
  • Recommendations. Is there a doctor or nurse you trust who can recommend a medical oncologist for you? Do you have a friend, colleague, or relative you trust who has had a good experience with a doctor they can recommend?
  • Expertise. Is your doctor a general oncologist or do they specialize in the kind of cancer you have? Do they attend medical conferences and keep up with cancer research? Advances in treatment happen quickly. Try to find someone who is up to date on the latest research. Look for a doctor who treats cancer of the same type and subtype as yours.
  • Communication style. Do you want a doctor who tells you all of your options and leaves the final decision up to you? Or do you want someone who doesn’t go into detail and just tells you what they think is the best thing to do? Think about which approach works better for you.
  • Approach to treatment. Some doctors recommend many tests and combined treatments, while others prefer a less aggressive approach. The decision is yours, but it is important for you to understand the choices.
  • Availability of Clinical Trials. Some treatments with the best chance of success may be available only through clinical trials. But not all treatment centers offer clinical trials. And not all centers have the same clinical trials. Be sure to ask about local clinical trials that might be right for you. Ask if they are willing to refer you to other clinical trials.
  • Geographic location. Think about travel that might be needed for treatment. How will you get there? How often will you need to go? Are you able to travel farther if it means getting better care?
  • Insurance. Your choice of doctors may be limited by your insurance. Check with your insurance provider and your doctor to make sure your care will be covered. Ask about appointments, tests, and treatments.
  • Urgent care needs. Is the medical oncologist available for urgent care needs? Does this doctor work with a team? Who is available to answer questions during off hours?

 

Members of Your Multidisciplinary Team

Each individual is unique; each person’s cancer is different. You are the expert in your cancer experience. Together, you and your health care team can work to get the best care for you. Knowing who is on your team will make it easier to efficiently manage your treatment and find resources you need.

  • Hematologist/oncologist: These doctors are specially trained to diagnose and treat cancer and specialize in the use of chemotherapy and other drugs to treat cancer.
  • Primary care physician:  The doctor who provides primary health care for you and your family.. Still see this doctor for regular check-ups and non-cancer-related issues like diabetes, hypertension, or asthma.
  • Specialist physician – The doctor with advanced training in the part of the body where your cancer started. They may have helped diagnose your cancer and continue to play a role in your treatment team. They may be a dermatologist, ear/nose/throat doctor, pulmonologist, urologist, obgyn, or other specialist, depending on the type of cancer you have.
  • Oncology nurse practitioner (NP) or Oncology physician assistant (PA) – They can diagnose and treat medical problems and prescribe medicine. They may see you with your doctor or independently. This may be the person you contact with urgent questions or concerns.
  • Nurses: You will have the most direct contact with your nurses. Oncology nurses, radiation therapy nurses and oncology nurse practitioners have special training in caring for people with cancer. Nurse practitioners can prescribe medications and diagnose illnesses. Your nurses will be able to answer many of your questions, give medicine, and provide emotional support. They are also usually in charge of implementing the treatment plan your doctor has set up for you.
  • Surgeon: These doctors perform biopsies (cells or tissues are removed from the body and examined to help with a diagnosis) and surgeries.
  • Surgical oncologist: These surgeons specialize in treating cancer.
  • Pathologist: These physicians examine biopsy and tumor tissue and are responsible for the accuracy of laboratory tests. They will provide you and your doctors with information about your tumor that will be used to determine how it will be treated.
  • Radiologist: These doctors read and interprets x-rays, ultrasounds, CT scans, MRIs and other imaging tests. This member of your team may also perform biopsies during special x-rays or ultrasounds.
  • Radiation oncologist: These radiologists specialize in the treatment of cancer using radiation.
  • Dosimetrist: The person will use the radiation oncologist’s prescribed dose of radiation for your tumor to calculate and plan your radiation treatment.
  • Radiation therapist: The person who will deliver your radiation therapy.
  • Medical physicist: The person who will be responsible for ensuring you receive the exact dose of radiation prescribed by the radiation oncologist.
  • Social worker: A person trained to identify social and emotional needs and provide services necessary to meet them. A social worker can help you and your family find resources to cope with cancer and its treatment such as financial, transportation, and home care needs.
  • Patient/nurse navigator: Navigators can help you talk with your health care team, help set up appointments, and help you get financial, legal, and social support.
  • Pharmacist: The doctor who will prepare and dispense your medications. She or he will be able to explain to you how your medications work.
  • Psychiatrist and psychologist: Mental health specialists who can help you and your family understand, manage, and cope with feelings, thoughts, worries, and behaviors. Psychiatrists have a medical degree and have the ability to prescribe medication.
  • Registered dietitian: A person who can help you maintain a healthy diet and get proper nutrition during your treatment and recovery.
  • Plastic surgeon: The doctor who specializes in cosmetic and/or reconstructive surgery.
  • Rehabilitation specialist: A person who specializes in helping patients maintain or regain their ability to perform daily activities. Depending on the type of cancer you have, you may see a physical therapist, occupational therapist, counselor, or speech therapist during and after your cancer treatment.
  • Home health aide: An aide can help you move around or with bathing. She or he may also cook or do some household chores.
  • Hospice care providers: These individuals provide specialized care to meet the needs of people who have terminal or end-stage cancer. This type of care focuses on providing physical comfort, reducing pain, and giving emotional or spiritual support.
  • Clergy: Chaplains conduct religious worship and perform other spiritual functions associated with beliefs and religion. Many people find prayer and spiritual counseling can be help them cope with cancer.

 

Don't Have Many Options for Health Care?

It may be hard to find a doctor. You may be limited by geography, insurance, or finances. As a first step, make sure that you have done a thorough search. There may be a doctor or hospital you haven’t heard about. Try these websites to find a doctor:

  • American Society of Clinical Oncology
  • National Cancer Institute-Designated Cancer Centers
  • If you can’t find a doctor nearby or have chosen a doctor who has not the kind of cancer you have very often, here are some things you can do to ensure that you receive the best possible care:
  • Learn about the kind of cancer you have. Read the resources provided here and on other websites recommended by your health care team. There is a lot of inaccurate information out there so be sure to ask your nurse for suggestions. Ask questions. Your doctor may not be able to answer them on the spot. Try to find a doctor who will look for information and resources to learn as much as possible about your disease and how to treat it.
  • Ask your doctor where to go for a second opinion. Does your doctor know another doctor at an NCI cancer center? Maybe there is someone you could see once who could consult on your case?
  • Call or email the closest NCI-designated cancer center. Ask if they have a visiting oncologist who comes to your area occasionally. Ask how you can get to see this doctor. Some hospitals have telemedicine services that could be useful to you or your doctor.
  • Find out if you are eligible for any clinical trials.
  • Call or email a cancer organization listed at the end of this book for advice.
  • Build your own health care team. Work with your doctor to find other resources and care team members.

 

Communicating with Your Healthcare Team

You’ve chosen your health care team. The next step is to make sure that you work with them in a way that is most helpful to you. Here are some tips for communicating with your health care team:

  • Keep a running list of questions to bring to office visits.
  • Bring a friend or family member to appointments to help listen and take notes.
  • Ask about the best way to get your questions answered. Is it better to call, email, or bring a list to appointments? Do you need to schedule an extra appointment if your list is very long?
  • Find out who to contact with questions and concerns between visits. Write down their contact information.
  • Ask questions until you are sure you understand. You deserve to get your questions answered in a way that makes sense to you. It’s okay to ask the same question again. Tell your doctor if you need something described in a different language or format (e.g., a picture).
  • ALWAYS tell your team about:
    • Any side effects or symptoms
    • Any natural treatments you are taking. This includes herbs, vitamins, supplements, or other complementary treatments
    • Medicines prescribed by any other doctor for other health conditions.
  • ALWAYS make sure your treatment goals are known and honored.

A patient navigator can also help you communicate with your health care team. Ask if your treatment center has patient navigators. 

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