Your Cancer Care Team

Cancer treatment can be complicated, so you will see many different health care professionals throughout your diagnosis, treatment, and recovery. The members of your health care team are trained to provide you with the best treatments and services available. They are dedicated to your health and well-being.

You are a full partner in your care as well. Keep the lines of communication with your team open. Remember, you are the expert on you. Tell your health care team your concerns, fears, and desires every step of the way. You have the right to have all of your questions answered as they arise and to be fully informed about your diagnosis, treatment, side effects, and long-term health outlook. You also have the right to be treated with sensitivity.

You might find these tips helpful when speaking or interacting with members of your cancer care team:

• Find providers with whom you feel comfortable.
• Your health care professional and you both need to talk and to listen to each other.
• If you do not understand something, ask that it be explained more clearly.
• Make a list of questions to bring to your visit, and make sure they all get answered.
• Bring someone along to your appointments for a “second set of ears” to help you remember everything that was discussed.
• Try to learn about your type of cancer before seeing your physician or oncologist.
• If you feel that your visits are too short, try to schedule a longer appointment.
• Don’t hesitate to talk about your concerns, or any cultural influences on your view of disease or your treatment plan.
• Stay in contact. Ask each health care professional the best method for you to use to reach them for follow-up questions—phone, e-mail or in person.
• Keep in mind that your treatment plan is individualized according to your specific diagnosis and medical condition. The members of your medical team may differ from those helping other cancer patients.

By understanding the role of each member of your health care team, and how they can help you, you will be able to participate more effectively in your care. The following professionals may be on your team:

Medical Oncologist

Often the lead member of your health care team, your medical oncologist will:

• Review your medical history, conduct physical examinations, lab tests, scans, and any other diagnostic tests
• Determine your exact diagnosis, including stage of your cancer
• Design your treatment plan and schedule
• Prescribe chemotherapy or other drug therapies
• Refer you to a surgeon, radiologist, or any other specialist you need

You will meet with your medical oncologist regularly throughout treatment and continue afterward with follow-up visits and tests.

Here are some questions to ask your medical oncologist:

Can you explain my diagnosis? What do the results of my tests show, and why is this important?

What stage is my cancer, and has it spread to other parts of my body?

What treatment plan do you recommend, and why do you feel this is the best approach?

Should I get a second opinion? 

Is chemotherapy painful or dangerous? Will I be vomiting for several days after each treatment?

How long and how often will I receive treatment, and where will I go for this? Are you the person who will administer my chemotherapy, my radiation? Will I have chemotherapy and radiation at the same time?

What are the common side effects of the drugs or combination of drugs that I will be receiving? How can I manage these side effects?

Do you have an assistant or a nurse whom I should call if I have questions or problems?

How will we know if my treatment is working? Will you order tests?

How often will I see you while I am under treatment and for follow-up visits once my treatment regimen has been completed?

Are there any available clinical trials that are appropriate for me and the type of cancer I have?

Am I at increased risk for developing cancer again, either in the same organ or in another part of my body? Are my children at increased risk for developing cancer, especially the type of cancer that I have?

Oncology Nurse

Your oncology nurse works closely with your medical oncologist or radiation oncologist to coordinate your care. He or she is important to your care and may be your main contact source. Your oncology nurse has several roles:

• Coordinate some aspects of your cancer care
• Oversee and provide care during your chemotherapy treatment visits
• Administer your chemotherapy or other treatment-related drugs
• Provide patient education to you and your family or caregiver and help you find needed resources
• Tell your physician of any problems you may have during treatment that need attention
• Answer your questions by phone, e-mail or in person
• Schedule medical tests and procedures; obtain test results
• Conduct cancer care research
• Give emotional support and counseling to you and your loved ones

Because your oncology nurses work closely with your medical oncologist and health care team, it is very important that you communicate openly and discuss any concerns you have. All of your questions are important, so don’t hesitate to ask. Oncology nurses are great information sources and are trained to help with physical and emotional issues. 

Here are some questions to ask your oncology nurse:

How long will it take when I come for chemotherapy?

Will you be the person administering my chemotherapy? Will I also see my oncologist that day?

I’ve heard that chemotherapy makes you nauseous. What can I do to avoid this?

How often do you need to check my blood? What if my counts are too low on the day I am supposed to receive a treatment?

If I have to delay a treatment because I am sick or my counts are too low, how will this affect my course of therapy, and my long-term outcome?

I am worried about losing my hair. How do I go about shopping for a wig or hair cover? How much does a wig cost?

How will I know if I have an infection? Is there any thing I can do to prevent getting an infection?

Surgeon or Surgical Oncologist

If you are having surgery, it will be highly individualized, depending on your type of cancer and its stage. For some cancers, surgeons who specialize in the type of surgery that you need or the type of cancer that you have may provide better outcomes compared to a general surgeon.

You will have an office visit and physical exam with your surgeon before the day of surgery. Your surgeon will review your medical records, speak with you about your options, and may perform additional tests. This is the time to ask questions that will help you understand what to expect during surgery and recovery.

Here are some questions to ask your surgeon:

Can you explain my surgical procedure in detail? How long will it take, and how much experience do you have performing this type of surgery?

Based on my tests and x-rays, do you feel confident that you can remove my entire tumor and that my surgery will be a success?

How long will my surgery take? Can I go home the same day; if not, how long do I have to stay in the hospital?

I do not like the idea of “going under” with general anesthesia and feeling groggy when I wake up. Can’t I just have local anesthesia? What type of anesthesia medication will I receive, and how long will it take for me to come out of it after my surgery?

I am prone to nausea. How can we make sure that I will not feel nauseous after I wake up from surgery?

What are the possible side effects of this type of surgery? Will my nurse keep a close eye on me to make sure I do not develop any complications?

What will my recovery be like, and when can I go back to work? Will I have restrictions in my daily activities or need any type of home care?

When do I need to come back for a follow-up visit? Will you remove my stitches at that time?

After Surgery: Will you see me in the recovery room to tell me how you feel the surgery went? Did it go as expected? If not, what did you find and what are our next steps?

Surgical Nurse

Your surgical nurse will prepare you for your operation. When you wake up, your nurse will take care of you in the recovery room as well. Some of a surgical nurse’s responsibilities include:

• Placing your IV before surgery
• Performing frequent post-operative physical assessments
• Managing your postoperative pain and side effects
• Reporting your condition to your surgeon
• Providing you with information and instructions to follow when you are recovering at home

Here are some questions to ask your surgical nurse:

What is your role in my surgery?

Will you help me get prepared for my surgery; for instance, will you be giving me an IV?

I am feeling nervous about my upcoming surgery. Is there anything you can do to help me to relax and cope?

Before I go to surgery, can you give me an idea of what to expect when I wake up again?  Will you be there when I wake up; if not, who will be?

My husband (wife) will be in the waiting room during my surgery. Can you see him (her)  as soon as the surgery is over and tell him (her) how it went?

How long will I be in the recovery room? Can my husband (wife) come into the recovery room? 

Radiation Oncologist

Radiation oncologists are physicians who specialize in treating cancer using radiation therapy. During your first meeting, this physician will discuss your diagnosis and treatment plan. Your radiation oncologist will determine the precise dose and placement of radiation you receive. Come prepared with questions to ask about radiation therapy.

You will also most likely undergo scans during the course of therapy to determine how well you are responding to treatment. Your radiation oncologist will interpret your scans. If he or she is your primary physician during treatment, you can discuss these results together.

Here are some questions to ask your radiation oncologist:

Is radiation dangerous or painful? What type and amount of radiation will I receive? Where will the radiation be aimed?

How many treatments do I need, and how long does each treatment take?

I have heard that radiation burns the skin. How can I prevent my skin from these burns? Is it like a sunburn?

What if I am sick and have to miss one of my radiation treatments? How will that affect my long-term outcome?

What are the general side effects of radiation, and what, if any, apply to the part of my body that will be treated?

How will we know if the radiation is working? Are there tests or scans that I need to take during or after my course of radiation treatment?

Will you be reporting back to my doctor to let him/her know about my progress?

You have recommended radiation seeds for my type of cancer. How are they implanted? Who will perform this procedure?

Radiation Therapy Nurse

Radiation therapy nurses provide care and support while you undergo radiation treatment. They explain the routine of your radiation sessions and what to expect. They also monitor you for any treatment-related reactions and report concerns to your radiation oncologist. Side effects can develop at any time, so be sure to check in with your radiation therapy nurse at every treatment session.

Radiation therapy nurses may also assist in other radiologic studies and tests that you may have as part of your diagnostic work-up. These include ultrasounds and MRIs (magnetic resonance imaging).

Here are some questions to ask your radiation therapy nurse:

Will I have to get undressed for my radiation treatments?

Is there any clothing that’s best to wear for radiation therapy sessions?

May I eat a meal before treatment?

What should I do if I become uncomfortable during treatment?

Which side effects should I watch for?

Do you have any advice about protecting my skin during treatment? May I spend time outdoors?

When will I know the results of my tests? How will I hear about those results?

Mid-Level Providers: Physician Assistant and Nurse Practitioner

Mid-level providers include physician assistants and nurse practitioners. They carry out a wide range of services and work closely with physicians and nurses. Physician assistants and nurse practitioners may coordinate your cancer care. They are qualified to perform some of the same functions as physicians, including:

• Manage your medical condition on a daily basis
• Take your medical history
• Update medical charts
• Make some treatment decisions
• Provide patient education
• Perform physical exams and some medical procedures
• Prescribe certain medications or tests and order refills
• Analyze some test results
• Assist in surgery

Your nurse practitioner and physician assistant also handle hospital admission procedures and provide discharge and follow-up care information. They stay in touch with you and your health care team. They also work closely with your medical oncologist, partnering on clinic visits or hospital rounds. Contact either your nurse practitioner or physician assistant if you have questions or issues that need immediate attention.

Here are some questions to ask your physician assistant or nurse practitioner:

How can I find reliable sources of information on the Internet about my type of cancer?

What is your role in my cancer care? Are you the person I should contact if I have a problem or question, instead of my doctor?

How do you assist my physician? In other words, what aspects of my care will you be handling?

How often will you report back to my physician about my condition?

Can I call you when I need a refill for my prescription medications?

I am taking several medications, and they are on a complicated dosing schedule. Can you help me organize my medications so that I will not miss any doses?

How can I manage the possible side effects that I might have with my treatments?

As my patient educator, are you the person to answer all my questions? What if you do not know the answer to my question or how to deal with my problem? Who will you ask?

Do you know of any cancer-related research studies that I can join?

Can you help me find a support group? Will you conduct it?

Dietitian

Cancer and cancer treatment can make eating difficult. Some people lose weight or have trouble eating foods that provide the right energy. You may also have some other digestive woes such as nausea and vomiting, constipation, and diarrhea.

Although you may be having appetite or digestive problems, your nutritional needs have not lessened. You may even need additional nutrients or calories at this time. Your dietitian can help keep you on track nutritionally, and give you some great recipes to make eating more enjoyable.

Here are some questions to ask your dietitian:

What are my nutritional needs during and after treatment? Should I be on a special diet?

I do not have much of an appetite. How can I get the nutrition I need when I do not even feel like eating?

Since I do not really feel like eating anyway, I thought this would be a great time to try to lose weight? Is it OK to go on a diet during treatment?

I do not have much energy these days. Is there anything I can eat or drink that would help me feel more energetic? Do I need a dietary supplement drink?

How can I tell if I am consuming enough calories and getting the nutrients I need?

I sometimes suffer from constipation and diarrhea. Can you recommend foods that will relieve these symptoms?

Some of the medication I am taking has increased my appetite, and it is becoming difficult to control my eating habits. How can I control my eating without feeling hungry all the time?

Do I have to give up being a vegetarian (or vegan) in order to get the nutrition I need right now?

When will my appetite return, and when will food taste normal to me again?

Can I still drink a glass of wine at dinner?

Social Worker

Your cancer diagnosis may be affecting your life in many ways. Not only has it stirred up feelings of confusion and worry, but you are now also faced with many practical and care-related decisions. Your social worker can help you get organized, both emotionally and task-wise. He or she can also help you locate and get the services you need.

Here are some questions to ask your social worker:

Now that I have been diagnosed, I feel confused. There are so many things to keep track of and decisions to make. How can I get my thoughts in order?

How can I find a support group? Also, aren’t there support groups for family members and children?

How can I arrange to prepare my living will and advance directive?

I need to find a financial assistance program since I do not have health insurance. Do you have any suggestions?

How can I get help arranging for transportation to my treatment center since I live far from town and do not drive?

I know I will need help at home after I am discharged from the hospital. How can I find a home care agency that could provide someone to help me?

Health Psychologist

Cancer can be difficult for anyone to cope with. You should consider talking with a health psychologist. Perhaps you would benefit from counseling for depression, anxiety, or any other feelings you may be having at this time.

Here are some questions to ask your health psychologist:

Since my diagnosis, I have been feeling quite upset and it is hard to concentrate. How can I find a counselor who specializes in cancer patients?

Can my spouse / partner join in on my counseling sessions? I did not realize it at first, but she (he) is quite upset too.

How can I learn to focus on my health instead of on my illness?

Having cancer has made me feel like a hypochondriac. I now imagine that I have all sorts of illnesses and health problems. How can I put my disease in perspective?

I have been hearing a lot about the mind-body relationship. Is it possible for my thoughts to have an effect on how I feel, or even how my health will be in the future?

Hospital Nurse

If you have had surgery and need to stay in the hospital, your hospital nurse will provide much of your care. The role of the hospital nurse is varied, and includes:

• Caring for you and your needs at this time
• Taking regular physical assessments, such as your temperature (to make sure you do not develop an infection) and blood pressure
• Keeping your chart updated
• Administering any medications you need
• Managing your post-operative pain
• Communicating any problems to your doctor
• Instructing you on home care

Here are some questions to ask your hospital nurse:

How long do I have to have an IV, and will you be the person to remove it?

Will I have to stay in bed all the time? Can I get up to go to the bathroom?  When can I have visitors?

When will I be able to start eating or drinking after my surgery?

How will you manage my pain? Has my physician ordered pain-relief medication for me?

I take a prescription medication twice a day. Will you make sure that I take these pills when I need to?

How often will you be taking my temperature and blood pressure? Will you need to wake me up to do this if I am sleeping? What if I develop a fever?

Will you be reporting to my surgeon about my condition, including any pain or side effects I might have?

Will you give me instructions to take home about how to care for my wound and any other care-related issues?

Clinical Research Nurse

You may receive treatment at a center that conducts research studies to help improve treatment methods or other aspects of cancer care. If you agree to participate in a study, your contact person may be a clinical research nurse. This professional’s roles include: 

• Enrolling you and other patients in the study

• Getting your written consent and other signed documents

• Explaining the purpose of the study and your role as a participant

• Answering any questions or concerns you have throughout the study

• Obtaining specimens (such as blood tests) for analysis

• Collecting study information and interpreting results

Medical advancements depend on clinical research studies. Your participation will help all cancer patients, now and in the future.

Here are some questions to ask your clinical research nurse:

Can you explain the informed consent form to me?

What am I required to do as a participant in this study?

Is there any cost to me? Will my insurance cover the costs of tests, treatment, medical care, travel or other study-related expenses?

Are there any side effects to watch for?

How will I learn the result of the study?

What follow-up will be necessary when my treatment ends?

Oncology Pharmacist

As an active partner in your treatment, the oncology pharmacist consults with your doctor or nurse about which medications and dosages are right for you as well as prepares and dispenses those drugs. 

If you are receiving chemotherapy treatment, the oncology pharmacist ensures that your chemotherapy drugs are available and ready when you need them. If you are unable to tolerate a certain medication, he or she will consult with your oncologist about possible alternative medications.

An oncology pharmacist can counsel you about when and how your medications need to be taken, correct handling, and possible interactions with food, drugs, and nutritional supplements. He or she can also advise you about drug costs and insurance coverage.

Radiation Therapy Team

The radiation therapy team prepares and delivers radiation treatments, and provides you with care and support during the treatment process. Radiation therapy nurses explain the routine of your radiation sessions and what to expect. They also monitor you for any treatment-related reactions and report concerns to your radiation oncologist. Side effects can develop at any time, so be sure to check in with your radiation therapy nurse if you have any problems or concerns.
 
As a member of the radiation oncology team, dosimetrists calculate and plan your radiation doses. Radiation therapists position you for treatment and administer the radiation dose.