Andrew E. Chapman DO, FACP, is a Clinical Professor of Medical Oncology in the Department of Medical Oncology of the Sidney Kimmel Cancer Center at Thomas Jefferson University Hospital and a Clinical Professor in Jefferson’s School of Nursing. Dr. Chapman currently serves as the Interim Chief of Cancer Services for the Sidney Kimmel Cancer Center in the Jefferson Health System and as Vice Chair for Clinical Operations for the Department of Medical Oncology at Thomas Jefferson University. Dr. Chapman is the co-founder/co-director of the Jefferson Senior Adult Oncology Center, specializing in the multidisciplinary evaluation and management of seniors with cancer.

Health care in the United States has become increasingly complex over the past 30 years. Patients face new issues and challenges when seeking care, including:

• The ability to see the right doctor at a convenient time and in a convenient location

• The need for better communication between different health care teams

• Duplication of testing that increases costs

• A complicated insurance system

There are efforts to solve some of these problems for patients, but the current health care environment can be especially hard for older adults with cancer to navigate. When you’re trying to understand the diagnosis, follow challenging treatment plans, and manage any mental and/or physical difficulties, coordinating cancer care is a full-time job for anyone. Older patients must often deal with a variety of issues on top of that, like the need to rely on a caregiver, reduced sight or hearing, difficulty reading treatment plans, or the financial burdens of cancer treatment. So if you’re an older adult with cancer or a caregiver, here are some things to think about:

1. Plan your needs before a doctor’s visit. Do you need visual or hearing aids?  Make sure to let your doctor’s office know before your appointment. You can ask your office to give you printed material in large print, if needed.

2. Bring the bottles. It’s very important that your medical oncologist know about every vitamin and medicine you regularly take. Some cancer treatments don’t work as well if you’re taking other medicines at the same time. So bring all of your bottles to your visit. Doctors usually prefer seeing all of the bottles rather than a list.

3. Bring a friend or family member whenever possible. This is good advice for anyone with cancer, but it’s particularly important for older adults with cancer. A lot of complex information is provided during a visit, so it can be difficult to remember it all after the visit ends. If your regular caregiver is unable to go with you, give them a call from the exam room so they can participate in the conversation.

4. Write down your questions. Keep a running list of questions at home about your cancer, your treatment, and how it might impact your life. Bring the list with you to your appointment. Make sure you’re satisfied with the answers you receive. If not, try asking your question again in a different way.   

5. Think about your goals. Cancer care isn’t only about the newest, best medicines. Think about the priorities in your life and the things that are most meaningful to you. Discuss those goals with your doctor. It’s important to understand the risks and side effects of each treatment option and what you stand to gain by receiving it. Make sure your doctor takes these goals into account when creating your treatment plan.

6. Inquire about telehealth appointments. Getting to and from appointments can be a challenge, so some doctors’ offices now offer telehealth appointments. Telehealth appointments allow you to talk with your doctor from a computer or smartphone from the comfort of your home. While it is more convenient, it’s just as important to prepare as you would for a regular in-office visit.

7. Keep in touch electronically. If you can, it’s a good idea to sign up for your doctor’s office’s health portal. You’ll be able to email your doctor questions, view your lab results, and let your team know about new symptoms and side effects.