Dr. Robert Maki, Physician Assistant Heather Hylton, and Nurse Practitioner Mee-Young Lee explain the roles of different members of an oncology care team, and how each contributes to the care of patients.
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ASCO® Cancer.Net: Doctor-Approved Patient Information
The Cancer Care Team -- An Introduction
The Role of Doctors on Your Team
Robert G. Maki, MD; Medical Oncologist; Member, American Society of Clinical Oncology: It’s very common to have a team of doctors that will take care of you over the course of your illness if you’re just recently diagnosed with cancer. That really applies for people who get the most common cancers, be they of the breast or lung, prostate, colon and what have you.
Heather Hylton, MS; Physician Assistant; Member, American Society of Clinical Oncology: There are different kinds of oncologists who may be a part of a patient’s cancer care team. This includes medical oncologists, who treat cancer using medications and other agents; and radiation oncologists, who treat cancer with radiation therapy; and surgical oncologists, who treat cancer using surgery. Pediatric oncologists specialize in the care of children who have cancer, and there are some oncologists who specialize in the care of women who have specific cancers. And they’re called gynecologic oncologists. And dermatologists can be involved in the care of patients who have skin cancers.
In addition to oncology specialists, there are often a number of other kinds of doctors involved in the care of patients who have just been diagnosed with cancer. And this can include pathologists who help determine what kind of cancer a patient has; and radiologists, who can look at images such as X-rays and other kinds of studies to see where the cancer might be in the body; a palliative medicine specialist, who will help a patient with symptoms, managing symptoms and helping prevent symptoms; and internal medicine doctors or other specialists.
Dr. Maki: I often see that the medical oncologist takes the helm and will engage the other services as they’re necessary throughout the patient’s care.
The Role of Other Health Care Professionals on Your Team
Dr. Maki: There are a number of other healthcare providers, many of whom are equal or of even more importance over the course of one’s treatment and that involves nursing staff, nurse practitioners, physicians’ assistants, phlebotomists, people who are actually delivering that care. And it’s critical that this entire team can work together in a coordinated fashion to deliver that best possible care.
Heather Hylton: Some of the members of a patient’s care team, once diagnosed with cancer, can include nurses, who help identify and manage symptoms a patient may be having. They give medications, including chemotherapy, if that is within a patients’ treatment regimen. They provide education, and they help coordinate research activity. PAs and nurse practitioners perform assessments and evaluations of patients, and recommend and review tests. They provide recommendations for treatments, and also provide patient education and counseling.
Mee-Young Lee, Nurse Practitioner; Member, American Society of Clinical Oncology: I do explain to my patients, you know, even if you’re not seeing your doctor, you’re seeing me and everything we do today will also be, you know, relayed to your doctor and we make decisions together, not just me on my own, and we’re always here as a team.
Dr. Maki: Cancer care is a complicated thing and it really does require a lot of professionals who are experts in different areas of care. That might involve people who are involved in nutrition, for example, to make sure that the diet that someone is getting over the course of their therapy is appropriate. A social worker is absolutely critical. Oftentimes in that transition between inpatient care in the hospital to outpatient care they’re deeply involved in making sure that the follow-up care is appropriate and that things will flow smoothly from the hospital to the outpatient setting and vice versa. There’s certainly our outpatient staff such as social workers who also help in that context as well.
When it comes to emotional needs, it’s obvious that a new cancer diagnosis involves the whole family. So, there are a variety of supports that are available be it from nursing staff; obviously the other clinical staff. Social workers are very important in that respect as well. Happily and increasingly, the social workers are engaged very early on because, you know, we’ve been doing this for a while. We understand that this is a serious situation and we want to make it better, and how do you get your head around all these new things that are happening to you. It’s a very difficult scenario.
And so, with the social workers, we have support groups as well as lot of education, which is pushed out now very early on in someone’s care to make sure that you’re mentally able to contend with everything that you’ve never experienced before.
What Is a Multidisciplinary Tumor Board?
Dr. Maki: The whole team has to communicate with one another. If these parts don’t speak with one another, then the gears just don’t mesh and the care is not optimal.
So, how does that manifest itself? In a lot of centers, there’ll be something called a multidisciplinary tumor board. And at these tumor boards, someone with a new diagnosis or a change in their diagnostic level, if they go from primary disease to metastatic disease, they need a change in their care plan. And sitting around a table will be the nursing staff and the nutritionist and the radiologists and the radiation oncologists, surgeons and medical oncologists. All of them are hearing about these changes in the situation for one person or another, and it’s up for that team sitting together to really come up with a good plan of action. And that’s really the most efficient way for care to be delivered by all of these different team members is in a unified multidisciplinary tumor board.
Where to Get More Information
Dr. Maki: The oncology team is outlined very well in a section on our website, Cancer.Net, which provides both information on some of these general topics that involve cancer, but also very specific information on each of the different subtypes of cancer, of which there are very many. That detailed information is patient friendly. It’s pretty easy to read, and also gives you some pointers as other places to potentially go to get some more information from there.
[Closing and Credits]
ASCO® Cancer.Net: Doctor-Approved Patient Information
ASCO's patient education programs are supported by Conquer Cancer™ The ASCO Foundation CONQUER.org
Dr. Mary Wilkinson, Dr. Raymund Cuevo, and the staff at Medical Oncology & Hematology Associates of Northern Virginia
Medical Oncology Hematology Consultants, Newark Delaware
Carolyn B. Hendricks, MD, Center for Breast Health
Dana-Farber Cancer Institute
Rockefeller Research Laboratories, Memorial Sloan Kettering Cancer Center
Palo Alto Medical Foundation, Sutter Health
The Adele R. Decof Comprehensive Cancer Center at The Miriam Hospital. The Miriam Hospital is a teaching hospital of The Warren Alpert Medical School of Brown University
University Hospitals Case Medical Center Seidman Cancer Center
University of Michigan Comprehensive Cancer Center
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