Who’s on an Oncology Care Team?

When someone is being treated for cancer, they will work with a team of medical professionals in the oncology department. This team approach ensures you get the best medical care possible. Who are some of the people on a care team?

Receptionist/Appointment Specialist

This will be the first person you talk to at the cancer center. They take your insurance information as well as your co-pay. When your appointment is done, they will make upcoming appointments that your doctor has ordered. These may include lab work, imaging, and future oncology appointments.

Lab Technician

The lab technician will take your blood, or urine and run any necessary tests on it.  If they are taking blood, they may access your port to do this. The results let your oncologist know a lot about your health. They can see whether you have signs of being immunocompromised. They can detect anemia and other issues such as low protein or magnesium levels. From this information, your doctor can make recommendations, including whether you will receive your treatment that day.

Care Coordinator/Patient Navigator

This may be a nurse, a social worker, or even a volunteer. He or she will be your “go-to” person. They will likely be one of the first people you will meet in the oncology department. Your care coordinator will learn as much as they can about you, your family, and your health. He/she will Find out what your needs are and then connect you to other people who can help with specific concerns. They may help you find financial resources, counseling and support services.

Our care coordinator’s name was Anne. She was so compassionate as she listened to our story. She even cried. Her kindness touched our hearts. We knew then, that to her, we were more than names on a chart. We were people with lives in the balance. When she learned that we had three young children at home, she told us about the Angel Foundation, a resource that helps families with a parent who has cancer.

Oncologist

Your oncologist is the person who pulls everything together. He or she had a goal of helping you live long and well. Communicating well with your oncology doctor. He or she will do their best to help you achieve your goals.

Palliative Care Specialist

This may be a doctor, a nurse, or a physician assistant. The palliative care specialist works with other members of your oncology care team to treat and symptoms of your cancer and the side effects of its treatment. They are especially skilled at pain control.

Oncology/Infusion Nurse

Asks intake questions about how you’ve been feeling since your last visit. It’s very important to tell him/her about any symptoms you’ve experienced, especially any changes. You will be asked to rate your pain on a scale from 1-10. Be honest about your pain so your care team can address it properly.

Tell the nurse about any changes in the medication you’ve been taking as well as any side effects you’ve experienced. Don’t forget about over the counter drugs. Something as simple as antacid can have interactions with your cancer medications. The medications you are taking also give your doctor clues as to your overall health. For example, if you are taking more pain medications than usual, it may indicate increased pain or the need to change to a more effective pain medication.

An infusion nurse will access your port, which is no easy feat, and they’ll administer chemotherapy. Nurses are trained to watch for side effects and other changes in a patient. I have great admiration for oncology nurses.

Physician Assistant

Physician Assistants do much of the same work that doctors do. In fact, it isn’t uncommon for people to think that a PA is an MD.  Often they will alternate appointments. This gives a patient another set of eyes to assess their health. It also allows the oncologist to see more patients without getting burned out. If you need an unexpected, last minute, appointment, it’s usually easier to get one with a physician assistant.

Every 3 months my husband gets a CT scan. A few days later, he sees his oncologist to talk about the scan results. The two monthly appointments in between scans, he sees a physician assistant. In his case, the PA is also a palliative care specialist. This is particularly helpful because he has a lot of pain.

Oncology Pharmacist

Oncology pharmacists are pharmacists who specialize in medications used to treat cancer. They understand how various drugs interact with one another as well as how to deal with the side effects of your cancer treatment. Oncology pharmacists regularly talk with patients about their treatment. They educate patients and caregivers about the cancer treatment and answer any questions they may have about their medications.

Chaplain

The chaplain in the cancer center does more than meets the eye. He or she is available to talk with patients and their family about spiritual matters. Having cancer makes faith a priority, even for people who haven’t given it much thought before. Chaplains who work in cancer centers are very good at supporting people when they are faced with life and death matters.

They not only serve the patients directly but also give counsel to the doctors and nurses who work in one of the most difficult medical fields. They are available to pray with patients and staff alike. Even though they will have a particular faith background, they are a valuable spiritual resource for patients and families from all faith traditions (or no faith tradition at all).

Oncology Social Worker

An oncology social worker is an expert in helping patients cope with life as a cancer patient. They can also help caregivers and the patient’s children. They can tell you about appropriate support groups as well as financial resources. If you have a non-medical question about living with cancer, an oncology social worker is a person you will want to talk to.

Psychiatrists in the Oncology Center

Living with cancer takes a tremendous toll on a patient, not only physically, but also emotionally and psychologically. Psychiatrists in the oncology center help patients with stress management, cognitive behavior therapy, pain management techniques, and counseling to maximize the quality of life for the patient and his or her loved ones.

Hematologist-Oncologist

This is a physician who specializes in the diagnosis and treatment of blood diseases including leukemia, lymphoma, hemophilia, anemia, and sickle cell disease. Your oncologist may also refer you to a hematologist if the effects of your cancer treatment are adversely affecting your blood health.

Pathologist

You’ll probably never meet your pathologist, but they are an essential part of your oncology care team. Pathologists are doctors. They are the people who look at cells, tissue, and organs, that are biopsied to determine whether a patient has cancer. Pathologists make the final diagnosis of cancer. They also look for mutations that impact what type of treatment a patient is given.

Registered Dietitian

While a lot of people tell their family and friends how they should and shouldn’t eat, a registered dietitian makes nutritional recommendations to patients based on science and the patient’s individual needs.

One of the first appointments Dan had after being diagnosed with cancer was with the dietitian who worked with the oncology department. She dispelled the myths of cancer nutrition and told us the hard facts. (1) 20% of people who die of cancer actually die of malnutrition. (2) She told us that best predictor of survival was maintaining or gaining weight. “If you feel like eating a Cinnabon, eat a Cinnabon,” she said. This ran contrary to what we had heard from a lot of people. She explained nutrition from the perspective of oncology. She said that Dan needed to concentrate on two things. He needed to keep his calories up and eat twice as much protein. That advice has served him well.

Radiologist

Radiologists are doctors who specialize in reading z-rays, scan, and other imaging technology. They help in the diagnosis process. You will have regular imaging throughout your cancer treatment, as well as follow-up scans to make sure you are still cancer free. The radiologist will read all those scans. Even though the radiologist is an important part of your oncology team, you will likely never meet him or her.

There is one exception. Interventional radiologists perform non-surgical minimally-invasive image-guided procedures. When my husband had the Gamma Knife procedure done to remove a brain metastasis, there was a radiologist as part of the team and we met him.

Physical/Occupational Therapists

These amazing people help cancer patients live as normally as possible. They teach you how to regain strength, balance, and skills that cancer may have tried to steal. They help with everything from therapeutic exercise to using tools that make life easier.

Dermatologist

Chemotherapy and radiation often have adverse effects on a patient’s skin. EGFR targeted therapies cause rashes and skin eruptions. Dermatologists will assess and treat these side effects. They also make recommendations for skin care in survivorship. In a survey of cancer patients, 84% said they had never been referred to a dermatologist and over half would have felt better if they had been. (3)

Surgeon

Before modern medicine, surgery was the only cancer treatment that had a chance of success. Surgeons work with your oncologist in a variety of ways. They often take the tissue sample for biopsies. They help diagnose and stage cancer. Surgeons help treat cancer when surgery is an option.

These are just some of the people who are part of your oncology team. There are so many people who affect your experience as a cancer patient. Often these team members overlap in what they do. They work together to give you the best, most complete care possible.

I am grateful to the people who have been a part of Dan’s care team over the years. They are special people who have always made us feel like he is in good hands.

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ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

Also, check out Facing Cancer as a Parent: Helping Your Children Cope with Your Cancer.

Also, put your memories into words with The Memory Maker’s Journal.

I also blog at Heather Erickson Author/Writer/Speaker

Footnotes:

1. http://www.cancercenter.com/community/nutritional-support/tab/preventing-malnutrition/
2. http://www.nbcnews.com/id/30812433/ns/health-cancer/t/push-fight-malnutrition-cancer-patients/
3. http://www.mdmag.com/contributor/beth-mclellan-md-/2015/07/5-ways-oncologists-and-dermatologists-can-work-together-to-improve-cancer-care-