If you’ve just been diagnosed with cancer, you’re probably still reeling. You may be grappling with issues that are profound -- like life and death -- and mundane -- like who will do the laundry when you’re in the hospital?
But you won’t fight this alone. Of course, you’ll have your family and friends. And you’ll have your doctor. But your medical care won’t just be in the hands of a single MD. Instead, you’ll need a whole cancer support team to help you through this. “Good cancer treatment always requires a lot of people,” says Jan C. Buckner, MD, chair of medical oncology at the Mayo Clinic in Rochester, Minn.
Of course, you may be wondering how this system works. How can you -- when you are probably feeling overwhelmed already -- pick an entire cancer support team? Here’s what you need to know.
Why Do You Need a Cancer Support Team?
Treating cancer often requires more than one approach -- not just chemotherapy for instance, but surgery or radiation, too. That usually means more than one doctor.
But good medical care is more than just treating the cancer itself. Cancer can affect every aspect of your life: your mood, your diet, and your family, to name a few. So you may need nurses, dietitians, therapists, and other experts on your cancer support team. People you may never meet -- like pathologists and anesthesiologists -- also help while working behind the scenes.
Having all of these experts on your cancer support team is invaluable. “Each member of the team can each bring a different perspective to diagnosis and treatment,” says Terri Ades, MS, APRN-BC, AOCN, director of cancer information at the American Cancer Society in Atlanta. “With more people on your team, you get more options.”
The Heart of Your Cancer Support Team: Your Doctor and Nurse
First things first: you need to start with a doctor. Usually this will be a medical or surgical oncologist, a doctor who specializes in treating cancer. Given the stakes, settling on an oncologist can be nerve-wracking. However, Harold J. Burstein, MD -- a staff oncologist at the Dana-Farber Cancer Institute in Boston and an assistant professor of medicine at Harvard Medical School -- urges people not to fret too much.
"The essential part of picking a doctor is finding someone whom you can trust and with whom you can communicate. If you feel the doctor is being clear, and understands your needs, that is a good sign. Fortunately, there are many outstanding physicians around the country. In cancer medicine, as in most types of complex medical care, experience matters, and clinics or physicians with extensive familiarity with your kind of cancer can often provide care with insights not always available everywhere," says Burstein.
There are other things you should consider. For instance, see a doctor who’s been recommended, either by your personal physician, family, or friends. Also, make sure that your doctor has a lot of experience in treating your specific type of cancer. See these related articles about questions you could ask your doctor and about what to look for in a specialist before you begin to choose your cancer support team.
In many cases, your oncologist will work closely with an oncology nurse or nurse practitioner. You may find that you deal with your nurse the most.
"Doctors are often very focused on delivering treatment with a high degree of technical accuracy. Oftentimes, nurses who know the patient well will have additional insight into how the patient is doing from a broader point of view. That is why it is so important to have an effective team of providers -- doctors, nurses, administrative staff -- all working together in your care," Burstein says.
Ades says that for many people, the duo of the oncologist and nurse forms the core of the cancer support team. They should guide you through your treatment. Just make sure you know who they are.
“When they get diagnosed with cancer, people see so many experts so quickly that some don’t even know who their doctor is,” says Buckner. That’s a problem. If you have any doubt, just ask. It may seem like a silly question, but you have to know who is coordinating your treatment -- and whom to call with questions.
Other Specialists on Your Cancer Support Team
For some cases, that core team of an oncologist and an oncology nurse may be the only experts you need for your cancer support team, says Ades. But most of the time, you’ll need the help of more specialists. So who else do you need to see? That depends entirely on your case. Many people may need to see a radiation oncologist for radiation treatments. If you need surgery, you may see a surgical oncologist or general surgeon who specializes in treating cancer.
Experts other than doctors also play a vital role in forming your cancer support team. “The care for someone with cancer always starts with the medical staff, but it quickly expands beyond that,” says Burstein. Cancer treatment isn’t only about treating cancer -- it’s about keeping the person feeling as well as possible during treatment.
For instance, during treatment, you need to pay attention to your overall physical health. A dietitian can make sure that you’re getting all of the nutrients you need during treatment -- which can be hard, especially if you’re nauseated by chemotherapy. A physical therapist can help you keep your strength up during treatment or build it back up afterward.
Getting through treatment will be a lot easier if you stay emotionally healthy, too. Although you might not think of a therapist or social worker as being important in cancer treatment, they often are. Cancer can have profound psychological effects. Many people become depressed or anxious during treatment. Talking through some of these issues can make a huge difference. Sometimes, family members may also need to meet with a therapist or social worker.
Complementary treatments -- like acupuncture and massage -- are also becoming increasingly common for people with cancer. These complementary therapies aren't usually intended to treat the cancer itself. But they can ease side effects and improve quality of life. They may even reduce the amount of medicine you need for treatment. At some hospitals and cancer treatment centers, acupuncturists or massage therapists are actually on staff and can coordinate treatment with your doctor.
Building Your Cancer Support Team
While having the collected expertise of a cancer support team may seem great, you may be anxious about having to choose all of its members. Luckily, you don’t have to.
"There are so many people who will be involved in your care that it’s virtually impossible to research every one of them,” says Burstein. That’s why it’s so important to have a doctor that you like and trust, since he or she will be pointing you toward specific experts. This can be an advantage, since your cancer support team is likely to work most efficiently if all of the experts have collaborated before.
“Usually, your doctor will already have a group of people that he or she works with all the time,” says Burstein. “So you don’t need to track down each person yourself.”
That said, if you already have a specific person in mind -- a surgical oncologist that your sister loved, or a dietitian you’ve worked with before -- talk to your doctor. If it would make you more comfortable, ask to have this person brought onto your cancer support team. By the same token, if you’re not comfortable with one of the experts your doctor has referred you to, tell your doctor. Ask to see someone else.
The important thing is that your cancer support team runs smoothly. “Having a team of people who can work well together is invaluable for someone with cancer,” says Burstein.
One advantage of getting care at a specialized center or large hospital is that you might be able to see everyone -- from oncologist to dietitian to therapist -- under one roof. It can make things easier for you and reduce the odds of miscommunication between health care providers, says Buckner. Still, you can get excellent medical care even if you do have to go to different medical centers. Just check in with your doctor to make sure that everyone on your cancer support team is working well together.
Asking for What You Need From Your Cancer Support Team
Part of your cancer support team’s job is to make sure that you’re getting the care that you need. Your caregivers should be regularly checking in to make sure that you're doing as well as you possibly can, both physically and mentally.
But that doesn’t mean you should leave everything up to the experts. You need to take an active role in your treatment. You’re not just a patient -- you’re a vital member of the team.
“Our goal is to make treatment as easy, comfortable, and successful as possible,” says Ades. “But patients have to tell us what they need.”
When you’re in treatment for cancer, things may change from day to day or week to week. Yesterday, you felt great, but today, the side effects are awful. Or you may suddenly realize that your chemotherapy schedule just doesn’t fit in with the rest of your life. As long as you keep your doctor up to date, your cancer support team can tweak your treatment, or add new experts as you need them. Don’t be shy about asking for help.
So never underestimate your own role in making your treatment work. If you need something that your cancer support team isn’t giving you, speak up.
