Choosing a Cancer Care Team
Take control of YOUR treatment right from the beginning, afterall you are the one that has to life with the consequences and not the medical professionals. Make the medical professionals accountable for everything that they do.
Patients should be managed not by an individual physician, but by an entire team comprised of specialists with an expertise in head and neck cancer.
You should consider the characteristics of physicians and/or health care facilities when selecting members of your cancer care team and/or treatment facility.
Cancer Care Team Roles
Head and neck cancer are likely to be managed by a team of health care professionals. You may see some of these team players only once or for a short duration, whereas others you may see during most of the treatment course. There are some members of the team, such as a pathologist or a head and neck radiologist, that you may never meet at all, but expertise in evaluating your pathologic slides or your imaging studies may be vitally important.
Who should be on this team? Whether or not you have some of these members on your team depends on your individual treatment plan. You may only require surgery and not need radiation, so you may only work with a surgeon and not a radiation oncologist. Your cancer care team may include the following team members:
- Registered dietitian/nutritionist:Ideally, a registered dietitian should assess the patient at baseline and periodically throughout his or her disease course. The dietitian will provide strategies to deal with treatment side effects. In addition, the dietitian may need to be consulted if a patient loses a significant amount of his or her ideal body weight.
- Speech pathologist:A baseline assessment of swallowing in addition to the ability to speak should be evaluated. The speech pathologist will recommend strategies and exercises to be performed during treatment and post-treatment to maintain or improve swallowing and speaking function. Many patients need rehabilitation with a speech pathologist post-treatment. Between 34 to 70 percent of head and neck patients will develop speech impairment during their treatment.
- Cytopathologist:A health care professional who uses a microscope to evaluate cells.
- Pathologist:A health care professional who uses a microscope to evaluate tissue; a pathologist will play a role in diagnosing the disease.
- Radiologist:A health care professional who specialises in evaluating images and will evaluate extensiveness of the disease; this health care professional will also play a role in diagnosing the disease.
- Radiation oncologist:A physician who uses radiation therapy to treat cancer.
- Surgeon:A physician who will physically cut the tumour out of the patient and/or reconstruct anatomic structures compromised from the removal of the tumour.
- Prosthodontist/dentist:Radiation can cause cavities, so you may wish to consult a dentist before treatment. You might need to consult a prosthodontist since teeth, parts of the jaw or other structures such as the nose or the ear may need to be removed to treat the cancer, and a prosthodontist specialises in creating a prosthesis to help you restore functions that may have been affected by your surgery.
- Medical oncologist:A physician who specialises in several aspects of cancer care, such as diagnosis and the management of cancer (e.g., chemotherapy). The medical oncologist is likely to be a specialist who you will interact with at several points during your cancer journey.
- Social worker:Works with the patient and the patient’s caregivers to address their psychological wellbeing.
Other health care professionals may work with you and/or the cancer care team, depending on your needs. For example, a psychiatrist may be part of the team. Alternatively, an addiction specialist may be a member of your team.
Evaluating Your Cancer Care Team
It is recommended that patients receive treatment from multidisciplinary teams; ideally, the team members will specialise and have expertise in head and neck cancer. Head and neck cancer are a relatively rare type of cancer; head and neck cancer comprise only 3.4 percent of all cancer types in the Australia.
Several studies have evaluated the characteristics of either physicians and/or health care facilities to affect outcomes. These studies have limitations: the studies were done using patients with different types of cancer and all studies did not evaluate the same characteristics.
Characteristics associated with physicians that contributed to improved outcomes were as follows:
- Performing a high volume of surgeries versus a low volume
- Specialists with expertise in the type of cancer versus generalists
Characteristics associated with hospitals that contributed to improved outcomes were as follows:
- Hospitals that performed a high volume of surgeries had improved patient higher survival rates compared to hospitals that performed a low volume of surgeries.
- Hospitals that provided other specialised services had an improved reduction of treatment side effects.
In summary, you may want to reflect on whether the following characteristics in a doctor and/or hospital are important to you. If so, do the research to see if the cancer treatment team and facility meets your criteria. Which of the following are important to you?
- Having a multidisciplinary team
- Having clinicians and/or a hospital with a speciality in head and neck cancer
- Health care professionals and/or hospitals that perform high numbers of medical procedures
- Receiving treatment at a location near your home, friends and family
Utilise the pdf resource document located in the Resources tab to assist you with your medical professionals.