It takes a ‘big village of clinics’ to build a dream cancer care team

When a patient is initially diagnosed with cancer, they may not know what the road ahead will look like, and more specifically, who will guide them. At first, you may only consider your oncologist, but the truth is that a cancer care team has many moving parts, all of which are essential to providing optimal care.

From nurse coordinators to clinical social workers and more, each member of the team plays a different role in advocating for patients’ needs, whether they are their specific treatment needs, side effect management, or their specific needs. psychological / psychosocial support.

“After that first initial appointment, there is a… huge village of clinics that takes care of the patient from anywhere to the doctor‘s administrative assistant who will take the calls for the patients or sort these messages from. portal, ”said Lisa Anderson, a pivot nurse specializing in gastrointestinal cancer at MedStar Georgetown University Hospital in Washington.

A medical team where each player is crucial

“There’s the clinic coordinator nurse who does all of the heavy lifting of education, symptom management, also takes patient calls and whatever the doctor wants them to do … you have the medical assistants who house the patients, you have the lab technicians who design the labs, the fellows, the doctors, the nurse practitioners, the physician assistants, the social workers, the dietitians, the geneticists. It’s a huge team just in this group, so behind every patient there are at least a dozen people who care for that patient, ”Anderson added, in a presentation at the 12th Annual Ruesch Center Symposium.

Depending on a patient’s stage of cancer, a surgeon may be the first or the last person they see. Often their surgeon will consider diagnosis, staging and coordination of care, all of which affect the timing of their treatment plans.

This means that surgeons will also work closely with radiologists, oncologists, primary care providers, rheumatologists or nephrologists.

“So, I mean, our job in the operating room is to coordinate the whole operation and the team, and our job before that, I think, is the same – because we’re really trying to coordinate. who should be where, when and how we are helping patients get through this, ”explained Dr Emily R. Winslow, regional director of hepatopancreatobiliary surgery at MedStar Georgetown University Hospital.

Surgeons also play a role in reducing patients’ anxiety about their procedures and explaining what will happen and what the recovery process should look like.

“I don’t think we should ever make it seem reasonable not to be afraid of an operation – there should be a little worry, of course, but we’re trying to put that in perspective against the worry about the problem the patient has, and why we need to have surgery and what it will be to get better, ”said Winslow.

Surgeons also often partner with other types of surgeons who have different areas of expertise, depending on the patient’s disease.

Smaller teams in each area representing the larger care team

Radiation therapy is another important and crucial part of gastrointestinal cancer treatment. About half of cancer patients receive radiation therapy at some point during their treatment journey, with goals varying between recovery, prolongation of life, or management of symptoms.

“With our field, another important aspect of what we do is the technology,” said Dr. Keith Unger in an interview with CURE®. “So having cutting edge technology and cancer treatments available – it can help improve outcomes. “

Unger is the Director of the Gastrointestinal Oncology Department and the Resident Program Director of the Radiation Oncology Department at MedStar Georgetown University Hospital. During his presentation at the symposium, he also explained that radiation includes more than the radiologist.

“Technically – the radiation side – I represent a huge team behind the scenes,” he said. “So we have physicists… there are also team members who are in front and who probably see you more than the doctors. Our radiotherapists interface with patients on a daily basis and are really a great support for patients throughout their radiotherapy treatments.

Navigating the emotional and psychosocial impacts of cancer

An essential part of the cancer care team also includes someone to help support the psychosocial care of patients and their families.

A clinical social worker can help patients navigate their diagnosis and treatment process, manage the care of their children, coordinate transportation, understand and resolve financial or insurance issues and implications, manage the impact on a patient’s career or work environment and work around difficult emotions.

“And there are some really fantastic resources that can help you navigate this specific intersection,” said Sara Field, clinical social worker at the George Washington Cancer Center. “Another thing I tell patients is that it becomes your responsibility as a patient to figure out what’s most helpful, what isn’t, and then communicate it. And that’s a lot easier said than done when you’re also navigating through a diagnostic. “

Field added that she often referred patients to support groups who can be helpful in resolving various issues with other people having a similar experience.

“We know that a significant number of people are very distressed when they are diagnosed with cancer, and that makes perfect sense, doesn’t it? This is probably one of the most difficult things someone will go through in their life, ”Field said in an interview with CURE®. “And so I think one of the things is really to tap into your tools or your skills, or what are your coping techniques that have helped you in the past, and to be really able to mobilize and mobilize them. use.”

She also explained that it is very important to mobilize an existing support system as people may want to help you but need help knowing what you need.

Important tools for patients

Ultimately, every cancer care team comes down to the most important member: the patient receiving treatment. And patients should always remember that it’s just as important that they stand up for themselves, Unger explained.

“I think it’s very important before embarking on treatments or making big decisions to really build a good relationship with your clinical team and make sure there is good communication, both ways. “, He explained.

It is also never a bad idea to ask questions or seek a second opinion.

“When making very important and important decisions like this, I have often found it helpful for my patients to bring them together with other patients who have been through similar situations so that they know the questions to ask, so that they can ‘they can have a better referral,’ Unger added.

If they have someone they can rely on to get to an appointment, patients should turn to that family member or friend to help them defend themselves. This could be someone taking notes during the visit, helping the patient remember questions they might want to ask, or just providing comfort and support.

Additionally, those loved ones who provide support or act as a patient’s primary caregiver should also be aware that they may seek help for their own emotional or practical needs.

“I always present myself as the social worker who provides care to patients and their loved ones,” said Field. “… My expertise and passion is really in mental health and emotional support for patients and caregivers. And I think we can always do better to meet the psychosocial needs of all of our patients. “

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