Cancer Care Teams Attack Cancer from All Sides: A Breakdown of Who’s In Your Corner

Most cancers require more than one type of treatment, including surgery, radiation and medicines, such as chemotherapy, hormone therapy, targeted drugs and immunotherapy.

"Cancer care is multidisciplinary, and a team approach is simply the best way to organize it," Elizabeth Berger, MD, tells SurvivorNet. Berger is a breast surgical oncologist in The Breast Center at Yale University's Smilow Cancer Center in New Haven, CT.

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The team isn't there to complicate your care, but rather to simplify it. Members of a cancer care team strive to stay on the same page and communicate a clear and uniform message to their patients.

"Teams communicate on an almost-daily basis. When I receive a [lab] report on a patient, I'm reaching out to the radiologist, the medical oncologist, right away. We have calls where all members of that patient's team are on the call discussing appropriate care for each patient," Berger says.

Your Care Team Works Together Like the Hub & Spokes of a Wheel

Core providers form the hub and can include:

• The surgeon
• The oncologist
• The radiologist

The spokes may be made up of various providers depending on what you need. Your team could include:

• A genetic counselor
• A nutritionist
• An emotional support
• A reproductive medicine specialist
• A physical therapist

The list goes on based on your individual circumstance. You'll also have oncology nurses and a pharmacist on your team.

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You won't hand pick each member of your team. Most likely, the doctor that you start your cancer care with, whether that's a surgeon or a medical oncologist, will refer you to the other doctors you need. Of course, if one of those doctors isn't a great fit, you can try another.

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"It's important for the provider to be someone you're comfortable working with, but you also want all the teammates to be people who 'play well together,' so as for whether one provider chooses the members of the team or whether you do it's a little bit of both," Berger says.

Working With Your Team

The team approach is intended to coordinate and streamline your care. But, it may still feel like a lot of moving parts with so many providers are involved in your care.

"I recommend that patients designate one of their doctors, whether that's the medical oncologist, the surgeon, or whomever, as their point person the one they go to for questions and discussions. The point guard of that team," Berger says.

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Your point person can address questions about lab results and your care. Sometimes, they will be able to answer your questions completely. Other times, the doctor may direct you to the appropriate member of the team for that question or reach out to that member him or herself.

At many cancer centers, the care team also includes a patient navigator. This person can help with logistics. "A patient navigator is someone to whom the patient can go and say, 'I am so confused and I don't know where I'm supposed to go or what I'm supposed to do,' when there are just too many moving parts," Berger says.

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As you get ready to start treatment, the American Society of Clinical Oncology recommends you ask specific  questions, perhaps to a patient navigator or a provider, about your care team.

Questions to Ask About Your Care Team

• Are my cancer care team members all at the same hospital/center or at different locations?
• Which doctor will lead my overall cancer treatment?
• Is there one person I should contact with any questions I have? How can I get in touch with the different professionals on my team?
• If I experience a new side effect or a change in how I’m feeling, who should I tell?
• Are there specific symptoms and side effects I should alert my team about right away?
• What is the best way to get in touch with my cancer care team in an emergency?
• Who can help me cope with the stress and emotions of cancer?

"Teams break down silos," Berger says, "so it's not just a bunch of doctors who all have access to the medical record. It's a fluid, constant conversation among the team members to provide the best and most tailored care for each patient."

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