So many of you have said that my post on choosing the best doctor was so helpful that I’ve decided to take it a step further and elaborate on an area I’ve worked in for a long time: oncology. As a certified oncology nurse, I know how important it is to have a doctor who’s not just knowledgeable about your particular type of cancer but who also makes you feel as comfortable as possible during this critical time in your life. It’s also crucial to look beyond the individual specialist and research other factors, such as their support team and any related services.
Here are the most important factors to consider before deciding who will be your caregiver while you fight your cancer battle:
- Choose a board-certified or board-eligible oncologist. Depending on the type and stage of cancer, a patient may prefer a specialty oncologist, such as a hematologist, thoracic oncologist, surgical oncologist, etc.
- Ask for a second opinion. Have the materials from the first doctor reviewed by an outside institution to ensure proper diagnosis. Duke University, Johns Hopkins Hospital, MD Anderson and UNC-Chapel Hill are excellent examples of major academic institutions that offer top-notch second opinions and treatment evaluations. Key opinion leaders in oncology are generally on staff at this type of major academic center.
- Find out what services are offered at the physician center. Questions to ask:
- How many physicians are part of the practice or department?
- Who covers for your physician when he is out of the office or on vacation?
- Are there supportive-care services for cancer patients at this center? This includes, but is not limited to, nutritionists, support groups, cancer treatment funds, social workers, prosthetic services (wigs, make-up, biomedical devices, etc.), chaplaincy services, acupuncture, pet therapy, hospice, etc.
- Where is everything located? This includes imaging centers, laboratories, and clinical areas where you will be evaluated. How much is parking? Does the center pay patient parking? How long will you be at the site during treatments? Will a patient need to stay overnight the day prior to their treatment for laboratory analysis and scans? What hotels are convenient, if required? What out-of-pocket costs do you need to consider, and what costs can the hospital assist with (meals, housing, etc)?
- Does the center offer clinical trials? This is critical so that patients can have new and innovative treatment options available to them.
- Is the doctor at a hospital or outpatient clinic? If you need surgery or are hospitalized, does he have admission privileges? Do you like this hospital?
- Learn how the cancer treatment center organized. The answer to these questions may be the make-or-break factor in your decision. Major factors to consider: Where will you receive infusions? Can a family member be with you during treatment? How many infusion chairs are at the center? Do they have a procedure room or private treatment room in the infusion center if you are not feeling well?
- Research the treatment site’s standard of care.
- How often will be scanning be done?
- What standard medications are ordered for your specific chemo treatment in case of nausea, vomiting, etc?
- What is your treatment regimen’s cycle? Every three weeks, once a week?
- Is it IV or an oral agent or combination therapy?
- Consider whether or not you (not your friends or family) like the doctor’s bedside manner.
- How much face-to-face time did the actual physician spend with you and your family?
- Were you treated with respect when your cancer diagnosis was initially presented to you? If the doctor was cold-hearted, uncaring, or in a hurry, GET ANOTHER ONCOLOGIST IMMEDIATELY.
- Were you encouraged to think about the treatment options presented? Were you given materials to take home and read, review, and discuss with your family? Ex: informed consent forms for clinical trials or specific disease-related materials.
- Ask how you (not the nurses or other supporting staff) will be able to communicate with the oncologist.
- Via email, or through a nurse, physician assistant, nurse practitioner, or secretary?
- Will you have communication between treatment visits? Is someone on the oncology team available to you between treatments?
- Does the oncologist communicate with your primary care physician? For example, are copies of your oncology medical records forwarded to your primary care physician?
- If you require a language besides English, are there interpreters, printed materials, etc., available in your language?
Discovering you have an illness such as cancer can be one of the most traumatic events you and your family ever experience, but the process can be far less distressing if you go into it armed with the information to make educated decisions. Not only will you know what to expect going in, but being informed will empower you to ask the hard questions and to get the treatment you deserve.