When you learn that you have cancer, you want the best treatment possible. Depending on where you live, you may have multiple options for where to receive that treatment or you may consider traveling for your care.
Your primary care provider or the doctor who made your diagnosis can provide referrals and help guide you through the next steps. You don’t just want a good cancer treatment center—you want a cancer center that’s a good match for you.
Ask yourself these questions when evaluating your options for care.
1. Do they have a lot of experience with my type of cancer?
It’s important to be sure you’re with a provider and in a place that is experienced with your type of cancer, so ask about the number of similar patients they see.
“For multiple cancer types, research shows that at high-volume centers, the treatment team will have the experience it takes for the best outcomes,” says UNC Health breast cancer surgeon David Eddleman, MD. “Don’t go somewhere that manages five cases of your type of cancer a month if you can go somewhere they manage 100 in a month.”
If you have an uncommon cancer, you may have to look longer to find an expert.
“If it’s a rare cancer, you might want an academic or specialty center, because you may need specialized expertise for something less common,” says UNC Health medical oncologist Ethan Basch, MD. “For any cancer, look at the experience of the providers—their years of experience but also if they’re in a practice or network with other providers they can consult.”
2. Can I get all my treatment here?
Cancer treatment usually has multiple steps, so you’ll want to ask if you’ll have all parts of your treatment in the same place or through the same system.
“A comprehensive center will have surgery, medical oncology and radiation oncology in the same system,” Dr. Eddleman says. “The majority of patients start in the surgical world, but then go through chemo or radiation. At different points of care, there will be different captains of the ship, but continuity of care is important.”
Your doctor can help you understand the path your treatment could potentially take and what types of services you might need regular access to, such as an infusion center for chemotherapy, a radiation oncology department or inpatient care services. You might also need or want access to physical or occupational therapy, financial coordinators, support groups or an on-site pharmacy.
“As an oncologist, I’m a strong believer in the importance of supportive services, including palliative care for symptom control, nutrition services, physical therapy and more,” Dr. Basch says. “These things improve a person’s well-being, so it’s important to ask whether you will be able to access those support services at a center.”
3. Who will be part of my team?
When you have cancer, you may see just one doctor, but there’s often a bigger team behind them. Don’t be afraid to ask about who is involved in your treatment, including behind the scenes.
“For every patient I see, I review their case with a multidisciplinary team of different experts,” Dr. Basch says. “This team model puts a lot of eyes on the case so we can do what’s in the best interest of the patient, according to the latest medical science.”
That team of experts is often called a tumor board. When you meet with an oncologist, you can ask if they will confer with other specialists on your case.
You may not meet all the members of your team, such as the radiologist who interprets your scans or the pathologist who analyzes tissue in a lab, but you can ask who you will see regularly. Keep in mind that if you receive treatment at an academic medical center, you may have a medical resident or fellow on your team.
“Part of our mission is to educate the next generation of medical providers, so on a team of multiple members, there may be someone in training,” Dr. Basch says. “There’s not a case where they’d be the only person you saw, but they might help to gather information, and we can pay more attention to what is going on, because there are multiple ears and eyes on the patient, all thinking together about the best treatment.”
It’s especially important to ask who your point of contact will be for your cancer team.
“There should be one person on the treatment team who can handle any question related to your cancer care, whether they answer it directly or find the person who can,” Dr. Eddleman says, noting that centers may have varying titles for this person, such as nurse navigator or care coordinator. “You should be able to easily access your clinical team at any time through this central person.”
In addition to answering questions, navigators or care coordinators can help direct you to relevant services or resources.
4. Will I have the option of clinical trials?
Depending on your diagnosis and the current options for treatment, you may want to pursue care at a place where clinical research is being done (typically, an academic institution or a large medical center).
“Clinical trials help us understand if a new drug, device or approach can add benefits, so we can broaden our knowledge about cancer treatment,” Dr. Basch says. “If a patient wants to participate in a study, we’ll explain in detail what it entails and if there are additional appointments or scans.”
Participating in a clinical trial doesn’t mean you’re a “guinea pig,” Dr. Eddleman adds. “You’re typically offered the option of the current best practice or something we think could be even better.”
5. Is this location convenient for me?
Your treatment may take many visits over many months, so it’s important to consider how far and how often you’ll have to travel. If you’re receiving care far from home, you’ll need to plan and budget for accommodations and consider what you will do if you need emergency care.
If your cancer is rare or your situation is complex, you may need to travel to see an expert. You can also ask if your local hospital connects to a bigger system and whether you’ll have access to those resources.
“The choice between home and a larger hospital can be made in partnership with your providers,” Dr. Basch says. “If a patient can get equally good, quality care close to home, they likely don’t need to travel. There’s a lot of value in receiving care closer to home, as long as it is high quality and appropriate.”
If you don’t live close to a large medical center, it can still be helpful to consult with a doctor at one, even if you won’t be treated there.
“If you’re able, I’d recommend getting an opinion at a major center, so that you have that knowledge of what experts who see high volumes of patients recommend,” Dr. Eddleman says. “Then, you can weigh that opinion and your comfort level with the treatment offered closer to home.”
6. Do I trust this team?
You may be seeing an expert in your type of cancer, but if you don’t feel comfortable asking questions or communicating your preferences, then it’s probably not the right fit.
“If you don’t trust your team, they shouldn’t be taking care of you,” Dr. Eddleman says. “You should have the utmost confidence that you as the patient are at the center of everything they do. As a doctor, I want you to trust me that I have your best interests at heart.”
Strong communication between patient and provider is essential for successful treatment. That means you need to be open about your priorities and concerns.
“Patients have to be honest with their providers if they don’t understand or if they’re uncomfortable with anything, and providers have to listen so they can understand their patients’ values and goals,” Dr. Basch says.
If you’re concerned about symptoms you are experiencing, talk to your doctor or find one near you.