A cancer diagnosis may feel overwhelming and almost unbearable. But know this: You’ve got a team behind you. Every patient within the UNC Health Care System is cared for by a group of experts, each one with specific skills. They work together to make sure you have the best possible care and support.
So what is the role of each person on the cancer team?
What do they do? This is the doctor specializing in cancer who handles chemotherapy treatments and other medications. Medical oncologists see patients at three different times:
- At diagnosis: The medical oncologist will assess the extent of the disease and assign it a “stage” number/letter that indicates severity. He or she will design a treatment plan and prescribe chemotherapy if needed.
- In treatment: If you’re getting chemotherapy, the medical oncologist will want to evaluate you regularly to see how you’re feeling and assess how well the treatment is working.
- In survivorship: Survivors go back to their medical oncologists for follow-up to detect any recurrence quickly and to check for delayed side effects from treatment.
“When we can bring the science to the clinic, one patient at a time, we are offering hope, and in that hope there is great strength.”
Hear from a medical oncologist: Maha Elkordy, MD, with UNC REX Cancer Care, finds great reward in sharing new discoveries with patients. “It’s such a joy to say, ‘For your disease, there was a new drug approved last week,’” she says. “When we can bring the science to the clinic, one patient at a time, we are offering hope, and in that hope there is great strength.”
What do they do? Radiation oncologists oversee the design of radiation therapy plans for patients and evaluate how well the treatment is working. Radiation therapy is different for everyone; a patient might have anywhere from one treatment to 40 or more. The treatment itself is delivered by a radiation therapist who operates the computer and equipment, but the patient typically meets with the radiation oncologist at least once a week during treatment to monitor side effects.
Hear from a radiation oncologist: Courtney Bui, MD, with UNC REX Cancer Care, says radiation oncologists usually see patients as they’re finishing other treatment. The patient may have had surgery and chemotherapy already, and radiation is the last step. “Sometimes, by the time they get to radiation, they’re reflecting on what’s happened so far. We spend a lot of time talking about their diagnosis and what happens from here,” Dr. Bui says.
What do they do? Surgeons who operate on cancer patients—typically called surgical oncologists—remove malignant growths. If you’re going to have surgery, you’ll see the surgeon for a couple of appointments before the procedure, in the hospital as you recover and afterward for follow-up.
Hear from a surgeon: Matthew Strouch, MD, is a colorectal surgeon with REX Surgical Specialists who often removes cancerous growths within the gastrointestinal tract. “Colon and rectal cancer can be cured by surgery,” he says. “To know the work I’m doing is actually curing cancer and saving lives is really exciting.”
What do they do? Patient navigators are the central source of support and stability for the patient as well as the cancer care team. They are nurses that act as the patient’s advocate, which requires them to have a comprehensive understanding of the patient’s treatment plan and personal circumstances. The patient navigator will:
- Answer questions about treatment.
- Coordinate appointments between multiple providers.
- Meet with patients during and after scans, tests and biopsies.
- Help patients communicate with providers and family members.
- Find resources to help patients with emotional, financial or family challenges.
- Assist patients in completing paperwork.
Hear from a patient navigator: “Patient navigators act as the patient’s voice,” says Kristin Knott, RN, BSN. “I am someone they can call and ask most anything about the treatment plan. I have prompt access to the physicians on their care team and am able to review what concerns them most. We get to know the patient very well. We know their support systems, their financial situation, their families. Knowing the little things, that’s really our job.”
What do they do? In cancer care, a social worker’s job is to make a tough situation easier. Social workers listen to fears and concerns and give patients a safe place to talk about what they’re going through, offering coping strategies when needed. Social workers also address more practical matters, such as helping establish child care during a parent’s treatment or applying for disability benefits. Social workers sometimes sit with patients during a chemotherapy infusion or help them make treatment decisions when they’re struggling with options.
“A big part of my role is just acknowledging what a stressful moment this is for the patient and their family, and working to reduce some of that anxiety,” says Loreal Massiah, MSW.
Hear from a social worker: “A big part of my role is just acknowledging what a stressful moment this is for the patient and their family, and working to reduce some of that anxiety,” says Loreal Massiah, MSW. “They know they have someone they can turn to whenever they need us.”
What do they do? Cancer treatment isn’t easy on the body, and nutrition is vital to getting and staying well. Dietitians work with patients to help them avoid malnutrition, maintain their weight and get adequate protein and fluids. They can help manage side effects of medication and the disease itself, such as constipation, diarrhea or altered taste. In cases where a feeding tube is necessary, the dietitian will work closely with the patient’s doctor to make sure calorie and protein needs are met.
Hear from a dietitian: “I work with all of the cancer care team members to address the best ways we can help patients who are facing nutritional challenges,” says Suzanne Smith, RD, who is a certified specialist in oncology nutrition. The role is a personal one, too, she adds. “There are some patients who almost become family. One of the most rewarding things is to see them after their cancer journey, and they’re doing well.”
What do they do? Cancer treatment can be expensive. It’s the financial counselor’s job to help ease that burden for patients so they can focus on getting well. At diagnosis, the financial counselor analyzes insurance coverage—or lack thereof—and estimates what the patient might owe after treatment is completed. He or she will help the patient find new sources of funding, either through secondary insurance, foundation dollars or financial assistance programs. Financial counselors help patients in all financial situations, whether they’re relatively well off or have no funds at all.
Hear from a financial counselor: “My goal is to try to help a patient complete treatment while spending as little of his own money as possible,” says Cynthia Adams, a financial counselor with UNC REX Cancer Care. She can’t change the fact that cancer treatment can be expensive, but “I can make it more bearable in regards to finance.”