Building Your Healthcare Team
When constructing the care plan for any chronic condition, it’s important to have a strong team of specialists to navigate your health with you. When creating a care plan for cancer specifically, it’s important to enlist the help of many specialists and trained providers and take a multidisciplinary team approach. This means enlisting the help of several different types of doctors and other experts, such as nurses, nutritionists, and mental health counselors. It is acceptable, and even encouraged to respectfully question your healthcare team, and challenge those working with you if you feel your needs aren’t met. However, in order to mold your team into exactly what you need, the team needs to be built first.
Providers and experts to enlist:
There are a variety of different individuals you can enlist on your prostate cancer team. The following list are a few examples of specialists you may run into on your prostate cancer journey, and maybe a few others to seek out that may provide invaluable support.
Primary care providers:
Your PCP is often your family doctor that you see for regular well-visits and common concerns. Your PCP may be the provider who performed the DRE (digital rectal exam) or PSA (prostate-specific antigen) test that led to your prostate cancer diagnosis. Your PCP will help coordinate all aspects of your medical care team, and refer you to subspecialists to address symptoms or issues as they arise.
This may include urinary problems or mood issues developed during treatment. After treatment, your PCP will help create a survivorship care plan for life moving forward, and will help make sure this plan is communicated with all others on your team. They can most likely perform many of your follow-up exams, and will help you monitor for recurrence, as well as reduce future risk factors such as obesity and smoking.
Upon receiving a diagnosis or suspecting prostate cancer, you may be sent to a urologist for further examination and treatment. Urologists are surgeons who treat conditions related to the male reproductive system and urinary system, with prostate cancer falling under their area of expertise. Your urologist will help provide you with treatment options, and may perform any surgeries you might need, such as a radical prostatectomy.
An oncologist is a provider who specializes in the treatment of cancer. There are two different types of oncologists that could be on your prostate cancer team: radiation oncologists and medical oncologists. Radiation oncologists specialize in treatment that involves radiation therapy. For prostate cancer, this may include external beam radiation therapy or internal radiation (brachytherapy).
Medical oncologists focus on other medications an options to treat cancer such as chemotherapy, and hormone therapy. Your medical oncologist will typically be the most up to date on new clinical trials, treatment options, and medical research in the field of oncology, and may act as the guiding opinion if other experts do agree on an aspect of treatment or your care. Some oncology practices also have oncology social workers to assist you with treatment decisions and follow-up. These providers also have extensive knowledge on the staging and grading of different cancers.
Nurses, Physician’s Assistants, and Nurse Practitioners:
These highly skilled providers often provide the support network for the previous providers and likely be highly involved in your care and treatment.
Psychiatrists and other mental health counselors:
Coping with a cancer diagnosis, along with treatment options like hormone therapy, can often take a toll on an individual’s mental state. For this reason, your PCP may refer you to a psychiatrist or other licensed mental health counselor to help you remain in your best fighting shape as a whole.
Physical therapists, fitness experts, and nutritionists:
Post-treatment especially, your body may be weak extremely stressed. Getting the right amount of appropriate physical activity and the proper nutrition can help you regain strength, relieve anxiety, and may help reduce your risk of further progression or recurrence of your prostate cancer.
Palliative care team:
For the smaller proportion of individuals with advanced stage or aggressive prostate cancer, there may be a time when palliative care, or comfort care measures, are considered. Palliative care can help manage side effects during treatment, as well as work to alleviate symptoms near the end of a cancer journey. Your palliative care team will make sure your wishes are followed throughout the rest of your battle, and that all of your needs, as well as your family’s needs, are addressed as best as possible.1-3
Choosing an experienced surgeon and questions to ask before an operation
As mentioned, one potential specialist on your healthcare team may be a surgeon, and you may pursue surgical treatment options, such as a radical prostatectomy. With any surgical procedure, it is important to feel comfortable with your provider, and trust in their skill and ability. It is perfectly acceptable to ask your provider, or their team, any and all questions you may have before making the decision on a surgeon or procedure. Below are some questions you may consider bringing to your surgeon or their team before a procedure or big decision:
- What risks or side effects could accompany this procedure?
- Will I have any limitations afterward?
- What will follow-up care entail after this procedure?
- Are your credentials up to date?
- How many of these procedures have you performed, and what is your success versus fail rate?
- Do you feel confident performing this procedure?
- Are there any other treatment options besides surgery with lower risks that I could benefit from?
- What signs or symptoms post-procedure should I contact you immediately about?
- Will I be able to reach you or your team after hours or on weekends?
- What should I do to prepare?
Of course, there are many more potential questions you can ask, and these are just a starting point. If your provider is unavailable when you have a question, you can always bring any concerns to their support team, including their nurses or physician’s assistants.
Getting a second opinion on treatment
It is never a bad idea to seek a second opinion on treatment, especially if you have multiple options you can choose from, or are feeling overwhelmed. Your provider should not take asking for a second opinion as an insult, and many providers will even help you find another provider to see. From there, both providers may be able to collaborate together to weigh in on your situation. Second opinions are so encouraged, that many insurance companies even require them for certain conditions, like cancers.
As always, you should be able to trust in your healthcare team and feel supported by them. If at any point during or post-treatment you feel that this isn’t the case, getting a second opinion or enlisting new providers might be the best option. If you do decide to get a second opinion or switch providers, it is important to bring all of your medical records, biopsy reports, surgery and discharge summaries, and any other pertinent information with you to make the transition as smooth as possible.
- Noonan EM, Farrell TW. Primary care of the prostate cancer survivor. Am Fam Physician. 2016; 93, 764-770.
- Skolarus TA, Wolf AM, Erb NL, et al. American Cancer Society prostate cancer survivorship care guidelines. CA Cancer J Clin. 2014;64:225-249.
- Treating Prostate Cancer. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/treating.html Accessed August 12, 2017.