Your Health Care Team: Your Doctor Is Only the Beginning

Coping with cancer is not an easy thing. The physical effects of illness and treatment can be quite severe, and the emotional and psychological impact of having cancer can be equally challenging. However, the good news is that there are many kinds of help available to you through the different members of your health care team.

Below is a description of the health care professionals who are usually accessible to someone who has cancer. Each of these people can play a vital role in helping you obtain the best treatment possible and maintain the highest quality of life throughout your diagnosis and treatment.


First Things First: Your Own Role

It may seem obvious, but it is very important to remember that you are the most important person on your health care team. As with any type of health care you receive, you are a consumer of services, and you should not be afraid to ask questions about what you are getting and who is providing it.

You might consider these tips:


Social Workers: Lots of Help from One Place

Social workers are professionally trained in counseling and practical assistance. They provide the broadest range of help to people with cancer, and are a good place to start if you have recently been diagnosed with cancer and unsure of what to do next. Oncology social workers specialize in cancer; most hospitals that treat cancer patients have certified oncology social workers on staff. Clinical or psychiatric social workers have an advanced degree or Ph.D. in social work and are trained to provide family therapy, marital counseling, or counseling focused on coping with chronic illness. A hospital social worker can also refer you to a clinical social worker in private practice in the community.

The hospital social worker can also provide counseling, find a support group for you, locate services in your community that can help you with home care or transportation, and guide you through the process of applying to the government for Social Service Disability or other forms of assistance. They can also help you understand your diagnosis and talk to you about treatment, side effects, and what to expect. If you need help finding a social worker in your area, start by contacting your local hospital.


Psychiatrists: If You Need Medication or Feel Depressed

A psychiatrist is a medical doctor who specializes in providing psychotherapy, or general psychological help. A psychiatrist specializes in helping people who are depressed, anxious, or otherwise unable to cope psychologically. Because they are medical doctors, psychiatrists can also prescribe medication, such as antidepressants or medication to help you sleep. To find a psychiatrist, you can ask your doctor for a referral, ask if your hospital has a psychiatric department, call your Health Maintenance Organization or other managed care plan, or ask a social worker to help.


Psychologists: Providing Therapy and Counseling

A psychologist is also someone who can assist you if you are feeling depressed, anxious, or sad. While not medical doctors, psychologists have obtained a doctoral degree in psychology and counseling; many specialize in marital counseling or chronic illness. Some cancer centers have psychologists on staff, but if you are looking for one, ask your doctor, your HMO, your hospital, or a social worker for a referral.


Nurses: A Very Important Role in Care

Nurses are an extremely important part of your health care team. Nurses have a wide range of skills, and are usually in charge of actually implementing the plan of care your doctor has set up for you. They are trained to administer medication and monitor side effects. All major medical centers have nurses who specialize in cancer. Whether you are staying in the hospital for care or receive it on an outpatient basis, you will benefit from seeking assistance, asking questions, or getting tips and advice from your nurse or nurse-practitioner. Nurses are often aware of support services in your community and can usually provide you with educational materials and pamphlets.

You may also arrange or request a registered nurse to visit you at home if needed. If the visit is approved by your doctor, it will usually be covered by insurance. Another option is to hire a private duty nurse who does not work for your hospital or health care service. This can be expensive and often is not covered by insurance, but can ease the burden of care on your family or loved ones.


Home Health Aides: Care at Home

Another form of home care is from a home health aide. Home health aides assist people who are ill and need help moving around, bathing, cooking, or doing household chores. Some state Medicaid programs will pay for home health aide care, provided they are supervised by a nurse. However, private insurance or managed care plans rarely pay for a home health aide unless there is also a need for skilled nursing care. To find home health aide care, ask your physician, nurse, or social worker, and remember to ask if the charges vary based on income. Also, the National Association of Home Care publishes a free booklet How to Select a Home Care Agency. The telephone yellow pages are another source, but be sure to check credentials, find out whether the agency is bonded, and ask for references.

Rehabilitation Specialists: Help for Recovery

Rehabilitation services help people recover from physical changes caused by cancer or cancer treatment. It includes the services of physical therapists, occupational therapists, counselors, speech therapists, and other professionals who help you physically recover from cancer. For example, physical therapy can help you rebuild the muscles in your arm and shoulder if you have had chest surgery.

Most physicians will refer you to rehabilitation services if you need them; be sure to ask if you think you might want them. Also, check to see if these types of services are covered under your insurance plan. Additionally, some cancer or social service organizations may provide you with free rehabilitation services if you are not insured for them.


Dietary or Nutritional Services

Cancer and cancer treatment can cause people to lose weight. For this reason, dietary or nutritional counseling or services are commonly prescribed for people with cancer. A dietitian can suggest ways to get enough calories, vitamins, and protein to help you feel better and control your weight, and can give you tips about increasing your appetite if you experience nausea, heartburn, or fatigue from your illness or treatment.

Most hospitals have registered dietitians on staff, and you can ask your doctor about meeting with them. If you are trying to locate a dietitian in your community, be sure to ask about experience and training. Remember to check if the services of a dietitian are covered under your insurance; if not, ask your doctor, nurse, or social worker about community-based programs that offer free services.


Clergy: Spiritual Support Is Important

Prayer and spiritual counseling can be very important in coping with a serious illness such as cancer. Many people find it useful to get help from clergy or other spiritual leaders, and there is no question that a strong sense of spirituality can help people face difficult challenges with courage and a sense of hope. Some studies show that people with cancer have less anxiety and depression, even pain, when they feel spiritually connected. Even if your beliefs are challenged by your illness, don't be afraid to reach out to others for help. It is important to remember that you are not alone at this time.


Hospice Care: Help with Terminal Illness

Hospice care focuses on the special needs of people who have terminal cancer. Sometimes called palliative care, this type of care focuses on providing comfort, controlling physical symptoms like pain, and giving emotional or spiritual support. Hospice care is usually provided at home, although there are hospice centers that operate much like hospitals and provide full-time care. Your doctor or social worker can refer you for hospice care.

Home hospice care is usually coordinated through a nurse, who then sends a home health aide, social worker, occupational therapist, clergy, or the type of specialist that is appropriate for the needs of the hospice patient. Hospice care is not for everyone. It is important to discuss this option carefully and get guidance from your doctor, nurse, or social worker.


Putting the Team Together: Find Help and Hope

A diagnosis of cancer may be the most difficult challenge you or your loved ones will ever face. That is why it is important to find help and try to maintain your sense of hope no matter what your situation. Your team of health care professionals is knowledgeable about the many different aspects of cancer: medical, physical, emotional, social, and spiritual. They are available to you as much or as little as you need, but it is difficult for them to know if you need help unless you ask for it. Don't be afraid, embarrassed, or hesitant to ask questions; voice your opinion, and seek the care you feel you need and deserve.

This fact sheet was adapted with permission from Cancer Care, Inc., a nonprofit social service agency whose mission is to help people with cancer and their families. Cancer Care's toll-free telephone number is 1–800–813–HOPE. The National Cancer Institute and Cancer Care, Inc., are in partnership to increase awareness of the psychosocial issues faced by cancer patients and to provide resources to cancer patients and their families.



>