Pancreatic Cancer Care: Who Should Be On Your Team?

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Learning that you have pancreatic cancer can be a tough and emotional time. You’ll need to make decisions about what treatments you choose to pursue. And you’ll need to plan for what your future with the disease might look like.

The process can come with a lot of challenges, but you don’t need to go through it alone. Health care providers and other caregivers are trained to meet your specific medical, psychological, and logistical needs from the point of being diagnosed with pancreatic cancer forward.

The members of your specific cancer care team may vary depending on the type of pancreatic cancer you’re diagnosed with, what type of treatment you undergo, and where you live and receive treatment. Here are some members of the pancreatic cancer care team who may be involved:

Gastroenterologist

A gastroenterologist, a doctor who specializes in diseases of the gastrointestinal tract, likely became a part of your care team when you first noticed symptoms of pancreatic cancer, such as diarrhea, abdominal pain, or unintended weight loss, among others, explains Walter Park, MD, a gastroenterologist and pancreas specialist at Stanford Health Care. Typically when those symptoms cannot be explained by your primary care doctor, you’ll be referred to this type of physician, who has expertise in issues that come up with the pancreas. He or she will run the initial tests that lead to a pancreatic cancer diagnosis. Your gastroenterologist may also be looped in throughout your treatment to help manage potential complications after surgery, such as diarrhea or pain.

Medical oncologist

Once a gastroenterologist finds signs of pancreatic cancer, he or she will likely refer you to to a medical oncologist—a doctor who specializes in treating cancer. The medical oncologist will confirm your pancreatic cancer diagnosis, explain your treatment options, help you decide what treatment approach is best for you, and prescribe and manage chemotherapy and other anticancer drugs if that’s part of your treatment plan. In most cancer centers, once you have been diagnosed with pancreatic cancer, your medical oncologist will be the physician who manages your cancer treatment, coordinating with the other physicians and specialists on your team, Park says.

“Once cancer has been diagnosed, the cancer specialist will often be the one who becomes the medical center home and primary care doctor,” Park adds. “Even if and when the patient goes into remission and is several years out, they will still probably follow up with the oncologist.”

Pathologist

Pathologists are doctors who identify diseases by studying cells obtained via biopsies under a microscope. A pathologist will work with your medical or surgical oncologist to confirm your cancer diagnosis, and may help later in the course of your treatment to help determine where a cancer has spread or if a tumor has been removed completely. While a pathologist is an important part of your medical team, you typically won’t meet them or work with them directly.

Surgical oncologist: If your tumor is operable, a surgical oncologist (a surgeon who specializes in cancer surgery) will be the doctor who performs that operation. Depending on your disease and where you get treated, the surgical oncologist may play a bigger role or even take the lead in managing your care.

Radiation oncologist

Some people diagnosed with pancreatic cancer receive radiation therapy, for example to help shrink a pancreatic tumor before surgery, or to relieve symptoms in people who don’t have other treatment options. The radiation oncologist is the doctor who determines the type and amount of radiation therapy an individual will receive, educates the individual about the radiation treatments they’ll undergo, and monitors that treatment. (Usually radiation therapy is given over several sessions and delivered by a radiation oncology nurse under the supervision of the radiation oncologist).

Endocrinologist

Endocrinologists are doctors who treat diseases in the glands throughout the body that secrete hormones. They may help with pancreatic cancer care in helping patients who have poorly controlled diabetes due to pancreatic cancer, or from complications that result after an operation during which part of all of the pancreas is removed, Park says.

Pain specialist

Depending on your symptoms and the treatment side effects you experience, your medical oncologist may bring in a pain specialist to help identify and treat your pain. This clinician may be an anesthesiologist, a neurologist, a neurosurgeon, or a psychiatrist specially trained in pain management, among other specialties. They will work closely with the medical oncologist managing your care to make sure your pain needs are addressed. They may manage your pain through medications (such as narcotics or opioids), complementary therapies (such as acupuncture, hypnosis, heat or cold therapy, or massage), and other methods.

Oncology nurses

Several specialties of oncology nurses may be part of your cancer care team. They’ll work with the physicians, surgeons, and others on your care team to help deliver treatment, manage side effects, and answer your questions or concerns. Oncology nurses may be trained in one of a number of different areas, including: perioperative care (support just before and after surgery), chemotherapy administration, radiation therapy administration, research (helping manage problems that arise as part of an individual’s participation in a clinical trial), and surgery.

Palliative care doctor or team

Palliative care is a type of medical care that helps people deal with the burdens that come with a serious illness, including symptoms of treatment and the disease (such as nausea or pain), psychological stress, financial struggles, needing help with child care, or problems with work caused by your illness. It can be given by several different providers.

“[The palliative care team] helps provide symptom relief and make sure quality of life is maximized,” Park says. “They’re often underutilized, but can be very beneficial team members.”

Registered dietitian

A dietitian may become part of your care team to provide support about what foods provide adequate nutrition during treatment, while not causing further irritation or problems.

Social worker

Social workers help provide information and support for patients about treatment decisions, support groups, financial resources, end of life, transportation assistance, home care, and more. Some hospitals and cancer centers have oncology social workers, who focus solely on meeting these needs as they pertain to people with cancer.

Psychiatrist or psychologist

Both are trained in providing psychological help through therapy and counseling. In addition, psychiatrists are medically trained and can prescribe medications for psychological needs (such as anxiety, depression, and other psychological distress) when appropriate.

Hospice team

If you and your care team make the decision to stop curative treatment, hospice is a type of care that helps keep you comfortable at the end of life. (Typically you can qualify for hospice if a doctor certifies that you have six months or less to live.) Hospice care is usually provided in your home under the direction of a hospice doctor or medical director, along with nurses, social workers, bereavement counselors, home health aides, and clergy, who all have training in the specific needs an individual will have when they face death and dying.

Clergy

Spiritual leaders (perhaps individuals you know, or ones from your faith who are affiliated with the hospital or cancer center you are receiving treatment at) can help with counseling and support as you face difficult medical struggles and/or the end of life. They may also be part of a palliative care or hospice team.

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