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Frequently asked questions

Q.

What is a multidisciplinary team?

A.

A multidisciplinary team consists of cancer specialists from diverse areas who work together to help you fight cancer with confidence. Your team may include:

  • Surgical oncologists
  • Medical oncologists
  • Radiation oncologists
  • Radiologists
  • athologists
  • Specially trained nurses
  • Nurse navigators and social workers
  • Physical therapists
  • Registered dietitians
  • Physicists
  • osimetrists
  • Pharmacists
The team comes together to develop a personal treatment plan that takes into account all aspects of care—everything from prescribing the most appropriate tests or therapies to addressing educational needs and emotional concerns. We’ll then discuss the plan with you so you can make informed choices about your preferred course of care.

Q.

What is medical oncology?

A.

Medical oncology, a subspecialty of internal medicine, is devoted to the diagnosis and treatment of malignant tumors. It primarily involves the use of chemotherapy (powerful medications that destroy cancer cells), as well as immunotherapy and targeted therapy. Medical therapies may be used in combination with cancer surgery and/or radiation therapy, depending on your unique needs.

Q.

Should I get a second opinion?

A.

Seeking a second opinion is a personal choice. There are several reasons you may want to consider doing so. Most patients are looking for reassurance that the first opinion is correct and that they are exploring all of their treatment options. It is important to us that you are aware of all that is available to you before deciding on a course of treatment. We may also recommend you seek a second opinion if an oncology subspecialist would be appropriate. The only time a second opinion for any type of medical care is not appropriate is in an emergency.

Q.

Will my health insurance pay for a second opinion or treatment?

A.

Many health insurance companies pay for second opinions. Your best source of information about your specific coverage is the insurance company that issued your health insurance policy or your employer's benefits office (if you are covered under a group policy through work). We recommend that you call to find out what they cover and if you need a referral or preauthorization.

Q.

How does chemotherapy work?

A.

Chemotherapy is designed to kill cancer cells. Depending on which drug is used, chemotherapy can be given in a variety of ways, including:

  • Orally Swallowed as pills, capsules or liquids
  • Intravenously (IV) Injected directly into a vein By injection Injected into a muscle in your arm, thigh or hip, or right under the skin in the fatty part of your arm, leg or belly
  • Topically Rubbed as a cream into your skin
Chemotherapy works by destroying cancer cells, but unfortunately it cannot tell the difference between a cancer cell and a healthy cell. So chemotherapy eliminates not only the fast-growing cancer cells but also other fast-growing cells in your body, including hair and blood cells. Some cancer cells grow slowly while others grow rapidly, so each chemotherapy drug is designed to target the growth patterns of a specific type of cancer cell. As a result, each drug works differently and is effective at specific times in a cancer cell’s life cycle. Your doctor determines the chemotherapy drug that is right for you.

Q.

What is the difference between chemotherapy, immunotherapy and radiation therapy?

A.

Chemotherapy involves medications given by injections or pills for cancer. Treatment is circulated throughout the entire body and is generally prescribed by a medical oncologist. It can be used to:

  • Make a tumor smaller before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
  • Destroy cancer cells that may remain after treatment with surgery or radiation therapy. This is called adjuvant chemotherapy.
  • Help other treatments work better.
  • Kill cancer cells that have returned or spread to other parts of your body.
Immunotherapy is given by IV infusion and is circulated throughout the entire body as an initial cancer treatment or after surgery to help keep cancer from coming back. Some types boost the body’s immune system in a general way and others help train the immune system to attack cancer cells specifically. Different types of immunotherapy can:
  • Take the brakes off the immune system to help it recognize and attack cancer cells. This is called an immune checkpoint inhibitor.
  • Start an immune response against a certain disease (a cancer vaccine).
  • Attack a very specific part of a cancer cell with synthetic versions of immune system proteins or monoclonal antibodies.
  • Radiation therapy is produced by a linear accelerator or another radiation source, and is prescribed by a radiation oncologist. The radiotherapy beams are focused on a very specific area of the body.

Q.

How does immunotherapy work?

A.

Immunotherapy, also called biologic therapy, is a type of cancer treatment that boosts the body's natural defenses to help your immune system fight cancer. It uses substances made by the body or in a laboratory to improve or restore immune system function. Immunotherapy may work by:

  • Stopping or slowing the growth of cancer cells
  • Stopping cancer from spreading to other parts of the body
  • Helping the immune system work better at destroying cancer cells
The immune system’s purpose is to attack any cell that it sees as unhealthy or abnormal. One reason that cancer cells thrive is that they are able to hide from your immune system. Certain immunotherapies can mark cancer cells so it is easier for the immune system to find and destroy them. Other immunotherapies boost your immune system to work better against cancer.

Q.

How is cancer pain managed?

A.

For a tumor that causes pain, surgery to remove the tumor and/or chemotherapy or radiation therapy to destroy all or part of it can help. There are also many medications used to treat pain. You and your doctor can discuss the options and adjust medications as needed to minimize your pain.

Q.

Is exercise recommended during treatment?

A.

Exercise has been shown to be safe for people going through cancer treatment, and in fact can be one of the best ways to relieve some of the symptoms associated with your cancer or treatment. Your medical oncologist will help find the right balance of maximizing therapy effectiveness while minimizing side effects, so you can integrate exercise into your life and stay as active as possible while in treatment. You’ll also work with a physical therapist who can create an exercise program that is safe for you throughout your cancer journey.

Q.

Is it possible to continue working while in treatment?

A.

Many of our patients remain at work and maintain a productive lifestyle during treatment. Whether or not you can work may depend on what kind of job you have. If your job allows, you may want to see if you can work part-time or from home on days you do not feel well. Our physicians are dedicated to finding a drug therapy balance that will most effectively fight your cancer while minimally affecting your daily routine and lifestyle.

Q.

How do staging and grading cancer affect treatment?

A.

Knowing the stage and grade of the cancer helps your doctors know what treatment to use and determine outcome. Staging reveals how far cancer has spread and grading helps predict how fast the cancer will grow and spread. Cancer is typically staged as:
Stage 0: Cancer hasn’t spread.
Stages I, II and III: Cancer has grown or has spread into nearby tissues and perhaps lymph nodes. The higher the stage, the farther the cancer has spread.
Stage IV: Cancer has spread beyond the lymph nodes into other parts of the body (metastasized). Grading, which is different from staging, refers to how abnormal tumor cells and tissue look under a microscope, an indication of how quickly a cancer is likely to grow and spread. Grading systems vary by cancer type, but in general the following system is used:
G1: Well differentiated (low grade)
G2: Moderately differentiated (intermediate grade)
G3: Poorly differentiated (high grade)
G4: Undifferentiated (high grade)

Q.

How does a positive attitude affect cancer treatment?

A.

The brain produces chemicals that affect how well our body fights disease. Through the mind-body connection, positive emotions and laughter send signals to the brain, which then produces chemicals that:

  • Increase blood circulation
  • Boost the immune system and help fight off infection
  • Relax muscles, restore energy and lower stress
  • Improve mood and better manage pain and stress

Q.

What if I have a radiation treatment on the same day as chemotherapy?

A.

Your nurse navigator will assist the team with coordinating your various appointments so everything is scheduled appropriately. If you have questions about the timing of your treatments, speak with your oncologist or nurse navigator

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