Even before a mesothelioma diagnosis is made, you will already be working with the team that eventually becomes the “mesothelioma treatment team.” The first time you discussed mesothelioma symptoms with your primary-care physician, he or she and, more importantly, you became members of a team made up of nurses, social workers, psychiatrists or psychologists, medical physicists, pharmacists, technicians, and dieticians, among others. Several types of physicians typically work with people diagnosed with mesothelioma.
- Primary-care physicians
- Medical oncologists
- Radiation oncologists
- Palliative-care physicians
A primary care physician, or PCP, is a generalist, a doctor who can help with a varied range of medical problems. The primary care physician provides routine physicals, examinations, immunizations, and diagnostic care. He or she is generally the “first line of defense” in your battle for health, and can refer you to trained specialists as appropriate.
Primary care physicians also teach disease prevention, and advocate for their patients. They get to know their patients, and are then able to suggest long-term health care plans based on that knowledge. They are usually located nearby, and are the first doctor you call when you have a problem. They may know the entire family, and can counsel all of them if illness strikes one or more members.
Your primary care physician, sometimes called a family doctor or general practitioner, can evaluate your symptoms, and run tests to determine what is causing them. If you or a close family member have a history of working with asbestos, it is very important that the PCP know this from the beginning. If the PCP suspects malignant mesothelioma, he or she will refer you to a specialist.
Pathologists are physicians who examine the tissues of the body, searching for signs of disease and damage. Pathologists are the doctors most likely to be involved with analyzing tissue or fluid for analysis, and they interpret the results of those tests and exams and provide the information to other specialists treating you. This information can be critically important for your diagnosis and treatment.
The pathologist will write a report describing the tissues or fluids examined, the condition of the cells, and whether the diagnosis of mesothelioma is confirmed by the state of the cells. The pathologist’s report will also describe the grade and type of cancer found in the cells, which is important in making treatment plans. This report will be sent to your medical oncologist, your surgeon if you have one, and can also be sent to your PCP. You may request a copy for your own records, if you are interested in reading the report yourself. Not everyone, however, wants to read such reports; many people prefer to have a doctor they trust explain them.
The National Cancer Institute’s Dictionary of Cancer Terms defines a medical oncologist as a physician who specializes in the treatment of cancer, using a combination of chemotherapy, biological therapy, and hormonal therapy. Medical oncologists often serve as the primary physician for a cancer patient, and may also serve in supporting roles for patients with more complex health conditions which include cancer. Medical oncologists often coordinate the efforts of a number of different health care specialists.
The medical oncologist is one of the doctors with whom you will begin to make treatment decisions. Most often the surgeon is the first person involved; if you do not have a surgeon he/she may refer you to one.
All of your physicians will communicate their findings, recommendations, treatment plans and treatments given to all of the other physicians involved in your case. A multi-disciplinary approach necessitates cooperation and communication among all of your physicians. Any of your physicians can also help coordinate non-medical services such as social services, nutrition consultations, treatment by a psychologist, etc. All of your physicians will provide you with detailed information to explain complex treatment.
A thoracic surgeon is a physician trained in treating lung cancer, chest wall tumors, emphysema, esophageal cancer, swallowing difficulties, and gastroesophageal reflux. Thoracic surgeons also handle lung transplants. Your first meeting with a surgeon may be in order to obtain tissue for a diagnosis and/or to determine if your disease can be resected (surgically removed).
There are many areas of specialization for surgeons, and a general surgeon may also be able to perform any surgery that is a necessary part of your treatment. You and your medical oncologist can discuss who will be the best surgeon in your case.
Depending on the type of mesothelioma, a surgeon may need to operate to remove as much affected tissue as possible. If the disease has affected your chest, as in pleural mesothelioma, a thoracic surgeon may be called in.
With trained in medicine and physics, the radiation oncologist directs the use of ionizing radiation to treat cancer and, occasionally, other disease. He or she carefully prescribes radiation doses and supervises the radiation technicians and the medical physicist. Radiation oncologists are well versed in technology, although their job is treating people with cancer. Sometimes the goal is a cure; other times the goal is relief of symptoms.
Palliative care physicians
Palliative care physicians are doctors who specialize in improving the quality of life for patients who face life-threatening or terminal illnesses, providing pain relief and other forms of mental and emotional support.
A palliative care physician manages the team that provides care in cases of serious illness. While this care may occur near the end of life, its purpose is to make people more comfortable in many ways during any life-threatening illness, including during treatments designed to cure the illness. Palliative care is designed to offer support to help patients live as fully as possible, and to alleviate suffering, whether or not their illness is considered terminal.
If you are experiencing uncontrolled pain, severe emotional distress, breathing difficulties or other issues related to mesothelioma, and do not feel that these issues are being fully met by your physicians, asking for a palliative care consult may be a wise decision.