Who's in Charge?

Maggie Hampshire RN, BSN, OCN
Last Modified: November 1, 2001

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Question
I'm searching for information on plan of care and follow-up care for a patient who was diagnosed in 1991 with anaplastic astrocytoma (brain cancer). Who coordinates a cancer patient's care (oncologist, neuro-surgeon, family physician)? The patient has increased neurological dysfunctions (memory loss, imbalance, hearing loss) but has not been assessed for progessions of these dysfunctions. Someone recommended a neuropsychologists evaluation. Where do we begin? Do we define ourselves who will be coordinating the patient's care or are family members responsible for deciding the patient's next course of action? If family members coordinate the patient's care, how do we contact a neuropyschologist?


Answer
Maggie Hampshire RN, BSN, OCN, Managing Editor of OncoLink responds:

During cancer treatment many different medical specialties are needed. Depending on the diagnosis surgery, medical oncology, and or radiation oncology are initially necessary. Eventually, side effects of treatments and effects of disease call for other medical specialties. It would be ideal for one physician to coordinate the multidisciplinary care that is necessary. Sometimes, as with managed healthcare, this is mandated by the healthcare policy. So, your "primary physician" must oversee and approve of all of your care. Although, it is necessary for the patient and family to take an active part in the management in their own care. For some good ideas on how to manage your care please see the following sites:

OncoLink's section Coping With Cancer

The National Cancer Institute's "Taking Time" resource

The OncoLink document Making Treatment Decisions: Informed Consent.