The surprising things you need to know before committing to a care team.
After a cancer diagnosis, your instinct might be to stick with the first oncologist you meet. Between processing confusion, bewilderment, and often fear, the idea of shopping around for doctors is overwhelming. But every care team is different, and considering what’s at stake — and how much time you might spend in treatment — finding a doctor you trust is the most important decision you can make. That’s why we asked an expert to explain how to determine whether your doctor and your treatment center is right for you.
Diane Reidy-Lagunes, MD, is a gastrointestinal oncologist at Memorial Sloan Kettering (MSK) Cancer Center in New York and host of the podcast Cancer Straight Talk from MSK. She’s on a mission to empower and educate cancer patients and their families about how to find the best care available. We asked her about the red and green flags to look out for when choosing a care team and a cancer center. Armed with this info, you can find a team you trust — so you can focus all your energy on healing.
Red flag: The first oncologist you see doesn’t have a lot of experience with your type of cancer.
“If you have a rare type of cancer, you’ve got to get a second opinion,” says Dr. Reidy-Lagunes. “Even if you love that first doctor, you should seek out a specialist who’s familiar with diagnosing and treating rare cancers. Also remember that even if your cancer seems common, like breast or colon, there can be rare subtypes.” She adds, “If there’s some ambiguity on treatment options or the diagnosis itself, you should probably speak to more than one oncologist, to make sure you understand what’s really going on.” Luckily, telemedicine makes getting a second opinion easier than ever — and ultimately, it may even be worth it to travel for your care.
The cancer center you choose should also have extensive experience treating patients with your condition. At a National Cancer Institute-designated hospital, you can expect everyone on your care team to be highly familiar with your type of cancer, even if it’s uncommon. “It’s not just the oncologist,” says Dr. Reidy-Lagunes. “The pathologist also specializes in that rare disease, and so does the surgeon. Having a multidisciplinary team ensures the best possible care and outcomes.”
Red flag: Your oncologist lays out a treatment plan without explaining your options.
You should feel like you and your doctor are collaborating, not like your doctor is the sole authority and you’re just following along. Dr. Reidy-Lagunes explains: “I always tell my patients, ‘I have a responsibility to give you my best recommendation, and we’ll work on the plan together.’ Ultimately, my job is to explain to the patient all of the potential options, and what I think is the best plan based on available treatments, potential side effects, and surgical options.”
Of course, there’s nuance to every individual case and an initial plan could change along the way, but a good oncologist will clearly explain why they think those changes are necessary. If your oncologist doesn’t explain either alternative options, or why their initial recommendation is the only treatment available, you should ask.
Green flag: Your oncologist asks for your priorities as a patient.
It can be intimidating to tell your doctor exactly what you want out of cancer treatment. Maybe you only want to be offered high-level info instead of granular details, or you prioritize quality of life over a more-guaranteed outcome that could have major side effects. “A physician should understand a patient’s personal needs, and the patient should feel comfortable enough with their doctor to express those needs,” says Dr. Reidy-Lagunes. She adds that someone from your care team should be available at any time, day or night, to address any side effects or answer urgent questions.
Green flag: Your doctor is honest with you, even if it means delivering difficult news.
The main goal for your physician is always to cure your cancer, but sometimes that’s not possible. Dr. Reidy-Lagunes explains why a physician should lay out a roadmap for a patient from the outset: “You should know what the goal of treatment is. Sometimes it’s to cure the cancer, but other times it’s just to keep the cancer in check for as long as possible. Your doctor should address these questions: Is this treatment curative? What does it mean if treatment is palliative? What are possible outcomes the patient can expect? How long will the treatment take? Knowing these answers upfront can help prepare you for what’s to come.”
Red flag: Nobody explains clinical trials you might be eligible for.
Depending on your diagnosis, a clinical trial could have a major impact on your health outcome — and there are thousands of trials going on across the country at any given time.
If you’re eligible for a trial that might benefit you, Dr. Reidy-Lagunes says it’s your physician’s responsibility to offer you more details. Though keep in mind that some clinical trials are only available at certain hospitals, which could complicate logistics. “Participating in a clinical trial might mean you need to change your care team while you’re on the trial.” she explains. “Even if it means you might no longer be their patient, your physician should always tell you about clinical trials they’re aware of. These trials not only help the patients of today, but of tomorrow.”
Green flag: The hospital where you’re being treated offers the most advanced medical testing and technology.
Advanced diagnostics like tumor genetic testing and rapid biopsies can make a world of difference when it comes to patient outcomes. Dr. Reidy-Lagunes explains why hospitals like MSK prioritize these advances to understand which genetic mutations are driving the cancer. “We’re able to test over 500 genes as soon as the patient’s diagnosed. This can be critical in personalizing the best treatment plan.”
Rapid biopsies can also have a major impact on survival rates: “As soon as we get the biopsy,” says Dr. Reidy-Lagunes, “we can start genetic testing, navigate you to the right specialist, and start your treatment as quickly as possible.”
Green flag: Your care team includes experts who’ll help you after your treatment is complete.
When you’ve just received a cancer diagnosis, the first thing on your mind probably isn’t who’s going to be there to help you after your treatment is done. But Dr. Reidy-Lagunes says that “survivorship” (meaning coping with life post-diagnosis and care) is a surprisingly important part of healing. “Survivorship programs make huge impact in improving your quality of life and decreasing the risk of recurrence,” she says. “At MSK, we’re so fortunate that not only do we have the very best treatment specialists, but we have a whole team to help you after treatment. This includes everything from exercise physiology, to the role of nutrition, to assistance with issues like hot flashes or sexual function — in fact, we have a whole clinic devoted to sexual health. Often there are small fixes that can alleviate issues you might have after treatment, which can have a huge impact on your quality of life.”
The bottom line: Don’t settle for a doctor just because they’re convenient or you’re worried about offending them by looking around. You owe it to yourself and your loved ones to choose wisely — because where you’re treated first matters.
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