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CHOOSING AN ONCOLOGIST AND TREATMENT CENTER

Your primary care doctor will probably have referred you to a specialist who is likely a medical oncologist , hematologist, or hematologic oncologist. Oncologists are physicians who specialize in diagnosing and treating cancer. Hematologists are physicians who specialize in diagnosing and treating disorders of the blood and lymphatic system.

Before agreeing to treatment by a doctor or clinic, be certain that your medical and personal needs will be met. Take time to check your doctor's credentials, as well as the credentials of the hospital or cancer center.

Keep in mind that if you are in a managed care program, your choices may be limited. However, if you are not entirely satisfied with your first consultation, you have the right to choose another healthcare team. Ask your primary care doctor for another referral, or ask other patients with lymphoma for their suggestions. It is important that you feel comfortable with your healthcare team and the quality of care you are receiving.

GETTING A SECOND OPINION

Before you start therapy, you may want a second opinion about the diagnosis and treatment plan. Some insurance programs require second opinions; others may cover it if a patient requests it.

If you decide to seek a second opinion, remember that it is best to request a complete copy of your medical records and to provide original x-rays, pathology materials, scans, and reports that are requested by the consulting doctor. It is suggested that you make 2 copies of these medical records – one for yourself and one that you deliver to the consulting physican, preferably before your appointment. A second opinion is not considered adequate unless the tumor sample is reviewed by another pathologist, preferably well versed in lymphoma. Your referring doctor or your healthcare plan can often recommend an oncologist you can visit to get a second opinion.
 

COMMUNICATING WITH YOUR HEALTHCARE TEAM

People who are diagnosed with lymphoma often want to learn all they can about their disease and treatment choices so they can take an active part in the decisions about their care. Many people, however, are shocked to learn that they have cancer. It is normal to feel a lot of physical and emotional stress after diagnosis. Some people are uncertain about how to talk with doctors, and the combination of stress and uncertainty may make it difficult to know what to say or what questions to ask.

 
Establish an open and honest dialogue with your physician and nurse regarding your diagnosis, what the prescribed treatment regimen is, how it works, what tests are involved, and what side effects and complications may be associated with it. Throughout the course of your illness, keep track of all questions that come to mind. Write them down because eventually you, your family, and friends are going to want answers. Before meeting with your doctor or nurse, whether for the first time or for follow-up visits, organize and write out your questions. Put the two or three most important questions at the top of your list, since time with your doctors or nurses may be limited. But make sure a member of your medical team reads all of your questions, because they may see some that are more important than you have realized.
 
It is helpful to have a member of your family or a close friend accompany you to the clinic to help you ask questions and understand and remember answers. It can also be helpful to write down the answers to your questions. Some patients bring a tape recorder to record the answers. Check with your doctor first though, to make sure he or she does not mind if you tape the conversation. In general, questions about chemotherapy should be directed to the medical oncologist, and questions about radiotherapy should be directed to the radiation oncologist. Most oncology nurses are also very well informed about cancer treatments, and are a wonderful source of information on a wide range of topics relating to your care.
 
Often families are very concerned about their loved one and want information. Because of growing confidentiality rules, your physician will not give out information to anyone without your expressed permission. For efficiency, it is suggested one family member be designated as the family contact to the physician. You, however, must inform your physician who this individual is to be.
 
ACTIVELY PARTICIPATING IN YOUR HEALTH CARE

Attitude is also very important. You are a partner in your treatment and many patients feel better when they participate actively in their care. The first steps in participating in your treatment are to ask questions, learn about your options, and work closely with your doctor. You must be comfortable with your physician and the approach that he or she takes. If you are not, discuss your concerns. Remember, confidence in your medical team often leads to confidence in your treatment. If it becomes apparent that you and your team are not a good match, ask for a referral.
 
Your questions will likely vary depending on the purpose of your meet-ting with your oncologist, e.g. the initial visit to discuss the diagnosis as opposed to a routine visit to monitor a remission. Ask for the timing of office visits, treatments and tests. Your doctor can help to explain what the tests will look for, define the possible responses, and the options for further care depending on treatment response.
Although each person is different and each response to therapy is unique, knowing someone who has been through the same treatment and who may have had similar concerns can be a source of great comfort. If you are interested in talking to and learning from people who have had similar experiences, ask your oncologist, hematologist, oncology nurse, or the oncology social worker about any support groups in your area. Consider joining the Lymphoma Support Network, a nationwide buddy program that matches patients or caregivers. This program offers the opportunity to share experiences and information, and offer support and encouragement. For more information about this program, call (800) 500-9976 or email: support@lymphoma.org.