Multi-disciplinary teamwork to optimize care of patients with prostate cancer
A diagnosis of prostate cancer is a major life-changing event that brings social, psychological, physical, and financial challenges. Other than the support from family and friends, a multi-disciplinary team is working closely together to coordinate the care of patients with prostate cancer. This ensures the best outcomes in all domains, including cancer treatment, nursing care, and psychological support. Who are the members of this team? Let us find out more about their roles:
- Urologist: The urologist is usually the leader of the team, and the doctor whom the patient has been seeing. Sometimes, different urologists are involved as well. A uro-oncologist subspecializes in managing urinary tract cancers and will be the main person for prostate cancer related surgery. However, side effects from cancer treatment can occur. In these cases, an andrologist may be needed to help manage erectile dysfunction, or a reconstructive urologist will be required if there are strictures (narrowing in the urine tract usually from scarring after surgery or radiation therapy) or fistulas (abnormal connection between the urine tract and other organs such as the intestines) after treatment.
- Radiation oncologist: The standard treatment for localized prostate cancer (i.e. cancer that has not spread out of the prostate) is either surgery to remove the entire prostate, or radiotherapy. The radiation oncologist is the doctor planning radiotherapy, which uses high doses of radiation to kill prostate cancer cells. At low doses, radiation is used in x-rays to see inside your body, such as x-rays of the chest or bones.
- Medical oncologist: When prostate cancer has spread, patients may need treatment such as chemotherapy. Medical oncologists are doctors who help with treatment for cancer using medication, including chemotherapy.
- Radiologist: Patients often need scans to diagnose and stage prostate cancer. For example, Magnetic Resonance Imaging (MRI) scan of the prostate is almost always done prior to prostate biopsies to localise the area of cancer. A radiologist is a doctor who specializes in the interpretation of these scans and helps identify areas suspicious for cancer.
- Pathologist: A pathologist is a doctor who examines body tissues. In prostate cancer cases, these are usually the specimens taken from prostate biopsies. The pathologist specializes in examining these tissues, identifying the presence and grade (or aggressiveness) of these cancers.
- Palliative medicine physician: A palliative medicine physician is a specialist who helps late stage prostate cancer patients with pain and symptom management, as well as coordinates their social and psychological support.
- Nurse specialist: These are experienced nurses who help coordinate the care within the team. They focus on support, education, management of treatment side effects and rehabilitation.
- Physiotherapist: Physiotherapists play an important role in optimizing quality of life after treatment. They provide education and rehabilitation on issues such as incontinence (e.g. pelvic floor muscle training) and education on sexual rehabilitation after treatment.
- Pharmacist: Prostate cancer patients often have other medical problems including diabetes, hypertension and heart diseases. A pharmacist assists in ensuring that there are no medication interactions between medications prescribed for prostate cancer and the patients’ usual medications. They also educate patients on side effects of the medications.
- Social worker: Many other parts of life are affected by a diagnosis of cancer, including self-image, work, family, friendships, and approach to living. Social workers counsel patients, providing emotional support and help people access practical assistance, including home care or transportation.
- Support group: A support group helps members to talk about their experiences in a relaxed environment. Listening to someone share about how he has suffered from prostate cancer and survived can bring hope to patients and help them cope better with their condition. An example of a prostate cancer support group in Singapore is the Singapore Cancer Society’s Walnut Warriors.