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“Who is Who” in Cancer Care

Cancer care will usually involve teams of health and social care professionals, working together to look after the physical, emotional and practical wellbeing of patients and their families. They may work in a variety of settings including the patient’s own home, acute and community hospitals and residential and nursing homes.

Here we provide a brief summary of ‘who is who’ and what they do. We have organised our list of professionals into alphabetical order, but everyone involved in your care should be working together and some will provide care in a variety of settings including home, community and hospital.

Allied health professionals: There is a wide range of specialists who will be there to provide different types of care and support during and after cancer treatment. These include dieticians, occupational therapists, physiotherapists, speech therapists and counsellors. They may be based in the community or the Hospital.

Cancer research nurse: If you have agreed to take part in the trial of a new drug or treatment you will be in contact with your research nurse. Their role is to coordinate your care while you are on the trial. This includes organising investigations and taking blood samples. The research nurse will provide you with information about the trial and answer any questions you may have. They are there to support both you and your family. Depending on the type of trial you take part in, some research nurses also give drug treatments.

Cancer specialist: A cancer specialist is a hospital doctor who specialises in diagnosing and treating cancer. The cancer specialist will usually be either an oncologist or surgeon.

Clinical nurse specialist: A Clinical Nurse Specialist (CNS) is a nurse who has been specially trained to help people with cancer or a certain type of cancer. The CNS will make sure that you and those who may care for you receive the best possible support and care. The CNS will usually be based in a Hospital but will also be responsible for coordinating the support and care you need when you go home.

Even if you do not have a CNS every cancer patient should have someone they can contact if they have questions or concerns. If you are not sure who this is, please ask a member of your healthcare team.

District nurse / Community nurse: District Nurses provide hands-on nursing care and practical advice at home. They can usually be contacted through your GP Surgery or Health Centre. They work closely with other members of the community healthcare teams and with specialist palliative care teams.

GP: Your General Practitioner or Family Doctor is responsible for all aspects of your health care at home and will also be working closely with other members of your healthcare team.

GPs can arrange referrals to specialists and help with symptoms and side effects both during and after treatment. They will be able to support you by talking through any questions or concerns you may have and can organise services if you need some extra help to live at home.

Hospital team: In North Wales there is an expectation that the care of all cancer patients will be discussed by a multidisciplinary team (MDT) who will work together to make sure treatment and care is the best it can be.

The MDT will meet regularly, usually weekly, to discuss new cases. The team will include staff trained to diagnose and stage cancer as well as those trained to treat cancer. Together they will confirm the diagnosis and staging before agreeing a treatment plan.

Key worker: For every cancer patient there should be one member of the healthcare team who will be nominated as a first point of contact and will coordinate help and support from other members of the team. If you are unsure who your key worker is, please ask.

Medical physicist: A medical physicist is a radiation expert who works closely with the clinical oncologist to plan radiotherapy treatment. They work out the amount of radiation you need and the best way of giving it, so that it targets the cancer and any effects on normal tissue are minimised.

The physicist is also responsible for carrying out regular checks on the radiotherapy equipment to ensure it delivers the correct dose. They ensure that radiation is used safely for patients, staff and members of the public.

Although the medical physicist may often work behind the scenes, radioisotope physics staff are directly involved with patients, for example delivering radioactive iodine treatment to patients and talking to them about the contact restrictions that have to be followed when leaving hospital.

Oncologist: An oncologist is a hospital doctor who specialises in non-surgical treatments of cancer. A clinical oncologist is a specialist in the treatment of cancer with both radiation and chemotherapy. A medical oncologist specialises in treating cancer with chemotherapy and other drugs. They may be based at a regional cancer treatment centre, but may also see you at your local hospital.

Palliative care doctors and nurses: These are health professionals who specialise in improving pain and other symptoms and will also provide support to both the patient and those who may be caring for them in meeting practical, emotional and spiritual needs. They provide care in a variety of settings, depending on the needs of the patient and family.

Pathologist: A pathologist is a doctor who will check cells in a laboratory and decide whether they are cancerous and if so what type of cancer it is and how it might behave. The pathologist will work with the multidisciplinary team to help decide the best type of treatment.

Radiographer: A diagnostic radiographer works closely with radiologists, carrying out x-rays and scans to help diagnose cancer.

Therapy radiographers work closely with clinical oncologists to plan and organise radiotherapy treatment. If you are having radiotherapy treatment the radiographer will be there to answer any questions you may have and provide advice about any possible side effects.

Radiologist: This is a doctor who specialises in using techniques such as x-rays and scans to diagnose cancer and help to decide on the best treatment.

Social workers: Your local Social Services Office will be able to provide details of available services and support, such as home help, care attendants, adaptations in the home and support and practical help for carers. Contact details for Social Services in your local area can be found under our ‘Support for Carers’ section.

The North Wales Cancer Treatment (Rhyl) has a resident social worker who is dedicated to providing support for people affected by cancer. District General Hospitals also have hospital based social workers. Please ask a member of your healthcare team if you feel you need some extra support at home.

Surgeon: A surgeon is a hospital doctor who performs operations to remove all or part of a cancer. The surgeon will usually be a specialist in carrying out operations for a particular type of cancer and may also operate to relieve symptoms that the cancer may be causing.

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