Patients

Initial consultation

At your initial visit, the medical oncologist will take a careful history of your past and present medical problems, as well as any family related cancer problems. You will also have a physical examination. Your recent tests results will be reviewed.

Decision making for people with cancer is the most complex in medicine.

Often there are several possible treatment choices. The difference in outcome may be small or large. In some instances, discussion with other clinicians (either within or outside our group) regarding your individual situation may help to ensure that all options have been considered. We want to ensure that the best treatment plan for you has been developed.

Often treatment programs will involve a number of different types of treatment, eg surgery, radiotherapy and chemotherapy.

Everyone with a new cancer is discussed at a weekly clinical meeting to optimise their initial management decisions. Sometimes these discussions will involve a formal meeting of different clinicians (multidisciplinary meeting, MDM). Further consultations may take place at other important decision points. If you do not want your details to be discussed, please let your doctor know.

Second opinion

Some people will consult us to seek a second opinion. This may be to explore the possibility of other treatment options being available, or to confirm that a treatment recommendation is appropriate. This is an area where it is important that all relevant information is available, either before or at the time of the visit.

We encourage people to seek a second opinion from another appropriate independent specialist if they are unsure about their situation.

Documentation

As consultant physicians, we can only see patients who are referred by another doctor. This means we need a letter of referral. This letter can be written by your general practitioner or a medical specialist such as a surgeon. For your initial consultation, it is preferable that the referral letter is written by the doctor that has referred you, as it should contain results of tests that have been performed to date and other details regarding your medical history. We need details of your past medical history as that may be relevant in reaching a decision regarding the best treatment for you.

It is often useful for you to write down the dates of significant events such as dates of operations, and what other treatments have been used, and when they were started and ceased. You should also bring any recent CT scans, other x-rays and reports from recent tests.

Letter of Referral

In order to qualify for a rebate from Medicare (and where appropriate your health fund), we need to have a current referral letter on file. We will ask your general practitioner for a referral which is valid “indefinitely”. If not specified, the letter is valid for only 12 months. A referral from a specialist is only valid for a maximum of 3 months.

Some general practitioners will require you to attend personally to obtain a referral letter.

Unfortunately, if a current referral letter is not available, you may be out of pocket for an increased amount as the Medicare rebate will be smaller.

Types of treatment

Medical oncologists provide care using a variety of drug treatments. They are also able to provide assessment about other issues such as inherited family risks, cancer screening, and follow-up after treatment.

There are several types of drug therapy:

  • Chemotherapy
  • Hormone or anti-hormone drugs
  • Biological (targeted) drugs

Drug treatments for cancer may have different goals:

  • Some treatments are given after surgery (and/or radiotherapy) to reduce the risk of the cancer coming back in the future. This is called “adjuvant” treatment.
  • Sometimes chemotherapy (with or without) radiotherapy is given before surgery, to improve the effects of surgery. This is called “neo-adjuvant” treatment.
  • Other treatments are given to try to destroy cancer completely (especially lymphomas and testicular cancer).
  • Frequently drugs are use to try to control cancer by slowing its growth. This is often the situation when a cure is unfortunately not possible. This is called “palliative” treatment.

Support

Having to deal with a possible or actual diagnosis of cancer is usually stressful for both the affected person and their family and supporters.

It has been shown that anxiety can be reduced by receiving information in a truthful and realistic manner.

Support will also come from other members of the team such as oncology nurses.

Sometimes people benefit from seeing a psychologist or psychiatrist. We have access to the appropriate professionals.

Communication

It is very important that all the doctors involved in your care are aware of your treatment plan and progress. This may include your general practitioner, surgeon and other specialists. We will write to them at regular intervals to keep them up to date.

Please let us know if you change any of your doctors so we can update your records.