Who Does What on a Cancer Care Team?

This page is for patients and caregivers trying to make sense of a cancer care team. It explains what each person does and who to ask for help with what.

Medical oncologist. Prescribes drug treatments — chemotherapy, immunotherapy, targeted and hormone therapy. Usually holds the long-term thread of your care.

Surgical oncologist or organ-specialized surgeon. Removes the tumor and lymph nodes. Provides the tissue your staging depends on. Owns wounds, drains, and questions about the operative pathology.

Radiation oncologist. Plans and oversees radiation. Sees you weekly during a course. Manages skin and other side effects at the treated site.

Advanced practice provider (nurse practitioner or physician assistant). Runs many of your routine visits. Manages side effects, orders tests and prescribes. Often the clinician you see most. Asking for them can be a way to get seen sooner.

Oncology nurse and infusion nurse. Gives treatment. Checks your labs and symptoms. Often the first to notice something is wrong. Nurses can answer many questions there was no time for in the doctor visit.

Pathologist. Examines your tissue. Produces the diagnosis, grade, receptor and biomarker results that the whole plan rests on. You can ask for the full report rather than a summary. You can also ask for a second-opinion review of your slides at another center.

Radiologist. Reads your scans. Sets stage and response. If you want another opinion, ask for the images themselves, not just the report.

Interventional radiologist. Does image-guided biopsies. Places ports and drains. Delivers some targeted treatments.

Oncology nurse navigator. Coordinates appointments, chases results, and explains what is next. Answers "who do I call about this." Ask whether your program has one. More programs do, since Medicare started paying for principal illness navigation services in 2024.

Oncology social worker. Handles transport, and lodging near a distant center. Handles disability and benefits applications, and workplace leave paperwork. Arranges counseling referrals and support groups. Helps you talk to your children. Connects you to copay assistance. Ask whether there is a cost. You do not need to be in crisis to ask for a referral.

Financial counselor or navigator. Estimates your out-of-pocket costs. Screens for manufacturer and foundation assistance. Sets up payment plans, and often runs prior authorization appeals, when insurance must approve care before you get it. Bring them in before the bills arrive, not after.

Oncology pharmacist. Checks interactions with your other medications and supplements. Explains how to take oral therapies. Sorts out side effects. Ask for a review of everything you take, including over-the-counter products and herbal supplements. Some of them interfere with cancer drugs.

Registered dietitian. Manages weight loss, appetite, swallowing problems, taste changes and nutrition through treatment. Ask specifically for one with oncology experience.

Genetic counselor. Works out whether hereditary testing is called for. Interprets the results. Advises on what they mean for family members. Relevant for many breast, ovarian, colorectal, pancreatic and prostate cancers.

Palliative care team. Physicians, nurses, social workers and chaplains focused on symptoms and quality of life. Available from diagnosis onward, alongside treatment meant to cure. This is not hospice. NCI says hospice begins when curative treatment is no longer the goal, while palliative care can begin at any point.

Rehabilitation specialists. Physical and occupational therapists, lymphedema therapists, and speech and swallowing therapists. Ask for referral early, rather than after a problem sets in.

Clinical research coordinator. Manages trial enrollment. Explains what the protocol requires. Schedules the extra visits trials involve.

Chaplain or spiritual care. NCI lists emotional and spiritual care among team services. Ask your hospital what is offered and whether there is a cost.

1. One named point of contact. Ask: "Who is my main contact between appointments?" Write down the name, direct number and email.
2. One after-hours number. Ask whether your practice has a 24-hour line. Save it in your phone under something you can find at 2am. Ask what temperature counts as a fever they want to hear about, and what other symptoms warrant an immediate call rather than a portal message.

Portal messages may not be read right away. They are for questions, not emergencies. For a fever or other urgent symptom, call right away. For a life-threatening emergency, call 911.

Program staffing, Medicare navigation payment and coverage rules described here are US-specific.

• NCI — Palliative Care in Cancer
• CMS — 2024 Physician Fee Schedule final rule press release (principal illness navigation)
• NCI — Finding Health Care Services