Armed with an expanded list of prescriptions, I find relief and the answer to the question: Who should be the primary care coordinator for cancer patients?
I abide by the adage that it takes a village to raise children. I now fully appreciate that it takes a team to care for cancer patients. My epiphany came during the same week that some cancer advocates in my network were debating whether a patient’s oncologist, urologist or internist should be the primary treatment navigator. Just two days ago, I added my two cents to the debate saying via an email that I wouldn’t give up my oncologist as my treatment point guard for anything. I still wouldn’t. But, as owner of my cancer franchise, I know first-hand how crucial it is to have a well practiced team that knows how to win a passing game.
Using my past few weeks as example and a few more basketball analogies…
1. Experiencing severe and highly unsettling palpitations, I emailed my oncologist (my point guard) for guidance. He passes the ball immediately to my internist for an EKG and preliminary assessment. In basketball, the point guard is also known as the team’s floor general and the best ball handler on the team. In football terminology, the point guard is a basketball team’s quarterback. The point guard is essentially the team’s captain, and his/her job is to make his/her teammates better and to hand out assists. At this point in my journey, I see my oncologist as the one who is going to make the fantastic scores against cancer and play a pivotal role in directing the team to victory.
2. Upon reading my EKG and spotting an aberration, my internist (my shooting guard) passes the ball to a cardiologist. Shooting guards can also be the team captain as well. A quality shooting guard should be able to consistently hit 20-foot jump shots. Besides being able to shoot the ball, shooting guards must also have good ball-handling skills because they have to be able to create their own shots off the dribble. They should also be able to make good passes.
3. After ordering a complete set of cardiac tests, my cardiologist (my power forward) quickly assess that, with no underlying cardiac disease, there is no point to be made from his vantage spot on the court and passes the ball back to my internist for the next play. A power forward plays a role similar to that of the center, down in the “post” or “low blocks”. On offense, he can “post up”, playing with his back to the basket, or set up for mid-range jump shots. On defense, he plays under the basket in a zone defense or against the opposing power forward in man-to-man defense.
4. In a scramble of appointment schedules (my quarterly oncology appointment happened to come first), the ball gets relayed to my point guard (oncologist). He is able to make an advance by writing a prescription to calm the increasing severity of my hot flashes. Then, to best score against the palpitations, he hands the ball off to the shooting guard (my internist) who is able to make a wide assessment the my current field of play and prescribes a mild medication that will hopefully score a winning point against my racing heart. In this process I had been working with a new internist. He was called off the bench and into the game because of the new schedule and sporadic availability my internist of three years. Impressed by the new player’s skills, I (as owner of the team) made the decision yesterday to move him into the first string.
Now, I admit my basketball knowledge is shaky a best. But I use the analogy to make a point. Assign what ever positions you like to your cancer team. Just remember that every cancer patient is different and every game is different, requiring a complex set of moves, expert decisions and passing. As owners of our individual cancer franchises, we need to build and manage a team that we trust. It must have an uncompromising commitment to teamwork–constantly communicating and passing for the best advantage. Only then can it ultimately claim a win for us.