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Pediatric Cancer Care Team

Every cancer journey is unique. Each patient needs a team of experts—doctors, nurses, and other health specialists—who provide treatment and care throughout illness, from diagnosis to treatment and beyond. Members of the care team may change over time as treatment plans and patient needs change. Children fighting cancer may have all of these specialists as part of their care team or only a few.

Core Care Team

The care team is led by a main doctor, or attending physician. The team also includes nurses, nurse practitioners, or physician assistants who help oversee regular patient care.

Oncologist in lab coat plays with toddler, throwing big foam blocks.

Pediatric oncologists coordinate and direct your child's cancer treatment, working closely with all members of your care team.

Pediatric Oncologist or Pediatric Hematologist/Oncologist
A pediatric oncologist is a doctor who specializes in treating cancer in children. This specialist directs and coordinates cancer treatment. A pediatric hematologist-oncologist is a doctor who specializes in treating cancers of the blood including leukemia and lymphoma. “Pediatric oncologist” and “pediatric hematologist/oncologist” are often used interchangeably.

Physician Assistant
A physician assistant (PA) is a licensed health professional who works under the supervision of a doctor to plan care, assess patients, prescribe medication and treatment plans, and perform certain procedures.

Nurse Practitioner
A nurse practitioner (NP) is a registered nurse who has additional education and training. A nurse practitioner works in collaboration with the physician to plan care, perform physical exams, administer tests, and prescribe treatment.

Registered Nurse
A registered nurse (RN) is a degreed and licensed health professional who provides a wide variety of nursing care. Responsibilities include monitoring patients, performing assessments, giving chemotherapy and other medications, overseeing daily needs, and providing patient and family education.

Care Team during Diagnosis and Treatment

There are different care team members who will help patients based on diagnosis and treatment needs.

Some care team members specialize in imaging methods used during diagnosis and treatment.

Radiologist and/or Interventional Radiologist
A radiologist is a doctor who specializes in diagnosing diseases using medical imaging methods, such as X-rays, computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET), nuclear medicine tests, and ultrasound.

Radiology or Imaging Technologist
A radiology technologist (also called a tech or radiographer) is a health professional who uses X-ray, CT, MRI, PET, nuclear medicine tests, and ultrasound to create images of the body. Imaging techs are often some of the first health professionals who patients meet during the cancer journey.

Depending on the type of cancer, the care team might include health professionals who specialize in certain cancer treatments such as chemotherapy or radiation therapy.

Medical Oncologist
A medical oncologist is a doctor who uses medicines such as chemotherapy, immunotherapy, and targeted therapy in cancer treatment. This person may also act as the child’s main physician (pediatric hematologist-oncologist).

Radiation Oncologist
A radiation oncologist is a doctor who treats cancer with high-energy radiation that can shrink tumors and kill cancer cells during the course of treatment.

Clinical Pharmacist
A pharmacist is a health professional who prepares and dispenses medications. Pharmacists also educate patients and families on the proper use and side effects of prescribed drugs. They work closely with the treatment team to determine medication doses and help keep track of medicines.

Infectious Diseases Specialist
Infectious diseases (ID) specialists are doctors with expertise in the prevention, diagnosis, and treatment of infections that can occur in children having cancer treatment. These specialists are usually asked to help when patients have unexplained fevers or other symptoms or if a serious infection is found. They may ask unusual questions about pets, travel, and hobbies to get clues about the cause of an illness and provide advice about the best tests and treatments for possible infections.

Three members of surgical team performing surgery in the operating room.

Doctors who specialize in cancer surgery are called surgical oncologists.

If surgery is required for diagnosis or treatment, a number of different specialists will be part of the care team.

Surgical Oncologist
A surgical oncologist is a doctor who performs operations or procedures to diagnose and treat cancer.

Surgical Specialist
Doctors may specialize in specific types of surgery. For example, a neurosurgeon performs operations on the nervous system including the brain and spine. An orthopedic surgeon specializes in surgery of the musculoskeletal system including bones, joints, and muscles.

Anesthesiologist
An anesthesiologist is a doctor who administers medicines that prevent or relieve pain and monitors patients during surgery or other procedures. Anesthesiologists provide local or regional anesthesia to numb or stop pain in specific areas of the body or general anesthesia that causes a temporary loss of consciousness.

Nurse Anesthetist
A certified registered nurse anesthetist (CRNA) is a registered nurse with advanced training in the practice of anesthesia. Responsibilities include preparing patients for anesthesia, giving anesthesia medications, and monitoring patients during procedures.

Pathologist
A pathologist is a medical doctor who specializes in the diagnosis of disease by looking at tissue and cells under a microscope and performing other tests. After a biopsy, a pathologist helps to determine whether a tumor is cancerous and, if so, what kind of cancer it is. Most patients never meet their pathologists, but these physicians play an important role in diagnosis and treatment. The pathologist is assisted by laboratory technologists.

Physical Support

Depending on the type of cancer and treatment needs, a variety of other health professionals may be part of the care team to assist patients in different aspects of assessment, recovery and adaptations to daily living.

Rehabilitation Specialist — Designs and implements care practices to help in areas such as movement and physical function, tasks of daily living, hearing, speech, communication, and functioning in school and work. Includes the specialties of physical therapy, occupational therapy, speech therapy, audiology, and learning.

Clinical Nutritionist — Offers comprehensive nutrition care by providing education for healthy eating habits, special diets and therapies for patients.

Palliative Care Physician — Provides interventions aimed at improving the quality of life for patients. Tends to symptoms such as pain, anxiety, or loss of appetite as patients undergo difficult medical treatments or procedures, such as surgery or chemotherapy.

Palliative Care Provider — Provides symptom and pain relief to improve quality of life during treatment.

Other Specialists on the Care Team

Depending on patient needs, other health professionals may be part of the care team to assist in different aspects of treatment and recovery. Some health professionals may represent specific specialty areas or disciplines such as neurology, psychiatry, endocrinology, cardiology, dermatology, urology, gynecology, ophthalmology, and dentistry.

Chaplain
A chaplain is a spiritual care specialist who supports patients and families with religious, spiritual, and emotional needs brought on by illness or other circumstances.

Child Life Specialist
A child life specialist is a health care professional who has training in child development. Child life uses play, art, and other activities to help children cope with cancer and prepare them for treatments and procedures using age-appropriate, child-friendly methods.

Clinical Nutritionist
A clinical nutritionist or registered dietitian (RD or RDN) is a nutrition professional who offer comprehensive nutrition care including education for healthy eating habits, special diets, and clinical nutrition therapies for patients.

Fertility Specialist
A fertility specialist, often a doctor or nurse practitioner, can help patients with reproductive health needs. In childhood cancer, certain treatments can affect a patient’s ability to have children in the future. Fertility specialists can help families understand risks and potential options to preserve fertility.

Genetic Counselor
A genetic counselor is a health professional with training in medical genetics and counseling. Genetic counselors interpret genetic test results, evaluate the risk of an inherited medical condition, and provides guidance to help families understand hereditary conditions.

Hospice Care Provider
A hospice care provider offers compassionate care to control symptoms and improve quality of life in advanced illness when no cure is available. Care may be provided in a variety of settings including hospital and home-based services.

Orthotic and Prosthetic Practitioners
An orthotist is a practitioner who helps patients with design and fit of orthopedic braces (orthoses) for patients with physical rehabilitation needs. A prosthetist provides patient care related to custom-made artificial limbs (prostheses).

Pain Management Specialist
The pain management team, led by a physician with advanced training in treating pain, specializes in assessing and treating pain, either with medications or techniques that do not involve medication.

Palliative Care Specialist
A palliative care specialist, often a doctor or nurse practitioner, is trained to meet the needs of patients with serious illnesses. Palliative care provides supportive care to reduce suffering and improve quality of life. These specialists help patients manage pain and physical symptoms and provides another layer of support for the entire family. The palliative care team may include additional health care providers to meet physical, emotional, social, and spiritual needs.

Psychologist
A psychologist is a mental health specialist who helps patients and families cope with emotional, behavioral, social, and cognitive concerns. Psychologists provide a variety of mental health resources including psychological assessment, counseling, behavioral interventions, and stress or pain management.

Rehabilitation Specialist
Rehabilitation specialists assess function and abilities and plan therapies to promote independence and quality of life. They focus on areas such as movement and physical function, tasks of daily living, hearing, speech, communication, and functioning in school and work. Care team members who specialize in rehabilitation include physical therapists (PT), occupational therapists (OT), speech-language pathologists (SLP), audiologists (AuD), and learning specialists. 

Social Worker
A social worker is a health professional who helps families with practical, social, and emotional concerns. Social workers provide counseling and support for different aspects of the cancer journey. They can also help families identify resources to help with a variety of challenges such as family education, financial concerns, and housing.

Other Members of the Care Team

Other health care providers may be part of the care team at various points during treatment. These include physicians and medical students completing training, representatives who help families navigate cancer treatment, and others whose job it is to provide care and improve the experience for patients and families.

Medical Student
A medical student is in training to become a physician. Medical students rotate through multiple disciplines as part of completing their third and fourth years of medical school.

Resident Physician
A medical resident is a doctor who has graduated medical school and is in a learning program to specialize in an area of medicine such as pediatrics. A resident works under the supervision of an attending physician.

Oncology Fellow
A fellow is a doctor who has completed residency and seeks further training in a specialty area. Fellows receive clinical and research training with a hospital as part of a multi-year program to achieve certification and expertise in a specialty such as medical oncology.

Licensed Practical Nurse
A licensed practical nurse (LPN) tends to practical needs of patients. These nurses provide daily care activities and skilled nursing tasks for patients at the bedside or in clinics where treatments take place.

Nursing Assistant/Patient Care Assistant/Medical Care Assistant
Care assistants work under the supervision of an RN or LPN to provide basic daily care functions for patients.

Oncology Clinical Nurse Specialist
Clinical nurse specialists are registered nurses with advanced training in a specialty area such as oncology (OCNS). They serve as a clinical expert and consultant for the nursing staff on complex patient issues and focus on improving efficiency and access to care.

Patient Advocate
Patient advocates assist families if they have a complaint or concern about the care they are receiving and do not feel comfortable speaking to their clinical team. Advocates may also help families through the clinical trial process by answering questions, making sure information is clear, and protecting patient rights.

Patient Representative /Registration Clerk/Patient Business Representative
Patient representatives or registration clerks assist patients with a variety of administrative needs. They register patients upon arrival, verify benefits and insurance coverage, and answer questions about hospital policies and billing procedures.

Communicating With Your Care Team

Cancer care is complex, and good communication among care team members, patients, and families is important. To make the most of that communication:

  • Be honest and open
  • Ask questions when you don’t understand. Write down your questions so you don’t forget.
  • Take notes and keep good records of medical information including tests, treatments, medicines, and appointments.
  • Write down the names of your care team members, what they do, and how to reach them.
  • Involve children in age-appropriate communication. This involvement helps build good relationships with the care team and gives children a sense of control.

It’s also important to have:

  • Reasonable expectations of yourself. This is a stressful time. Don’t expect to understand or remember everything. Ask for help, and use the different resources that are available.
  • Reasonable expectations of your care team. Your doctors and nurses won’t always have the answers. Often decisions are not simple. And, having a team, although important, can sometimes make communication more complicated.


Reviewed: June 2018

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