Your cancer care team: who does what?

How your cancer care team works

A multidisciplinary team, often shortened to MDT, brings together professionals with different areas of expertise. They may discuss your diagnosis and care at a tumour board, consult one another directly or share responsibility through an agreed treatment pathway. The wider care team also includes people who support you outside formal meetings.

For example, a surgeon may assess whether an operation is possible, while a medical oncologist considers whether medicines should come first. A pathologist clarifies the tumour type, a radiologist reviews its extent and a dietitian helps address poor intake before treatment. These contributions answer different parts of the same question: what is appropriate for this person?

Some roles overlap, and one professional may cover several functions. Titles also vary between countries and hospitals. Ask what someone does in your centre, especially when a title such as nurse practitioner or patient navigator is unfamiliar.

Your own priorities belong in these discussions. Tell the team about concerns such as caring for children, keeping your voice, walking independently, fertility, treatment costs or travelling from another city. With your permission, family members or other caregivers can help share information and support decisions. The team's recommendation still needs to be explained to you, with an opportunity to discuss benefits, risks and alternatives.

Professionals who assess symptoms and establish the diagnosis

Primary care and general medicine doctors

Your general practitioner (GP) or family physician may be the first person to investigate a persistent symptom and arrange a specialist referral. A general physician or internal medicine doctor may assess symptoms affecting several body systems or help manage other illnesses alongside cancer.

Their role continues after the diagnosis. Diabetes, blood pressure problems and other everyday health needs still require attention. During follow-up, the cancer team and primary-care doctor should agree who monitors which problems, rather than leaving you uncertain about where to go.

Organ specialists and doctors who perform diagnostic procedures

Your first specialist may have expertise in the affected organ. A gastroenterologist investigates digestive symptoms and may perform endoscopy, using a camera to look inside the digestive tract. A pulmonologist investigates lung problems and may perform bronchoscopy, using a camera to examine the airways. An ear, nose and throat (ENT) specialist assesses those areas. A gynaecologist focuses on the female reproductive system; a urologist on the urinary system and male reproductive organs; a dermatologist on the skin; and an ophthalmologist on the eyes.

These doctors may remain involved to obtain tissue, relieve an obstruction or help manage the affected organ.

Pathologist and histopathologist

A pathologist is a doctor who diagnoses disease by examining cells, tissues and laboratory findings. A histopathologist focuses on tissue examination. You may never meet this doctor, but their report can be central to treatment planning.

Depending on the sample and cancer type, the report may describe the diagnosis, tumour grade (how abnormal the cells look), relevant markers (features that may help identify the cancer or guide treatment), and findings in lymph nodes or the edges of tissue removed during surgery. A biopsy removes cells or tissue for examination, but a small sample cannot necessarily establish the full stage, meaning the extent of the cancer. If the diagnosis is unusual or uncertain, the team may seek review by a pathologist with expertise in that tumour.

Understanding your biopsy and pathology report↗

Cytopathologist, haematopathologist and molecular pathologist

Some pathologists have a more focused role. A cytopathologist examines individual cells or small groups of cells, including samples obtained from fluids or through a thin needle. A haematopathologist specialises in disorders of blood, bone marrow and lymphatic tissues. A molecular pathologist interprets tests involving genetic or other molecular changes.

They work with laboratory scientists and technologists who prepare samples, perform specialised tests and check their quality. These services can refine the diagnosis or identify a finding relevant to treatment. The choice of tests depends on the diagnostic and treatment questions being asked.

Radiologist and diagnostic radiographer

A radiologist is a doctor who interprets imaging such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans and may perform diagnostic procedures. They help assess where a tumour is, its relationship to nearby structures and changes over time. Some specialise in areas such as breast, chest or brain imaging.

A diagnostic radiographer, also called an imaging technologist in some settings, usually acquires the images and operates the equipment. The person positioning you for a scan and the doctor reporting it often have different roles. Imaging findings are interpreted alongside pathology, symptoms and other information.

Nuclear medicine physician and nuclear medicine team

Nuclear medicine uses radioactive medicines for imaging and, in selected circumstances, treatment. A nuclear medicine physician interprets studies such as positron emission tomography (PET) scans, which show how a radioactive tracer is taken up in the body. They also assess whether particular radioactive medicines are appropriate for treatment.

The wider team can include nuclear medicine technologists, radiopharmacists and physicists. Technologists support patients and acquire images; radiopharmacists help prepare and quality-check radioactive medicines; physicists contribute to measurement and safe use of the equipment and radiation. Nuclear medicine and external-beam radiotherapy are related through their use of radiation, but involve different methods and services.

Understand PET scans and theranostics↗

Doctors who treat the cancer

Medical oncologist

A medical oncologist specialises in treating cancer with medicines. These may include chemotherapy; hormone therapy, which changes hormone production or action; targeted therapy directed at particular cancer features; and immunotherapy, which helps the immune system act against cancer. The choice depends on the cancer and its features.

Their work includes recommending a treatment plan, explaining its purpose, checking whether it is helping and managing treatment-related problems. They also coordinate with other specialists when medicines are combined with surgery or radiotherapy. Treatment may be intended to cure the cancer, reduce its risk of returning, control it or relieve symptoms; your doctor should explain the goal in your situation.

Surgical oncologist and cancer surgeon

A surgical oncologist treats cancer through operations. The work can include obtaining a biopsy, removing a tumour and appropriate surrounding tissue, assessing relevant lymph nodes and considering the effects of surgery on function.

Cancer operations are also performed by surgeons trained in particular organs. The appropriate expertise depends on the procedure. A consultation should explain why surgery is being considered, its likely extent, whether other treatment should come first and what recovery may involve. Having a surgeon on the team does not mean an operation will necessarily be needed.

Cancer specialists for particular organs and body regions

You may hear several different specialist titles:

• Breast surgeon: operations for breast cancer and related breast conditions.
• Colorectal surgeon: operations involving the colon, rectum and related structures.
• Thoracic surgeon: operations within the chest, including relevant lung and oesophageal procedures.
• Hepatobiliary and pancreatic surgeon: operations involving the liver, bile ducts and pancreas.
• Urological oncologist: surgical care for cancers such as prostate, bladder, kidney and testicular cancer.
• Gynaecological oncologist: specialist care for cancers of the reproductive organs, often including surgery and coordination of further treatment.
• Head and neck or ENT cancer surgeon: operations involving relevant structures of the mouth, throat, neck and nearby areas.
• Oral and maxillofacial surgeon: operations involving the mouth, jaws and face.
• Endocrine surgeon: operations involving glands such as the thyroid, parathyroids or adrenals.
• Neurosurgeon: operations involving the brain, spine or nervous system.
• Orthopaedic oncology surgeon: surgical care for bone and soft-tissue tumours affecting the musculoskeletal system.
• Ocular oncologist: specialist care for cancers involving the eye, with treatment depending on the tumour.

These are areas of expertise rather than a list of appointments everyone should arrange. Ask whether the proposed surgeon regularly manages your type of cancer and performs the operation being recommended.

Plastic and reconstructive surgeon

A reconstructive surgeon helps restore form or function after tissue is removed. Examples include breast reconstruction, reconstruction after head and neck surgery, or repairing a large tissue defect.

Planning may need to happen before the cancer operation, even if reconstruction will occur later. Ask whether reconstruction is relevant, what it can realistically achieve and how it fits with other treatment. The options depend on the operation, your health and your preferences.

Radiation oncologist

A radiation oncologist is a doctor who prescribes and oversees radiotherapy, which uses radiation to damage cancer cells. They decide whether radiation has a useful role, what area should be treated and how the potential benefits compare with the risks.

Their work includes planning treatment with the radiotherapy team, explaining expected effects and reviewing problems during and after treatment. Radiotherapy can be used in different ways, including treatment aimed at cure, reducing recurrence risk or relieving symptoms. It does not automatically mean the cancer is advanced.

Haematologist and haemato-oncologist

A haematologist specialises in blood disorders; a haemato-oncologist focuses on blood cancers such as leukaemia, lymphoma and myeloma. Some doctors have training in both haematology and medical oncology.

These specialists interpret blood and bone marrow findings and coordinate treatments suited to the particular blood cancer. Care may involve medicines, transfusions, infection support or referral for transplantation or cellular therapy. The exact combination varies greatly between diagnoses.

Stem cell transplant and cellular therapy teams

A transplant specialist assesses suitability for a stem cell transplant, which gives blood-forming stem cells to restore blood-cell production after intensive treatment. They oversee preparation, treatment and follow-up. A transplant nurse coordinator helps organise assessments, explain the process and keep the many steps connected. Pharmacy, nutrition, infection, laboratory and transfusion services are also important.

Cellular therapies also need a coordinated team. One example for selected cancers is chimeric antigen receptor (CAR) T-cell therapy, in which immune cells are modified to recognise a target on cancer cells. Apheresis professionals collect particular blood cells using a machine that separates blood components, while specialist laboratories process or prepare cell products. The clinical team monitors treatment and complications. CAR T-cell therapy and stem cell transplantation are different treatments; eligibility for one does not automatically establish eligibility for the other.

Interventional radiologist

These doctors use imaging to guide procedures through needles, catheters or small incisions. Their work may include image-guided biopsies and selected treatments such as tumour ablation, which destroys tissue locally, or embolisation, which blocks a blood supply.

An interventional procedure may form part of a wider plan. Its suitability depends on the cancer, location, treatment goal and your overall condition.

Professionals who help deliver treatment safely

Oncology pharmacist

An oncology pharmacist checks how cancer medicines and supportive medicines can be used safely for an individual patient. Their work can include reviewing treatment regimens, doses, allergies, organ function, interactions and side effects, as well as overseeing preparation and dispensing.

They can explain how to take an oral anticancer medicine, whether it has food restrictions, how to store it and what to do if a dose is missed. Give them your complete medicine list, including non-prescription products, vitamins, herbal remedies and supplements. A community pharmacist can also help, with cancer-specific questions coordinated through the oncology team.

Medical physicist

A medical physicist helps ensure that radiotherapy equipment and treatment delivery meet the required standards. Their work includes technical checks, measurements, dose verification and quality assurance.

You may not meet the physicist, but their work supports the accuracy of treatment. The radiation oncologist makes the clinical prescription; physicists help ensure that it can be delivered as intended.

Medical dosimetrist and treatment planner

A dosimetrist develops the technical radiation plan with the radiation oncologist and physicist. They calculate how the prescribed dose can cover the target while limiting exposure to nearby healthy tissues.

Depending on the service, specially trained physicists or planning radiographers may perform these functions. The job title can differ while the planning work remains essential.

Radiation therapist and therapeutic radiographer

Radiation therapists, also called therapeutic radiographers in some countries, position you for treatment, operate the equipment and deliver the planned sessions. They explain the practical process and help identify concerns that need clinical review.

This professional is different from a radiation oncologist, who is the doctor overseeing the treatment. It is reasonable to tell the therapist about discomfort, difficulty maintaining the position or symptoms that have changed.

Anaesthetist and perioperative team

An anaesthetist assesses and manages anaesthesia, using medicines to prevent pain during an operation or procedure. Depending on the approach, this may numb an area or make you unconscious. They monitor vital functions and help plan pain relief. They need to know about other illnesses, previous anaesthetic problems and all medicines you take.

Perioperative means around the time of an operation. Operating theatre nurses, anaesthesia staff and recovery nurses support care before, during and immediately after the procedure. An intensive care specialist may become involved if severe illness or a complex recovery requires organ support and close monitoring.

Laboratory and technical teams

Phlebotomists collect blood samples, while laboratory scientists and technologists perform and check tests used in diagnosis and treatment monitoring. Pharmacy technicians and radiopharmacy staff support preparation and supply within their training. These roles contribute to the information and medicines on which care depends.

Blood-bank and transfusion teams support testing and provision of blood components when needed. Biomedical or clinical engineers help maintain medical equipment. Their work is often behind the scenes, alongside the professionals you see during treatment.

Nurses and professionals who coordinate your care

Oncology nurse and chemotherapy or infusion nurse

Oncology nurses provide much of the day-to-day care during cancer treatment. Depending on their role and training, they assess symptoms, give prescribed treatment, monitor for reactions, care for intravenous lines and explain how to manage treatment at home.

Nursing care also includes listening to concerns that may be difficult to raise in a short consultation. Tell your nurse about symptoms, missed medicines, eating difficulties or problems managing at home. They can assess what needs action and involve the appropriate clinician.

Clinical nurse specialist and specialist cancer nurse

A specialist cancer nurse may focus on a cancer type, treatment or area such as symptom control. They can explain the diagnosis and treatment, support decisions, coordinate referrals and act as a familiar contact.

Some centres use the term key worker for the professional who helps you navigate care. Ask how to contact them, which questions they can handle and how quickly to expect a response. Clinical responsibilities and prescribing rights depend on local qualifications and rules.

Nurse practitioner and advanced clinical practitioner

Some teams include nurse practitioners or advanced clinical practitioners. Depending on their qualifications and the healthcare system, they may assess patients, review symptoms and help manage treatment or follow-up. Nurse practitioners are nurses with additional education and clinical training; advanced clinical practitioners may come from different healthcare professions.

These titles do not imply identical responsibilities everywhere. If you are unsure, ask what decisions the practitioner can make and when the responsible doctor becomes involved.

Physician assistant and physician associate

A physician assistant is a trained clinical professional who works with doctors and the wider healthcare team. In some countries, a related role uses the title physician associate. Their work may include taking a medical history, examining patients, reviewing symptoms, supporting procedures and helping with inpatient or outpatient care.

The responsibilities, supervision and authority attached to these titles depend on local regulations, training and hospital policy. The title is not the same as a doctor's personal assistant or medical secretary, whose work is administrative. Ask how the role functions in your centre and which doctor holds responsibility for the overall treatment plan.

Specialist nurses for stomas, wounds and continence

A stoma is a surgically created opening through which bowel contents or urine can leave the body. A stoma nurse helps you understand the practical changes, use and fit an appliance, protect the surrounding skin and build confidence in self-care.

Wound and continence specialists also help with relevant healing problems and bladder or bowel control. When a stoma is anticipated, ask whether a specialist nurse should be involved before surgery as well as afterwards.

Patient navigator, care coordinator and case manager

Navigators and coordinators help connect the steps between diagnosis, treatment and follow-up. They may assist with appointments, referrals, paperwork, transport, accommodation or access to support.

Some are nurses or social workers; others have a non-clinical navigation role. They can help you find the right service, but medical questions need someone qualified to assess them. A financial navigator or counsellor may help explain expected costs, insurance processes and assistance options. Ask what is available locally and which applications or documents are required.

Community nurse, home-care nurse and home-care assistant

After discharge, a community or home-care nurse may provide agreed nursing care such as wound dressings or other authorised treatment. A home-care assistant or healthcare aide may help with personal care and daily activities, within their training.

Ask what the service actually provides, how often someone visits and who deals with problems between visits. Home care should come with a practical plan that the patient, family and local professionals understand.

Nursing assistants and healthcare support workers

In hospital, nursing assistants and healthcare support workers help with comfort, washing, dressing, eating and moving around. Some perform basic observations within their training and under the supervision of registered professionals. Their close contact with patients helps them notice concerns and pass them to the nursing team.

Patient educator

A patient educator helps you and your family find understandable information about the diagnosis, treatment choices, side effects and life with cancer. They may work through a hospital information or resource centre. Ask for explanations in a language and format you can use, and for help preparing questions for your clinical team. In some services, a nurse or another team member provides this support.

Nutrition, rehabilitation and everyday function

Oncology dietitian and nutrition-support team

A dietitian assesses nutritional needs and helps you find a workable eating plan during treatment. This may include adapting food for poor appetite, nausea, altered taste, bowel problems, mouth discomfort or weight change. Advice should fit your usual foods, culture, budget and other medical conditions.

Ask for help early if eating is becoming difficult or weight is changing unintentionally. The plan may focus on maintaining strength and adequate intake rather than following general weight-loss advice.

If ordinary food and drink cannot meet your needs, a nutrition-support team may consider oral supplements, tube feeding or intravenous nutrition in appropriate circumstances. These decisions involve the cause of the difficulty, the expected benefit and your treatment goals. They are not routine requirements for everyone with cancer.

Rehabilitation medicine doctor and physiotherapist

A rehabilitation medicine doctor, also called a physiatrist, assesses problems affecting function, movement and independence. They can investigate contributing causes and coordinate rehabilitation with other professionals.

A physiotherapist, or physical therapist, helps with issues such as strength, walking, balance, joint movement and physical recovery. The programme is adapted to the cancer, treatment and any relevant precautions. Rehabilitation can begin before or during treatment; it does not always need to wait until treatment ends.

Occupational therapist

An occupational therapist helps you do the activities that make up everyday life. This can include washing, dressing, cooking, managing the home, caring for children or returning to work.

They may suggest changes to routines, ways to manage fatigue, equipment or adaptations that make activities more manageable. The word occupational refers to meaningful daily activities, not only paid employment. For someone struggling to bathe safely or manage stairs and household tasks, this can be an important referral.

Lymphoedema specialist

A lymphoedema specialist assesses and manages swelling related to impaired lymph drainage. They may be a specially trained physiotherapist, nurse, occupational therapist or doctor.

Care can include skin care, suitable exercise, compression and self-management advice, with other treatments where appropriate. New swelling needs assessment before assuming it is lymphoedema, because swelling can have other causes.

Speech and language therapist

A speech and language therapist, also called a speech-language pathologist, helps with communication, voice and swallowing problems. Their work can be particularly important in head and neck or neurological cancers.

They may assess swallowing safety, recommend tailored exercises or strategies and advise on suitable food and drink textures. After some operations, they help people develop other ways to communicate. A dietitian focuses on nutritional intake; a swallowing therapist focuses on how swallowing works and its safety. The two often work together.

Audiologist

An audiologist assesses hearing and helps manage hearing changes, including changes associated with certain cancer treatments. Their role may include baseline testing when relevant, monitoring and advice about hearing support or communication strategies. Report a new hearing problem to your cancer team so that assessment can be arranged.

Dentist, oral medicine specialist and dental hygienist

Dental and oral-care professionals help prevent and manage mouth problems before, during and after relevant treatments. This can include identifying infection, planning dental care, managing dry mouth or oral discomfort and supporting long-term oral health.

Some treatments affect healing, blood counts or jaw health, so dental procedures should be coordinated with oncology. Dental assessment is especially relevant in certain treatment pathways, including radiotherapy affecting the mouth and jaws.

Maxillofacial prosthodontist and prosthetic services

A maxillofacial prosthodontist is a dental specialist who helps replace missing oral or facial structures with an artificial replacement called a prosthesis. This may support eating, speech, appearance or function after surgery. An oral and maxillofacial surgeon performs relevant operations involving the mouth, jaw and face; the prosthodontist focuses on prosthetic rehabilitation.

Other prosthetic and orthotic professionals may help with artificial limbs, braces or supportive devices. Breast-prosthesis fitters can help with an external breast form after surgery. The appropriate service depends on the operation and the person's needs.

Emotional, social and practical support

Oncology social worker and medical social worker

A social worker helps patients and families manage the social, emotional and practical effects of illness. Their work may include assessing support at home, exploring difficulties with caregiving, connecting families with community resources and helping with applications for appropriate assistance.

Oncology social workers may also provide counselling, support groups and help with family communication, within their qualifications. They can be particularly useful when the problem crosses several areas: for example, a patient needs treatment in another city, has dependent children and is worried about losing income. Social work is broader than arranging financial help, and support can begin early.

Psychologist, psycho-oncology professional and counsellor

A psychologist can help with problems such as scan anxiety, fear of recurrence, low mood, difficulty adjusting, disrupted sleep or changes in body image. Counsellors and appropriately trained therapists may support coping, relationships and family communication.

Psycho-oncology describes a focus on the psychological and social aspects of cancer; it is not a single qualification. Ask about the professional's training and experience. Support is appropriate when distress affects daily life, and you can raise concerns before they reach that point.

Psychiatrist

A psychiatrist is a medical doctor who diagnoses and treats mental health conditions. They may recommend psychological treatment, prescribe medicines when appropriate and assess how symptoms relate to cancer treatment, other medicines or a medical problem.

A referral can be useful for significant depression, anxiety or other complex symptoms. Psychological and psychiatric care can complement each other.

Spiritual care professional and chaplain

Spiritual-care professionals support people with questions about meaning, hope, values, faith or spiritual distress. Support should follow your wishes and can be relevant whether or not you practise a religion. They may also help you connect with your own faith community if you want this.

Medical interpreter and communication support

A trained medical interpreter helps you and your clinicians communicate across languages. Sign-language interpretation and other communication support may also be needed. These services are especially valuable for discussing diagnoses, choices and consent.

Family members can provide support, but interpreting complex or sensitive medical information places a different demand on them. Ask about professional interpretation when language is a barrier.

Practice managers and the administrative team

Practice manager, clinic manager and service manager

A practice manager helps organise the service in which clinical care takes place. Depending on the setting, responsibilities can include staffing, clinic schedules, administrative systems, budgets, facilities and processes for handling patient concerns. A larger hospital may use titles such as clinic manager, service manager or operations manager for related functions.

Their work matters when repeated organisational problems affect care: appointments are difficult to arrange, information is not reaching the right team or you cannot find a route to resolve an administrative concern. They can help investigate the process and identify who should act. A management role does not itself authorise someone to interpret a scan, change treatment or give medical advice.

MDT coordinator and cancer pathway coordinator

An MDT coordinator helps organise tumour-board meetings, bring together the required information, record the discussion and track the agreed next steps. A cancer pathway coordinator may follow the sequence of referrals, tests and appointments, helping identify an administrative gap.

These roles support the process; the clinicians make and explain the medical recommendations. If a report or referral seems to have disappeared between departments, the coordinator may help establish where it is and who needs to review it.

Medical secretary, receptionist and appointment team

Medical secretaries and administrative assistants support correspondence, referrals, clinic organisation and communication with the clinical team. Receptionists and appointment staff help with registration, scheduling and directing enquiries. Medical-records staff help manage the authorised release or transfer of reports and other records.

Be clear whether you are asking about an appointment or reporting a symptom. Administrative staff can help route a message, but a clinical concern needs assessment by a qualified clinician. If something is urgent, use the team's agreed urgent-care contact rather than relying on a routine booking message.

Billing, insurance and patient relations staff

Billing and insurance teams help explain estimates, payment processes, authorisations and required documents. A social worker or financial navigator can help explore assistance where available. Ask what the estimate includes and who can clarify exclusions or additional costs.

Patient-relations staff or a patient advocate can help you raise concerns about communication, access or the experience of care. Their remit varies, so ask how the service works. A useful administrative outcome is a named person, a clear next step and a way to follow up.

Symptoms, other illnesses and treatment complications

Palliative medicine doctor and palliative care team

Palliative care focuses on symptoms, quality of life and the wider effects of serious illness. The team may include doctors, nurses, pharmacists, therapists, social workers and spiritual-care professionals. They help with concerns such as pain, breathlessness, nausea, sleep problems, emotional strain and caregiver needs.

Palliative care can be provided alongside treatment aimed at cure or cancer control. A referral does not mean that treatment has stopped. Early support can be appropriate when symptoms or decisions are complex. The team can also help you discuss what matters most and plan care that fits your priorities.

Pain specialist

A pain specialist assesses difficult pain and considers its causes and treatment options. Some have a background in anaesthesia; others work through palliative medicine or another specialty. Selected patients may benefit from an intervention such as a nerve block alongside other care.

Pain services and palliative care often overlap. Ask which service is appropriate for the problem, especially if pain remains troublesome despite the current plan.

Infectious diseases specialist, microbiologist and allergist

An infectious diseases specialist helps diagnose, prevent and treat infections, including in people whose immune defences are weakened. Microbiology professionals identify organisms and provide information that helps guide antimicrobial treatment.

An allergist or immunologist may assess a suspected medicine allergy and help plan supervised management when appropriate. Not every infusion reaction is an allergy; the treating team needs to assess what happened.

Other medical specialists

A cardiologist looks after heart health and may advise on monitoring during cancer treatment; a nephrologist helps with kidney problems. An endocrinologist manages hormone and gland disorders; a neurologist assesses nervous-system problems; a hepatologist manages liver disease.

Some doctors focus on fields such as neuro-oncology, involving brain and nervous-system tumours, or dermatological oncology, involving skin cancers. A hospital physician or hospitalist may coordinate general medical care during an admission. They work with oncology to consider your health needs together.

Genetics, fertility and sexual health

Clinical geneticist and genetic counsellor

Cancer genetics professionals assess personal and family history, explain whether inherited-risk testing may be appropriate and discuss what different results could mean for you and your relatives.

Testing a tumour for treatment-related changes is different from testing for an inherited cancer predisposition. A tumour finding may prompt further assessment, but it does not automatically establish that a change was inherited. A genetic counsellor can help explain the distinction, uncertainties and possible next steps for the family.

Fertility specialist and oncofertility team

Fertility specialists discuss how treatment could affect future fertility and whether preservation options are suitable. The team may include a reproductive endocrinologist who manages fertility and reproductive hormones, a urologist or andrologist with expertise in male fertility, an embryologist who works with eggs, sperm and embryos in the laboratory, and a fertility nurse.

Where relevant, options may include sperm, egg or embryo freezing, with other approaches considered for particular circumstances. Raise fertility concerns before treatment starts whenever possible. The fertility and oncology teams need to coordinate what can be done safely within the available time.

Sexual health clinician, sex therapist and pelvic health physiotherapist

Cancer and treatment can affect comfort, sexual function, body image and intimacy. A sexual-health clinician, gynaecologist or urologist can assess physical problems. A qualified sex therapist or couples therapist can help with the emotional and relationship effects.

A pelvic-health physiotherapist may help with selected pelvic-floor, pain or continence problems after assessment. Support should reflect your concerns and circumstances; these issues are relevant whether or not you have a partner.

Teams for children, young adults and older people

Paediatric oncology and paediatric haematology team

A paediatric oncologist or paediatric haematologist treats children with cancer. Care takes account of growth, development, family life and the possible long-term effects of treatment.

The team may include paediatric surgeons, specialist nurses, psychologists, therapists, teachers and child-life or play specialists. Play and age-appropriate explanations can help children understand procedures and express worries. Support for parents and siblings is also part of the wider picture.

Adolescent and young adult team

Young people may need support with education, employment, relationships, fertility and growing independence. An adolescent and young adult service brings these needs into cancer care. Whether the treatment follows an adult or paediatric approach depends partly on the type of cancer; service age ranges vary.

Geriatrician and geriatric oncology team

A geriatrician specialises in the care of older adults. A geriatric assessment considers everyday function, memory and thinking, nutrition, other illnesses, medicines and support at home, helping identify needs that may affect treatment or recovery.

This can lead to practical help such as reviewing medicines, addressing falls risk or strengthening home support. Age alone does not describe a person's fitness or priorities.

Research, survivorship and end-of-life care

Clinical trial investigator, research nurse and study coordinator

If a clinical trial is being considered, the investigator explains the study and oversees its conduct at the centre. Research nurses support participants and monitor problems; study coordinators organise visits, records and trial requirements. Research pharmacists and data managers may also contribute.

A coordinator is not necessarily a nurse or doctor. Ask who answers medical questions and who handles scheduling. The team should explain the trial's purpose, alternatives, uncertainties, possible costs and consent process.

Survivorship and late-effects team

A survivorship service helps organise care after treatment, including appropriate follow-up, management of persistent or late effects and communication with primary care. It is a service or team rather than one universal specialist title.

A written care plan can record the treatments received, follow-up arrangements, possible late effects and which clinician is responsible for each part of care. Your needs may change as you return to work, manage an ongoing effect or move between hospitals.

Hospice and end-of-life care team

When care focuses on comfort near the end of life, a hospice or end-of-life service may support symptoms, nursing needs, family communication, spiritual concerns and bereavement. Services may be provided at home or in a care setting, depending on local arrangements.

Ask what support is available, including overnight help and urgent advice. A home-based service does not automatically provide continuous bedside care. Hospice and palliative care overlap, but palliative care also has a role much earlier in illness.

Knowing who to contact

The clinician coordinating care may be a medical oncologist, surgeon, haematologist, radiation oncologist or another specialist. That responsibility can change between treatment phases. Ask for a named clinical lead and a clear contact for routine coordination.

Keep a simple care-team record with each person's name, role, contact details and main responsibility. Add the next appointment and the number to use outside normal hours. When care is shared between cities or hospitals, ask who receives the reports, reviews the results and arranges the next step.

Treatment choices or sequencing

Relevant oncologist or surgeon and the MDT

Medicine instructions or interactions

Oncology pharmacist and prescribing team

Poor intake or weight change

Dietitian and treating team

Swallowing or voice difficulties

Speech and language therapist and relevant clinician

Walking or everyday activities

Rehabilitation doctor, physiotherapist or occupational therapist

Persistent emotional distress

Psycho-oncology professional, psychologist, counsellor or psychiatrist

Caregiving, travel or financial pressures

Social worker, navigator or financial counsellor

Appointment, referral or records problems

Coordinator, secretary or practice manager

Difficult symptoms

Treating team, palliative care or pain service

Questions to ask your care team

• Who is coordinating my treatment now and who will take over at the next stage?
• What does each professional I am seeing contribute to my care?
• Have the relevant specialties reviewed the treatment sequence?
• Could nutrition, rehabilitation, fertility, emotional or practical support help me now?
• Who explains test results and who checks that they have been reviewed?
• Which number should I use for routine questions and which for urgent problems?
• If care is shared between hospitals, who sends the records and confirms the next step?
• What should I do if I cannot arrange a recommended service or afford a proposed part of care?

Frequently asked questions

Related reading

• How a tumour board brings specialist opinions together↗
• When a second opinion may help↗
• Practical support for family caregivers↗