A new diagnosis of cancer is often paired with difficult emotions and we understand how trying this time may be. In the midst of this emotional turmoil, patients find that they must also gather information, learn new medical terms, understand treatment choices and options and make difficult decisions-all of which can be can be very overwhelming. You are not alone in this journey and we are here to help. 

Your practice will offer informed and coordinated care for newly diagnosed cancer patients. The specialists at your practice works together to coordinate the most appropriate care for each individual. These specialists include, but are not limited to, surgical oncologists, medical oncologists and radiation oncologists. Please select the topics below to learn more. 

Doctor Visit Checklist

 Your doctor visit is an important meeting that can be most effective if you plan ahead. It is important that you give the doctor the information he/she needs and that you fully understand their recommendations. Here are some suggestions to help you through this process. 

Things to consider before you arrive 

  • Be sure to know where your appointment will located. It may be helpful the day before your appointment to confirm the location.
  • Arrive 30 minutes before your first appointment (in order to complete paperwork) and 15 minutes before future scheduled appointments.
  • Bring your insurance card or referral.
  • Your practice will need to gather records such as lab test results, copies of x-rays or other imaging studies , surgery and pathology reports. If the practice is missing anything, they may call you for more information. Please notify your practice of any special needs for upcoming lab tests, such as a port device that should be accessed for collection of blood samples. 
  • Please be sure to bring your prescribed and over-the-counter medications in their original containers to the appointment to discuss with your doctor.
  • Important: Remember to make a list of specific questions and/or concerns you have about your condition. This may include prognosis, treatment impact on work and daily activities, ability to exercise, ability to travel, exposure to friends and family or financial impact.
  • Consider asking family or a friend to accompany you to your appointment.

Your appointment day

  • Remember to bring your list of questions and/or concerns to discuss with your doctor. Be honest and complete in talking to your doctor. Do not be afraid to bring up your goals and how your life may be impacted, as well as issues that you may find embarrassing such as incontinence , memory loss or sex. 
  • Remember to bring your medications and over-the-counter medications to discuss with your doctor.
  • It may be helpful to take notes and do not be afraid to ask questions if you do not understand something.
  • Ask for handouts and brochures that you and your family can review at home. Your doctor may refer you to our website or another trusted internet site for more information.

Care Team Staff

Here is a list of staff members that may be apart of your care team:

  • Physicians and Mid-Level Providers

In addition to physicians there may be nurse practitioners and physician assistants on your team.  All are dedicated to fighting your blood disorder or cancer. They are relentless in their determination to see that you and your family get the care and compassion you need. 

  • Nurses

Oncology nurses are specifically educated and trained in the care of patients with cancer and blood disorders. Oncology nurses are RN’s that  have independently studied and successfully passed a national exam to get certification in the specialty of oncology. If you have any questions about your illness, treatment, or the side effects of your medications, please feel free to discuss these concerns with them.

  • Laboratory

Your practice may have an in-house lab. It is there that they are able to quickly process most of the tests needed for your appointment with the doctor.

  • Patient Advocates

Patient advocates work one-on-one with every patient to assist them in understanding their insurance coverage and responsibilities. If you don’t have insurance, they will recommend what options might work best for you and help with the application process for national programs for which you might be qualified that would provide grants and supplemental services to assist in getting your needed treatment.

  • Research Department and Clinical Trials

Your practice may have a dedicated research department. They work closely with the physicians to ensure that patients are aware of options for clinical trials and have the opportunity to participate in them. Your practice will seek out clinical trials that would offer the greatest benefit to their patients. These studies are carefully vetted to ensure the highest quality of care is provided with maximum safety. 

  • Billing Staff

The cost of health care is a concern for many of patients, and your practice is committed to providing the best care for their patients at costs that are usual and customary for the area. Ultimately, though, you are responsible for the bill. The billing staff is experienced and dedicated to making sure you get bills that are correct and understandable.

  • Medical Assistants

Medical assistants may be the first points of contact on your appointments. They will record your vital signs, review your medications, ask about allergies and escort you to the doctor. They can provide brochures or CDs on general medical conditions and are a great source of information about community and social services.

  • Medical Secretaries

Medical secretaries are an important part of your care team. They will coordinate all your appointments with other departments – such as  CT scans, radiation and surgery – and contact you if anything changes. If you need to meet with a physical therapist or a dietitian, they’re the ones who will make sure this happens. 

When you get home

  • Review the materials your doctor gave you. If there is something you are unsure of or do not understand, please call the practice and speak to a member of your health care team.
  • Follow the doctor’s instructions-including medication, dietary and lifestyle recommendations that may have been discussed at your appointment.
  • Keep your doctor informed of any change in your condition. Please keep a list of any future appointments with your practice.
  • Please call the practice if you have any questions or concerns. Your health care team is there to support you through this process.

When to Contact Your Doctor

When you are feeling ill, please call your practice first and they will determine if your problem can be solved safely and efficiently in the clinic or at home. Because your practice has access to electronic health records, your doctors and medical team have your history at their fingertips, which will speed your treatment. If you are wondering if you should go to the emergency room or urgent care, call your practice first. Many of the problems  you may encounter may be addressed without an ER visit. Please call your practice with any concerns, symptoms, questions or problems that arise, do not feel that you are bothering them. They will make sure you get what you need, either there or by coordinating with your primary doctor, your surgeon or other specialists.  

Same-Day Appointments

If you would like a same-day appointment, please let your practice know. It may be with your primary oncologist, the doctor on call, a nurse practitioner or a physician’s assistant. Your care team will do their best to make sure you are seen that day.

Test Results

If you are calling for test results, remember that most physicians schedule a follow-up visit to discuss test results with you. If your doctor has told you he or she will call you with test results, please remember that may take several days for those results to become available. The doctor must personally review the test before you can receive a call about the results. If you are waiting for your doctor to call with results and you have not heard back within a week, please call the office. 


If you feel you are ill enough to require hospitalization, please call your practice first. They will be able to assess your situation to best help you. If hospitalization deemed best, you practice may be able to fast track the admissions process. 

Second Opinions

It is important to us that you feel you are getting the best possible medical care. If you ever desire a second opinion, please let your practice know and they will be happy to send your medical records to the doctor of your choice, or to recommend another doctor for review. 

After Hours

After the clinic is closed your call is transferred to the answering service, which contacts the on-call doctor. When the doctor calls you back, he or she may not have had time to pull up your medical records from the computer and may not be familiar with your situation. To better assist the physician, be prepared with the following:

  • Have an updated list of your allergies and medications ready. (You can ask your doctor for a copy at your next appointment.)
  • Have your pharmacy name and telephone number ready.
  • If your phone is set to block unknown callers, please unblock it while waiting for the doctor to call you back. 

Your Labs

Your practice may have a web portal in which you can review your lab results. Results may be available immediately or within several days. Your paper results will only be sent to you if you request them. If you have had lab tests done recently by your primary care physician, or another healthcare facility, please inform your doctor so the results can be obtained and avoid needless duplication of routine blood work.  If you have a port, your practice will have designated staff available to access your port and draw blood. This may happen in the lab, treatment room or exam room. Make sure to remind your care team when you get a port so it is noted in your record. If you don’t have a port, don’t worry, your care team will draw your blood painlessly.

Many lab tests can be performed right in the practice. Other tests are sent to participating reference labs according to your insurance policy rules. Reference labs are national labs that perform a wide variety of tests. If your tests are sent to a reference lab, you will receive billing statements directly from these reference laboratories in addition to a billing statement from your practice for drawing the blood. All laboratory draws should be scheduled to avoid delays. Please notify the front desk of any changes to your insurance. Many times your insurance will determine where outside lab tests will be sent. The results of some tests performed at the practice can be provided to the patient at the time of visit, if requested. Please note that medical issues should be discussed with your nurse or doctor for laboratory staff cannot advise you on issues of that nature.


Imaging provides a non-invasive and painless way of visualizing tissues and organs in the body so that abnormalities can be identified. There are many different techniques for generating images. Some techniques used for detecting or diagnosing cancer include:

  • Radiography (X-ray)
  • Dual Energy X-ray Absorptiometry (DEXA) scan
  • Positron Emission Tomography (PET) scan
  • Magnetic Resonance Imaging (MRI)
  • Computed Tomography (CT) scan
  • Combined CT/PET scan
  • Bone Density Scan

In the imaging department, IV access may need to be established to administer contrast material for the scan. If IV access is difficult or problematic for you, ask a someone on your care team to arrange IV access.

Radiography (X-ray)

Radiography involves the use of radiation (X-rays) to create an image of the body. Radiographs are created by passing small, highly controlled amounts of radiation through the body, capturing the resulting image on a special type of photographic film. Radiation passes through the various structures of the body differently. For example, very little radiation passes through the bones, leaving white “shadows” on the X-ray film. This is why X-rays are very useful for evaluation bones, as detecting fractures.

X-rays are useful for determining whether cancer has spread (metastasized) to the bones. Because cancer cells are so dense and metabolically active, tumors, or masses of cancer cells, may also appear white on an X-ray, as is the case with lung cancer.

Dual Energy X-ray Absorptiometry (DEXA) Scanning

DEXA scanning is the most widely used method for measuring bone mineral density. Bone density may weaken with bone metastases (cancer that has spread to the bones), or with osteoporosis (a weakening of the bones related to aging). DEXA scanning rapidly directs X-ray energy, alternating from two different sources, through the bone being examined. Once the X-rays have passed through the bone, their strength is recorded. Bone density, or bone loss, is calculated from the amount of energy that travels through the bone and is picked up by the detector. The minerals in bone, predominantly calcium, weaken the transmission of the X-rays through the bone. The denser the bone, the less the X-rays get through to the detector. The use of two different X-ray energy sources greatly improves the precision and accuracy of the measurement.

Positron Emission Tomography (PET)

Unlike techniques that provide anatomical images, such as X-ray, CT and MRI, PET scans show chemical and physiological changes related to metabolism. This is important because these functional changes often occur before structural changes in tissues. PET images may therefore show abnormalities long before they would be revealed by X-ray, CT, or MRI.

Before a PET scan, a patient will receive an injection of a radiopharmaceutical, which is a drug tagged with a basic element of biological substances called an isotope. These isotopes distribute in the organs and tissues of the body and mimic natural substances such as sugars, water, proteins, and oxygen. The radioactive substance is then taken up by the cancer cells, allowing the radiologist to visualize areas of increased activity.

After the patient has received the injection, a small amount of radiation is passed through the body, revealing details of cellular-level metabolism. Although the radiation used is different from that used in radiography, it is roughly equivalent to what is administered in two chest X-rays. After the scan is complete the radiation does not stay in the body for very long.

PET is useful for diagnosing multiple types of cancer, and for monitoring response to therapy-effective therapy leads to rapid reductions in the amount of glucose that is taken up by tumors. PET imaging can easily reveal this drop in metabolic activity and show a patient is responding positively to a particular course of treatment. PET has been shown effective for predicting outcomes, detecting the spread of cancer, and/or monitoring therapeutic response in a wide range of cancers, including breast, colon, lung, ovarian, head, neck, and thyroid cancers, as well as melanoma and lymphoma.

Magnetic Resonance Imaging (MRI)

MRI uses strong magnet and radio-frequency waves to produce an image of internal organs and structures. Under the influence of the strong magnet, the hydrogen atoms in the body line up like compass needles. Next, the patient is exposed to radio waves that cause the hydrogen atoms to momentarily change positions. In the process of returning to their orientation under the influence of the magnet, they emit a brief radio signal. The intensity of these radio waves reflects what type of tissue exists in that area of the body. The MRI system goes through the area of the body being imaged, point by point, collecting information from how the radio waves emit. A computer generates an image of organs and structures based on these radio wave recordings. MRI has proven useful for detecting some types of cancer, and in some cases may be more effective than biopsy, mammography, or ultrasound.

Computed Tomography (CT)

A CT scan is a detailed radiograph, or X-ray. The CT imaging system is composed of a motorized table that moves the patient through a circular opening and an X-ray machine that rotates around the patient as they move through. Detectors on the opposite side of the patient from where the X-ray enters record the radiation exiting that section of the patient’s body, creating an X-ray “snapshot” at one position (angle). Many different “snapshots” are collected during one complete rotation of the X-ray machine. A computer then assembles the series of X-ray images into a cross-section, or a picture of one small slice of the body. A CT scan is a series of these cross-sectional images.

PET/CT Combination Scan

Recent research indicates that a combination PET/CT scan may be more effective than whole body MRI for diagnosing the extent of spread for various cancers. Researchers from Germany conducted both PET/CT and MRI on 98 patients with various cancers. Overall, PET/CT scanning was 77 percent accurate for detecting the original cancer, cancer spread to nearby lymph nodes, and cancer spread to distant sites in the body, compared with only 53 percent accuracy with MRI.

Bone Densitometry (DXA)

A bone densitometry (DXA) machine performs quick and painless assessments of a patient’s bone strength. A bone densitometry reading (different from a bone scan) helps your physician determine whether you have osteopenia or osteoporosis (bone weakening) and whether you might need treatment to help prevent a future bone or spine fracture.

Loss of bone strength can occur due to age, lack of mobility, certain illnesses including cancer and certain medications – even with adequate calcium and vitamin D intake and exercise. Current medical literature recommends that a DXA study be performed on all women over the age of 65, all men over 70, and younger people with problems such as early menopause, a history of smoking, thyroid or parathyroid disease, lactose intolerance, intestinal malabsorption or chronic diarrhea, or a family history of bone disease or osteoporosis. People being treated with medications such as aromatase inhibitors (breast cancer), androgen deprivation (prostate cancer), long-term steroids or seizure medications such as Dilantin or Phenobarbital should also have regular bone density studies performed.

Insurance and Imaging 

Many insurance companies require prior authorizations for your imaging. While getting an authorization is legally your responsibility, your practice will help you get these prior authorizations so that the insurance companies will pay their share. They must get these authorizations before your imaging occurs or the insurance company will deny payment and make it your responsibility. Please help your care team by giving them your current insurance information. It can take several hours or even days of phone calls to obtain the authorizations. Occasionally your doctor must discuss the reason for imaging with the insurance company.

Side Effects

Please do not hesitate to call your doctor for any problems that you may be having. You may experience side effects while on treatment. Please visit our Side Effects page to learn more.