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It’s a scary moment when your doctor says, “There’s a chance this could be cancer.” Even as you’re processing those words, you’re faced with important new decisions, such as which doctor to trust and which treatment options are best.
“With a wealth of resources and advances in treatments like immunotherapies, a cancer diagnosis no longer has to be so frightening,” says Jill O’Donnell-Tormey, CEO and director of scientific affairs at the Cancer Research Institute (CRI) in New York City.
After absorbing the news that you or a family member has been diagnosed with cancer, it’s essential to get an accurate diagnosis and then seek the best possible medical care and treatment. Selecting the right cancer treatment center can make a significant impact on the overall outcome. The following expert advice will help you make challenging decisions with more confidence.
[See: 2024-2025 U.S. News Best Hospitals for Cancer]
How to Select a Cancer Treatment Center
Where do you go to confirm your diagnosis and start treatment — a convenient local hospital or a cancer center in the closest city? Many community hospitals provide some cancer care, such as surgery to remove tumors and radiation and chemotherapy options for a variety of cancers. They typically do not offer advanced surgical treatments, radiation therapy or genomic testing.
By contrast, cancer centers focus solely on caring for cancer patients. They offer oncology expertise and the latest treatments and technologies, often for multiple cancer types and rare cancers.
“Cancer centers have a broad team of not only physicians and surgeons, but also support care to ensure a more successful outcome,” says Dr. William Dahut, chief scientific officer at the American Cancer Society. “Some centers may even specialize in a single type of cancer like breast cancer or lung cancer.”
Not everyone has a choice of cancer centers, especially in rural areas. Many people have to travel farther to reach specialized cancer treatment.
“It makes sense to travel farther, if needed, to receive dedicated cancer care, at least when planning and initiating your treatment,” says O’Donnell-Tormey. “The major cancer centers are where the world-class doctors are, so it’s worth going at least once to meet the medical team and learn about their experience in treating specific cancers.”
Particularly with rare cancers, it’s really important to find a top cancer center to get an opinion, says Dr. Diane Reidy-Lagunes, a medical oncologist and associate deputy physician-in-chief at the regional care network for Memorial Sloan Kettering Cancer Center in New York City. “Those particular diseases are just much more challenging to diagnose and treat, and you want to make sure with an uncommon cancer that the oncologist really understands that disease.”
[SEE: Questions to Ask Your Oncologist at Your First Cancer Appointment.]
NCI-Designated Comprehensive Cancer Centers
The National Cancer Institute (NCI) recognizes centers around the country that meet rigorous standards for state-of-the-art research, including developing new and better approaches to cancer prevention, diagnosis and treatments.
Of the current 72 NCI-designated cancer centers, 57 are further recognized as comprehensive cancer centers, which are also known for their leadership, resources and substantial research across medical disciplines. Most are affiliated with university medical centers.
“Fortunately, we have really good data that’s been published over the past decade that NCI-designated comprehensive cancer centers provide better survival for patients with cancers,” says Dr. Joseph Califano, physician-in-chief at Moores Cancer Center at the University of California–San Diego Health. “That’s not just for rare cancers, but also for very common cancers like lung, colon, breast and prostate cancer.”
The threshold to become an NCI-designated comprehensive cancer center is high. “The center has to demonstrate to the NCI that it’s broad-based and treats all the major and even smaller types of cancer with focused efforts and teams,” Califano says.
[Find: The Doctor That Is the Right Fit for You.]
Best Hospitals for Cancer Rankings
Every year, the U.S. News Best Hospitals rankings include Best Hospitals for Cancer. You can see how hospitals score in key aspects of cancer care.
The Best Hospital rankings comprise nearly 900 hospitals that see a large proportion of challenging cancer cases. You will find the 50 top hospitals for cancer treatment, followed by high-performing hospitals, and can tailor your search by cancer specialty and location among adult and pediatric cancer centers.
Find the Right Doctor
It’s important to find an experienced oncologist you can trust with your cancer care. Start by finding out whether a doctor you’re considering focuses on specific types of cancer or certain treatment approaches.
“Some doctors are using the latest cancer treatments like immunotherapies, since they offer a long-term solution to ending many cancers,” O’Donnell-Tormey says. “It’s crucial to choose a doctor who has experience in treating your particular cancer and in using the latest treatments.”
These tips can help you choose the right doctor for your cancer care:
— For a referral to an oncologist, your primary care physician is a good starting point. The American Cancer Society provides some tips on what to look for in a cancer doctor.
— Make sure the doctor and cancer center accept your health insurance and are in your network. If you’re on Medicare, rest assured that most cancer doctors accept Medicare, but always confirm.
— The U.S. News Best Doctors listing lets you search a wide group of oncologists nationwide by years of experience, location and whether they’re affiliated with a top hospital.
— Board certification is another indication of an oncologist’s qualifications. Cancer doctors can be certified for one of three main specialties: medical, surgical and radiation oncology — as well as for a variety of subspecialties such as gynecologic oncology.
When choosing a potential doctor, ask about their qualifications in treating your particular type of cancer. “Make sure that you feel confident they understand this disease,” Reidy-Lagunes says.
You also need to feel comfortable with physicians on your cancer team. “When you first meet your oncologist you want to get your questions answered,” she says. “And if you feel like the oncologist isn’t listening to you, it’s okay to try to find another one.”
Get a Second Opinion
Experts agree: Second opinions are valuable when it comes to getting the best cancer care.
“Most oncologists recommend a second opinion,” says Dr. Jyoti D. Patel, medical director of thoracic oncology and assistant director for clinical research at the Lurie Cancer Center at Northwestern University. “No one ever feels bad when patients ask for one. Certainly, asking for a second opinion or a referral to a cancer center makes good sense, particularly for rare tumors or for anyone who is thinking about investigational options and clinical trials.”
Time taken to get another opinion and explore options is usually time well-spent.
“It all can be so overwhelming, and sometimes patients say, ‘I just want to start tomorrow,'” Reidy-Lagunes says. “But the emphasis is on, ‘You want to start the best treatment for you, to give you the best possible shot.'”
With rare cancers or pediatric cancers, second opinions regarding the best treatment are even more critical, she says. That includes confirming the pathology diagnosis, or what’s under the microscope.
Explore Comprehensive Services
Cancer care goes far beyond diagnosis and treatment. When eating becomes difficult because of nausea and vomiting from chemotherapy, or radiation causes mouth sores and digestive-tract damage, nutritional support is a must. People suffering emotional fallout from cancer often benefit from psychological or spiritual counseling. Pain management can make a world of difference in being able to tolerate the side effects of cancer treatment.
Multidisciplinary teams bring together a variety of service providers. Nutritionists, nurse navigators, social workers, specialty therapists, palliative care specialists and others work alongside oncology physicians and oncology nurses to provide holistic care. When choosing a hospital, ask about the scope of health care team members and the range of services they offer.
“Cancer care is not as oncologist-focused as it was maybe 20 years ago,” Patel says. “It’s much more patient-focused, so really think about the cancer care team as one that is much broader.”
Most cancer centers also have financial services to help patients and families deal with insurance coverage or find resources to assist with expenses related to travel for specialized treatments such as proton beam radiation.
“Cancer is associated with an enormous amount of toxicity that extends well beyond what we think of as the usual stuff of chemo, radiation and surgery,” Califano says. “There’s a huge psychosocial impact on families. Issues with work and financial toxicity are really significant. So, a multidisciplinary team can help with these (aftereffects) of treatment in a comprehensive way so that people get back to work, health and wellness.”
Learn About Clinical Trials
Clinical trials offer the opportunity to receive cutting-edge cancer treatments, particularly for treatment-resistant cancer.
“If patients are seeking a clinical trial, we encourage them to do so upfront,” Patel says. “Not only for treatment-resistant disease but to really think about novel therapies even as their first line of treatment. Consider the drugs approved in recent years: These oral drugs are now all frontline therapies.”
Whether you’re interested in participating in a cancer research trial or are uncertain, it’s good to ask about clinical trials when choosing a cancer facility. Increasingly, studies are being offered across a larger network of offices.
“Clinical studies done at the major cancer centers sometimes have sites in local centers that are more easily accessible,” O’Donnell-Tormey says.
Genetic Testing
If your cancer provider doesn’t bring up genetic testing, ask about it. Depending on your specific type of cancer or tumor, genetic testing results may open the door to more personalized, targeted treatment and also offer clues about cancer risk. Technology has advanced to allow for broad testing genetic panels at reasonable costs, even if it’s not covered by insurance.
“If you have a family history suggestive of cancer, you really want to talk to your oncologist and ask, ‘Do I need to have genetic testing?'” Reidy-Lagunes says. “Particularly in a young patient, any children or any patient younger than 50, we have to ask ourselves: Could it be from an inherited gene?” In some cases, she says, it might be appropriate for a patient’s direct family members, such as children or siblings, to be tested as well.
Genetic testing can help guide treatment decisions. “Technology advances have allowed us to personalize treatment,” Reidy-Lagunes says. “Based on those genes, we can identify mutations or damaged genes.” Another question to ask your doctor: “If genetics are important for me, what’s the turnaround time for testing, and do you have the facilities to do that?”
Cancer Navigators and Patient Advocates
When the cancer domain is new and overwhelming — with all the varied treatments, the growing number of treatments and procedures, the unfamiliar terminology and the momentous decisions — a patient navigator, or patient advocate, can provide invaluable guidance.
Hospital-based patient navigators are employed by an individual medical center or health facility and work within that setting. For example, a breast cancer center might have breast cancer navigators on staff to help patients throughout their hospital experience. Navigators know their particular facility inside and out, and can help patients through multiple appointments, discharge planning and other hospital hurdles and complexities to keep their diagnosis and treatment on track. They can also connect patients to various sources of support within the hospital. For example, they can help patients find financial assistance for expensive medications, offer education on medications and help patients make appointments for other physicians, scans and chemotherapy infusions.
Patients and families can hire private patient navigators to help them find their way through the larger health care system to achieve better outcomes.
“We work only for the patient and follow them through the continuum of care as long as they need it,” says Elisabeth Schuler, a board-certified patient advocate and certified senior advisor who works with families nationwide and is based in northern Virginia. “We’ll go to outside appointments; we will find second opinions,” says Schuler, who is also founder and president of Patient Navigator LLC.
Some ways patient navigators can serve as mentors and coaches: They help patients research their disease and understand treatment options, unravel insurance issues, find doctors, accompany patients to visits and assist with medical paperwork. If needed, they also help patients get second opinions or find different hospitals.
Bottom Line
While not all cancers are curable, many of them are treatable. That makes finding the best cancer treatment center a top priority after being diagnosed with cancer. Look for cancer centers with doctors and health care teams who have experience treating your type of cancer or tumor type.
Whether you’re looking at the U.S. News Best Hospitals rankings or selecting a center from the National Cancer Institute’s designated list, there are resources available to help you find the best options near you. Do your research to learn whether the center provides comprehensive services, such as the latest advancements in cancer treatment and genetic testing, but also if they offer support care such as nutrition, pain management and psychological counseling.
Meet with the health care team and make sure they are listening to your needs. Ask about their experience caring for people with your specific type of cancer and if they are involved in research or clinical trial programs that you may qualify for.
“Cancer care is a team sport,” Califano says. “Finding a facility where you have highly developed teams that treat a lot of what you have is one of the best things you can do.”
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Where to Go For Cancer Treatment originally appeared on usnews.com
Update 08/29/24: This story was published at an earlier date and has been updated with new information.
