Medical oncology

Treating cancer can be extremely complex.⁵ It often involves a team of medical specialists working together to design the best course of action. As the exact nature of your cancer is unique to you, your treatment plan needs to be as personalised as possible to your specific condition.⁵ This may mean one or more forms of treatment.⁵ Your specialist doctors will explain why a certain treatment approach is being recommended and what it involves.

Remember you are in charge of your treatment so it’s important to ask questions, particularly if there is something you don’t quite understand or are unsure about. Having a friend, family member or carer accompany you to your appointments can also be helpful as there is usually a lot of information to take in. At GenesisCare you are welcome to bring whoever you need to your appointments for support.

When you think about medicines used to help treat cancer, one word that may spring to mind is 'chemotherapy' or 'chemo'. Chemotherapy is generally associated with cancer stopping drugs that are injected into a vein (called an intravenous infusion), but some chemotherapy medications can also be given as oral tablets.³ Chemotherapy may be offered as a stand-alone treatment for cancer, or as part of a combined approach together with surgery and/or radiation therapy.⁶ Chemotherapy can also be used to help control cancer when a cure may not be possible.⁶

Many different medications exist to treat cancer.⁵ Some work across multiple cancer types, whereas others are far more specific and may only be effective for a particular type of cancer.^6-9

If there are any complementary therapies you are interested in, we invite you to have a chat about them with your team so we can see if there is a way they can be included in your treatment plan. We can even help coordinate with external services.

When learning more about a cancer care provider, the below list of services may help you better understand your treatment options:

• Access to a nurse specialist to help coordinate your care
• A consistent care team
• A consultant who will be directly involved in your care
• Family feel where staff aim to know your name and your story
• Patient satisfaction scores of 95+
• Care that is as personalised as possible
• Minimal wait times
• Free or validated parking for medical oncology patients
• Multidisciplinary team discussions about patient cases, when required
• Comprehensive medication assessment for interactions between current and prescribed treatment
• Eligibility for participation in relevant clinical trials assessed
• Access to allied health services

When your doctor refers you to a GenesisCare clinic, the chosen centre will reach out to organise your first appointment.

You will need to bring to this first appointment:

• Your letter of referral
• Any scans/pathology reports you may have - we will also request these from your referring doctor before your appointment
• Your Medicare and any private health insurance details

At your first appointment you will be asked about your medical history and general health - this can be done beforehand via our online portal, or in person on the day together with our friendly team. Then, the medical oncologist or haematologist will go through the initial findings of your referring doctor with you, before discussing treatment options, potential side effects and your overall treatment plan.

They will explain how often you need to come in and who you will be seeing throughout your treatment with GenesisCare.

A small number of people decide not to proceed with treatment - this decision can be made together with your treating doctor. 

A Patient Services Officer (PSO) will have a conversation with you and explain the whole billing process and any out-of-pocket expenses before your treatment commences. They will check your level of cover if you have private health insurance and let you know what you are eligible for and what excess costs may look like. How much you will have to pay out-of-pocket will depend on your level of cover.

If you do not have private health insurance or are an overseas patient you will still have a consultation with a PSO. They will provide you with an itemised costing of treatment before any treatment begins.

Some points to be aware of:

• Depending on your level of cover, private health insurance may cover the costs of admission and medical oncology treatment delivery
• Private health insurance does not cover consultation costs, but Medicare may cover part of these costs
• If you have private health insurance, GenesisCare sends all insured service bills directly to the health fund so you don’t have to file claims
• Chemotherapy and immunotherapy are considered inpatient services
• Any medications not covered by the Pharmaceutical Benefits Scheme (PBS) will need to be paid for before treatment - if you have been prescribed any high-cost medications one of our pharmacists will also reach out to discuss these with you

Who might you see?

A medical oncologist is a doctor who has had special training in the diagnosis and treatment of cancer. They are one of the healthcare professionals who look after someone who has cancer and may coordinate treatment with other specialists.² These specialists may include:

• Haematologist - a doctor with specialised training in diagnosing and treating disorders related to the blood¹⁶
• Radiation oncologist - a doctor who has been specially trained to use radiation to treat cancer¹⁷
• Cancer geneticist - a doctor with additional training in the study of genes and inheritance and how that may relate to cancer. They can help counsel individuals and families on the risk of developing different types of cancer¹⁸

Each GenesisCare centre has a single point of contact that you can call and be connected to the clinical support person who can best answer your specific questions.

What treatments might you get?

Depending on the type of cancer, its location and your medical history there are several treatment options available to you. In addition to the therapies listed above, these may include:

• Radiation therapy uses high energy X-rays or other particles to treat cancer and can be used at all stages.⁴
• Theranostics is an approach to cancer therapy which combines diagnostics and treatment techniques to detect and treat some cancer types.^19,20
• Haematology treatment for blood cancers varies depending on the type, stage and spread. Haematology treatments may include various types of therapy (chemotherapy, immunotherapy, targeted therapy - listed above) as well as stem cell or bone marrow transplantation.²¹ These last two (stem cell and bone marrow transplant) are not offered at GenesisCare centres, but we may refer you to a clinic or hospital if your treatment team thinks it could be needed.

Your GenesisCare doctor may also discuss your eligibility for participating in a clinical trial.

How might treatment be given?

There are a range of factors that can influence how a cancer treatment plan is developed, including:²²

• The type of cancer
• The tumour location
• How fast the tumour is growing
• How advanced the tumour is
• Your age and general health
• Your personal choice regarding treatment

Your team of doctors and specialists strive to develop a personalised treatment plan for you based upon the above. How each type of medical oncology-related treatment is given can vary, and may include (or be a combination of):^23-25

• Oral medicine - tablets, capsule or liquids
• Intravenous injection - where the medicine is put straight into your bloodstream
• Intravenous infusion - where the medicine is slowly put into your bloodstream over a period of time
• Subcutaneous injection - just under the skin
• Intramuscular injection - into the muscle

Treatment may be given in cycles. This is where you have treatment for a period of time, then have a break (no treatment) to allow your body to recover. A single treatment can take as little as 30 minutes to a few days (depending on your unique combination of therapies). A treatment cycle may last from one to four weeks and a series of cycles is known as a course of treatment. A treatment course can take three to six months and include four to eight treatment cycles.²⁶

Potential side effects of treatment

All cancer treatments may have side effects.^23-25 The type and severity of side effects will vary between individuals.^23-25 You can ask your doctor for detailed information about the side effects which you may experience with any treatment recommended for you. For more information on some of the common side effects experienced by medical oncology patients visit: https://www.eviq.org.au/patients-and-carers/patient-information-sheets/managing-side-effects.

You may experience a range of emotions and experiences at different times from diagnosis, through treatment and afterwards. You may find you cope better with some aspects of having cancer than others. During treatment there may be physical demands on your body that disrupt your usual routines. You may need to take time off work or get help managing your family and household responsibilities.²⁷

The important thing to remember is that there is no right or wrong way to feel. Support is available for any physical or emotional side effects you may experience. Exercise is one way to help with both the emotional and physical toll of cancer and its treatment.²⁷

We suggest speaking with your GenesisCare treatment team to understand more about support services that are available to you, during what may be a challenging time. 

Caring for someone with cancer can be an emotional rollercoaster. From the rewarding feelings of satisfaction from helping a loved one to the fear, stress or grief, being a carer can take its toll on your family. It can impact their health, relationships, work or finances.²⁸

It's important that anyone close to you knows that however they are feeling is totally normal and that how they feel may change from day to day. There are several things they can do to help cope with the situation, such as:²⁸

• Looking after their own health and wellbeing – try to remind them to take time for themselves to ensure their own needs are being met
• Eating well and exercising
• Take each task one at a time
• Ask for additional support from other family members or friends when needed
• Learn as much as you can about your cancer together
• Have a chat with their employer about the situation to see if there is any support available or if work can be a bit more flexible during this time

Refer to your GenesisCare centre for specific information on what is available to you. You can locate your nearest GenesisCare centre here

Refer to your GenesisCare centre for specific information on what is available to you. You can locate your nearest GenesisCare centre here

Remember, you can ask questions of your GenesisCare team at any time throughout your treatment and beyond. Here are some examples of things you might want to know:

About your healthcare team

• Who is in my healthcare team?
• What do they do?
• Who do I speak to if I have questions?
• How do I contact them?
• How often will I see each member of my team?

About your treatment

• What treatment am I going to get?
• Will it be combined with other treatments?
• How often will I be getting this treatment?
• What is the aim of this treatment?
• What side effects might I experience?
• How should I prepare before getting treatment?
• Who do I call if I have questions or concerns before, during or after treatment?
• How will we know if the treatment is working?
• What is the plan if it doesn’t work?
• Can I reschedule my treatment appointment?

Other questions

• How much will everything cost?
• Can I keep working?
• Is telehealth available for any of my appointments?
• Is there anything else I can be doing to help – e.g. complementary therapies or exercise?
• How do I access allied health services like a dietitian or psychologist?

TIP: Write down your questions in advance of your appointments because people often experience information overload when talking to their doctor.

Remember, it’s OK if you have more questions later or if you forget to ask. You can always contact your GenesisCare centre and speak to someone who can help answer your questions. 

1. National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘oncology’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/oncology (accessed September 2023).
2. National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘medical oncologist’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/medical-oncologist (accessed September 2023).
3. National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘chemotherapy’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/chemotherapy (accessed September 2023).
4. National Cancer Institute, ‘Radiation therapy’. Available from: https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy (accessed September 2023).
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7. National Cancer Institute, ‘Hormone therapy to treat cancer’. Available from: https://www.cancer.gov/about-cancer/treatment/types/hormone-therapy (accessed September 2023).
8. National Cancer Institute, ‘Immunotherapy to treat cancer’. Available from: https://www.cancer.gov/about-cancer/treatment/types/immunotherapy (accessed September 2023).
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13. Cancer Council, ‘Immunotherapy’. Available from: https://www.cancer.org.au/cancer-information/treatment/immunotherapy (accessed September 2023).
14. American Cancer Society, ‘Immunotherapy’. Available from: https://www.cancer.org/content/dam/CRC/PDF/Public/6678.00.pdf (accessed September 2023).
15. Cancer Council, ‘Targeted therapy’. Available from: https://www.cancer.org.au/cancer-information/treatment/targeted-therapy (accessed September 2023).
16. National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘hematologist’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/hematologist (accessed May 2023).
17. National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘radiation oncologist’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/radiation-oncologist (accessed May 2023).
18. National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘geneticist’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/geneticist (accessed May 2023).
19. Gomes Marin JF, Nunes RF, Coutinho AM, et al. Theranostics in Nuclear Medicine- Emerging and Re-emerging Integrated Imaging and Therapies in the Era of Precision Oncology. Radiographics. 2020;40(6)-1715-1740.
20. Vu TM, Loveday BPT, Behrenbruch C, Hollande F, Heriot AG. Theranostics- a fifth pillar of contemporary cancer care? ANZ J Surg. 2022;92(11)-2782-2783.
21. City of Hope (formally Cancer Treatment Centers of America), ‘Hematologic oncology’. Available from:  https://www.cancercenter.com/treatment-options/hematologic-oncology (accessed May 2023).
22. Commonwealth of Australia. Department of Health. Cancer treatment. July. 2021 [cited Aug. 2023]. Access from; https://www.healthdirect.gov.au/cancer-treatments
23. eviQ. Understanding chemotherapy. ID: 3083 v4. Last reviewed 19 October 2022.
24. eviQ. Understanding immunotherapy. ID: 4082 v1. Last reviewed 23 December 2021.
25. eviQ. Understanding targeted therapy. ID: 4083 v1. Last reviewed 12 January 2022.
26. Cancer Research UK. Treatment cycles and courses of treatment. Available from: https://www.cancerresearchuk.org/about-cancer/treatment/cancer-drugs/how-you-have/treatment-cycles-and-courses#:~:text=A%20cycle%20means%20that%20you,make%20up%20one%20treatment%20cycle (accessed November 2023).
27. Cancer Council. Emotions and cancer. November 2021 edition.
28. Cancer Council. Caring for someone with cancer. September 2020 edition.