Making sure you have the right medical team in place is important to your physical and emotional wellbeing. While it’s normal to want to get your cancer dealt with by the first available specialist, it’s worth taking a little time to make sure you are comfortable with each member of your medical team. Remember, you may have to see these people for a number of years as you go through your treatment and follow up appointments.
You have a choice
While you may initially be referred to one particular specialist, you do not need to stay with that specialist. If you are unhappy about who you have been referred to, it’s a good idea to seek a second opinion.
When looking for a surgeon or medical oncologist, word of mouth goes a long way. If you’re not sure where to start, you may like to get recommendations from other women who have experienced breast cancer.
Public or private?
If you have breast cancer, you do not have to have your treatment in the private health system. You can choose to go public if you want to. You can choose or combine treatment in the private and public health system (e.g. chemotherapy and surgery in the private health system, radiotherapy in the public health system).
Here are some advantages and disadvantages of each health system so you can be empowered to make a choice regarding your treatment and care.
As a public patient
You are entitled to be treated as a public (Medicare) patient in a public hospital even if you have private health insurance; however you must let your doctors know upfront.
- You will not be charged for most of your treatment and care.
- You are more likely to have a multidisciplinary team (MDT) coordinating your care.
- You are more likely to have access to a breast care nurse, social worker, physiotherapist and other allied health professionals.
- You are more likely to have all of your treatment team in the same place.
- You will be treated by doctors nominated by the hospital – you cannot choose your doctors.
- You may see many different health professionals during the course of your treatment.
- You may have to wait longer for appointments and treatment, but this should not affect the outcome of your treatment.
As a private patient
If you don’t have private health insurance you can pay to be treated as private patient; your doctors can tell you how much this will cost. Before treatment you may want to clarify how much it will cost and exactly what your private health insurance will cover. Your doctor can provide a quote and your private health insurer can tell you which treatments are/are not covered by your insurance, what gaps you may have to pay, and what other services you can claim, e.g. a wig, post-surgery bra, or lymphoedema garment.
- You can choose your specialists and the hospital in which you wish to be treated.
- Timelines for treatment are generally shorter.
- Depending on your level of cover, you may be able to stay in a private hospital and have a private room.
- You could be faced with substantial out-of-pocket costs for your treatment, e.g. you may have to pay an ‘excess’ or gap for your surgery.
- Private health insurance only covers inpatient procedures, so you will not be covered for any treatment as an outpatient, e.g. radiotherapy, radiology, pathology tests and visits to specialists in their rooms. While these do attract Medicare rebates, the rebate may not always cover the whole fee.
- You are less likely to have access to allied health professionals such as a social worker or physiotherapist.
More information on public and private patient care can be found on our Financial and practical assistance fact sheet and our tip sheet that accompanies our The financial impact of breast cancer report.
Who will be on your medical team?
The members of your medical team that you may see may include:
- medical oncologist
- radiation oncologist
- breast care nurse
- oncology nurse.
If you have a strong relationship with your GP, they can also play role in your care. Your GP can clarify any information given to you by your specialists, help you with treatment decisions, and assist you to find practical and emotional support. Ask your specialists to send copies of all tests and planned treatments to your GP.
In Australia it is considered best practice for breast cancer treatment to be managed though a multidisciplinary team (MDT) approach. This means that the health professionals involved in your care meet to discuss the best treatment options for you.
As well as the health professionals listed above, the MDT may include a pathologist and radiologist, and others involved in cancer care.
You can ask your surgeon if a multidisciplinary team is involved in your treatment.
Getting the most out of your medical consultations
- If you can, take someone with you to your medical appointments. Taking your partner or a support person will help them better understand your treatment. They can also take notes in case you forget something later on.
- Try to write down any questions you might have before your appointment. It’s easy to forget things during a medical appointment and having them written down is an ideal reminder of what has been on your mind. Put your most important questions at the top of your list, in case you don’t get time to ask them all.
- The Personal Record provided in My Journey Kit has a section for you to write down your questions and answers for medical appointments.
- If you think that talking to others will help, join our online network.
- The ‘Find a surgeon’ function on the BreastSurgANZ website provides a list of breast surgeons in your local area.
- The Cancer Australia website has a directory of breast cancer-related services available through public and private hospitals and clinics across Australia
- Cancer Australia also produces clinical practice guidelines for health professionals, which set out standards for the treatment and care of women with breast cancer. These guidelines are available in an easy to read format called the Guide for women with early breast cancer.