The role of the family doctor is very important. She is the one who ensures continuity between the hospital and home, who supports both the patient and his family members throughout the disease, and who opens and closes the case.
The role of the family doctor is of the utmost importance at the beginning, when the suspicion of cancer first arises. She is the one who prescribes the first diagnostic tests. It is also her job to handle screening for the early diagnosis of tumors. Moreover, she is responsible for referring the patient to this or that center, and for deciding which specialist examinations are necessary.
After this, the family doctor will usually “step aside” and leave the management of the case in the hands of the specialists. In this phase, various decisions will need to be taken: whether to operate; to start therapy first; whether to administer adjuvant therapy; to administer a first-, second- or third-line therapy for metastatic disease. These decisions are all taken by the specialist center. During this phase, the family doctor will play a supporting role, handling any problems that may arise at home during the various stages of the therapy. For instance, she may refer the patient back to the center, or to the emergency department, if the therapy is having excessive toxic effects, or she may decide to manage any such problems at home.
In the most advanced phase of the disease, the family doctor may remain close to the patient and his family, and manage supportive treatments. In cases that end well, she can manage the patient’s follow-up, referring to the center only if any uncertainty arises.
These are the tasks that should ideally be carried out by the family doctor who has the patient’s trust. If this trust is lacking, it is better to change the family doctor.