Dr. Paul Oberstein, a pancreatic cancer specialist from NYU Langone, explains why patients should seek care from a specialist and discusses the advantages of a multidisciplinary care team. Dr. Oberstein also shares key questions to ask your doctor following diagnosis and stresses the importance of understanding your diagnosis and treatment plan.
Dr. Paul Oberstein is Section Chief of Gastrointestinal (GI) Oncology at NYU Langone and Assistant Director of the Pancreatic Cancer Center of NYU Langone’s Perlmutter Cancer Center. Learn more about Dr. Oberstein.
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Transcript
Dr. Paul Oberstein:
My name is Paul Oberstein. I’m a GI and medical oncologist. My title is Section Chief of GI Oncology at NYU, and I’m an associate professor of medicine at NYU as well. So, my primary role is that I see patients, and I run a group that sees a pretty large number of patients with GI cancers. Including, I would say the most common one we see is pancreatic cancer, and that’s where I personally practice. We provide comprehensive care to patients. We also try to incorporate clinical trials and cutting-edge multi-disciplinary treatment for all of our patients when appropriate.
Jamie Forward:
Why should someone diagnosed with pancreatic cancer seek care with a specialist?
Dr. Paul Oberstein:
Yeah, so it’s a really great question. I absolutely think someone should seek care with a specialist. What a specialist is is something that I think can be discussed to be very clear. But what we mean by saying that is that there are options for pancreatic cancer treatment that not every person is aware of. So, there have been a lot of advances in the last couple of decades, specifically how we manage treating patients in addition to the chemotherapy, which we’ll talk about.
The supportive care, the additional testing, the other parts of what we do to try to maximize quality of life and duration of life for patients. In pancreatic cancer especially, because it’s such a difficult to treat cancer, it really requires multi-disciplinary care. So, getting an opinion or getting information from someone with that exposure and that comfort is very important, and that’s what we call experts.
Jamie Forward:
Okay. Wonderful. And so, Dr. Oberstein, what are some important questions that patients should bring to their doctor or care team when making decisions about treatment following a diagnosis?
Dr. Paul Oberstein:
Yeah. So, obviously a person being diagnosed with pancreatic cancer is a very large event, is very devastating, overwhelming, and confusing. And it’s because it’s really that big and that big of a disruption and impact on a person. So, I think the key thing is to prepare, right? It’s to think about what the questions are. It sometimes helps to write them down or put them in some format. Just because in that moment it’s easy to get confused or overwhelmed. And it often takes more than one visit, right? To get all the answers.
Or it probably will take more than one visit. I think that’s really important to be comfortable with. You don’t have to ask all the questions in the first 10 minutes or get all the answers. It’s really important to understand what the diagnosis is. Has it been confirmed as pancreatic cancer, or what type of pancreatic cancer, the stage of the cancer, meaning whether it has spread or not really guides the treatment decisions.
And so, it’s very important to understand if we know the stage, if not what tests still need to be done, like CAT scans or other tests to establish the stage. And then, of course, what’s the treatment plan. And I think that, as I mentioned, treatment for pancreatic cancer is very often involving multiple teams including surgeons, usually medical oncologists, sometimes radiation doctors or gastroenterologists. And it’s really important to understand who’s in charge, who’s going to help guide the next steps, and what those might be.
I would say beyond that very general sense, the actual treatment regimens, the goals of treatment, meaning not just what we recommend next week, but what do we hope will happen – what do we hope will happen next, what’s possible. Those are all really important things to talk about. Some people want to talk about them more than others, then that’s totally fine. But someone should feel comfortable talking to their doctor about that.
Jamie Forward:
Right. And why is bringing a care partner along and having them be involved so important during that time?
Dr. Paul Oberstein:
Right. So, the simplest thing I can say is that this is something that if a person has support, it’s that much easier or clearer to manage. It’s overwhelming. Very often most people think pancreatic cancer will have significant physical symptoms. So, they feel tired or weak or they have trouble eating, and that’s overwhelming. Or they have pain. Very often pain is present. So, having someone else there who both can support the person and advocate on their behalf, but also be a good pair of ears to listen to what’s happening is really important, and it’s also important after the fact.
Right? Very often people go home, and they don’t remember the exact details, which is fair. But it’s good to have a team or someone supporting a person both either at the visit or afterwards, and during the treatment of their cancer.
Jamie Forward:
Sure. That’s great advice.