Prepare for Your Visit
How to Prepare for Your First Biologic Therapy Program Appointment
To help you prepare for your visit to the Cancer Center's Biologics Clinic, we have prepared an FAQ (frequently asked questions) document. Below you will find the answers to questions you may have in preparation for your consultation. In addition, you will find phone numbers for those questions that are not answered here.
Your medical insurance information: If you are covered by an HMO or an out-of-state insurance plan, you will need to obtain authorization or referral from your primary care physician (PCP) prior to your appointment. If we do not have an authorization or referral at the time of your visit, you may be asked to sign a waiver, which assigns the financial responsibility to you for services provided.
Your medical records: We must receive all medical records related to your diagnosis (including prior history of your disease diagnosis) from all physicians caring for you prior to your appointment. Records can be faxed to 617-632-9260.
Your radiologic films/scans: Your radiology films/scans (chest X-rays, ultrasounds, CT, MRI, PET or bone scans) must be hand-carried by you to your appointment and we request that they be digitized onto a CD if possible.
Your pathology/cytology slides: We must receive all of your pathology/cytology slides no later than one day prior to your appointment. This includes all pathology/cytology slides with reports from all biopsies, fine needle aspiration and/or other surgical procedures related to your diagnosis (including prior history of your disease diagnosis). Our staff will handle the requisitioning of these materials and contact you if we need your assistance and/or signature authorization to obtain. If for any reason we are unable to obtain your pathology slides and reports prior to your appointment, your appointment may need to be rescheduled.
We encourage you to bring a family member or a friend to your appointment. Having such a person with you can provide support and another set of ears to hear the information you receive from the physicians regarding your diagnosis or plan of treatment.
Our clinic is located in the Shapiro Clinical Center, 330 Brookline Avenue, 9th Floor, Reception A.
Please allow two to three hours for your initial consultation.
When you arrive at the clinic, please check in with one of the receptionists at the front desk.
The phlebotomist may call you to have your blood drawn. Once that is completed you will be escorted by one of the receptionists to an examination room where you first meet with a nurse. The nurse will talk with you and take your vital signs to get a sense of how you are doing.
One of our biologic physicians will meet with you next and perform a physical exam and discuss diagnosis and treatment options with you. Do not hesitate to ask questions during the discussion.
Before you leave, an appointment will be scheduled for your next visit. It is possible that the physician will order a scan, such as a CT scan or an MRI. In that case, specific and clear instructions will be given to you so that you know exactly where to go and why you are having the scan.
Follow the links below based on your specific needs. The Biologics Clinic is located in the Shapiro Clinical Center, which is part of BIDMC's East Campus. Patients can enter the Shapiro Clinical Center either at the Brookline Avenue entrance or the Longwood/Binney Street entrance near Starbucks Coffee.
The most convenient place to park is in the garage below the Shapiro Clinical Center. The entrance to the garage is behind the building off Binney Street. You can expect to pay up to $20 for parking depending on the length of your appointment.
Garage directions and parking rates »
Note: If you park in the East Campus Main Garage, you will arrive at the Feldberg building and will need to walk to get to the Shapiro Clinical Center. You can walk along Brookline Avenue toward Longwood Avenue. The entrance to the Shapiro Clinical Center is approximately two blocks down the street. Alternatively, go inside to the second floor of the Feldberg building, and follow the signs to the Shapiro Clinical Center.
In addition to the doctors and nurses who will provide your care, the services of other health care professionals are available to you during and after your treatment.
Social workers are available to help our patients and their families cope with the many issues that arise when faced with cancer. They can provide support and counseling to you and your family as well as links to helpful resources in your community. Social workers are part of the health care team and work with you and your doctors and nurses to enhance your recovery and well-being. To contact one of our social workers, please call (617) 667-3421.
Case managers are registered nurses who specialize in helping patients and families make plans for continued recovery and care after they are discharged from the hospital. If as part of your care, you have been hospitalized your case manager will work with the nurses and physicians caring for you to make sure that you understand the information you are given when you leave the hospital about your recovery process. They are also available to help answer questions about health insurance or benefits provided under a particular health plan. To reach someone from case management, please call (617) 632-7250.
Rehabilitation services: physical therapists, occupational therapists and speech-language pathologists:Depending on your needs, you may see a physical therapist, an occupational therapist or a speech-language pathologist during your stay in the hospital. These specially trained professionals will help you if your nurse or doctor thinks that you need help with daily activities, such as getting out of bed and walking, eating (including being able to swallow safely), bathing, dressing or communicating.
Respiratory therapists are on staff to help patients who are having difficulty with their breathing. They provide a variety of treatments and help administer inhaled medications. In some cases, respiratory therapists see patients who will be using inhaled medication at home to teach them how to use their medicine or how to care for needed equipment. In intensive care, respiratory therapists manage ventilators and provide other care related to respiratory functions.
Interpreters: The medical center has a comprehensive interpreter services program to make sure that all patients and families can communicate with their health care teams. Virtually any language needed can be accommodated through our on-site staff or through our extensive network of resources, including interpreting services via telephone. If you need to reach an interpreter,please call (617) 667-4423.
Financial services: If you have health insurance and particularly if you are covered by a HMO or out of state insurance plan, you will need to obtain authorization/referral from your primary care physician (PCP) prior to your appointment. If we do not have an authorization or referral at the time of your visit, you may be asked to sign a waiver, which assigns the financial responsibility to you for services provided.
If you have questions about your bill please call (866) 306-7643.
If you do NOT have health insurance and you are worried about paying your hospital bill, please call our financial assistance office at (617) 667-5661. They will talk with you about whether you may qualify for free care or government insurance.
More questions or need to cancel or reschedule : If you have any questions or if you cannot keep your appointment, please do not hesitate to contact our administrative assistants at (617) 632-9250.
If you require a TTY/TDD telephone (phone for the deaf), please let your nurse know and one will be provided for you.
If your physician determines that you need to have surgery to remove a tumor of some kind, you will have a pre-admission testing visit approximately one week prior to your surgery date. Here, you will meet with nurses and the anesthesiologist to attain additional blood work prior to surgery. These appointments are generally held on BIDMC's West Campus.
It is likely that your physician in the Biologics Program at BIDMC will schedule you for a radiographic scan to learn more about the extent of your disease. You might be scheduled for a scan on the same day as your clinic visit, or you might be scheduled at a later date. In either case, your physician will make sure that you know how to get to the scan site before you leave the Biologics Clinic.
There are a few different types of scans that you might have:
Short for "computed tomography scan," CT scans take a series of detailed pictures of areas inside the body at different angles; the pictures are created by a computer linked to an X-ray machine. CT scans are used to detect a tumor, provide information about the extent of the disease, help plan treatment and determine whether the cancer is responding to treatment. A CT scan uses slightly more radiation than a chest X-ray, but the benefits generally outweigh the risks. CT scans are usually taken in segments as opposed to full body scans. For example, you might have a chest CT scan, or an abdominal or head CT scan.*
Short for "magnetic resonance imaging," MRI is a procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or X-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, nuclear magnetic resonance imaging and NMRI.*
Nuclear Imaging (PET and SPECT): Nuclear imaging uses low doses of radioactive substances linked to compounds used by the body's cells or compounds that attach to tumor cells. Using special detection equipment, the radioactive substances can be traced in the body to see where and when they concentrate. Two major instruments of nuclear imaging used for cancer imaging are PET and SPECT scanners.
The positron emission tomography (PET) scan creates computerized images of chemical changes, such as sugar metabolism, that take place in tissue. Typically, the patient is given an injection of a substance that consists of a combination of a sugar and a small amount of radioactively labeled sugar. The radioactive sugar can help locate a tumor, because cancer cells take up or absorb sugar more avidly than other tissues in the body.
After receiving the radioactive sugar, the patient lies still for about 60 minutes while the radioactively labeled sugar circulates throughout the body. If a tumor is present, the radioactive sugar will accumulate in the tumor. The patient then lies on a table, which gradually moves through the PET scanner 6 to 7 times during a 45-60-minute period. The PET scanner is used to detect the distribution of the sugar in the tumor and in the body. By the combined matching of a CT scan with PET images, there is an improved capacity to discriminate normal from abnormal tissues. A computer translates this information into the images that are interpreted by a radiologist.
PET scans may play a role in determining whether a mass is cancerous. However, PET scans are more accurate in detecting larger and more aggressive tumors than they are in locating tumors that are smaller than 8 mm and/or less aggressive. They may also detect cancer when other imaging techniques show normal results. PET scans may be helpful in evaluating and staging recurrent disease (cancer that has come back). PET scans are sometimes used to check if a treatment is working because they can reveal whether tumor cells are dying and thus using less sugar.
This imaging technique uses sound waves with frequencies above those humans can hear. A transducer sends sound waves traveling into the body which are reflected back from organs and tissues, allowing a picture to be made of the internal organs. Ultrasound can show tumors, and can also guide doctors doing biopsies or treating tumors.*
Learn more about these techniques at Imaging.Cancer.gov »
*Text reprinted from National Cancer Institute