Once you discover that you have been diagnosed with cancer, seeking rapid and definitive treatment is critical to surviving and ultimately beating the cancer. Finding an oncologist, that is, a doctor that specializes in treating most types of cancer is an extremely important task.
Oncologists are medical doctors that have finished medical school and completed a three-year residency in internal medicine. After that they have completed a fellowship of one to three years in duration that allows them to specialize in the practice of oncology. Oncologists in a private practice setting are usually board certified in internal medicine, oncology, hematology or some combination of all three. If you are obtaining cancer treatment in a hospital setting, your care may be directed by an oncology fellow. An oncology fellow is a physician who has already completed medical residency but who is still training to become an oncologist. Even if your care is primarily directed by an oncology fellow, important decisions will be discussed with a board certified oncologist.
Generally, your oncologist is responsible for three very important things 1) diagnosing and evaluating the specific type of cancer, 2) choosing and administering chemotherapy and 3) coordinating care with other physicians that treat cancer.
Our bodies are made of many different types of cells. For example, our brains contain neurons (nerve cells), glial cells, ependymal cells and others. Cancer is caused when a single type of cell—a single cell, really—multiplies uncontrollably. This single cell gives rise to millions of cancer cells that do not die on their own. In order to determine how best to treat a cancer or tumor, the precise cell type needs to be identified. Even after the cell type is identified, certain cells are further subdivided and may respond differently to various treatments. For example, certain tumors of the breast may be sensitive to hormonal agents. By testing for a specific receptor type on cancer cells, the oncologist can determine if a receptor blocking agent should be used. The first critical duty of an oncologist is characterize the cancer as specifically and accurately as possible. Once, this is done, the proper chemotherapy, including dose and duration of therapy can be chosen.
Certain cancers may respond to surgery or radiation. Your oncologist will coordinate care with surgeons and radiation oncologists if your tumor would benefit from these treatments. Most often, surgeons will excise the tumor prior and then chemotherapy is administered to kill any cells that were missed during the procedure. In some cases, the tumor may need to be “debulked” or reduced in size to make it more accessible to the surgeon. “Debulking” a tumor involves some chemotherapy, radiation or a combination of both prior to surgery. These treatments reduce the size of the tumor which aids in surgical removal. After surgery, your oncologist will likely prescribe additional chemotherapy.
Finding an oncologist can be time-consuming, but selecting a trained oncologist that is willing and able to coordinate care among several medical professionals is the key to managing your cancer and increasing your chances of becoming a true cancer survivor.