An oncologist is a doctor who specializes in diagnosing and treating people who have cancer.
If you have cancer, an oncologist will design a treatment plan based on detailed pathology reports that say what type of cancer you have, how much it has developed, how fast it is likely to spread, and what parts of your body are involved.
Since most cancers are treated with a combination of therapies, you could see several different kinds of oncologists during the course of your treatment.
Medical oncologists treat cancer using chemotherapy, hormonal therapies, biological therapies, and other targeted treatments. People often think of the medical oncologist as their primary cancer doctor.
Medical oncologists help their patients manage side effects, and they help monitor and maintain well-being. A lot of the time, patients follow up with their medical oncologists after treatment is complete.
Radiation oncologists use high-energy photon beams to target and destroy cancer cells. Roughly one half of all cancer patients will have radiation treatments as part of their cancer care.
Some cancers respond best to small “seeds” of irradiated material implanted in the affected area, while others respond best to intense beams of radiation that are so highly targeted they’re called “radiosurgery.”
A surgical oncologist may be one of the first doctors you see if your primary care physician suspects that you have cancer. Surgical oncologists often perform biopsies, removing a small section of tissue so it can be checked for cancer cells.
If cancer cells are present, then you might see the surgical oncologist again — this time to have the tumor and surrounding tissues removed. The surgeon will help you prepare for and also recover from any surgical procedures you have during cancer treatment.
Pediatric oncologists diagnose and treat children who have cancer. About 175,000 children under the age of 15 are diagnosed with cancer every year worldwide. In the United States, about 80 percent of children who are diagnosed with cancer and treated will survive.
Some pediatric oncologists specialize in certain types of cancer, and some focus on conducting research on childhood cancers. An important part of the work of most pediatric oncologists is educating families whose children are undergoing treatment for cancer.
Gynecologic oncologists specialize in treating cancers that affect women, such as ovarian, cervical, uterine, vaginal and vulvar cancers, but they also often treat complicated gynecological conditions that are not cancerous like endometriosis and fibroid tumors.
Like other cancer specialists, gynecological oncologists have several years of training that focuses specifically on cancers affecting women.
Doctors who specialize in treating blood cancers like leukemia and lymphoma are called hematologists, because they may also treat blood disorders that are not cancer, like sickle cell anemia and hemophilia.
WHAT TO BRING WITH YOU
- A friend or family member. Not only could an empathetic helper offer support, they could take notes to help you remember details you might overlook or forget later.
- Medical records. Bring all your records, including copies of any imaging tests, plus a list of medicines and supplements you take.
What to expect
Your first oncology appointment may last two to three hours. That’s because your oncologist will need to spend some time gathering information about your health. You should also expect:
- Emotion, or a curious lack of it. Anxiety, anger, and sadness are common reactions when you find out you have cancer. It’s also possible that you’ll feel a numb sense of shock at first.
- A physical exam. Even though you’ve had a physical exam from your primary care doctor, your oncologist will likely perform one as well.
- Some additional tests. You may have additional blood work or imaging tests.
- Meetings with other cancer care team members. You may meet with other healthcare professionals or people who can help you understand the insurance process and costs involved in treatment.
- An early prognosis. It’s not unusual for an oncologist to be able to give you a basic prediction of how long it will take you to recover.
What to ask
It’s not uncommon to have lots of questions right up until the moment you’re face to face with your doctor. Then — poof! — they disappear. The stress produced by a cancer diagnosis could even temporarily “freeze” someone who’s normally very good at getting the answers they need to make good decisions.
For that reason, it might be a good idea to keep a pen and paper (or a notes app on your phone) handy in the days leading up to your appointment, so you can make note of your questions.
Questions for your oncologist
Doctors at the MD Anderson Cancer Center suggest patients consider these questions as a starting point:
- What are we hoping to learn from these tests?
- Why am I having this treatment?
- What are the side effects of this medicine?
- How successful has this treatment been for other patients?
- When should I be able to return to work?
- Could you please explain that again in simpler terms?
- Are there any clinical trials that might help me?
Your oncologist might do a physical examination to find abnormalities that could indicate cancer. They might also do blood and urine tests or imaging scans like MRIs, ultrasounds, and CT scans. They might do one or more biopsies to check for cancer cells in tissues.
Oncology is a subspecialty of internal medicine. After graduating from medical school and becoming a licensed physician, doctors must complete a three-year residency in internal medicine.
After the residency, medical oncologists must complete a further two to three years in a medical oncology fellowship. Surgical oncologists must first complete a general surgical residency, followed by a two-year surgical oncology fellowship.
Becoming a radiation oncologist is a five-year process that includes an internship in internal medicine, followed by a radiation oncology residency.
One good place to start is by asking your primary care physician for a recommendation. You may want to get several names so you can verify which ones are part of your insurance network.
Another option is to find a hospital you trust, and then find out which oncologists are associated with that hospital. The American Cancer Society has a hospital checklist that may help you figure out which hospitals near you will be the best option for cancer care.
The American College of Surgeons certifies cancer centers that meet a stringent list of requirements through the Commission on Cancer (CoC). Using their hospital locator is a good way to find trusted cancer care centers near you.
An oncologist is a doctor who treats cancer. Some of the subspecialties include medical, surgical, radiation, pediatric, and gynecologic oncologists.
Oncologists who specialize in blood cancers are called hematologist-oncologists. These doctors have completed rigorous, highly specialized training in cancer diagnosis and treatment through residencies and fellowships they complete after medical school.
If you have been referred to an oncologist, you should expect some further testing. You will likely be treated by several different cancer care specialists, depending on what kind of cancer you have.