What Type of Doctor is an Oncologist?

Types of Oncologists and What They Do

oncologist talking to a patient
What are the types of oncologists?. istockphoto.com

If you've been told you need an oncologist, what does this mean? If you look at a list of physicians you've probably noted that there are many different types of oncologists. What role will an oncologist play in your cancer care, and what aspects of cancer care do each of the types of oncologists cover? How can you choose a good oncologist?

What is an Oncologist?

An oncologist is a medical doctor who specializes in the diagnosis and treatment of cancer.

Some oncologists treat patients with all forms of cancer, and others specialize in only one type of cancer. This can be confusing as you may have more than one type of oncologist participating in your care, for example, a medical oncologist who manages your chemotherapy and a radiation oncologist who manages your radiation therapy.

An oncologist goes through many years of training. This begins with 4 years of undergraduate work at a college or university followed by 4 years of medical school. After graduation from medical school, these physicians complete a 3-year residency in internal medicine followed by 3 years as a medical fellow in oncology. Many oncologists have more training as well, such as graduate work in the sciences needed to manage a research laboratory.

There are Several Primary Types of Oncologists

There are a number of different types of oncologists, which can be very confusing if you decide to look at the phone book or online to find an oncologist.

Types of oncologists include:

  • Medical oncologists - These physicians treat cancer with medications including chemotherapy, targeted therapies, immunotherapy, and coordinate other types of treatment. For many people, their medical oncologist acts as their main doctor during cancer treatment, and coordinates care received by other doctors and specialists. These doctors also manage the symptoms of cancer as well as the side effects of treatment. If a cancer is incurable, they also help people find palliative care or hospice care.
     
  • Radiation oncologists - Radiation oncologists are physicians who treat cancer with radiation therapy. These physicians go through residency training in radiology and then subspecialize by doing a fellowship in radiation oncology. They are responsible for "mapping" out the area on your body that will be treated with radiation and calculating the radiation dose and the number of treatments that are optimal for your cancer. A radiation therapist may treat symptoms related to radiation therapy (such as dry mouth and radiation burns) but it is often your medical oncologists who manages the full spectrum of your symptoms.
     
  • Surgical oncologists - Surgical oncologists are physicians are surgeons who treat cancer with surgical procedures. With lung cancer, it is common for thoracic surgeons to perform lung cancer surgery
  • Gynecologic oncologists - These oncologists treat primarily ovarian, uterine, and cervical cancers. In many cases, they perform the function of both medical oncologists and surgical oncologists in that they both perform surgeries for these cancers and design chemotherapy protocols.
  • Pediatric oncologists - These oncologists specialize in the treatment of cancers in children, usually those between birth and the age of 18.
  • Hematologist-oncologists - The term hematologist-oncologist may be used as an alternative to the term oncologist alone, referring to doctors who have completed a fellowship in hematology and oncology. It is increasingly being used now to specify physicians who specialize in the treatment of blood-related cancers, such as leukemias, lymphomas, and myeloma.

Other Doctors Who Care for Cancer Patients

In addition to oncologists, there are often several other types of doctors (and health care providers) who may be involved in your care. These may include:

  • Pathologists - You may think of pathologists as doctors who perform autopsies and look at slides containing cancer cells under a microscope. While they do often perform these important functions, the role of pathologists in cancer treatment has expanded greatly in the past few years. With the advent of targeted therapy, many pathologists are taking an active role as part of a cancer patient's health team. In addition, to making a diagnosis of cancer and the type of cancer, pathologists also interpret studies done to determine the molecular profile of a cancer.
  • Palliative care specialists - Palliative care physicians are doctors who specialize in improving the quality of life for people with cancer rather than directly treating a cancer. It's important to note that palliative care is not the same as hospice. Your medical oncologist may recommend that you see a palliative care specialist even if your cancer is curable, in order to maximize your comfort during treatment.
  • Rehabilitation specialists - Now that so many people are surviving cancer, the concept of survivorship is finally being addressed. rehabilitation specialists—such as those who are board-certified in physical medicine and rehabilitation—may design a program for you during or after treatment with the goal of returning you to health. The late effects of cancer treatments can range from physical disabilities to pain to posttraumatic stress in cancer survivors, and this type of physician can help you adjust to your "new normal." Rehabilitation physicians may help coordinate treatments such as physical therapy and counseling in order to help you have the best quality of life with your cancer.
  • Other specialties - Physicians from many other specialties are often involved in cancer care. For example, pulmonologists are lung specialists who often assist in helping patients with lung cancer, and gastroenterologists are doctors who specialize in the digestive tract and often help manage the treatment of esophageal cancers, stomach cancers, and colon cancers. 

Choosing an Oncologist

Many people wonder how to choose an oncologist when they are diagnosed with cancer. There are several factors to consider in making these choices. Studies suggest that doctors who care for greater numbers of patients with particular cancers have better outcomes, and your choice of an oncologist may come down to choosing the best cancer treatment center available. If you have an uncommon type of cancer or wish to take part in clinical trials, the larger cancer centers may offer more options. Other considerations include:

  • Your insurance coverage
  • Your location
  • Travel preferences

When you have cancer, it can be important to get a second opinion. In doing so it's often recommended that your second opinion doctor be part of a separate medical system and ideally part of one of the larger cancer centers.  Even if your second opinion (or third or fourth) recommends the same treatments, the opinion can help you feel more confident in the choices you have made for treatment.

Communicating with Your Doctors

As noted by scanning the lists above, you may have several different physicians helping to manage your cancer. It's important to talk with these physicians and understand clearly what symptoms and treatments are being managed by each one. Who do you call if you have a symptom at 2 am? Most often your medical oncologist will play the role of coordinator but it's important to establish this before your need help.

Preparing to See Your Oncologist

Before you see your oncologist and other doctors who will take care of you, it can be helpful to write down a list of questions to ask. Check out these tips for preparing for and improving your oncology visits

Examples: After Jan's doctor suspected she may have cancer, he referred her to an oncologist.

Sources:

American Society of Clinical Oncology. Cancer.net. Types of Oncologists. Updated 09/19/15. http://www.cancer.net/navigating-cancer-care/cancer-basics/cancer-care-team/types-oncologists

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