© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Watch the Cancer.Net Video: The Oncology Team - Why is Multidisciplinary Care So Important, with Michelle Lau, MD, adapted from this content.
- A medical oncologist, surgical oncologist, radiation oncologist, and pediatric oncologist are doctors who treat people with cancer.
- Other members of the oncology team may include an oncology nurse, physician assistant, oncology social worker, pathologist, dietitian, and additional professionals as needed.
The process of diagnosing and treating cancer is complex and often involves a team of doctors, nurses, and other health care team members. This approach combines the skills of several different disciplines to provide the best possible care.
With many specialists on the team, it is often difficult to understand each person's role. You will find more information about these professionals below.
The education of doctors
All oncologists (doctors who treat people with cancer) begin their education with four years of premedical education at a college or university, followed by four years of medical school where they earn an MD (medical doctor) or DO (doctor of osteopathy) degree. After medical school, a doctor must pass an examination to become licensed to practice medicine and complete a three- to seven-year residency, such as general surgery or internal medicine. In the United States, each state has its own standards for licensing doctors.
Many oncologists receive additional training (called a fellowship) after their residency in a specific subspecialty, such as breast surgery or medical oncology. Independent specialty boards certify doctors in each specialty and subspecialty to ensure a professional level of competence for all who earn certification.
Types of oncologists
Medical oncologist: This is a doctor who specializes in treating cancer with medication. Medical oncologists complete a three-year residency in internal medicine, followed by a two-year fellowship in oncology. They prescribe chemotherapy (the use of drugs to kill cancer cells) and work with primary care physicians and other medical specialists. Often, the medical oncologist is the coordinator of the treatment team and keeps track of the various tests results and follow-up exams performed by other specialists. A person with leukemia, lymphoma, or other blood-related cancer may be cared for by a hematologist (a doctor that specializes in the treatment of blood disorders). A hematologist also completes a three-year residency in internal medicine followed by a fellowship in hematology, oncology, or hematology/oncology.
Surgical oncologist: This is a doctor who specializes in treating cancer using surgery. Surgical oncologists complete a five-year residency in general surgery and a two-year surgical oncology fellowship. They may choose to specialize even further and devote training to one type of cancer, such as breast or lung cancer.
Radiation oncologist: This doctor specializes in giving radiation therapy to treat cancer. Radiation oncologists complete a five-year radiation oncology program. The first year focuses on internal medicine, while the rest focus on radiation oncology. Unlike medical and surgical oncologists, a fellowship is not required to be a certified radiation oncologist.
The American Society of Clinical Oncology (ASCO) also recognizes pediatric oncology and gynecologic oncology as distinct disciplines within the field of oncology.
Pediatric oncologist: This is a doctor in one of the three primary oncology disciplines above who specializes in the treatment of children and adolescents with cancer. Pediatric oncologists are trained as pediatricians (doctors who specialize in the treatment of children and adolescents) and then receive additional training in oncology.
Gynecologic oncologist: This doctor specializes in diagnosing and treating cancer in a woman's reproductive system. Gynecologic oncologists obtain training in obstetrics/gynecology and then complete two to four years of formal training in all forms of treatment of gynecologic cancers, which include surgery, radiation therapy, chemotherapy, and investigational treatments. They also study the biology and pathology of gynecologic cancer.
Additional members of the medical team
Oncology nurse: This is a health care professional who helps care for a person with cancer. An oncology nurse serves in many roles depending on their experience, advanced education, and specialized certification. A nurse's role ranges from giving chemotherapy to coordinating care between the clinic and home, as well as conducting research.
To be certified as a registered nurse (RN), a person must graduate from a state-approved school of nursing. The program may be a four-year university program, a two-year associate degree program, or a three-year diploma program. An RN must also pass a licensing examination to begin practicing nursing.
Nurses need additional experience to specialize in the area of oncology, and many choose to obtain certification in oncology. Certification as an oncology nurse (OCN) requires a minimum of one-year experience as an RN, a minimum of 1,000 hours of oncology nursing practice, and completion of at least 10 contact hours of continuing education in the specialty of oncology nursing. Another certification is the Certified Pediatric Oncology Nurse (CPON).
Oncology nurse practitioner: This professional is an advanced practice nurse educated at either the Master's or Doctoral level. Oncology NPs see patients independently and work in collaboration with and under the supervision of an oncologist to enhance the care of people with cancer. Responsibilities of an oncology NP may include performing health assessments and physical examinations, ordering and interpreting diagnostic and laboratory tests, prescribing medications, and ordering chemotherapy. In addition, they are experts in helping patients manage side effects of cancer treatments. Some advanced oncology NPs perform procedures such as a bone marrow aspiration, biopsy, and intrathecal chemotherapy (chemotherapy that is injected into the fluid-filled space between the layers of tissue that cover the brain and spinal cord). Oncology nurse practitioners (NPs) begin training as family or adult NPs; if they choose to focus in oncology, they take a national exam to become certified as an Advanced Oncology Certified Nurse Practitioner (AOCNP).
Physician assistant: This is a health care professional educated at a Master's or Doctoral level who has been certified by the National Commission on Certification of Physician Assistants. Physician assistants (PAs) work with and under the supervision of a doctor, delivering a broad range of services. Responsibilities may include performing regular cancer screening tests, conducting physical examinations, ordering and interpreting tests, diagnosing and treating cancer, assisting in surgery, helping mange side effects, prescribing medications, and ordering chemotherapy. In addition, PAs educate and counsel people about their disease. Meanwhile, some PAs perform procedures, including lumbar puncture (the process of taking a sample of cerebral spinal fluid to look for cancer cells, blood, or tumor markers), paracentesis (the removal and analysis of fluid from the abdomen with a needle), and biopsy.
Oncology social worker: This professional provides a variety of services, which may include counseling patients and families in discharge planning (transferring care from the hospital to home) and home care, helping with coping skills and lifestyle changes, and facilitating support groups. Social workers are also trained to help people living with cancer cope with financial concerns and provide links to community resources.
Social workers often possess a Masters in Social Work (MSW) degree. The MSW program is typically two years in length and includes course work in human growth and development, social policies and programs, methods of practice, and social research. Most programs require at least 900 hours of supervised fieldwork. Oncology social workers receive specialized training in cancer care through continuing education and on-the-job experience.
Pathologist: A pathologist is a medical doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. A pathologist is responsible for interpreting the results of biopsies (removal of tissue for examination under a microscope) and laboratory tests. A pathologist's recommendations provide the final diagnosis of cancer. Although a pathologist usually works directly with the treating oncologist, a person with cancer may never meet his or her pathologist.
Dietitian: This food and nutrition professional answers questions about nutrition and helps people with cancer plan menus to cope with special needs. For example, a dietitian may teach a person with head and neck cancer how to prepare liquid food after surgery. In hospitals and other health care facilities, the dietitian provides medical nutrition therapy. A registered dietitian (RD) has completed an accredited practice program (usually six to 12 months) and passed a national examination.
Diagnostic radiologist: This professional is a medical doctor who specializes in performing imaging tests to diagnose disease. A diagnostic radiologist is responsible for reviewing requests for x-rays, ultrasound tests, magnetic resonance imaging (MRI) tests, and magnetic resonance angiography (MRA) tests, performing procedures, and interpreting results.
Rehabilitation therapist: This includes physical, occupational, speech, or recreational therapists who help patients return to their highest level of independence. For example, rehabilitation therapists may help people with brain tumors regain speech and independence or help women with breast cancer learn exercises to regain strength after a mastectomy.
Chaplain: A chaplain is a trained member of the clergy who offers spiritual support and rituals for patients and their families, facilitates support groups, and offers support in health crisis situations. Most hospitals have clergy on staff who work with people of all faiths. Some people may prefer to work with their own clergy person.
Patient navigator: This is a person who helps guide patients, survivors, families, and caregivers through the health care system. Navigators offer numerous services including arranging financial support, transportation and child care during treatment; coordinating care among several doctors; and providing emotional support.
Last Updated: April 20, 2012