Key Messages:

• A medical oncologist, surgical oncologist, and radiation oncologist are the three main types of doctors who treat people with cancer.
  
  
• Other doctors who treat people with cancer include a diagnostic radiologist and a pathologist.
  
  
• Several types of health care professionals make up the support staff, which may include an oncology nurse, social worker, rehabilitation therapist, and more.

The process of diagnosing and treating cancer is complex and often involves a team of doctors, nurses, and other health care members. A team approach combines the skills of several different disciplines to provide the best possible care.

This team may include several types of oncologists (doctors who specialize in treating people with cancer), a diagnostic radiologist, a pathologist, an oncology nurse, and support staff, such as an oncology social worker, a dietitian, and a chaplain. More information about these professionals is below.

The education of doctors

With many specialists on the team, it is confusing to know each person’s role. All 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 have 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: A doctor who completes a three-year residency in internal medicine, followed by a two-year fellowship in oncology. A medical oncologist may give 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.

Surgical oncologist: A doctor who completes a five-year residency in general surgery and a two-year surgery oncology fellowship. A surgical oncologist may choose to specialize even further and devote training to one type of cancer, such as breast or lung cancer.

Radiation oncologist: A doctor who completes 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: A doctor who specializes in the treatment of children and adolescents with cancer and includes all three primary oncology disciplines above in the care of their patients.

Gynecologic oncologist: A doctor who obtains his or her training in obstetrics/gynecology (doctors that specialize in diagnosing and treating conditions and diseases of a woman’s reproductive system) and then completes two to four years of formal training in all forms of treatment of gynecologic cancers, which include surgery, radiation therapy, chemotherapy, and investigational treatments. The gynecologic oncologist also studies the biology and pathology of gynecologic cancer.

The role of a second opinion

Many people prefer to get another doctor’s advice before moving forward with treatment. This is called getting a second opinion. A second opinion may help confirm and/or modify your doctor’s recommended treatment plan and may reassure you about its accuracy. Seeking a second opinion is common, and most doctors welcome another doctor’s opinion.

More members of the medical team

Diagnostic radiologist: 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.

Pathologist: A medical doctor who specializes in interpreting laboratory tests and evaluates 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 their pathologist.

Oncology nurse practitioner: Oncology nurse practitioners (NPs) are advanced practice nurses educated at either the Master’s or Doctoral level. They 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). 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 and 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: To become an oncology nurse, a person must first be certified as a registered nurse (RN), which means graduating 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. A registered nurse 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). Learn more about the role of an oncology nurse.

Nurses serve 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. Nurses who have advanced degrees may become licensed as NPs and are qualified to diagnose, treat, and prescribe medications under a doctor’s supervision.

Oncology social worker: Like oncology nurses, social workers serve in different roles. A social worker may counsel patients and families in discharge planning (transferring care from the hospital to home) and home care, help with coping skills and lifestyle changes, and facilitate 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. Read more about how an oncology social worker can help.

Dietitian: A dietitian is a food and nutrition professional who 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.

Rehabilitation therapist: A rehabilitation therapist is a physical, occupational, speech, or recreational therapist who helps 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: This professional 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.

More Information

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