From the April 1, 2002 issue of the Journal of Clinical Oncology.After a cancer diagnosis, a patient's first priority is to get the best treatment possible. An essential first step in this process is for patients to see a cancer specialist, called an oncologist. Oncologists are medical professionals who undergo extensive medical training to treat people with cancer. Unfortunately, not all cancer patients are referred to cancer specialists by their doctors. A new study from Dr. Craig C. Earle at the Dana-Farber Cancer Institute found that black patients diagnosed with advanced lung cancer were less likely to see a cancer specialist than white patients. Since all patients in the study were Medicare recipients, disparity in health insurance was not the cause of the lack of referrals to oncologists. The income level of cancer patients and where they lived were also directly related to their likelihood of seeing a cancer specialist. The study results are particularly troubling in light of a new report from the Institute of Medicine that found that African Americans receive lower quality health care than whites, even if they have the same insurance coverage and income levels. Although advanced lung cancer is not highly curable, cancer specialists are increasingly using chemotherapy to help relieve symptoms and pain associated with the disease, providing comfort to their patients. Dr. Earle believes that additional studies are needed to see if physicians are not referring certain types of cancer patients to oncologists or if the patients themselves are choosing not to see a cancer specialist. Specific factors leading physicians and patients to make these decisions also need to be studied. The research illustrates the importance of ensuring that cancer patients are educated about their disease. This means gathering information about their specific disease and available treatment options from credible sources. It also means demanding access to a cancer specialist to ensure that they receive the best possible care. If your doctor is unwilling or unable to refer you to a cancer specialist, the American Society of Clinical Oncology provides a listing of accredited oncologists nationwide. The list can be accessed on the Internet at http://www.asco.org/ac/1,1003,_12-002215,00.asp . Also ask for help -- ask a family member, ask a friend, or ask a member of your place of worship. They may know of a cancer specialist who can help.