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When It's Cancer: The 10 Essential Steps to Follow After Your Diagnosis Excerpt from When It's Cancer: The 10 Essential Steps to Follow After Your Diagnosis

by Toni Bernay, Ph.D., and Saar Porrath, M.D.

The Role of Oncologist

As your medical team takes shape, you may bring onboard not one but several oncologists. Within the realm of oncology are multiple subspecialties, each of which fills a specific role on the cancer treatment continuum. Though they work in the same field of medicine, they won't necessarily share the same view of your particular cancer. That's not a bad thing. Their different philosophies and methodologies will help point you to your full range of treatment options, so you can make informed decisions.

Diagnostic oncologists. The first link in the oncology chain of care is the diagnostic oncologist, who can pinpoint the particulars of a cancer. As an example, let's suppose that a woman has found a lump in her breast. Her primary care physician may refer her to a diagnostic breast oncologist for a complete breast examination, which would include a physical breast exam, a mammogram, and probably an ultrasound. Should these screenings confirm the presence of a lump, the oncologist would be able to gather more information about it via a fine or core needle biopsy or, if necessary, a stereotactic (noninvasive) biopsy. Any of these could rule out a more invasive biopsy procedure. Other suspected cancers may require a radiologic procedure such as an MRI or a CT, PET, or CT/PET scan.

Surgical oncologists. Once the diagnostic oncologist finds a cancer, the surgical oncologist will get rid of it via a surgical procedure. Most of these surgeons specialize in general categories of cancer -- such as a surgical gynecological oncologist, who concentrates on women's cancers. Some surgeons narrow their focus to specific types of cancer, such as breast cancer.

Treating medical oncologists. A patient requiring further treatment after surgery may be referred by the surgical oncologist to a treating medical oncologist for chemotherapy. Actually, you may have one of these oncologists on your medical team even if you don't undergo surgery. The treating medical oncologist sees patients on a regular basis, administering treatment and managing side effects. Ideally, it's a local physician, so the patient can stay close to home and to loved ones.

To find a treating medical oncologist who's skilled in administering a particular therapy protocol, your best bet may be the national expert who developed it. You also might look for someone who, though perhaps not familiar with the protocol, has a special interest in treating your type of cancer.

Radiation oncologists. Radiation oncologists fill essentially the same role as treating medical oncologists, only they specialize in radiation therapy. Modern radiation protocols can contribute to cure, in addition to serving as a palliative measure.

Research medical oncologists. Unlike their colleagues, research medical oncologists see patients primarily in the course of carrying out experimental protocols. Their goal is to find cures for specific types of cancer, as well as measures that can prolong life or enhance quality of life. Most research medical oncologists are affiliated with university hospitals or national cancer centers.

Reprinted from: When It's Cancer: The 10 Essential Steps to Follow After Your Diagnosis by Toni Bernay, PhD, and Saar Porrath, MD 2006 Toni Bernay, PhD Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling (800) 848-4735 or visit their website at