Introduction
A cancer diagnosis can give rise to various questions and concerns in patients and their relatives. One of the questions people may have is, ‘Who will guide me through my cancer treatment?’ A medical oncologist is one of the physicians who can be involved in cancer treatment and care for a cancer patient.
A medical oncologist is a physician specializing in the treatment of cancer with drugs and systemic therapy aiming at controlling and curing the disease.
Depending on the type and stage of cancer treatment may include chemotherapy, immunotherapy, targeted therapy, hormonal therapy, or a combination of various approaches.
Treatment of cancer may vary from case to case, even patients diagnosed with the same cancer may require various recommendations for treatment according to certain criteria (stage of cancer, test results, health condition of the patient, previous treatment and other factors).
Understanding the role of an oncologist can help patients be more prepared while making decisions on their cancer treatment. In this article we will talk about what a medical oncologist does, what happens during an oncology consultation and why personalized treatment of cancer is crucial.
What Is a Medical Oncologist?
A medical oncologist is a physician specialized in the diagnosis, treatment and management of cancer with medications and systemic therapy.
Medical oncology involves the knowledge about the ways how cancer develops, its behavior and the possibilities of using various therapy approaches for controlling and treating it. A medical oncologist may be involved starting from the diagnosis of cancer till treatment and follow-up.
Depending on the type of cancer a patient may be suffering from an oncologist may:
- Review biopsy and pathology reports
- Evaluate the type and stage of cancer
- Assess the results of imaging and laboratory investigations
- Discuss treatment options
- Manage a systemic treatment plan
- Monitor the response of the cancer to treatment
- Manage treatment-related side effects
- Order additional tests if needed
- Coordinate cancer care with other cancer specialists
- Provide follow-up care and support
What Types of Cancer Does a Medical Oncologist Treat?
Medical oncologists can be involved in the treatment and management of various types of cancer.
These may include:
- Breast cancer
- Lung cancer
- Prostate cancer
- Cervical cancer
- Blood cancers
- Brain tumors
- Bone cancers
- cancers
- And others
Each type of cancer may vary in terms of its behavior and may require different approaches for its diagnosis and treatment.
For example, treatment of breast cancer may vary significantly from treatment of lung cancer or blood cancer. For the same type of cancer treatment can vary according to the stage and biological features of the disease.
This is why the personal medical evaluation is necessary prior to deciding on the approach for treatment.
What Treatments Does a Medical Oncologist Provide?
One of the duties of a medical oncologist is the recommendation and management of the appropriate medications and systemic treatment for cancer.
Depending on the type of cancer and individual patient’s situation treatment may include chemotherapy, immunotherapy, targeted therapy, hormonal therapy or combinations of these approaches.
Chemotherapy
Chemotherapy involves medications which can either destroy cancer cells or prevent their growth and division. It may be applied at different stages of cancer treatment and sometimes it may be combined with surgery, radiotherapy, immunotherapy or targeted therapy.
The type of chemotherapy, dosages, schedule and duration of the treatment depend on different factors, including the type of cancer and treatment goals.
People often have concerns regarding the side effects caused by chemotherapy, which are individual and depend on the specific drugs used. The oncology team will monitor patients during the treatment and may recommend measures for management of side effects.
Immunotherapy
Immunotherapy is a type of cancer treatment which helps the patient’s immune system identify or fight cancer cells.
It is applied for certain types of cancer and is not suitable for all patients. The decision on the use of immunotherapy can depend on such factors as the type of cancer, its stage, biomarkers, previous treatments and patient’s health.
Because immunotherapy may sometimes lead to immune-related side effects the patients receiving such medicines require close monitoring.
Targeted Therapy
Targeted therapy involves the use of drugs which are specially designed to act on the certain characteristics or targets of the cancer.
For some types of cancer the laboratory or molecular tests may be performed in order to find out whether a particular target is present. If it is identified, targeted treatment may be considered as a treatment option.
The use of targeted treatment is one example of how modern oncology becomes more personalized.
Hormonal Therapy
Some cancers are affected by hormones. The hormonal or endocrine therapy can be used for certain hormone-dependent cancers in order to reduce the effect of particular hormones on cancer cells.
The type of treatment will depend on the type of cancer and individual patient’s medical evaluation.
Combination Treatment
Treatment of cancer may involve more than one type of treatment.
For example a patient may receive surgical treatment followed by chemotherapy or another systemic treatment. In certain cases radiation therapy may be combined with systemic treatment.
The timing and purpose of the treatments will depend on the type and stage of cancer and general treatment plan of the patient.
When Should You Consult a Medical Oncologist?
A medical oncologist may be involved after a cancer diagnosis although it depends on the patient’s individual situation.
The doctor may consult you when:
- Your biopsy confirms the presence of cancer
- Tests indicate a cancer diagnosis
- Chemotherapy is considered for treatment
- Immunotherapy is appropriate
- Targeted therapy may be applied
- Cancer recurs after treatment
- Cancer has spread to other parts of the body
- You need help with treatment options
- You need an oncology consultation
In many cases treatment of cancer involves the participation of several specialists. A medical oncologist may coordinate the work of surgeons, radiation oncologists, pathologists, radiologists and other specialists.
What Happens During the First Oncology Consultation?
The first oncology consultation can be overwhelming, especially if a person has just been diagnosed with cancer. Bringing your records and preparing your questions before the consultation may help to get more from it.
During the consultation the medical oncologist may evaluate:
- Biopsy or pathology reports
- Blood test results
- Reports from CT, MRI, PET, ultrasound or other imaging methods
- medical history
- Previous cancer treatments
- Medicines used currently
- Other relevant health conditions
- medical records
Then the doctor will explain you the diagnosis, the stage of cancer, possible treatment approaches and the need of additional tests.
Sometimes a treatment plan can be developed during the consultation. In other cases additional tests and review of the pathology and imaging reports may be needed before treatment decisions will be made.
Why Is Personalized Cancer Treatment Important?
Cancer is not a single disease, there are various types and sub-types of cancer which may differ in their behavior even if they are developing in the same organ.
Personalized treatment of cancer involves consideration of such factors as:
- Type of cancer
- Stage of cancer
- Features of the tumor
- Biomarker or molecular test results
- Previous treatments
- General health condition
- General physical condition
- Pros and cons of treatment
- Individual treatment goals
For some cancers biomarker or molecular testing can help doctors identify whether the patient may benefit from a targeted treatment or another type of therapy.
This approach allows considering the features of the cancer in the development of the treatment plan.
What Is the Difference Between a Medical Oncologist, Surgical Oncologist and Radiation Oncologist?
Cancer treatment often involves several specialists each having their own specialization.
Medical oncologist is specialized in treatment of the cancer with medicines (chemotherapy, immunotherapy, targeted therapy and hormonal therapy if appropriate).
Surgical oncologist is specialized in the treatment of certain cancers.
Radiation oncologist is specialized in treatment of cancer with radiation therapy.
These specialists can work together as a cancer treatment team. In accordance with the patient’s diagnosis, the specialists mentioned above may contribute to the treatment plan.
This approach will help to address different aspects of cancer treatment.
How Does a Medical Oncologist Monitor Cancer Treatment?
Cancer treatment needs monitoring. A medical oncologist does not simply prescribe treatment without follow-up.
Depending on the situation the monitoring may involve:
- Physical examination
- Blood tests
- Imaging studies
- Evaluating symptoms
- Evaluating treatment-related side effects
- Tumor or biomarker evaluation when needed
- Assessment of the response of cancer to the treatment
If the treatment is effective and the patient tolerates it well, the planned treatment will continue.
In case of serious side effects or inadequate response to the treatment, the treatment plan may have to be changed.
Thus, regular follow-up is a necessary part of cancer treatment.
What Should You Bring to Your Oncology Consultation?
Preparing to the oncology consultation may help the doctor to understand the patient’s medical history.
It may be useful to bring:
- Biopsy or pathology reports
- Imaging reports and scans
- The recent results of blood tests
- Discharge summaries from hospitals
- Information on cancer treatment
- List of medications used
- Medical records
- Questions or concerns
If you have reports, organizing them chronologically will facilitate the review of your medical history.
You can also ask a family member or trusted person to come along. Having someone by your side may be helpful when a lot of information has to be considered.
Questions to Ask Your Medical Oncologist
Patients may sometimes feel reluctant to ask any questions during the oncology consultation. However, understanding the treatment plan is very important.
Some of the useful questions which can be asked are:
- What type of cancer do I have? What is the stage of my cancer?
- What treatments are available for me?
- What is the main aim of the treatment that is proposed to me?
- Do I need any tests before starting treatment?
- Is it important to do any tests related to the genes or molecules of my cancer?
- How long will the treatment last?
- What are the possible side effects of the treatment?
- Which symptoms should I inform the doctor about immediately?
- How will we know whether the treatment is working?
- Are there any steps I can take in my life to help with treatment?
You don’t need to ask all these questions in one time. Writing down those questions that are important to you beforehand can help to remember them during the consultation.
How Can You Choose a Medical Oncologist?
Selecting an oncologist is a choice. People and their relatives should take into account not only the ads or ranking online.
Such factors as:
- Training and experience in oncology
- Easy-to-understand communication
- Will to explain the treatment options
- Following up after treatment
- Working with other cancer doctors
- Availability of the facilities for testing and treatment
- Comfortable communication with the questions and concerns
can be taken into account while selecting an oncologist.
People should also check the qualifications of the physician and communicate directly with the healthcare professional regarding their medical condition.
Why Is Communication Important During Cancer Treatment?
Cancer treatment can be challenging both for the body and the mind of the patient. Patients may have questions or concerns during different stages of the treatment.
Good communication between the patient and the medical team is very important.
Inform the healthcare team about worsening of the symptoms, concerns regarding medications, issues with the treatment plan or any other factors which can affect the treatment process.
Do not change the treatment on your own. If you have any concerns about the medications or treatment, talk to the oncology team.
Family members can also play a huge role in helping during the cancer treatment.
What Role Does Follow-Up Care Play?
The care of the cancer patient does not finish because the treatment is finished.
Depending on the type of cancer and the treatments used, the follow-up may include visits, examinations, blood tests, scans and other procedures.
Follow-up will help the medical team to monitor the patient’s health, assess the condition of the patient, detect problems and decide whether additional tests or treatment is necessary.
The frequency and the period of the follow-up vary from patient to patient.
Cancer Treatment Is a Journey
Treatment of cancer is usually a process and not a single visit or procedure.
Patient’s journey can include a diagnosis of cancer, staging of the cancer, development of the treatment plan, receiving treatment, monitoring of the results, treatment of side effects, assessment of the treatment effectiveness and then the follow-up.
During this journey the patient can get help from the oncology team providing relevant recommendations according to the patient’s condition.
Patients and their families can be also proactive in this process by organizing their records, visiting regularly, communicating freely and asking questions in case of doubts.
Conclusion
A medical oncologist is a physician who can be involved in the treatment and management of various types of cancer. From the review of test results and development of the treatment plan to handling chemotherapy, immunotherapy, targeted therapy, hormone therapy and side effects of the treatment a medical oncologist can be involved in the treatment of a cancer patient.
Cancer treatment is individual, the best treatment will depend on such factors as the type of cancer, its stage, test results, overall health of the patient, previous treatments and wishes of the patient.
If you or a family member is suffering from cancer, the consultation of an oncology specialist can help you understand the diagnosis and the options for treatment.
Dr. Jyoti Gupta Anand concentrates on the oncology care considering the needs and health condition of each patient. The patient can discuss his/her diagnosis, treatment options and any concerns with the oncology team and understand the treatment plan better.
The goal of the cancer treatment is not only to provide the treatment but to develop the plan that is right for the patient’s health condition.
Medical Disclaimer
This article is for informational purposes only. It is not a substitute for advice, diagnosis or treatment. Decisions on the treatment of cancer should always be made in consultation with a doctor, considering the patient’s medical history, test results and overall health.