By Dr Ananya Mandal, MD
Oncology deals with the study of cancer. Within oncology there are several sub-specialities that deal with different types of cancer.
Different cancers affecting different parts of the body e.g. breast, prostate, lungs, blood cells (leukemia) or other organs behave in different manner, are of different grades and cellular type, respond differently to treatment and have different set of effective treatment regimen.
This mandates the need for different specialities of oncologists and does away with a “one size fits all” approach. Cancer-care, however, is a multidisciplinary approach and consists of a team of professionals who help in the treatment of the patient.
Sub-specialities of oncologists
- Radiation oncology – this deals with the use of radiation therapy in treating cancer
- Surgical oncology – this branch involves surgeons who are skilled in cancer and tumor removal. Since cancers are highly vascular (rich in blood supply) surgeons who practice oncology need special skills in order to excel in onco-surgery.
- Medical oncology – these oncologists deal with the treatment of cancer using chemotherapeutic agents. In North America the term clinical oncologist and medical oncologist is used interchangeably.
- Interventional oncology – these are interventional radiologists who specialize in minimally invasive image guided tumor therapies.
- Gynecologic oncology – these physicians deal with cancers of the female reproductive organs alone
- Pediatric oncology – these oncologists deal with childhood cancers alone
- Other subspecialties include:
- Neuro-oncology - that deals with cancers of brain and spinal cord
- Hemato-oncology that deals with blood cell cancers
- Uro-oncology that deals with cancers of the urogenital tract like prostate gland etc.
Cancer-care usually involves a multidisciplinary team. This includes:
- a medical oncologist – the team co-ordinator who manages diagnosis, treatment planning, management of cancer, management of cancer-related problems and follow up
- a radiation oncologist – who supervises the radiation therapy
- a surgical oncologist – a surgeon who removes the tumor using surgery
- a pathologist – this medical doctor helps in examining the biopsied or excised tumor tissues or blood samples under the microscope and helps in diagnosis of the cancer. These physicians are important because the plan of therapy depends on the reports of the pathologist.
- a radiologist to help in diagnosis of the cancer using imaging techniques.
- specialized doctors of the concerned organ system involved. For example, liver cancer patients need a Gastrointestinologist on the team and a lung cancer patient needs a Chest physician on the team. A brain cancer patient likewise needs a neurologist on the team.
- a cosmetic surgeon or reconstructive surgeon – for some cases after surgery reconstruction of the damaged organ may be needed. For example, in breast cancer patients, these surgeons help in recreating the removed breast and nipple using tissues from other parts of the body.
- a physician’s assistant helps in diagnosis and treatment under the direct supervision of a physician
- an oncology nurse for day-to-day care while in the hospital - these nurses are specially trained in managing cancer patients
- a social worker - these play an important role in helping the patient navigate the health care system and also helps in coping with the cancer diagnosis and the economic and emotional burden of treatment
- a physical and occupational therapist – for patients who may become disabled or physically weak after therapy these professionals can help. For example, bone cancer patients who need removal of their affected leg (for example) need the help of a physical therapist.
- an anaesthetist or expert in pain management for terminal stage cancer pain management
- a diet advisor or nutritional therapist to advise on the appropriate and healthy diet during and after cancer therapy
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)