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Cancer Treatment Centers of America

What's the Difference: Oncology specialties

CTCA,
Oncologist
The Difference Between

The language of cancer can be a confusing mix of unpronounceable words, sound-alike terms and scientific jargon. But some of the nuances in cancer types, terms and titles may indicate deep differences in the diseases, diagnoses and treatments. This blog is an installment in an occasional series called “What's the difference?” designed to help clear up some of the confusion in cancer vocabulary and help increase our cancer IQ.

Once they are diagnosed with cancer, many patients and their caregivers turn to the internet to decipher the intimidating medical lexicon they must begin to navigate. In addition to trying to learn about the many tongue-twisting chemotherapy drugs and highly scientific treatment protocols, consulting with the specialists who treat cancer—called oncologists—may also play a critical role in the journey. But first, it’s important to understand what they do.

The so-called father of medicine, Greek physician Hippocrates (460-370BC), is credited with coining the word cancer to describe tumors, while another Greek physician, Galen (130-200 AD), is believed to have expounded on the definition to include the term oncos (Greek for swelling), according to the American Cancer Society. The invention of the microscope, followed by widespread availability of anesthesia, resulted in rapid progress in the field of oncology by the mid-19th century. Since the 1990s, a multitude of oncology specialties have evolved along with innovative therapies, resulting in a declining mortality rate, according to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program.

The branch of medicine dedicated to diagnosing, treating and researching cancer is known as oncology, while a physician who works in the field is called an oncologist. Some oncologists focus solely on particular cancer types or treatments. Depending on the type, stage and location of a cancer, multiple oncology specialists may be involved in a patient’s care. The field of oncology has three main specialties—medical, surgical and radiation—and numerous sub-specialties.

A medical oncologist is a licensed physician (typically in internal medicine) trained in diagnosing, staging and treating cancer. This specialist also leads the development of the cancer patient’s treatment plan, which may include surgery, chemotherapy, immunotherapy, targeted therapy or hormone therapy, while also coordinating with other oncology specialists and clinicians who may have a role in the patient’s care. A medical oncologist is also the doctor a cancer patient will continue to see after treatment, for checkups over the long-term.

A surgical oncologist is a surgeon who specializes in performing biopsies and removing cancerous tumors and surrounding tissue, as well as other cancer-related operations.

A radiation oncologist specializes in treating cancer with radiation therapy to shrink or destroy cancer cells or to ease cancer-related symptoms.

Many cancer types are treated by an oncology sub-specialty. Gynecologic oncologists, for example, are trained to treat cancers of the female reproductive system such as those affecting the uterus, cervix, or ovaries, while hematologic oncologists specialize in diagnosing and treating blood cancers (leukemia, lymphoma and multiple myeloma). A neuro-oncologist treats cancers of the brain, spine and peripheral nerves.

When searching for an oncologist, it’s a good idea to ask prospective physicians if they are board certified in an oncology specialty, says Maurie Markman, MD, President of Medicine & Science at Cancer Treatment Centers of America® (CTCA). Board certification means that, in addition to having completed a residency program, the doctor has also completed an oncology fellowship, which provides training in diagnosing and treating cancer, and he or she has successfully passed a rigorous testing and peer evaluation process in an area of expertise.

“It’s aspirational for an oncologist to be board certified, where such certification exists,” says Dr. Markman, who is board certified in three specialties: internal medicine, medical oncology and hematology. He notes that board certification is not offered for every cancer type, but in those cases, patients may ask doctors about their experience and training in their specialty.

“Ask about the hospital’s experience with your type of cancer,” he says, suggesting that patients or caregivers do their homework and seek a reputable cancer center or hospital. “Ask if the nurses are certified by the Oncology Nurses Society. One of the advantages of a cancer program is that cancer is what doctors in that program are focused on and trained in, and the more patients you take care of, the more experience you have, especially with rare cancers.”

Read more about hospitalists, an emerging specialty. >>