Should you see an oncologist? If you have a cancer diagnosis, the answer is probably yes


Ajeet Gajra, MD, says medical oncologists play a variety of roles in cancer treatment. (PHOTO BY SUSAN KAHN)


In modern American health care, it’s your primary care doctor who oversees your medical care. He or she keeps track of your health, fielding your questions and concerns, referring you to specialists when appropriate.

Your primary care doctor is someone to keep in your life if you face a cancer diagnosis, because you may still have health needs that are not related to cancer.

A medical oncologist is someone to add to your head care team if you receive a cancer diagnosis. They specialize in the diagnosis and treatment of cancer, but their role goes beyond prescribing medication.

“A medical oncologist is not just a chemo doctor. They play many roles,” says Ajeet Gajra, MD, an associate professor of medicine specializing in hematology and oncology at Upstate. “They can be the doctor who creates a treatment plan for the patient, or the scientist who provides prognostic information. A big part of their job is to help patients come up with a cancer care plan.”

Gajra believes anyone with a cancer diagnosis can improve their understanding of their disease by seeing a medical oncologist. He could think of one exception: non-melanoma skin cancers, which are typically removed in simple surgeries by dermatologists or surgeons.

The medical oncologist may provide treatment, insight into what treatment is necessary, or other related referrals. Someone with tongue cancer, for instance, may have the cancer removed and then require speech pathology or help learning to swallow. Someone who faces surgery for cancer may want to see an oncologist to learn of options beyond surgery, or to go over the pathology report afterward.

Having a team approach to cancer is a key to the care at the Upstate Cancer Center. Gajra recalls a patient who found his way to Upstate after having a small lung cancer removed. The patient, whose treatment had been surgical, had not understood that cancer was also found in a lymph node – meaning it had spread from his lung and would require additional treatment. The surgeon, focused on performing a good operation, had not paid full attention to the finer points of the pathology report.

Focusing on those details is a strength of a good medical oncologist and one example of the benefit of the team approach.

“The patient needs to be sure that somebody sits down and reads through the pathology report,” Gajra said. “That will help determine if any additional treatments are needed.”

The risk of developing cancer is much higher among cancer survivors than the general population. Smokers who develop lung cancer and are treated successfully still may develop a second lung cancer. Also, radiation and chemotherapy that are used to treat cancers can prompt other cancers to develop later.

A medical oncologist can help insure proper surveillance so that these issues are recognized as early as possible.

What is a cancer care plan?

Your cancer care plan may include:

  1. A treatment plan, including options and possible side effects.
  2. A treatment summary, for when active treatment concludes. This communicates the care you received, any ongoing issues that need to be addressed and a list of medications you are taking.
  3. Survivorship, telling the follow-up care you will require for the rest of your life.

For examples, visit the American Society of Clinical Oncology or the National Coalition for Cancer Survivorship.

spring16cancerThis article appears in the spring 2016 issue of Cancer Care magazine.

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