Medical oncology
Medical oncology is a specialized field of medicine focused on the diagnosis and treatment of cancer through various drug therapies, including chemotherapy, hormonal therapy, and biological therapy. Medical oncologists are physicians who assess and manage cancer patients, coordinating their treatment with other healthcare providers like surgeons and radiation oncologists to ensure comprehensive care. This specialty is crucial in modern cancer treatment, as it addresses a wide range of cancers, such as breast, lung, prostate, and blood-related cancers.
Training for medical oncologists includes completing a medical degree, followed by a residency in internal medicine and additional fellowship training in oncology. They are well-versed in the complexities of cancer treatment and work closely with a multidisciplinary team to develop individualized care plans, monitor treatment responses, and manage side effects. Medical oncologists also engage in research and clinical trials to advance treatment options and improve patient outcomes.
The field is supported by guidelines from organizations like the American Society of Clinical Oncology, which establishes quality standards for care. This collaborative and patient-centered approach aims not only to enhance survival rates but also to improve the overall quality of life for patients facing cancer.
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Subject Terms
Medical oncology
ALSO KNOWN AS: Chemotherapy, immunotherapy, biological therapy
DEFINITION: Medical oncology is the medical specialty that treats cancerous diseases with chemotherapy, hormonal therapy, biological therapy, and other drugs. It complements other cancer treatment modalities, including surgery, radiation therapy, rehabilitation, and palliative care. Medical oncologists are physicians who specialize in the assessment and management of patients with cancer and are trained to administer chemotherapy and other cancer medications. Medical oncology practices can be found in university medical centers, community hospitals, specialized cancer hospitals, and comprehensive cancer centers.
Subspecialties: Gynecological oncology, medical oncology/hematology, pediatric oncology/hematology, radiation oncology
Cancers treated: Various, especially blood-related cancers such as acute as well as gastric, breast, bladder, testicular, colorectal, lung, prostate, and ovarian cancers
Training and certification: Medical oncologists first obtain a four-year medical degree from an accredited program and board certification from the American Board of Internal Medicine, then complete a one-year internship in a clinical setting, followed by three years of postgraduate residency training in the use of medical and chemotherapeutic treatments of adult cancerous conditions. Oncology fellows who specialize in combined hematology and oncology receive an additional year of training.
Medical oncology fellows are eligible to take a Certification Exam in Medical Oncology, offered by the American Board of Internal Medicine, after completing a minimum of three years of successful training. They become certified as diplomates of the American Board of Internal Medicine after passing this exam. Once certified, medical oncologists may further their training by participating in one or more years of clinical or laboratory research.
Medical oncologists are trained in the basic science and clinical expression of cancer in adults. They are involved in patient care, teaching, and research. They study the etiology of cancer as well as its evaluation, diagnosis, and management in ambulatory and hospitalized patients. Medical oncologists acquire experience in treating a wide variety of neoplastic diseases and in managing the entire spectrum of medical complications of cancer and its treatments. Specific areas of study include chemotherapy, surgery, radiation therapy, and biological therapy. Medical oncologists may specialize in certain types of cancer or certain therapies, such as immunotherapy, but they have the expertise to treat all forms of cancer with a variety of drug therapies.
Oncology clinical practice guidelines, quality care standards, and quality assurance measures in the United States have been established primarily by the American Society of Clinical Oncology (ASCO), a nonprofit organization representing more than 25,000 cancer professionals worldwide. It offers scientific and educational programs and a wide range of initiatives to promote the exchange of cancer information. ASCO publishes clinical practice guidelines and the National Initiative on Cancer Care Quality, which includes quality-of-care indicators. It also supports the Quality Oncology Practice Initiative, an oncologist-led, practice-based quality improvement program to promote excellence in cancer care.
Services and procedures performed: A medical oncologist is often the main healthcare provider for adults diagnosed with cancer. The medical oncologist plans and coordinates the diagnosis and treatment of new or recurrent malignancies. Oncologists coordinate the patient’s diagnostic tests, develop a treatment plan, determine the appropriate systemic or adjunctive drug regimen to treat the patient’s condition, and supervise the dosage, schedule, and administration of cancer drugs to treat localized or metastatic malignancies. Medical oncologists also develop cancer treatment protocols, participate in clinical trials and research, and ensure that quality standards for chemotherapy delivery are followed.
Medical oncologists are part of a team of cancer health care providers whose goals are to provide early detection; accurately diagnose the condition; offer prompt, appropriate treatment to improve quality of life and survival; provide psychological guidance through complex treatment phases; reduce long-term effects of chemotherapy and radiation therapy; and provide long-term follow-up. Medical oncologists are trained in chemotherapy drug indications and toxicities so that they can safely administer these therapies while minimizing side effects and appropriately managing complications.
Related specialties and subspecialties: Medical oncologists work with a multidisciplinary team that includes the primary care physician and other specialists, such as clinical oncologists; oncologist surgeons including urologic surgeons, orthopedic surgeons, and neurosurgeons; diagnostic radiologists; radiation oncologists; infectious disease specialists; pathologists; oncology nurses; physical therapists; and oncology social workers and other allied health care professionals, such as educational specialists, registered dietitians, and pharmacologists.
Communication between the medical oncologist and the patient’s primary care physician is essential to ensure the continuum of care. Medical oncologists consult with radiation oncologists and oncologist surgeons so that chemotherapy can be combined with radiation and surgery to provide the best outcome for the patient.
Oncologist surgeons use surgical techniques such as laparoscopy and thoracoscopy to diagnose and treat cancers. They first obtain a four-year medical degree from an accredited program and board certification from the American Board of Surgery, then complete five years of residency training in an accredited general surgery program and at least two years of fellowship training in oncological surgery.
Diagnostic radiologists obtain and interpret medical images to determine the patient's disease. They obtain a four-year medical degree from an accredited program and board certification from the American Board of Radiology or the American Osteopathic Board of Radiology. Then, they must pass a licensing examination and complete at least four years of residency training in an accredited radiology program.
Radiation oncologists, also known as clinical oncologists, treat cancers using radiation. In the United States, most radiation oncologists complete residency training in radiation oncology in a program approved by the American Council of Graduate Medical Education or the American Board of Radiology.
Infectious disease specialists are physicians who concentrate on diagnosing and treating infectious diseases. Their training consists of a four-year medical degree from an accredited program, board certification from the American Board of Pediatrics, three or more years of residency training, and two to three years of additional training in infectious diseases.
Pathologists are physicians who specialize in the pathology of hematologic malignancies and solid tumors. They assess malignancies using immunochemistry and molecular techniques. Their training consists of a four-year medical degree from an accredited program, board certification from the American Board of Internal Medicine, three or more years of residency training, and one to two years of additional training in pathology.
The Oncology Nurses Society facilitates the professional development of oncology nurses. Oncology nurses educate patients and their families, provide medical care, and administer medications. Oncology clinical nurse specialists are registered nurses with a master’s degree in oncology nursing. They understand treatment protocols and how to manage treatment complications and prepare and administer medications, including chemotherapy. Oncology nurse practitioners are registered nurses with a master’s or doctoral degree.
Bibliography
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“Oncology (Medical) - Overview.” Mayo Clinic, 9 May 2023, www.mayoclinic.org/departments-centers/oncology/sections/overview/ovc-20198225. Accessed 26 June 2024.