You’ll likely have several different healthcare professionals as part of your team. In this guide, we’ll help you understand the different specialists that may be taking care of you at different points along your cancer journey. We’ll explain what each person does and how you can access their services. So let’s get started!
An oncologist is a doctor who specializes in treating cancer. If you are taking chemotherapy, targeted therapies, or immunotherapy as part of your treatment plan, an oncologist will oversee that portion of the treatment. If you are diagnosed at a later stage, like stage III or IV, your oncologist will likely be the primary doctor overseeing your treatment.
Oncologists are very good at what they do, but it’s important to remember that they specialize in treating patients using drugs, like chemo, which kill cancer cells. They are not specialists in treating cancer with radiation or surgery.
At most major cancer centers, your oncologist will participate in team meetings with other specialists to discuss complex cases. In the US, these teams are called “tumor boards.” In the UK, they are referred to as “multi-disciplinary teams” or “MDT” — and they may have different names in other countries. If you have a stage IV diagnosis, or a more complicated case, your oncologist may present your case at tumor board meetings at several points during your treatment. At these meetings, your case will be assessed by your oncologist, as well as the radiation oncology team and surgical team to see if you are a candidate for localized radiation treatments and/or surgery.
Throughout your treatment, it’s important to remember that different doctors specialize in different areas, and different doctors may have different approaches to treatment. If you disagree with the treatment plan given to you by your oncologist, it can never hurt to get a second opinion. If you want to know whether or not you are a surgical candidate, it is a good idea to get a second opinion directly from a surgeon. If you are interested in localized radiation treatments, it’s a good idea to go directly to a radiation oncologist for a second opinion.
Sometimes, patients have a primary oncologist who manages their regular treatment, while also consulting with another oncologist with particular expertise. Patients may get a second opinion from that oncologist and then meet with them and/or have their primary oncologist connect with them at significant points during care. This can be helpful especially if logistics like travel make receiving care from that second opinion oncologist challenging. If you have a specific mutation or rare aspect to your cancer, it is important to make sure someone on your care team, either primary or secondary, has experience with rare aspects of your specific case.
When a doctor specializes in radiology, they can choose to focus on one of three different areas: therapeutic, interventional, or diagnostic. A therapeutic (radiation) oncologist is a radiologist who treats cancer by using radiation technology. These doctors treat cancer cells using techniques such as EBRT and SBRT.
Like we said earlier, a doctor specializing in radiology can focus on one of three different areas: therapeutic, interventional, or diagnostic. If they choose to focus on diagnostic radiology, we often refer to them as just a radiologist. This doctor reads and interprets your scan results, which your team uses to help guide future treatment decisions.
If surgery is part of your treatment plan, you will see a surgical oncologist — a surgeon that specializes in treating cancer. They also perform certain types of biopsies to help diagnose cancer.
Depending on the type of surgery you are having, you may work wtih multiple surgeons with different specializations. For example, if you are undergoing a colon and liver resection, the entire surgery may be done with a GI surgeon and liver surgeon working together.
If your oncologist tells you that you are not a surgical candidate, it never hurts to get a second opinion directly from a surgeon. Oncologists are very good at treating cancer with chemotherapy, targeted therapies and immunotherapies, but if you want to discuss surgical options, it is usually best to request an opinion directly from a surgeon.
Primary care physician
Your primary care physician (PCP) is your regular family doctor, who you see for check-ups and basic medical problems. It’s important to keep your PCP informed about what’s going on with your cancer treatment and involved with your care. The easiest way to do this is request that your cancer center share your medical records with your PCP. If this is not an option, you can request physical copies of your medical records and drop them off with your PCP.
You should continue to see your PCP for regular check-ups, screenings, and monitoring for any health conditions you had before being diagnosed with cancer.
Chemotherapy, radiation and surgery (particularly bowel surgery) can affect the way your gut works. Many patients experience changes in appetite, taste and digestion. Some patients also experience weight loss or gain due to treatment. A dietician can be very helpful in navigating all these changes. They’re a great resource for tips, tricks, and new recipes to help you cope.
Newly diagnosed cancer patients are often faced with lots of well-meaning diet and lifestyle advice from family and friends. A dietician can help you weed through the immense amount of information out there about cancer and to help you figure out what’s best for your body.
Most cancer centers will have dieticians on staff. If you feel like talking to one would be helpful for you, it should be as simple as asking your oncologist for a referral. Many dieticians offer telehealth options — and some will even come meet with you during your chemo infusions, so you don’t have to worry about coming in for an extra appointment.
An integrative doctor is a physician that looks at the ways diet and lifestyle modifications can help improve wellbeing. Nowadays, many major cancer centers have an integrative doctor on staff. They can offer exercise recommendations, tips for improving sleep, or suggestions for how to maintain a healthy diet and weight while going through treatment.
Some integrative doctors may also recommend specific diets, vitamins or supplements.
Remember that it is important to consult with your oncologist before starting any vitamins or supplements or before making any radical changes to your diet and lifestyle.
Palliative care specialist
Palliative care specialists are doctors and nurses who work to help patients manage symptoms and side effects. Palliative care is not the same as hospice care, and may be involved at any point during your treatment. They are used to dealing with complex cases and symptoms, so they may be able to suggest medications and other remedies your oncologist or PCP may not have thought of. Many people from COLONTOWN Community have said that their palliative care teams have helped improve their quality of life immensely. If you think a palliative care specialist would benefit you, ask your oncologist for a referral.
Watch this video to learn more about palliative care.
Most major cancer centers have a social worker on staff. Their job is to make sure that patients have all the resources they need to stay safe and have the best quality of life possible. They have a good knowledge of the resources available at your cancer center, and can also recommend resources in the local community.
If you are having trouble paying for treatments, a socal worker can help you access your cancer center’s financial assistance program and recommend local organizations that may be able to help. If you are having family problems or do not feel safe at home, your social worker can recommend services to support you. If you are struggling with your emotions, your social worker can refer you to mental health services.
Overall, if you have been diagnosed with CRC and have any non-medical issues that are affecting your quality of life, it’s a good idea to request an appointment with your cancer center’s social worker.
Mental health professional
It doesn’t need to be said that receiving a cancer diagnosis is extremely stressful, and treatments can be difficult — both mentally and physically. While some patients can get support from family and friends, many patients find it helpful to work with a mental health professional, such as a psychologist, psychiatrist, therapist or counselor.
If you are struggling to cope, do not feel shy about reaching out for help. Ask your oncologist, PCP, or social worker at your cancer center what resources are available to you. They should be able to refer you to a mental health professional at your cancer center, or point you in the direction of support groups and organizations in your local community.
If you were diagnosed with a mental health issue prior to being diagnosed with cancer — or diagnosed during your treatment — it’s important to have a mental health professional as an integral part of your care team.
Managing both a mental health and cancer diagnosis?
Join us in one of our COLONTOWN Facebook groups:
- Our Safehaven group is for patients who have a specific mental health diagnosis and have also been diagnosed with CRC.
Want to join? Fill out the registration form here.
If your oncologist recommends germline testing, you will meet with a genetic counselor. Germline testing is a blood test that checks for heritable gene mutations present in all cells of your body — including the tumor.
This is used to determine if you have gene variations that might put you and your immediate family members at greater risk of getting cancer. Once the results are available, you will have an appointment with a genetic counselor to help you interpret the results.
These types of tests are usually recommended for patients with a family history of cancer or patients who are diagnosed under 45 years of age. If you have any questions about whether germline testing is appropriate for your situation, ask your oncologist. If you want to learn more, check out our section on germline testing.
Want to learn more? Want to hear about other people’s experiences with second opinions? Need a recommendation for a top surgeon?
Join us in Colontown, where we discuss the answers to all of these questions and more! Fill out the registration form here.
Last updated: May 30, 2023