When do I communicate with a surgical vs. med oncologist

Working with Surgical vs. Medical Oncologists

This is an excellent question about navigating your care team! Understanding when you'll see different specialists helps you prepare for appointments and know what to expect.

The Two Main Roles

Surgical Oncologist:

• Specializes in removing tumors and affected tissue through surgery
• Performs biopsies to get tissue samples for testing
• May remove lymph nodes to check if cancer has spread
• Handles surgical aspects of treatment planning

Medical Oncologist:

• Specializes in systemic (whole-body) treatments like chemotherapy, targeted therapy, immunotherapy, and hormone therapy
• Manages your overall treatment plan and coordinates care
• Monitors your response to treatment and manages side effects
• Often becomes your primary cancer care coordinator

Timeline: When You'll See Each

Early in diagnosis:

• You may see a surgical oncologist first if a biopsy is needed to confirm the diagnosis and get tissue for testing (hormone receptor status, HER2 status, and other biomarkers)
• The surgical oncologist may also perform sentinel lymph node biopsy or axillary lymph node surgery

After diagnosis is confirmed:

• You'll typically see a medical oncologist to discuss your overall treatment plan
• According to NCCN Guidelines for Patients: Metastatic Breast Cancer, treatment planning is based on test results from biopsies and imaging studies
• Your medical oncologist will determine the systemic therapy approach based on your cancer's specific characteristics

Throughout treatment:

• Medical oncologist becomes your primary oncologist for ongoing management
• You may return to the surgical oncologist if additional surgery is needed (like removing the primary tumor or addressing complications)

Your Care Team

The NCCN Guidelines emphasize the importance of having a coordinated care team. This typically includes:

• Medical oncologist (primary coordinator)
• Surgical oncologist
• Radiation oncologist (if radiation is recommended)
• Nurses, social workers, and other support staff

Questions to Ask at Your First Appointment

1. Will I need surgery as part of my treatment plan? If so, when?
2. Who will be my primary oncologist coordinating my overall care?
3. How will my surgical and medical oncologists communicate about my treatment?
4. What should I expect at each type of appointment?
5. How often will I see each specialist?

Your care team will work together to create a comprehensive treatment plan tailored to your specific diagnosis and needs.

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.