After a diagnosis of breast cancer, along with all of the escalating emotions and thoughts a new patient faces, he or she will meet a set of health care professionals that will become important in the treatment plan. The process of diagnosing and treating cancer is complex and involves a team approach combining the skills of several different disciplines. It can be difficult to understand each person’s role. Please see below for information about these professionals.
The education of doctors
A doctor begins their education with four years of premedical education at a college or university, followed by four years of medical school where they earn an MD (medical doctor) or DO (doctor of osteopathy) degree. After medical school a doctor must pass an examination to become licensed to practice medicine and complete a three to seven year residency, such as general surgery or internal medicine. In the US, each state has its own standards for licensing doctors.
A doctor who specializes in treating cancer is called an oncologist. Many oncologists have additional training (called a fellowship) after their residency in a specific subspecialty, such as radiation oncology or medical oncology.
The oncology team
A diagnostic radiologist, who you may have met at your breast imaging center, is a medical doctor who specializes in performing imaging tests to diagnose disease. A diagnostic radiologist is responsible for reviewing requests for mammograms, ultrasound tests, and magnetic resonance imaging (MRI) tests. The diagnostic radiologist performs biopsy procedures and interprets results.
A pathologist is a medical doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. A pathologist is responsible for interpreting the results of biopsies and laboratory tests. The pathologist’s recommendations provide the final diagnosis of cancer. Although a pathologist usually works directly with the other members of the team, a patient with cancer may never meet their pathologist.
A surgeon is a medical doctor who specializes in treatment of disease by surgical operation. A surgeon can also choose to specialize in a certain type of surgery and would acquire additional training in their chosen specialty. A surgeon will discuss surgical options and evaluate the surrounding axillary (underarm) lymph nodes. The types of surgery recommended for removal of tumor from the breast are:
- A lumpectomy is the removal of the tumor and a small, clear (cancer-free) margin of normal tissue around the tumor. Most of the breast remains. For both DCIS and invasive cancer, follow-up radiation therapy to the remaining breast tissue is generally recommended. A lumpectomy may also be called breast-conserving surgery, a partial mastectomy, or a segmental mastectomy.
- A mastectomy is the surgical removal of the entire breast.
A medical oncologist is a doctor who specializes in treating cancer with medication. Medical oncologists complete a three year residency in internal medicine, followed by a two year fellowship in oncology. They may give chemotherapy (drugs that kill cancer cells) and work with the rest of the team in coordinating treatment schedules. The medical oncologist often is the coordinator of the treatment team and keeps track of necessary test and follow-up exams that are needed.
A radiation oncologist is a medical doctor who specializes in giving radiation therapy to treat cancer. Radiation oncologists complete a five year radiation oncology program. The first year focuses on internal medicine, while the rest focus on radiation oncology. Radiation therapy is the use of high energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment used with breast cancer patients is external beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen usually consists of a specific number of treatments given over a specific time.
An oncology nurse is a registered nurse who helps care for a person with cancer. Nurses serve in many roles depending on their experience, advanced education and specialized certification. An oncology nurse’s role ranges from giving chemotherapy to coordinating care between the clinic and home, as well as conducting research. Certification as an oncology nurse (OCN) requires a minimum of one-year experience as an RN, a minimum of 1000 hours of oncology nursing practice, completion of continuing education credits in the field of oncology and a passing of the national exam.
A breast health navigator is a nurse, usually an RN, who is knowledgeable about breast disease, breast cancer treatments and the psychosocial impact of disease on recovery. A navigator works collaboratively with the multidisciplinary care team to develop and implement a care plan for the breast health client. This role is a new one in many health care systems and has evolved due to our complex health care delivery system. Your breast health navigator is your health care advocate during this time and is able to provide assistance along your care continuum.
American Society of Clinical Oncologists. (2010). Breast cancer treatment. Retrieved from:http://www.cancer.net/patient/Cancer ?sectionTitle=Treatment
EduCare Inc. (2010). What is a breast health navigator? Retrieved from: http://www.educareinc.com/pros_role.php
National Cancer Institute. (2010). How to find a doctor or treatment facility if you have cancer. Retrieved from: http://www.cancer.gov/cancertopics/factsheet/Therapy/doctor-facility
Oncology Nursing Certification Corporation. (2010). OCN eligibility criteria. Retrieved from: http://oncc.org/TakeTest/Certifications/OCN/Eligibility