A cancer diagnosis can be scary. You want to make sure you get the best treatment possible. But how do you know who to go to? No matter what type of cancer you have -- or whether you need surgery, chemotherapy, radiation, or all three – should you see a doctor who specializes in your particular type of cancer? Or will a generalist do?
Like most things medical, the answer isn’t crystal clear. And many people may not have much of a choice. Because there are more than 100 different types of cancer, finding someone who specializes in the type of cancer you have may be a challenge. So before you get too anxious about finding a specialist, ask yourself these three questions:
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What kind of cancer do I have? For most cancers, little data exists proving that going to a specialist in your cancer will lead to a better outcome. Common cancers, such as colon cancer, are going to be treated very well by most medical oncologists, says Otis W. Brawley, MD, chief medical officer for the American Cancer Society. However, if you have a more rare cancer, such as ovarian cancer, it may be beneficial to see a specialist, because a generalist may not have much experience treating your particular type of cancer.
What’s my course of treatment? If you need chemotherapy, a general oncologist can probably do just fine. "Whether I go to the Mayo Clinic, Sloan-Kettering, MD Anderson, or my community oncologist, they’re all going to give me the same drugs in the same dosage on the same schedule, so it’s going to be the same treatment," says Michael Fisch, MD, chair of the department of general oncology at MD Anderson Cancer Center in Houston. "The question then becomes, where do I want it given?" On the other hand, if you’re having a procedure, particularly a surgical procedure, it may be worth it to see a specialist. Although not studied in all cancers, some data have found that the more procedures a surgeon does, the better he or she will be at it. For example, women with ovarian cancer who have their debulking surgery (surgery to remove the bulk of the cancerous mass and decrease its size) by gynecological oncologists do better than those whose surgeries are performed by general surgeons. Men with urologic cancers who are operated on by doctors who do more of those operations have better outcomes.
What are my goals? If you have an early stage, curable cancer it may be advantageous to see a specialist, says Timothy Gilligan, MD, a medical oncologist at the Cleveland Clinic. Testicular cancer, for example, is a very curable cancer that usually affects young people, and there are not that many cases of it around, says Gilligan. Hodgkin’s lymphoma is similar. Even though the treatment is relatively straightforward, mistakes in management can have huge consequences for a young person with a curable cancer, he says. If, on the other hand, you have an incurable cancer and your aim is to minimize the burden on you and your family, you might not want to travel the country searching for a specialist.