What to consider when choosing an oncologist

If you’ve been diagnosed with cancer, building your treatment team is the first priority after diagnosis. Depending on the type and stage of cancer you are diagnosed with, your treatment team may include a medical oncologist, radiation oncologist, and surgical oncologist. Within these specialties, oncologists may further specialize in treating a specific type of cancer, for example prostate cancer, breast cancer, blood cancer, or skin cancer. These specialists undergo additional fellowship training focused on the type of cancer they treat.

Taking the time to carefully vet and choose the oncologists who will treat your cancer can also have a positive impact on the outcome of your treatment. One study highlighted the importance of choosing a hospital that monitors and reports the quality of surgical care provided. This study found that post-cancer-surgery mortality was lower at the hospitals that monitored these quality metrics. Undergoing surgery at hospital that performs a higher volume of a specific type of cancer surgery also has been associated with better outcomes. Another study focused on outcomes for people who had surgery for lung cancer. Those whose surgeons performed a higher volume of lung resection surgeries had shorter hospital stays and lower rates of post-surgery infections.

The value of getting a second opinion after a cancer diagnosis

Getting a second opinion before choosing a treatment team and path can not only provide peace of mind, it has the potential to change your diagnosis, treatment options, and choice of physician. A second opinion for people diagnosed with cancer may include a review of the pathology by a pathologist who specializes in diagnosing your specific cancer. Pathology helps determine the stage of the cancer and can affect your treatment recommendations. It can also lower your risk of being over or under treated.

Having another oncologist review your case may lead to other treatment options or access to clinical trials. In addition, if your first opinion is from a doctor at your community hospital, an in-person or virtual second opinion from a specialist at a medical Center of Excellence may give you access to doctors who have more experience treating your condition, as well as access to cutting-edge treatments and technologies and clinical trials.

Some people hesitate to get a second opinion because they feel they need to start treatment right away to achieve the best outcome. In most cases, however, unless you’re facing an emergency, you do not need to start treatment immediately and can safely take the time needed to get a second opinion.

In fact, studies have found that cancer patients who get second opinions benefit from taking the time to seek them. One study found that 43% women diagnosed with breast cancer who sought a second opinion at a National Cancer Institute-designated cancer center with a tumor board received a change in diagnosis. Another study of people diagnosed with diffuse large B-cell lymphoma found that a second opinion changed the staging for 36% of these patients, which can affect the choice of treatment.

Finding an oncologist

There are several online resources that can help you identify oncology specialists, including:

• The American College of Surgeons
• The National Cancer Institute’s list of NCI-designated centers (cancer centers that meet rigorous standards for cross-disciplinary, state-of-the-art research focused on developing new and better approaches to preventing, diagnosing, and treating cancer)
• The American Society for Therapeutic Radiology and Oncology
• The American Society of Hematology (for blood cancers)
• Specialty-focused societies like the American Brain Tumor Association, the Society of Gynecologic Oncology, and the Society of Urologic Oncology (for prostate cancer and other types of urologic cancer)

For PinnacleCare members, your Health Advisor and our expert team does all the work for you. We can provide a list of carefully vetted physicians and medical Centers of Excellence that specialize in treating the type of cancer you’ve been diagnosed with, connect you with specialists for second opinions, and provide evidence-based information on your diagnosis and treatment options.

Questions to ask when choosing an oncologist

There are several key questions that can help you gather the information you need to choose the members of your oncology team:

• Ask about the physician’s experience and credentials: Find out how long the physician has been in practice, how many patients they treat with the type of cancer you’ve been diagnosed with, whether they are board certified and fellowship trained, at which hospitals the physician has privileges, and whether they work with a multidisciplinary team (for example medical, surgical, and radiation oncologists and specially trained advanced practice providers and nurses). For surgeons, inquire what their complication and 30-day mortality rates are.
• Ask about potential treatment options: For some types and stages of cancer, there is more than one appropriate treatment option. For example, for early-stage prostate cancer, observation and watchful waiting may be an option for you or, if radiation is recommended, proton beam therapy (a targeted form of radiation that lowers the radiation exposure to surrounding tissue and organs) may be an appropriate option. Ask the oncologist what treatment(s) they recommend and why.
• Learn about the risks and benefits of the recommended treatment: All treatments for all conditions carry potential risks and benefits. Discuss the potential risks and side effects of the suggested treatment as well as the potential advantages, such as a higher potential for cure or remission or less impact on your quality of life during treatment. Ask what the potential long-term impacts of the treatment are, for example fertility issues or the risk of developing other types of cancer in the future.
• Discuss your prognosis and the goal of treatment: Prognosis is a projection of the likely course and outcome of your disease. The factors that are considered include the type and stage of cancer, your age, and your overall health. Prognosis can help give you an understanding of how likely your cancer is to respond to certain treatment options and what the likelihood of the recurrence of your cancer is. Doctors determine prognosis by looking at studies of groups of people with the same or a similar diagnosis to yours. Depending on the type of cancer you’ve been diagnosed with and the stage of the disease, the goal of treatment may vary. Ask your physician if the goal is to cure the disease, achieve remission, or relieve symptoms caused by cancer, such as pain.