Oncologist vs radiation oncologist

Type of Oncologist
I am a two time cancer survivor (breast cancer the first time, lung cancer the second). Both times I was encouraged or just plain shuttled straight to the oncologist a month after surgery. I was lucky. I was in a teaching university hospital center where many kinds of oncologists worked. I thought the expert who I saw for breast cancer could follow me for the lung cancer as well. After all, it was cancer and he was an oncologist (cancer doctor in my book). Actually, he said what he preferred was a pulmonary oncologist to see me for at least once to determine my need for chemo or any other treatment. He said that he knew a lot about cancer from his studies, but as a breast cancer specialist who knew breast cancer better than any other kind of specialist, he had high regard for those who specialized in lung cancer. For the best treatment plan possible and so no stray problems were missed, he recommended I go to the pulmonary oncologist. I had stage 1-A lung cancer of a type that the surgeon didn't think would require any further treatment beyond surgery and regular monitoring unless it re-occured. Nevertheless, I am conservative by nature and decided it was better to do as my breast oncologist suggested and see the pulmonary oncologist. The pulmonary oncologist looked over my records, advised me about the probabilities of reoccurance and told me that I was not sick enough to keep seeing her! My risk was too low to consider chemo (she went over the research as far as I was able to follow), but if it re-occurred I could return to her for treatment. Just doing chemo with all its side effects as a precaution does not necessarily extend life or reduce the probability of re-occurance. The research on chemo indicates that it just isn't that good yet. I wish. Like in breast cancer, the doctors wait until there are symptoms that the cancer is aggressive (that means it is spreading...) before they pull out the big guns. However, the pulmonary oncologist did suggest that I may wish to see a pulmonologist to help my breathing and possibly monitor me over the years after the surgeon dismissed me. My operation was in 2004. I saw the p. oncologist early in 2005. Last fall I got tired of coughing so much and finally went to see the pulmonologist locally/ He helped loads with allergy and breathing treatments that has me almost back to normal for me. (My oxygen level was and is great, but I hated coughing all day on folks! Now I don't cough much at all most days). The surgeon is running tests (either an xray or CAT scan) every 6 months and seeing only 1 time a year if everything is good. I had my six month xray this morning and have my fingers crossed that I won't see the surgeon this summer! The breast cancer oncologist is going to be seeing me as long as I am taking pills for that: at least another two years I think, but it is down to a once a year visit so I can get my prescription. I look forward to a day when we have a preventative like we do with breast cancer to take for lung cancer after surgery when chemo is either finished or not indicated. Right now, the research isn't there yet. The problem is money. Breast cancer hits pretty young actresses that can live long enough to raise lots of dough. Lung cancer just doesn't have the same curb appeal to get the sponsers. But I am getting on my bandwagon. If I were you, I would call the nearest teaching university hospital that specializes in lung cancer treatment and go in for a consultation with the best pulmonary oncologist that you can get.That in plain speak is a lung cancer chemo specialist. They can tell you what your risks are with and with-out chemo. Then they can set up a plan that can be carried out either there or in your local community with the specialists are there. They may even advise you on the benefits of certain supplements (ask about selenium, vitamin C) and exercise on survival and reducing re-occurance.

I would not stick with the radiologist oncologist only because you are not likely to need radiation. That is used mostly for cancer control when cancer is aggressive and needs shrinking either for pain control or so operating can be considered.

I would not go with only a pulmonologist because breathing is their speciality, not chemo and you have questions about whether chemo is beneficial or not. I would ask the pulmonary oncologist about whether a pulmonologist or the surgeon should follow your case now that surgery is completed if he or she doesn't think you need to be followed by a pulmonary oncologist.

Hope that helps!

C. Abbott