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Specialization within Oncology – The Future of Cancer Care in India

Oncology is a very vast specialization. It is further divided into Surgical, Radiation and Medical Oncology. Within each field, Oncologists can again specialize in treating particular parts of the body. For example, a Breast Surgeon is one who deals with surgery of benign and malignant diseases of the Breast. Similarly a Breast Oncologist is one who treats the medical aspects of Breast cancer, be it chemotherapy, targeted therapy or hormonal therapy.

The question arises then, why specialize within the branch of Oncology? Most hospitals in our city have only one medical, one surgical and one radiation oncologist available, who then has to treat all types of tumours.Knowledge in our field is growing rapidly and exponentially and there is something new every day, it is impossible to keep up with the latest information on treatment of every type of cancer.

Therefore where a group of three or more medical oncologists are practicing together, site or disease Specialization within Oncology makes utmost sense. The decisions a Breast Oncologist makes vis a vis a community based general oncologist will be more informed, more balanced and precise and will likely improve the survival outcomes for the breast cancer patient.

For example, in patients with stage IV Breast cancer the choice between using chemotherapy and hormonal therapy is very important. In many cases one can use hormonal therapy alone with good results and without the side effects of chemotherapy. There are some patients that can live with stage IV disease on oral therapies for 5 or even 10 years.

Similarly the decision to give chemotherapy or not give in patients who have had surgery for breast cancer is also difficult and requires careful thought, knowledge and experience.

The use of targeted agents like Herceptin in Breast cancer is now common place for Her2 positive patients. Whether to give one targeted drug or 2 drugs, to give it for 6 or 12 months are also decisions which require considerable expertise.

Molecular and Genetic testing has become important for patients with Breast cancer. The medical oncologist has to be aware of these tests and exactly when during the patients treatment to order them. 10% of Breast cancer run in families and have a hereditary basis. Running genetic clinics with the genetic counsellor and managing the preventive and treatment aspects for those patients with hereditary breast cancer is a complex issue and not all oncologists are familiar with it.

Therefore Breast Oncology is a prime example of why specialization within the field of Oncology is the need of the hour for centres and Institutes of Tertiary care in Tier 1 and 2 cities in India.

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    About Author


    Dr. Shona Nag

    Sr Medical Oncologist and Director Oncology Dept
    Contact: +91 88888 22222
    Email – [email protected]

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