Heme/Onc

[XxdtxX]

Anyone know what the typical day is like for a heme/onc ( mostly outpatient or inpatient). Do they have a grueling lifestyle like cardiologists. Any methods they use to treat cancer besides chemo. And lastly do most people find heme/onc depressing since they often have to deal with very sick patients.

-Thanks

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[sanfilippo]

When I did a rotation at another university's hospital, i saw a nurse wearing a big button on her coat, saying: "Oncology nursing is NOT depressing!"

I guess it depends on whether or not you can handle treating some folks with terminal illnesses. Some people can't or won't for whatever reason.


As far as I know, chemotherapy and some hormone therapy is all medical oncologists used to fight cancer (and their pharmacologic armamentarium for side-effects). Radiation is left to the radiation oncologists and surgery is left to the surgeons (gyn onc, urology, surgical onc, gen surgery, colorectal, ENT, etc.). I guess some academic oncologists are now dabbling in bone marrow/stem cell transplantation as well.

I have not done a formal hem/onc rotation, but the clinic side is very busy as I spent 1 onc clinic per week during my month of ambulatory IM. I can't say much about inpatient.

-S.

 

[Dawg_MD]

I actually got to spend a little time with the hemoncologist while doing my Peds rotation and loved it. They do see a good number of cancer patients, but they also see a variety of other blood disorders such as Sickle Cell and ITP which I found very interesting. I would actually consider doing Peds-hemonc if I did not have to do a Peds residency first. I know this sounds bad, but if I did not get a fellowship, I would not be happy seeing only children in a general practice.

 

[dharmabum7]

no the hours are not as grueling...but the specialites are quite different...end of life issues are quite considerable in heme onc...your role is to one end advise with chem etc...but also to guide people through the process of dying...this can be difficult people after a while and thus heme-onc has a higher burn out rate based on the many oncologists i have spoken with...

this being said its also fulfilling...its an exciting area and as there is an interesting foray of research going on....whch i think is very exciting....

mostly what they do is chemo, hormonal and then coordination with radiation oncology....unlike gi, cards, there are very few procedures in heme onc....except for bone marrow aspirates.

so to answer your original question, its not as grueling physically but defiantely it has different emotional component than other areas of medicine...and to quote, it takes a "special kind of person to do heme-onc"...basically you have to a person who can deal with death and dying...its depressing because many people find its hard to develop a relationship with a patient and watch them die...but this being said, its very individual...some docs are better at dealing with that...

the money question is up in the air for this field...there are changes being made to the way is chemo is reinbursed...so it remains to be seen how much money oncologists will make in the future...the ny times ran on article last year on why cancer docs were being paid too much and the medicare/medicaid is begining to change this, i have heard that insurance companies are taking note as well, but who knows?

my advice is after having rotated in both of these areas, cards and heme onc are completely different!!!!! so i would suggest you rotate through both just to get a sense. good luck.