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Radiation Onc. and Medical Onc?

Discussion in 'Radiation Oncology' started by SupergreenMnM, Mar 27, 2007.

  1. SupergreenMnM

    SupergreenMnM Peanut, not chocolate
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    I've seen some professors out there who list being board cert. in both radiation oncology and medical oncology. Are there fellowships out there for radiation oncology after residency (if not why? Is internal med residency that necessary for the fellowship?) or did these people do two residencies plus a fellowship?

    Do Radiation oncologists ever treat patients medically? I'm wondering because clinical oncologists (UK) supposedly treat patients both with chemo and radiation, but that doesn't seem to be the case here? Thanks for the answers!
     
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  3. QuantumMechanic

    QuantumMechanic Avatar=One of the Greats
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    You'd think that the base IM knowledge and skill set is critical to the medical oncologist since they essentially assume a primary care role for their patients.
     
  4. SupergreenMnM

    SupergreenMnM Peanut, not chocolate
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    And its THAT different from what rad.onc residents do that they would be lost in a med.onc fellowship? I also thought most oncology was referals? (note: I'm asking here, not asserting)
     
  5. QuantumMechanic

    QuantumMechanic Avatar=One of the Greats
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    right, oncology is all referrals, but during cancer treatment, the medical oncologist essentially fills the role of the primary care physician (here for a special set of pts). The medical oncologist manages the patient's treatment plan and will refer to radiation oncologists and surgical oncologists and any other specialists that are relevant for care, so that the pt can receive the appropriate treatment.
     
  6. stephew

    stephew SDN Super Moderator
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    actually no medical oncologist dont typically act as pcps. they do have a medicine base but typically will NOT take over as the pcp for these patients as they are specialized. they are not the people who should be playing with your cardizem.
     
  7. QuantumMechanic

    QuantumMechanic Avatar=One of the Greats
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    from the IM subspecialties FAQs thread (http://forums.studentdoctor.net/showthread.php?t=199551)

    the point is that to do med onc, you need to be able to manage a wide range of IM issues to appropriately treat cancer patients. I'm no onc expert, but I thought that would be rather obvious?
     
  8. stephew

    stephew SDN Super Moderator
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    a good med onc doesnt try to manage what he doesnt speciallize in. Just like a good cardiologist wont be managing your hemeonc related issues. That's how it works real world, as it should.
    Yes medoncs know more IM than radoncs. radoncs typically are a bit better versed in oncology than medoncs.
     
  9. SimulD

    SimulD Senior Member
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    I think I had a similar impression until I was an intern on an inpatient onc service. Yes, you are their "primary" physician, but you are by no means their "primary care" physician. You may manage them for neutropenic fever, infections, thrombocytopenia, TLS, acute hyper/hypotension, etc. But, you will not be tweaking their metformin and lipitor, nor will you be performing Paps or performing DREs to screen for prostate cancer. If they get the sniffles during treatment, you may write them for some Allegra, or if they have trouble sleeping, you may write for some ambien. There's a subtle difference between "primary" physician and "primary care" physician.

    -Simul
     
  10. Adawaal

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    I'm not even sure about the Med Onc knowing more than Rad Onc concept. Med Oncs have to know how to multiply a patient's weight by a dosage to do their "treatment planning." They tend to know virtually nothing about radiation and even less about surgery/anatomy/staging/pathology. I find that Rad Oncs tend to be much better versed about chemo than Med Oncs are about radiation. We also know much more surgery/anatomy/staging/pathology than the chemo gods do as well. Of the three oncological specialties, I've found that Rad Onc is best-versed with the literature as well.
     
  11. stephew

    stephew SDN Super Moderator
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    no, medoncs know more internal medicine overall. but frankly like the radonc, over time they lose some of their general medcine as their specializing.
     
  12. SupergreenMnM

    SupergreenMnM Peanut, not chocolate
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    So...back to my first question, are there (or do you ever see in the future) medical oncology fellowships that will be open to rad oncologists so they can do both (i.e. like clinical oncologists in UK)?? Does a radiation oncologist ever also give chemo?
     
  13. stephew

    stephew SDN Super Moderator
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    no, but there was a presentation recently about how the field should change to keep its turf and reestablish repspect and doing chemo was one of the issues (along with reestablishing inpatient service). i dont see it happening though, not cytotoxic drugs anyway.
     
  14. Thaiger75

    Thaiger75 Senior Member
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    I know some places in Asia (Japan) that the rad oncs are more like oncologists and do give chemo
     
  15. stephew

    stephew SDN Super Moderator
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    in many places outside of the us this is the case.
     
  16. SupergreenMnM

    SupergreenMnM Peanut, not chocolate
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    Sarcasm aside...and I'm not looking to put any med oncs out of business, I'm just split between medical oncology and radiation oncology and want to have my cake and eat it too ;)
     
  17. stephew

    stephew SDN Super Moderator
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    choose based on what you like doing. they're very different fields. A fundemental difference is that Radonc is more comparable to surgery in that its a technique related approach. Medonc is more medicine-like and based on supporting the patient throughout treatment. Obviously ther eis more to both but this is a core difference.
     
  18. salmonella

    salmonella Gram-Negative Rods
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    Just out of curiosity, are you guys concerned about occupational safety of working with cancer patients? Studies have shown that patients who are on active chemo excrete cytotoxic drugs through their urine and sweat. Nurses who come in contact with them and those who handled chemo had increased chance of getting leukemia and bladder cancer. Since rad onc have to see cancer patients daily in clinics, I wonder if chemo substances could get into us by physical contact or inhalation/aerosol.
     
  19. stephew

    stephew SDN Super Moderator
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    no, dont worry about it.
     

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