Oncology is the study of cancer.
An oncologist is a doctor who treats cancer and provides medical care for a
person diagnosed with cancer. Oncologists are physicians who
manage patients with cancer.
Cancer is a term for diseases in which abnormal cells divide without control
and can invade nearby tissues. Cancer cells can spread to other parts of the
body through the blood and lymph systems.
Oncologists diagnose and assess stages of cancer, recommend and implement
appropriate treatment plans and continually monitor progress.
ANZSCO ID & description: 253314:Investigates, diagnoses and treats patients
with
cancer using chemotherapy and biological therapy. Registration or
licensing is required.
Alternative names: Clinical Oncologist, Cancer
Specialist.
Specialisations:
The field of oncology has 3 major areas based on
treatments: medical oncology, radiation oncology, and surgical oncology.
Medical oncologists treat cancer using
medication, including chemotherapy, immunotherapy, and targeted therapy.
Radiation oncologists treat cancer using
radiation therapy, which is the use of high-energy x-rays or other particles
to destroy cancer cells.
Surgical oncologists treat cancer using
surgery, including removing the tumor and nearby tissue during a operation.
This type of surgeon can also perform certain types of biopsies to help
diagnose cancer.
There are also medical terms for
oncologists who specialize in caring for specific groups of patients or
groups of cancers. Here are definitions for some common terms:
Gynaecological oncologiststreat cancers in such reproductive organs as the
cervix, fallopian tubes, ovaries, uterus, vagina, and vulva.
Geriatric oncologistswork with people with cancer who are age 65 and older. Older adults can
have additional challenges. Geriatric oncologists specialize in
providing the best care for older adults.
Haematologist
oncologists: treat blood cancers, such as
leukemia, lymphoma, and myeloma.(on
another page within this site - under Haematologist)
Paediatric oncologists
treat cancer in children and teens. Some types of cancer occur most
often in these younger age groups. When these types of cancer
occasionally occur in adults, those adult patients may choose to work
with a pediatric oncologist.
Neuro-oncologists treat cancers of
the brain, spine, and nervous system.
Thoracic oncologists
treat cancers inside the chest area, including the lungs and esophagus.
Urologic oncologists
treat cancers in the genitourinary system, such as the bladder, kidneys,
penis, prostate gland, and testicles.
An oncologist manages a patient's care throughout the course of the
disease. This starts with the diagnosis. Their role includes:
Recommending tests to determine whether a person has cancer
Explaining a cancer diagnosis, including the type and stage of the
cancer
Talking about all treatment options and your treatment choice
Delivering quality and compassionate care
Helping you manage symptoms and side effects of cancer and its
treatment
Working conditions
Most oncologists start their careers in hospitals and clinics,
eventually moving into private practice.Oncologists usually work long hours and at times are on call.
Oncology work can be emotionally draining as a lot of time is spent dealing
with patients who have a serious disease - frequent time-out is a must.
A person's cancer treatment plan may include more than one type of
treatment, such as surgery, cancer medications, and/or radiation therapy.
That means different types of oncologists and other health care providers
work together to create a patient's overall treatment plan. This is called a
multidisciplinary team.
Cancer care teams often include a variety of other health care
professionals, including pathologists, radiologists, physician assistants,
nurse practitioners, oncology nurses, social workers, pharmacists, and more.
Doctors from other areas of medicine can also be part of this team. For
example, a dermatologist, which is a specialist in skin problems, may help
treat skin cancer.
Tools and technologies
Oncologists are expected to be familiar with a variety of medical
equipment and instruments associated with chemotherapy, radiotherapy and
other cancer treatment.
Education and training/entrance requirements
Oncologists must be registered through the Australian Health Practitioner
Regulation Agencywith the Medical Board of
Australia.
Minimum qualifications
The minimum education requirement for an oncologist is Fellowship of the
Royal Australasian College of Physicians.
Did You Know?
Oncologist and writer Dr Ranjana Srivastava shares what she wish she
had known earlier about her career choice and the challenges it
presented along the way.
Books by Ranjana: A Better Death: Conversations About the Art of
Living and Dying Well and What it Takes to Be a Doctor
Medical oncologists treat cancer
using medication, including chemotherapy, immunotherapy, and targeted
therapy.
Medical oncologists specialize in
treating and managing solid tumours through nonsurgical methods, such as
biological therapy, chemotherapy, immunotherapy, and hormonal therapy. These
professionals are often the primary cancer doctors in treating people.
They help patients manage side
effects and coordinate cancer treatment plans. Medical oncologists may also
follow up with patients after completing treatment.
ANZSCO ID:
253314
Alternative names: Medical Oncology
Physician, Clinical Oncologist,
Knowledge, skills and attributes
A
medical degree in oncology and the successful completion of a residency
and fellowship in oncology.
Certification to practice oncology
A caring
and compassionate nature when dealing with patients
A
thorough and up-to-date working knowledge of cancers and cancer
treatment options
Technical skills to operate medical equipment and tools related to
cancer treatment
Strong
communication, interpersonal, and leadership skills.
Medical Oncologists investigate, diagnose and treat patients with cancer
using chemotherapy and biological therapy.
Examines
patients to determine the nature and extent of problems after referral
from general medical practitioners and other medical specialists, and
undertakes laboratory tests and diagnostic procedures.
Analyses
test results and other medical information to make diagnoses.
Prescribes and administers drugs, as well as remedial and therapeutic
treatment and procedures.
Records
medical information and data.
May
admit or refer patients to hospitals.
May
consult other medical specialists.
Working conditions
Most Medical Oncologists start their
careers in hospitals and clinics, eventually moving into private practice.
Oncologists usually work long hours and at times are on call.
Oncology work can be emotionally draining as a lot of time is spent dealing
with patients who have a serious disease - frequent time-out is a must.
Tools and technologies
Medical Oncologists are expected to
be familiar with a variety of medical equipment and instruments associated
with chemotherapy, radiotherapy and other cancer treatment.
Education and training/entrance requirements
To become a medical oncologist, you must first become a qualified
medical practitioner and then specialise in oncology.
To become a medical practitioner, you need to study a degree in medicine.
Alternatively, you can study a degree in any discipline followed by a
postgraduate degree in medicine.
To specialise in medical oncology, doctors can apply to the Royal
Australasian College of Physicians (RACP) to undertake further training and
ultimately receive fellowship.
To be eligible for this specialist training, on completion of your medical
degree, you must work in the public hospital system for a minimum of two
years (internship and residency).
To work as a medical oncologist in Australia, you will need to obtain
registration from the Medical Board of Australia.
Radiation oncologists are medical specialists who use radiation therapy
(also known as radiotherapy) to treat and manage cancer in patients.
ANZSCO ID & description:253918: Provides medical care and management of
patients with cancer and other medical conditions through the conduct and
supervision of radiation treatment; and advice on the provision of
palliative and other supportive care of patients with cancer. Registration
or licensing is required.
Knowledge, skills and attributes
A radiation oncologist needs:
the ability to cope
with the physical and psychological demands of the job
to be accurate and have an eye for detail
problem solving skills
understanding, patience and empathy
excellent communication skills to liaise with other physicians and
provide clear information to patients
Radiation oncologists work with and assess patients with cancer and plan the
course of best treatment for them. Radiation oncologists may remove the
cancer, or where that is not possible, alleviate pain to improve the quality
of life of a patient. They determine and prescribe the most suitable dose of
radiation using high energy X-rays, electron beams or gamma rays to treat
their patient.
They are ultimately responsible for assessing individual patients,
determining the best management plan, overseeing treatment and assessing
progress. Radiation Oncologists may order tests and imaging, prescribe
medications, and consult with other doctors involved with cancer treatment.
Working conditions
Radiation oncologists work for public and private hospitals. They may
supervise and teach medical students and trainees. Radiation oncologists may
also perform research and conduct clinical trials. They may be required to
be on-call in case of an emergency.
Most radiation oncologists in Australia work in the metropolitan areas.
They must wear personal protective equipment and adhere to strict safety
requirements when performing procedures with radiation.
Tools and technologies
Radiation oncologists work with radiation therapists and medical physicists
to deliver radiation treatment with a radiation machine called a linear
accelerator (linac). Radiation oncologists usually use external beam
radiation therapy (EBRT) techniques, but may also use intraoperative
radiotherapy, total body irradiation, or brachytherapy, where radiation is
delivered inside the patient. They may be required to wear lead aprons or
thyroid shields if they are performing a procedure near radiation.
Education and training/entrance requirements
To work as a radiation oncologist in Australia, you will need to obtain
registration from the Medical Radiation Practice Board.
To become a radiation oncologist, you must first become a qualified medical
doctor and then specialise in radiation oncology.
To become a medical practitioner, you need to study a degree in medicine.
Alternatively, you can study a degree in any discipline followed by a
postgraduate degree in medicine.
To specialise in radiation oncology, doctors must apply to the Royal
Australian and New Zealand College of Radiologists (RANZCR) to complete the
Radiation Oncology Training Program.
To be eligible for this specialist training, on completion of your medical
degree, you must work in the public hospital system for two years
(internship and residency).
Surgical
oncologists treat cancer using surgery, including removing the tumor and
nearby tissue during a operation. This type of surgeon can also perform
certain types of biopsies to help diagnose cancer.
Surgery is one of the most common treatments for cancer. It’s used for a
variety of reasons, including to determine a diagnosis and staging through
biopsy, tumor removal or reduction (also called debulking) and palliative
surgery to help relieve symptoms. Some patients have surgery alone, while
others undergo surgery as part of an overall plan that may include radiation
therapy, chemotherapy and other treatments.
A surgical
oncologist, also, is a surgeon who is involved in cancer care through
clinical practice, research, advocacy and education.
Surgical oncologists are general surgeons with specialty training in
procedures for diagnosing, staging (determining the stage of cancer), or
removing cancerous growths. The most common procedures performed by surgical
oncologists are biopsies and surgery for cancerous growth removal.
They can
also perform surgery to stage cancer and determine how far cancer has
spread. In certain circumstances, surgical oncologists may also perform
preventive surgeries. In some cases, surgery may be the only treatment you
need. In other circumstances, you may have surgery and receive additional
treatments such as chemotherapy or radiation. In these cases, a surgical
oncologist may be an important part of the cancer care team.
Surgical
oncologists may perform surgeries to treat different cancers, especially
solid tumors and those contained to one area. Whether surgery is recommended
depends on several factors, including the type of tumor, its location and
its stage when diagnosed. Providers also consider the patient’s preferences
for treatment, age and ability to tolerate surgery.
Surgical oncologists are surgeons who devote most of their time to the study
and treatment of malignant neoplastic disease. They must possess the
necessary knowledge, skills, and clinical experience to perform both the
standard as well as extraordinary surgical procedures required for patients
with cancer.
Surgical oncologists must be able to diagnose tumors
accurately and to differentiate aggressive neoplastic lesions from benign
reactive processes. In addition, surgical oncologists should have a firm
understanding of radiation oncology, medical oncology, and hematology.
They must also be capable of organizing
interdisciplinary studies of cancer. Surgical oncologists should also be
trained in pathology, because they will be called on to excise appropriate
tumor samples for pathologists and make decisions about adequacy of surgical
margins.
Surgical oncologists have a shared role with medical
oncologists as the “primary care physicians” of cancer treatment. Almost all
cancer patients will initially be managed by one of these two specialists
who will bear the ultimate responsibility for coordinating appropriate
multimodality care for the individual patient.
To diagnose cancers, surgical oncologists may
perform biopsies. Biopsy procedures can include:
Needle biopsies such as fine needle aspiration
or core biopsies
Excisional (removing an entire suspicious area,
such as a mole or tumor)
Incisional (removing a portion of a suspicious
area)
Laparotomy (abdominal surgery)
Endoscopic or laparoscopic (surgery using a
scope)
Skin biopsy
Following a biopsy, a surgical oncologist will send tissue samples to a
pathologist, who checks for cancer cells. If cancer is present, you may see
the surgical oncologist again to have a tumor or other tissue removed. A
surgical oncologist may also choose to perform a staging surgery to find out
a tumor’s size and if cancer has spread.
Surgery can be an effective way to remove cancerous growths associated with
skin, breast, liver, pancreatic, colon, or other types of cancers. When
treating cancer, surgical oncologists may remove all or part of cancerous
tumors, remove surrounding healthy tissue, or remove nearby lymph nodes.
Surgical procedures used will vary based on the purpose of the surgery as
well as the portions of the body and size of the tissue affected.
In summary, Surgical oncologists
may remove:
Primary tumors
Lymph nodes around the tumor
Local or regional tumors that
recur
Distant metastases
Surgical oncologists may perform open surgeries or
minimally invasive procedures such as:
Surgical oncologists often work with medical
oncologists, who may deliver chemotherapy if needed. In recent years,
surgical oncologists have become more multidisciplinary and may offer
treatments and procedures like advanced genomic testing, targeted therapy,
neoadjuvant therapy and adjuvant therapy.
As a surgical oncologist, you’ll split your time
between the operating room and a medical office. You may meet between 20 and
30 patients per day to discuss treatment options and conduct pre-operative
appointments. You’ll also conduct follow-up appointments to discuss the
results of the surgery and further treatment options.
Empathy, endurance and dedication are required for a surgical oncology
career. You may perform a surgery that takes eight hours and you may have a
surgery that takes 90 minutes. Both of these surgeries could occur on the
same day. In between surgeries, you may return patient phone calls or do
paperwork to document case notes and chart directions for patient care.
Outside of clinical and surgical work, a surgical oncologist often engages
in research projects, academic writing for journals and the supervision of
surgical oncology fellows. Ongoing continuing education is necessary to
remain credentialed and stay current with new trends and methods of medical
interventions.
Technologies and innovations like
CRISPR, artificial intelligence, telehealth, the Infinium Assay,
cryo-electron microscopy, and robotic surgery are helping accelerate
progress against cancer.
Education and training/entrance requirements
Surgical oncologists are medical doctors or
osteopathic medical doctors who have trained in surgery with a focus on
cancer diagnosis and treatments.
Becoming a surgical oncologist involves several educational steps:
1. Obtain a medical degree
A medical degree is required if you wish to become an oncologist. Consider
enrolling in a Bachelor of Medical Studies, Bachelor of Medicine/Bachelor of
Surgery (MBBS) or studying a degree in any discipline followed by a
postgraduate degree in medicine.
2. Apply for specialist training
After gaining the necessary experience, you can apply to the Royal
Australasian College of Physicians (RACP) to undertake further training in
surgical oncology.
3. Undergo specialised training
Once accepted into the RACP training program, you can begin your specialised
training in surgical oncology. This training
typically includes a combination of clinical rotations, research projects
and educational activities to develop your expertise in the diagnosis and
treatment of cancer.
4. Obtain RACP fellowship
Once you've successfully completed the training program and meet all the
requirements, you may receive fellowship from the RACP. This fellowship
signifies your achievement as a specialist surgical
oncologist.
5. Secure registration
Practising as an oncologist requires registration with the Medical Board of
Australia. The registration process involves submitting the necessary
documentation, including your medical qualifications and evidence of
specialist training in surgical oncology.
Some surgical oncologists choose to specialize in their field with
additional research into specific cancers such as skin, gastrointestinal
(stomach or intestine related), or gynecological. Surgical oncologist
specialties can also be in specific age groups, such as pediatrics.
Oncology nurses are registered
nurses with in-depth knowledge and experience in caring for cancer patients.
The patients they care for may be babies or older patients experiencing many
different forms of cancer. They work closely with oncologists,
radiographers, pathologists, dieticians and physicians to support the care
of their patients. Given the nature of the role and frequent contact with
their patients, oncology nurses typically build solid relationships.
Many patients require regular
appointments and long-term care. They can find comfort in their
relationships with nurses, who they often see as patient advocates, working
closely with patients to determine the right level of care. For example,
they may liaise with the family and healthcare providers to determine the
necessary steps, including ethical and legal considerations, to transition a
cancer patient from curative to palliative care.
Oncology nurses are responsible for interpreting
pathology results and have an in-depth knowledge of the expected side
effects of cancer treatments. It's important for an oncology nurse to have
several skills to support their patients effectively, including:
Empathy:
Looking after patients with cancer can mean helping people cope with
fearful emotions. Demonstrating empathy when assisting patients and
their families can help build and strengthen relationships. Patient
care, particularly chemotherapy, can also challenge a patient's
endurance. Showing that they understand these challenges with empathy is
important in supporting and caring for patients. As an oncology nurse,
putting yourself in the patient's situation and asking them questions
can be a valuable way to improve your empathy skills.
Communication:
Oncology nurses communicate with patients and their families
about their care and treatment programs. Communication is critical for
patient care, particularly when discussing patients' medication.
Oncology nurses are responsible for ensuring patients and their families
understand the specific drugs to take, including quantities and
frequency.
In addition to communicating processes and treatment plans in simple
language, listening to patients is equally important. Patients often
have many questions after a diagnosis. Being comfortable asking their
oncology nurse these questions can help patients better understand how
to cope with their diagnoses. Compassion and strong interpersonal skills
are valuable skills for developing a career in oncology nursing.
Attention to detail:
Oncology nurses are responsible for regularly monitoring patients
and assessing their condition, making attention to detail essential.
Noticing small changes in patients can help identify whether to stop or
change their treatment. Identifying changes in a patient's condition may
also mean recommending referrals to additional specialists.
Critical thinking:
Oncology nurses treat various forms of cancer that affect
different types of patients. Cancer and its treatment plans can affect
patients differently and oncology nurses are responsible for swiftly
responding to patients' needs. Critically assessing a situation to
determine the right course of action for each scenario is an important
skill to help with patient care.
Time management:
Often, oncology nurses assist multiple patients, each with
different treatment plans, so they learn to manage their time
effectively to administer medications correctly. Being on time for
patient appointments can also help demonstrate patient care and
strengthen relationships. Planning, delegating and setting boundaries
for patient care can all help improve your time management skills.
Emotional intelligence:
An oncology nurse uses interpersonal skills to listen to patients
and show sensitivity to their needs. Emotional intelligence means
responding appropriately to patient behaviours and questions while
assessing their understanding of the disease and their emotional state.
This skill can help identify how best to communicate with a patient. For
example, reading a person's reactions and understanding that they might
not want full disclosure can help you determine the right approach for
communicating with the patient.
An oncology nurse primarily focuses on being the
main point of contact for their patients' ongoing care. Some oncology nurses
may decide to switch to a clinical nurse specialist role. For example, they
may educate and assess patients, conduct radiation therapy or specialise in
gynaecology. In addition, oncology nurses may become involved in research
and clinical trials.
making initial and ongoing patient assessments
as patients proceed through their treatment plans
monitoring any side effects from patients'
medication and treatment and referring them to oncologists for any
severe or unusual issues for further assessment
analysing and interpreting test results
providing support and information to patients
and their families in simple language to help them understand treatment
options
explaining possible side effects and how to
manage them to patients and their families
managing patient caseloads to ensure continuity
of care
collaborating with the broader oncology team
creating specific care plans for patients,
including referring to other healthcare professions where required
building a patient profile with each patient
that considers their health history and information that's important for
care providers to know
monitoring patients' physical and emotional
status
assisting with clinical trials and other forms
of research to help improve treatment processes
administering chemotherapy following guidelines
and protocols
ordering medicines, supplies and chemotherapy
assisting patients with side effects and
monitoring for any allergic reactions
managing, training and mentoring student nurses
attending training to maintain professional
development
documenting all patient care to keep medical
records updated
ensuring continuity of care within nursing teams
and the broader oncology support team
Working conditions
Oncology nurses work in a variety of healthcare
settings where patients seek treatment for cancer, including hospitals,
community centres, private clinics or cancer centres. These specialised
nurses support patients who have various types of cancer.
Oncology nurses most often work in clean and sterile
hospital environments, although some may work in community-based clinics.
Full time oncology nurses typically work a 40 hour week but needs to be
available 24 hours a day, 7 days per week for emergencies. Since many
medical facilities throughout Australia are understaffed due to the global
nursing shortage, overtime has become standard practice with double shifts a
frequent occurrence. Oncology nurses must also adhere to strict
confidentiality policies due to the delicate health condition of cancer
patients.
Tools and technologies
Digital health technology is of special interest to
oncology nurses because monitoring and interventions for symptoms are the
pillar of cancer care. Using digital health technology would allow for
timely assessment and planning by the patient’s health care team. Managing
symptoms effectively allows the patient to continue treatment and have good
quality of life.
If becoming an oncology nurse interests you, here
are four steps to follow:
1. Complete an undergraduate degree: The
first step to becoming an oncology nurse is completing registered nurse
training, for example, a bachelor's degree in nursing. Courses specialising
in nursing can provide knowledge and skills relating to anatomy, psychology
and biology. A bachelor's degree typically takes three to four years of
full-time study to complete.
2. Become a registered nurse: Once you graduate
from a nationally accredited nursing program, you can apply to the
Australian Health Practitioner Regulation Agency (AHPRA) to practice as a
registered nurse. You can also apply if you're a final year nursing student
or are within six weeks of completing your approved study program. Nurses
who have an annual practising certificate (APC) with the Nursing Council of
New Zealand can also apply. You may also be a recent graduate of an approved
degree or a midwife with a current practising certificate.
3. Gain experience: Once you register as a nurse,
you can begin working to gain practical experience. Registered nurses
usually work in hospitals, private clinics, aged care or other community
health settings. While you may start out in other specialities, you can look
for opportunities or transfers to oncology departments once you have some
experience. This can help you obtain professional experience within this
specialisation area to determine if it's the right career move for you.
4. Further study: While employers don't always
require you to complete further study, additional training can enhance your
knowledge and skills to provide specialised care. For example, you may
require additional training if you work in a specialist cancer centre. There
are various available courses, including the Graduate Certificate in Cancer
Nursing or the Graduate Diploma in Nursing Science (Oncology Nursing).
Graduate diplomas typically take one year to complete, either full-time or
part-time. Completing further study can also benefit you if you're
considering working in clinical research, providing insights into future
treatment trends and innovative technology advancements.
Employment Opportunities
There is a severe
nursing shortage throughout Australia across all areas of nursing. This
arises from the aging of the nursing workforce, nurse recidivism, and the
smaller number of nurses entering the profession. This combined with the
aging of the population and the increased incidence of cancer in older
adults means that the field of oncology nursing is expected to grow faster
than the average for all occupations