A cancer diagnosis comes with a lot of medical appointments, from checkups with your oncologist and chemotherapy to radiation, bloodwork, surgery, and more. Amid this full schedule, it’s easy to overlook another important element of your healthcare: primary care.
Enter oncogeneralists, a type of primary care doctor (PCP) who specializes in treating people who are in treatment for cancer or are survivors.
What Is an Oncogeneralist and What Kind of Training Do They Have?
An oncogeneralist is a primary care physician with expertise caring for cancer patients and survivors, according to the American Association for Cancer Research (AACR). There is no specific training that an oncogeneralist receives outside of the training required to be a primary care doctor. Expertise in this area comes from regularly seeing patients who’ve been diagnosed with cancer, says Teresa Wu, MD, a staff physician in the department of vascular medicine at the Cleveland Clinic and a former oncogeneralist at Mount Sinai in New York City.
“Seeing the same kinds of patients over and over, you develop a certain skill set that’s hard to develop unless you have that experience,” Dr. Wu says. “[A provider] who’s had that experience may be more attuned to recognizing and treating certain conditions, whether that’s side effects from treatment or issues we more commonly see in patients who have cancer [that are] related to mental or physical health.”
Benefits of Going to an Oncogeneralist
1. A Holistic Approach
While an oncologist may be able to identify and treat other conditions, their main focus is going to be treating a person’s cancer. An oncogeneralist, on the other hand, can have a more holistic view of the patient’s health. For example, an oncogeneralist can watch out for and treat any potential side effects of cancer treatment, such as chemotherapy-induced neuropathy, osteopenia or osteoporosis resulting from surgical or chemical menopause, and hypertension that could result from the use of steroids during treatment.
Additionally, people may have other health conditions before being diagnosed with cancer, such as diabetes, high cholesterol, or arthritis, Wu points out. These and other conditions still need to be monitored and managed during and after cancer treatment.
Oncogeneralists can also ensure that a patient is getting their other age-appropriate cancer screenings, which may be different from the type of cancer they were diagnosed with, such as mammograms, colonoscopies, and Pap smears.
In addition to physical health, oncogeneralists can also look out for mental health concerns, Wu says. This is an aspect of care that should not be ignored: One study found that 17 percent of cancer survivors experienced moderate to severe depression, while 9 percent reported moderate to severe anxiety.
2. Team-Based, Coordinated Care
A report by the American Association for Cancer Research found that cancer survivors receive the best care if their care is well coordinated.
“As the primary care physician or oncogeneralist, you work closely with patients’ oncologists, whether that’s during or after treatment,” Wu says. “If [I had any] concerns or questions [about a patient], I would pick up the phone and call [their] oncologist, and they would do the same.” This kind of team-based approach and communication between providers improves patient care, she says.
“Certain cancer patients’ cases can be complex, and a team-based approach to care is crucial,” says Wu. “As an oncogeneralist, I collaborated closely with other specialists who also focused on treating cancer patients. We would have multidisciplinary discussions about patients we all shared.”
Team-based, coordinated care allows for medical issues to be examined from different angles, she says. This can help lead to a more accurate diagnosis and optimal treatment for the patient.
3. Continuity of Care
The transition from active cancer treatment to survivorship is difficult — you go from seeing your oncology team very regularly to seeing them only for checkups at intervals that grow larger the further out you get from treatment. An oncogeneralist can help bridge this gap and be an integral component of survivorship care, according to a study published in The Oncologist.
Having an oncogeneralist who gets to know and care for you during cancer treatment can help smooth the transition to survivorship after the completion of active treatment, Wu says. Patients who require ongoing treatment, like those with metastatic breast cancer, can also benefit from continuity of care.
Along with an oncologist, an oncogeneralist will be able to help address any preexisting conditions, as well as new conditions that aren’t cancer-related, says Wu.
How to Find a Primary Care Doctor After a Cancer Diagnosis
Wu says that an oncogeneralist is a relatively new role and not yet that common. This can make it difficult to find a provider with this title. However, many primary care doctors may have this experience but without the title, she points out.
If you don’t already have a primary care doctor when you’re diagnosed with cancer, the first place to start is to ask your oncologist for a referral. Larger academic medical institutions or cancer centers may be more likely to have PCPs on staff with expertise in cancer, Wu says.
If this doesn’t yield any results, the next step would be to do online research. While many primary care providers may just be called “internist” or “generalist,” they often list areas of expertise or interest in their bio. Read through doctor profiles and look for areas of interest like “cancer” and “survivorship.”
If you can’t find an oncogeneralist or a primary care doctor with this specific expertise, that’s okay. It can be beneficial to go to a PCP with experience in cancer, but it’s not essential if you’re unable to find this type of provider or there isn’t one in your area.
The most important thing is being sure to include primary care in your healthcare after a cancer diagnosis — and really, always, Wu stresses. “Primary care physicians are advisors and advocates for your health,” she says. “They are essential for navigating care, and anyone with or without cancer should have one.”