The term “oncologist” is an umbrella designation for a medical doctor specializing in the prevention, diagnosis, and treatment of cancer. Whether an individual oncologist performs surgery depends entirely on their specific sub-specialty. Cancer management requires a multidisciplinary approach, with specialists collaborating through various methods of intervention. Treatments are generally categorized into local therapies, which affect a specific area, and systemic therapies, which affect the entire body.
The Core Distinction: Surgical vs. Medical Oncology
The distinction between a surgical oncologist and a medical oncologist provides the most direct answer to whether an oncologist performs surgery. A surgical oncologist completes a general surgery residency followed by specialized fellowship training focused on cancer treatment. Their primary role is the physical removal of tumors and surrounding tissue, often including nearby lymph nodes, through operative procedures. These specialists determine if a tumor is operable, perform diagnostic biopsies, and execute curative or palliative resections.
In contrast, a medical oncologist focuses on systemic treatments and does not perform surgery. This specialization involves administering medications that travel throughout the body to target cancer cells, such as chemotherapy, immunotherapy, hormonal therapy, and targeted therapy. The medical oncologist typically acts as the primary coordinator of the patient’s overall cancer care, managing these drug-based therapies and providing long-term follow-up. They treat cancers like leukemia and lymphoma, where surgery is not the primary option.
The Role of Radiation Oncology
A third major sub-specialty is the radiation oncologist. These physicians specialize in using high-energy radiation, such as X-rays or proton beams, to kill cancer cells and shrink tumors. They work by damaging the cancer cells’ DNA, preventing them from multiplying. Radiation oncology is a localized treatment that precisely targets a specific area of the body, unlike systemic medical oncology or physical surgical removal.
The radiation oncologist’s work involves meticulous treatment planning, using advanced imaging like CT and MRI scans to define the exact tumor volume. They calculate the optimal radiation dose and delivery method, such as external beam radiation or internal brachytherapy. Radiation can be used before surgery to shrink a tumor (neoadjuvant), after surgery to eliminate residual cells (adjuvant), or as the sole treatment option.
Specialized Surgical Fields in Cancer Treatment
While the surgical oncologist is the general cancer surgeon, many other surgical specialists focus their practice entirely on cancer within a specific organ system. These specialists reinforce that many oncologists are indeed surgeons. Gynecologic oncologists, for example, treat cancers of the female reproductive tract, including ovarian, uterine, and cervical cancers, requiring extensive surgical expertise specific to complex pelvic procedures.
Neuro-oncological surgeons are specialized neurosurgeons dedicated to removing tumors of the brain and spinal cord. These highly specialized operations require intricate knowledge of the central nervous system, as surgical excision remains the primary treatment for many solid brain tumors. Head and neck surgeons also function as oncologists, specializing in the surgical management of cancers affecting the larynx, thyroid, mouth, and throat. These specialists combine surgical skill with a deep understanding of oncologic principles to treat cancers in their respective anatomical regions.