The Online Asbestos, Asbestos Cancer, & Mesothelioma Authority
Types of Mesothelioma Doctors
Even before a diagnosis of mesothelioma is made, you will already be working with the team that eventually becomes the “mesothelioma treatment team.” The first time you discussed the symptoms of mesothelioma with your primary-care physician, he or she¾and more important, you¾became members of a team made up of nurses, social workers, psychiatrists or psychologists, medical physicists, pharmacists, technicians, and dieticians, among others. Several types of physicians typically work with people diagnosed with mesothelioma. (1)
- Primary-care physicians.
- Pathologists.
- Medical oncologists.
- Surgeons.
- Radiation oncologists.
- Palliative-care physicians.
Primary-care physicians
A primary care physician is a generalist, a doctor who can help with a varied range of medical problems. The primary care physician provides routine physicals, examinations, immunizations, and diagnostic care. He or she is generally the “first line of defense” in your battle for health, and can refer you to trained specialists as appropriate. (2)
Primary care physicians also teach disease prevention, and advocate for their patients. They get to know their patients, and are then able to suggest long-term health care plans based on that knowledge. They are usually located nearby, and are the first doctor you call when you have a problem. They may know the entire family, and can counsel all of them if illness strikes one or more members. (3)
Your primary care physician, sometimes called a family doctor or general practitioner, can evaluate your symptoms, and run tests to determine what is causing them. If you or a close family member have a history of working with asbestos, it is very important that the PCP know this from the beginning. If the PCP suspects mesothelioma, he or she will refer you to a specialist.
Pathologists
Pathologists are physicians who examine the tissues of the body, searching for signs of disease and damage. Pathologists are the doctors most likely to be involved with your laboratory testing, and they interpret the results of those tests and exams and provide the information to other specialists treating you. This information can be critically important for your diagnosis and treatment. (4)
The pathologist will receive any biopsies that your doctors send, and prepare the samples for examination. This often involves freezing and cutting a very thin slice (called a frozen section), which is stained to be examined under a microscope. The frozen section can be examined rather quickly, often while a surgeon awaits the results in the operating room. Only the pathologist can make a definite diagnosis of mesothelioma based on the biopsy. While oncologists and surgeons may feel certain, it is by examining the cells that the pathologist makes the final diagnosis. So, while you may never meet a pathologist, they are very important in your care. (5)
The pathologist will write a report describing the tissues or fluids examined, the condition of the cells, and whether the diagnosis of mesothelioma is confirmed by the state of the cells. The pathologist’s report will also describe the grade of cancer found in the cells, which is important in making treatment plans. This report will be sent to your medical oncologist, your surgeon if you have one, and can also be sent to your PCP. You may request a copy for your own records, if you are interested in reading the report yourself. Not everyone, however, wants to read such reports; many people prefer to have a doctor they trust explain them.
Medical oncologists
The National Cancer Institute’s dictionary of Cancer Terms defines a medical oncologist as a physician who specializes in the diagnosis and treatment of cancer, using a combination of chemotherapy, biological therapy, and hormonal therapy. Medical oncologists often serve as the primary physician for a cancer patient, and may also serve in supporting roles for patients with more complex health conditions which include cancer. Medical oncologists often coordinate the efforts of a number of different health care specialists. (6)
The medical oncologist is the doctor with whom you will begin to make treatment decisions. He or she will refer you to surgeons or other health care providers, order scans and other tests, arrange for meetings of the entire team, and generally supervise your care. All of the other members of the team will report their results, findings and treatment plans to your medical oncologist. This is the doctor with whom you will talk most often, and who will coordinate non-medical services, such as social services, nutrition consults and psychological care, as needed.
A medical oncologist must provide detailed information, explain complex treatment choices clearly, offer hope and support, and establish a deep trust with each patient. Not only is your life in his or her hands, but the quality of your life also depends on the decisions made by your medical oncologist. When choosing a medical oncologist, medical reputation is important, but your feelings of trust, ability to communicate well with the doctor, and overall connection with the doctor are nearly as important. (7)
Surgeons
A thoracic surgeon is a physician trained in treating lung cancer, chest wall tumors, emphysema, esophageal cancer, swallowing difficulties, and gastroesophageal reflux. Thoracic surgeons also handle lung transplants. (8)
There are many areas of specialization for surgeons, and a general or other surgeon may perform any surgery that is decided to be a necessary part of your treatment. You and your medical oncologist can discuss who will be the best surgeon in your case.
Depending on the type of mesothelioma, a surgeon may need to operate to remove as much affected tissue as possible. If the disease has affected your chest, as in pleural mesothelioma, a thoracic surgeon may be called in.
Radiation oncologists
With training in medicine and physics, the radiation oncologist directs the use of ionizing radiation to treat cancer and, occasionally, other disease. He or she carefully calculates doses, supervises the radiation technicians, and the medical physicist. Radiation oncologists are well versed in technology, but they prefer working with people to pure research. In the final analysis, their job is treating people with cancer. Sometimes the goal is a cure; other times the goal is relief of symptoms. (9)
Radiation oncologists oversee both external radiation therapy¾the type usually delivered by a large machine¾and internal radiation therapy, during which small amounts of radioactive material are placed in or near the cancer during surgery. One of his or her most important jobs is pre-treatment planning. Because radiation therapy damages cells, pre-treatment planning is important to ensure that many cancer cells are damaged, while few healthy cells are damaged. The radiation oncologist also carefully determines an individual’s lifetime exposure, in case future radiation therapy may be needed. (10)
Palliative-care physicians
Palliative care physicians are doctors who specialize in improving the quality of life for patients who face life-threatening or terminal illnesses, providing pain relief and other forms of mental and emotional support. (11)
A palliative care physician manages the team that provides care in cases of serious illness. While this care may occur near the end of life, its purpose is to make people more comfortable in many ways during any life-threatening illness, including during treatments designed to cure the illness. Palliative care is designed to offer support to help you live as fully as possible, and to alleviate suffering, whether or not their illness is considered terminal. (12)
If you are experiencing uncontrolled pain, severe emotional distress, breathing difficulties or other issues related to mesothelioma, and do not feel that these issues are being fully met by your physicians, asking for a palliative care consult may be a wise decision.
- Mesotheliomahealth.org. “Mesothelioma Doctors - Types to Consider”.
Accessed: 10 July 2007. - Little Company of Mary. “What is a primary care physician?”. FAQ.
Accessed: 10 July 2007. - American Academy of Family Physicians. Policy and Advocacy. “Primary care”.
Accessed: 10 July 2007. - American Society for Clinical Pathology. Pathology Careers. “What is a Pathologist?”.
Accessed: 10 July 2007. - The Doctor’s Doctor. “Who is the Pathologist?”.
- National Cancer Institute, “Dictionary of Cancer Terms.”
Accessed: 12 July 2007. - Peter Kennedy, M.S., M.D. “Choosing an Oncologist” LearningPlaceOnline.com.
Accessed: 12 July 2007. - The Society of Thoracic Surgeons. “What is a Thoracic Surgeon?”
Accessed: 12 July 2007. - National Cancer Institute, “Radiation Therapy for Cancer: Questions and Answers”.
Accessed: 12 July 2007. - Ibid.
- World Health Organization. Cancer. “Palliative care”.
Accessed: 12 July 2007. - Ibid.