Dr Adam Januszewski and Dr Alison Jones discuss what medical oncology involves, what training you need to undertake, and the qualities required to succeed in the specialty.
Medical oncologists are responsible for overseeing the treatment of patients with cancer. This involves discussing therapeutic options, supervising systemic treatments and supporting patients through their care. Patients are living longer with more complex treatments and therefore the specialty is one of the fastest growing. Most consultants will specialise in one to three tumour types, and acute oncology allows specialist input and advice to acutely unwell patients.
Medical oncologists are involved in the care of patients with cancer from first diagnosis through treatment to survivorship or transition to palliative care. It is therefore an extremely rewarding speciality where continuity of care means that medical oncologists are able to establish excellent relationships with their patients, often over many years.
Improving the survival of patients with cancer is a key role for medical oncologists and therefore patients will be on novel treatments and clinical trials. This makes clinical research an important feature and a significant proportion of trainees therefore undertake higher degrees. This can take many forms – including lab, translational or clinical trial-based research. As a result oncology is a dynamic and challenging speciality, which brings with it much variety.
Training in medical oncology involves rotating through and learning about the management of all the major types of cancer. This includes becoming competent in the supervision of systemic treatments, which incorporates chemotherapy, endocrine therapy and newer biological agents (such as antibodies and immunotherapy). Furthermore, with the multi-disciplinary approach of cancer care trainees learn the complex care pathways and multi-modality nature of treatments.
Dr Adam Januszewski
National Institute for Health Research (NIHR) academic clinical fellow, specialist registrar in medical oncology
An insight into the state of knowledge on cancer a century ago can be glimpsed in digitised items from the RCP library. These include Cancer of the Stomach by Mayo Robson AW (1907) and The natural history of cancer, with special reference to its causation and prevention by Williams W R (1908).
The RCP has a silver Comfort Crookshank Award for Cancer Research Medal that was presented in 1960 to Sir Charles Dodds FRCP (1899–1973). Sir Charles was a research based physician who dedicated himself to understanding the causes of cancer and its prevention. He was on many highly regarded committees such as the Cancer Research Campaign, and in 1962 he became president of the RCP.
In 1970 the Imperial Cancer Research Fund established a research unit in medical oncology at St Bartholomew’s Hospital and Gordon Hamilton-Fairley FRCP (1930–1975) was appointed its director; a year later the fund endowed a chair in medical oncology to be held at the hospital and he became the first professor in this specialty in the UK. His ability, his drive and his personality made the unit an immediate success. He rapidly acquired international status in his chosen field. He was a brilliant lecturer, capable of holding any audience spellbound, and his advice was sought by individuals, official bodies and governments.
The National Chemotherapy Board and Cancer Research UK have launched guidance on the consent for systemic anti-cancer therapy (SACT) and national SACT regimen-specific consent forms. The aim of the guidance and forms is to support clinicians to ensure that patients receiving SACT are fully informed when consenting to treatment.
The National Chemotherapy Board has also produced guidance in response to concerns that patients often delay reporting serious SACT side effects to dedicated help lines.
The National Chemotherapy Board has produced a covering letter and template on 30-day SACT mortality.