A surgical oncologist is a general surgeon who spent an additional two years developing expertise in the management of cancer patients. This specialty training follows 5-7 years of general surgery training. All 5 surgical oncologists at the Roger Williams Medical Center trained at Society of Surgical Oncology Fellowship Programs. In addition to becoming highly proficient in performing complex surgical procedures, surgical oncologists are experts in managing the cancer patient as a whole. When caring for cancer patients, difficult questions often arise with respect to the integration of surgery, chemotherapy, and radiation therapy. In addition to choosing the necessary treatments, the coordination of the different forms of therapy is crucial. An in depth understanding of how different tumors behave is also important for deciding who should and should not receive surgical treatment, along with other forms of therapy. Surgical oncologists are specifically trained to integrate surgical therapy into a comprehensive treatment plan. Every patient and every tumor is unique – surgical oncologists are trained to recognize and manage the distinct situation facing each patient and family.

The Roger Williams Cancer Center offers the following benefits:

• Expertise – All of the surgical oncologists have trained at Society of Surgical Oncology Fellowship training programs after their general surgery training. Treatment by a surgeon dedicated to cancer care is one advantage of receiving care at a cancer center.
• Convenience – We coordinate your appointments and tests for you. In addition, we are often able to have you see multiple specialists during the same visit to save your valuable time and minimize stress.
• Coordinated multidisciplinary care – When you see one of our cancer care experts, you see us all. Your case will be discussed in a conference attended by our surgical oncologists, medical oncologists,radiation oncologists, gastroenterologists, pathologists, and interventional radiologists. Complex cases are best managed by a team of experts.

Your surgical oncologist may decide a biopsy is necessary before offering a recommendation for treatment. Yet, in many cases a biopsy is not necessary before moving on to treatment. The important question is whether or not a biopsy will alter the treatment plan.

Lymph nodes are removed for the following reasons:

• To remove tumor that has already spread to lymph nodes – When tumor is detected in lymph nodes by physical examination or on imaging tests, your surgical oncologist will often recommend removing the nodes along with the main tumor. At times, a needle biopsy of an enlarged lymph node may be done to determine if cancer is present. Lymph nodes can become enlarged for many reasons, including infections.
• To detect microscopic tumor in lymph nodes which helps to determine the prognosis and may prevent tumor recurrence in the lymph node region – Your surgical oncologist may perform a procedure called sentinel lymph node mapping to determine if lymph nodes contain microscopic tumor deposits. This procedure uses radioactive tracers and a blue dye injected at the primary tumor site to locate the first lymph nodes that may be involved with tumor. This is done primarily in selected cases of melanoma and breast cancer. If the sentinel lymph node procedure reveals tumor in the sentinel lymph nodes, a more extensive procedure to remove additional lymph nodes may be recommended. If the sentinel lymph nodes contain no tumor, then a more extensive procedure is not needed and valuable information is gained.
• The lymph nodes are attached to the tissues your surgical oncologist must remove to treat the main tumor.

Modern imaging technology is incredibly powerful, allowing your cancer care team members to detect tumors when they are small in size and in locations impossible to examine with a physical examination. While CT scans, MRIs and PET scans are often helpful, they can result in findings unrelated to your cancer which may lead to additional tests or procedures. The unique circumstances of your case will be carefully considered when your cancer care team determines the need for a CT scan, MRI, or PET scan.