The Compleat Oncologist

We all take pride in our designated profession—oncology, the study of tumors. In its infancy as a specialty, oncology focused on the biology of tumors and the means to alter the relentless progression of these uninhibited cells. Had the specialty restricted its purview to only the use of specific antitumor interventions, we would have designated ourselves as cancer surgeons, radiotherapists, and chemotherapists. But we do not: we are surgical oncologists, radiation oncologists, and medical oncologists. Although it is perhaps literally the study of tumors, in reality oncology is the study of the care of the cancer patient, care viewed in it all its dimensions. From this overarching perspective, supportive care and symptom management are seen as being as much a part of the oncologist's expertise as surgical techniques or radiation and chemotherapy dosing. What has also emerged is a group of clinical scientists who have made their research goals the systematic study of symptoms—their pathogenesis, measurement, and amelioration. In some areas of supportive care, the needs of the cancer patient are unique. The science and pharmacology of managing chemotherapy-induced nausea and vomiting is a prime example of a symptom complex primarily addressed in the cancer world. In others areas, the symptom was traditionally studied and treated by other disciplines, and only recently has oncology focused on the ramifications of management within the context of antitumor therapy. In some instances, this must involve the acquisition of new skills and an expansion of clinical expertise. A good example is depression, which is...

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Rodger J. Winn is the Editor-in-Chief of JNCCN, as well as chair of the NCCN's Guidelines Steering and Principal Investigators Committees. His past positions include Associate Professor of Clinical Medicine at the University of Texas M. D. Anderson Cancer Center. Dr. Winn received his medical degree from Jefferson Medical College of Philadelphia. His postgraduate training includes an internship and residency at Jefferson Medical College, and he also completed a medical oncology fellowship at Memorial Sloan-Kettering Cancer Center in New York. He is board certified in internal medicine and holds subspecialty certification in oncology.
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    PassikSDDuganWMcDonaldMV. Oncologists' recognition of depression in their patients with cancer. J Clin Oncol1998;16:15941600.

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