What is the difference between a surgical oncologist and a general surgeon?
Surgical oncologists at Massachusetts General Hospital are board-certified in general surgery and have undergone additional specialty training in cancer surgery. Each surgeon in the Division of Gastrointestinal and Oncologic Surgery focuses his or her clinical practice on the management of only one or two types of cancer, ensuring patients receive a high degree of specialization and expertise.
Do I need to see a surgical oncologist (specialist in cancer surgery) rather than a generalist?
It is not possible to accurately predict which patients will benefit by having their care provided by a specialist rather than a generalist. Accordingly, the Division of Gastrointestinal and Oncologic Surgery makes its services available to all cancer patients. At times, a case that appears to be straightforward may actually be more complicated or possibly become so. Surgical oncologists are specialized, having focused their practices on one or two specific cancers. Because of specialization, surgical oncologists may have access to newer approaches and/or clinical trials of which non-specialists may not be aware.
If I have already seen a surgeon, do I need a second opinion?
It is very common for patients to seek a second opinion for their diagnoses. Physicians are aware that this happens frequently and are not offended when told by their patients that they would like to see another doctor. Copies of records and films are easily duplicated by the hospital or doctor’s office for the second opinion. After consultation with a surgeon at Mass General, you may choose to return to your first surgeon for your operation or you may decide to transfer your care to Mass General. The decision is entirely up to you.
Benefits of obtaining a second opinion may include:
- After providing an opinion, your surgeon will be pleased to help you obtain another opinion, if requested
- Hearing an alternate opinion
- Increasing your confidence in the recommended treatment plan
- Learning about opportunities for clinical trials
What is a multidisciplinary clinic?
Multidisciplinary clinic sessions at the Massachusetts General Hospital Cancer Center comprise clinicians from different disciplines, including surgical oncology, medical oncology, radiation oncology, radiology, pathology, nursing and social services. This team evaluates patients, their records and any pathology slides or X-rays to formulate a diagnosis and treatment plan. Multidisciplinary team evaluation provides patients with the benefit of receiving input from multiple physicians during a single clinic appointment. This results in a comprehensive evaluation and a plan tailored specifically to the patient. Additionally, weekly conferences are held among clinicians to discuss complex cases. Patients benefit from these discussions as clinicians share their expertise and help identify potential treatment plans.
The oncologic surgery portion of the division is physically located within the Mass General Cancer Center. This location facilitates on-the-spot, multidisciplinary treatment planning with other Cancer Center oncologists, even when patients are not scheduled for a multidisciplinary clinic visit.
Is the Mass General Cancer Center a Comprehensive Cancer Center designated by the National Cancer Institute?
Yes. The Mass General Cancer Center is one of the seven Harvard University institutions that jointly comprise the Dana-Farber/Harvard Cancer Center, which was designated a Comprehensive Cancer Center by the National Cancer Institute in 1999. A Comprehensive Cancer Center combines the disciplines of laboratory science, clinical science and basic research to facilitate the development of new and improved techniques to prevent and treat cancer.
How do I schedule an appointment with a surgeon at Mass General?
To schedule an appointment with a surgeon on our team, you may:
- Request an appointment online
- Contact us
- Ask your physician to call one of our doctors
How long does it take to get an appointment?
Appointments with our team are most often made the same week as requested. In the instance that a physician is booking appointments more than a week in advance, our office will try to accommodate you by scheduling an appointment with another equally qualified physician who can see you sooner or on a non-clinic day (schedule permitting).
What information do I need to gather before my appointment?
If you are a patient whose diagnosis of cancer was made at Mass General, Dana-Farber Cancer Institute, Newton-Wellesley Hospital or North Shore Medical Center, we will have access to many of your records on the Mass Geenral Brigham computerized medical record system. You will still need to bring with you to the visit all X-ray films (e.g., mammograms, CT scans, PET scans, MRI scans).
If you are a patient whose diagnosis of cancer was made elsewhere, you will need to ask your physician to send your pertinent medical records, such as:
- Colonoscopy reports
- Clinic/office notes
- Operative and pathology report
- Results of recent blood tests
You will also need to bring with you to the visit all X-ray films and pathology slides (e.g., mammograms, CT scans, PET scans, MRI scans).
It is important to know all of the medications that you are taking (and their dosages). Please bring a list of these medications. It is also important to bring with you the complete names, addresses, fax numbers and phone numbers of your current physicians.
When you are scheduling your appointment with a surgical oncologist in the Cancer Center, our access nurses will help you determine anything else you may need to bring.
What is the difference between radiology reports and radiology images?
Radiology images are the actual X-ray pictures that are taken when you have a CAT scan, MRI, PET scan, mammogram or other type of X-ray. In contrast, radiology reports are the doctor’s written (paper) report or interpretation of the scans or X-rays. Radiology reports can be faxed to us. Radiology images should be saved onto a disk by the radiology facility. The disc should either be mailed or preferably hand carried to your appointment. If you have the films mailed, you should use a method that can be tracked (e.g., FedEx or UPS). It is beneficial for your surgeon to see the actual films, rather than relying upon a radiologist’s report.
What is the difference between pathology reports and pathology slides?
Pathology slides are the glass slides that contain the actual tissue specimen. Pathology reports are the doctor’s written (paper) report or interpretation of the slides. The reports can be faxed or mailed to us. The slides must be sent or hand carried to the appointment so that they can be submitted for review by our pathologists. If you mail these slides, you should use a method that can be tracked (e.g., FedEx or UPS).
When will my surgery be scheduled?
Once you have seen the doctor, your surgery will be scheduled as soon as possible and/or medically necessary. Some patients require further testing in order to be cleared for surgery. If this is the case, your surgery will be scheduled once you have completed the necessary tests.
What types of insurance do you accept, and do I need a referral?
Mass General accepts most health insurance plans, including Medicare and Medicaid. Before scheduling your hospital visit, check with your health insurance provider to see if you are covered and learn the specifics of your coverage. Insurance plans are agreements made between you and your insurer, and Mass General cannot ensure that an insurance provider will pay for your care. It is your responsibility to understand what types of coverage your health insurance provides and to be sure that you meet all requirements stipulated by your specific plan.
Your health insurance provider will be able to inform you of your level of coverage and what, if any, copayments, coinsurances and deductibles will be your responsibility. If you do not contact your provider, you can be ultimately be responsible for all or a large portion of your bill.
If you are enrolled in a managed care group, such as an HMO or PPO, you might need a referral from your primary care physician. Please contact your physician for authorization before your appointment, elective procedure or admission to the hospital. Depending on your insurance provider, you might be required to pay a deductible or copayment. In some cases, a deposit can be required. An admitting office coordinator will discuss any deposit details with you.
The Patient Experience
What can I expect to happen at my first appointment?
At your first appointment, you can expect to meet with your surgeon and he/she will:
- Review your prior medical history and perform a physical examination
- Review your X-rays and medical reports
- Discuss a treatment plan
- Answer any questions that you or your family may have
If you are scheduled for a multidisciplinary clinic, you will meet with several physicians before a treatment plan is discussed with you. You can also expect to leave with the date and time of any other appointments that you might need scheduled.
Will I be admitted to the hospital at my first visit?
It is unlikely you will be admitted to the hospital on the day that you see your surgeon. If you require additional testing, this will be scheduled. If you require surgery, this will also be scheduled at a later date. The vast majority of patients having surgery report to the hospital on the same day as their operation (rather than being admitted to the hospital the day before their operation).
Patients having some types of operations are not admitted to the hospital at all. Rather, they have their operations and are discharged the same day as their operation (e.g., skin surgery). Other patients will be scheduled to stay in the hospital for one or more nights. The hospital will check with your insurance company before your operation to make sure that your insurer will pay for these services.
If I need a biopsy, will this procedure be done in the office?
Minor surgical procedures, such as small skin biopsies and simple lymph node biopsies, may be performed in a treatment room in the clinic on the same day as your initial evaluation. However, most patients will have their biopsies (e.g., breast biopsy) performed in the operating room at Mass General on another day.
If I have surgery at Mass General and need chemotherapy/radiation, can I be treated closer to home?
If you have your operation at Mass General and have been told that you will need additional treatment, such as chemotherapy or radiation therapy, you have the option of receiving these treatments at the Mass General Cancer Center or at a facility closer to your home. If you decide to have your treatment closer to home, your surgeon can refer you to one of the many affiliated community institutions or to a hospital of your choice. Our surgical oncologists work closely with medical oncologists and radiation oncologists from various institutions throughout New England as well as throughout the United States.
Are the clinical trials at the Dana-Farber Cancer Institute different from those available at the Cancer Center?
They are the same. Clinical trials available for patients at Dana-Farber Cancer Institute are available for patients at Mass General as a result of a completely integrated clinical trials program between the two institutions, in addition to Brigham and Women’s Hospital.