How to Choose the Right Oncologist or Cancer Surgeon

Choosing the right oncologist or cancer surgeon is one of the most important decisions a patient can make. In this session, Dr. Jason Sager (Founder & CEO of Sagely Health) and Jeremy Sewell (CTO of Sagely Health) discuss the factors that can significantly impact cancer treatment and outcomes.

How Do Patients Get Assigned an Oncologist?

A cancer diagnosis often comes unexpectedly, and many patients are assigned an oncologist or surgeon by their primary care doctor or hospital system. However, patients have the right to choose their doctor and should actively consider their options.

Common ways oncologists are assigned:

Emergency situations – Patients experiencing sudden complications (e.g., a blocked organ) are assigned a specialist immediately.
Incidental findings – Cancer is sometimes detected during unrelated medical tests, prompting a referral.
Through primary care doctors – Patients with concerning symptoms are referred to an oncologist.

While it is common to go with the first assigned doctor, it’s important to evaluate other options, especially for complex or high-risk cancers.

Understanding Urgency in Cancer Treatment

Many patients feel pressure to start treatment immediately after diagnosis. However, most cancers are not medical emergencies, and patients typically have time to explore their options.

True emergencies include situations such as:

Certain aggressive cancers (e.g., Burkitt’s lymphoma) requiring immediate intervention
A liver tumor blocking bile ducts
A colon tumor causing obstruction

For most cases, there is time to gather second opinions, understand treatment options, and find the right doctor. A rushed decision is often not necessary and can lead to suboptimal outcomes.

Key Factors in Choosing an Oncologist or Surgeon

When selecting a cancer specialist, experience and expertise matter. Here are some key considerations:

Is this surgeon a cancer specialist?

A good answer is five or more cases per week (rather than a couple per month).
Ask, “Are you a cancer surgeon?” or “How many cases like mine do you handle weekly?”

Does this doctor work at an NCI-accredited cancer center?

This is a simple way to ensure you’re receiving care from a facility with the latest treatments and expertise.
National Cancer Institute (NCI)-designated centers are recognized for high-quality cancer care and see a high volume of cancer patients.

What are the surgical success factors?

Experienced surgeons at NCI centers reduce complications and increase success rates.
A good surgeon aims for negative margins (removing the entire tumor with a rim of normal tissue).

Is there a role for treatment before or after surgery?

Adjuvant therapy (after surgery): Lowers the risk of recurrence using chemotherapy, targeted therapy, or radiation.
Neoadjuvant therapy (before surgery): Helps shrink tumors to make surgery more effective.

How does personality and communication style factor in?

If a surgeon claims, “I never have to reoperate”—that’s not realistic.
A confident doctor is good, but overconfidence can be a red flag.

When to Seek a Second Opinion

Patients with high-risk cancers should always get a second opinion. A high-risk cancer is one with a more than 20% chance of recurrence.

A second opinion is also valuable if:

Your cancer has returned or progressed, meaning standard treatments may no longer be effective.
Surgery is being recommended, but you’re unsure about its necessity or effectiveness.
You were diagnosed at a non-NCI center and want confirmation of your treatment plan.

What should you ask when getting a second opinion?

“Should I consider a clinical trial?”
“Are there any alternative treatment options?”
“What is the risk of my cancer returning?”

Advanced & Metastatic Cancer: Choosing the Right Doctor

When surgery is no longer an option, finding an oncologist who specializes in advanced treatments becomes critical.

Key considerations for advanced cancer patients:

Advanced options include tumor sequencing, proteomics, targeted therapies, and immunotherapies.
Seek a specialist at an NCI-accredited cancer center who has access to clinical trials and emerging treatments.
Ensure your doctor is familiar with the latest treatment guidelines (e.g., NCCN guidelines).

Not all oncologists have access to cutting-edge treatments—patients should seek doctors who participate in clinical research and personalized cancer care.

Final Takeaways from Dr. Sager

If possible, go to an NCI-accredited cancer center.
Always ask if treatment before or after surgery could improve your outcome.
If your cancer is high-risk, get a second opinion.
Ask about clinical trials and innovative treatments, especially for advanced cancer.

Cancer care is complex, but patients have the power to make informed decisions. By carefully selecting the right specialists and treatment strategies, you can improve your chances of a successful outcome.