Medical oncology: its origin, evolution, current status, and future

Over the last 26 years, the subspecialty of medical oncology has been evolving, and in the process bringing to the community improved oncologic management. During this evolution, guidelines for training new members of the subspecialty have been developed, and these have been heralded as important strides forward in medical education. Continual adjustment to new technology and changing population needs represent challenges for the future.

The steps in the development of this subspecialty, which are documented in educational publications, are reviewed in this article.

Medical oncology evolved because of the introduction of multiple new cancer therapies and an awareness of the need of patients with cancer for continual care, from diagnosis to the end-of-life phase. Together, certified medical oncologists represent the third largest of the current subspecialties of internal medicine. Training guidelines and the needs of the work force are being continually assessed in an effort to maintain an important future for these specialists.

Medical oncologists are cancer specialists who are not in competition with primary care physicians, but are instead supportive. By serving as principal caregivers (those subspecialists who provide most of a patient's health care needs), and by paying increasing attention to older patients with cancer, medical oncologists will remain in demand.