1. What is the difference between a Surgical Oncologist and a General Surgeon?
   
   
2. Do I need to see a specialist in cancer surgery?
   
   
3. What is a multi-disciplinary clinic?
   
   
4. Is the Massachusetts General Hospital Cancer Center a Comprehensive Cancer Center designated by the National Cancer Institute?
   
   
5. If I have already seen a surgeon, do I need a second opinion?
   
   
6. Are the clinical trials available at the Dana-Farber Cancer Institute different from those available at the Massachusetts General Hospital Cancer Center?
   
   
7. How do I schedule an appointment with a Surgical Oncologist?
   
   
8. How long does it take to get an appointment?
   
   
9. What information do I need to gather before my appointment?
   
   
10. What is the difference between radiology reports and radiology films?
    
    
11. What is the difference between pathology reports and pathology slides?
    
    
12. What can I expect to happen at my first appointment?
    
    
13. Will I be admitted to the hospital at my first visit?
    
    
14. If I need a biopsy, will this procedure be done in the office?
    
    
15. When will my surgery be scheduled?
    
    
16. If I am evaluated at Dana-Farber Cancer Institute by one of the Massachusetts General Hospital (MGH) Surgical Oncologist's and need an operation, where will the operation be performed?
    
    
17. If I have my surgery at Massachusetts General Hospital (MGH) and need chemotherapy and/or radiation therapy after surgery, do I have to be treated at MGH or can I be treated closer to my home?
    
    
18. Are there moderate-priced accommodations for us close to the Massachusetts General Hospital?
    
    
19. What type of insurances do you accept?
    
    
20. Do I need an insurance referral?

ANSWERS:

1. What is the difference between a Surgical Oncologist and a General Surgeon?
   Massachusetts General Hospital (MGH) Surgical Oncologists are board-certified in General Surgery and have undergone additional specialty training in cancer surgery. Furthermore, each Surgical Oncologist focuses his or her clinical practice on management of only one or two types of cancer. Thus, surgical oncologists offer a very high degree of specialization and expertise. Cancer surgery is generally considered complex surgery and published data have demonstrated that hospitals and surgeons with the highest volume experience with specific operations have the lowest complication and death rates.
   
   
2. Do I need to see a specialist in cancer surgery?
   It is not possible to accurately predict which patients will benefit by having their care provided by a specialist rather than a generalist. Accordingly, Massachusetts General Hospital Surgical Oncology makes their services available to all cancer patients. Not infrequently, a case that appears to be “straightforward” may actually be more complicated, or may become more complicated. Each Surgical Oncologist is specialized, having focused his or her practice 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.
   
   Most of the Massachusetts General Hospital Surgical Oncologists are also on staff and evaluate patients at Dana-Farber Cancer Institute. If you are evaluated at the Dana-Farber Cancer Institute by one of the MGH Surgical Oncologists, you will have your operation at Massachusetts General Hospital. Dana-Farber Cancer Institute is an outpatient facility that sees patients in an outpatient clinic setting and will administer outpatient chemotherapy, but no surgeries are performed on their campus. Your health records and any tests that are performed at Dana-Farber Cancer Institute are easily accessible to the staff at the MGH, making the transition to MGH seamless.
   
   
3. What is a multi-disciplinary clinic?
   Multidisciplinary clinic sessions include clinicians from different disciplines, including surgical oncology, medical oncology, radiation oncology, radiology, pathology, nursing, and social services. This team evaluates the patient, their records, and any pathology slides or x-rays to formulate a diagnosis and treatment plan that incorporates several viewpoints. Multi-disciplinary 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. Patients also benefit by the presentation and discussion of complex cases at multidisciplinary weekly tumor board conferences.
   
   The Surgical Oncology practice is physically located within the MGH Cancer Center. This location facilitates on-the-spot, multi-disciplinary treatment planning with other MGH Cancer Center oncologists, even in situations in which a patient had not been scheduled for a multidisciplinary clinic visit.
   
   Surgical Oncologists work closely with a team of physicians in the MGH Cancer Center including medical oncologists, radiation oncologists, pathologists, radiologists, plastic/reconstructive surgeons, genetic counselors, oncology nursing staff and social workers to develop individualized treatment plans.
   
   
4. Is the Massachusetts General Hospital Cancer Center a Comprehensive Cancer Center designated by the National Cancer Institute?
   Yes. The MGH Cancer Center is one of the seven Harvard institutions that jointly comprise the Dana-Farber/Harvard Cancer Center, which was designated by the National Cancer Institute in 1999 as a Comprehensive Cancer Center. 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.
   
   
5. 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 diagnosis. 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 doctors office for the second opinion. After consultation with a Surgical Oncologist at the Massachusetts General Hospital, you may choose to return to your first surgeon for your operation, or you may decide to transfer your care to Massachusetts General Hospital. The decision is entirely up to you.
   
   There are many benefits to obtaining a second opinion:
   1. increasing your own confidence in the recommended treatment plan;
   2. hearing an alternative opinion;
   3. learning about other opportunities for clinical trials that were not presented to you.
      
   4. After receiving an opinion from a Surgical Oncologist at the Massachusetts General Hospital, he or she will also be pleased to help you obtain another opinion if requested.
      
      
6. Are the clinical trials available at the Dana-Farber Cancer Institute different from those available at the Massachusetts General Hospital Cancer Center?
   All clinical trials available for patients at Dana-Farber Cancer Institute are available for patients at Massachusetts General Hospital as a result of a completely integrated clinical trials program between the two institutions, in addition to Brigham and Women’s Hospital.
   
   
7. How do I schedule an appointment with a Surgical Oncologist?
   To schedule an appointment with a Surgical Oncologist at the Massachusetts General Hospital Cancer Center, you may:
   • Call the Surgical Oncologist’s office directly; Ask your physician to call one of the Surgical Oncologists
   • Call the Surgical Oncology practice manager, Kolleen Kosowicz 617-726-5507.
   • Breast cancer and breast diseases:
     Dr. Michele Gadd 617-724-4800
     Dr. Kevin Hughes 617-724-4800
     Dr. Michele Specht 617-724-4800
     Dr. Barbara Smith 617-724-4800
   • Gastrointestinal cancers
     (stomach cancer, colon cancer, rectal cancer, or pancreatic cancer)
     Dr. James Cusack 617-724-6153
     Dr. Sam Yoon 617-724-6153
   • Hepatobiliary cancers
     (liver cancer, gallbladder cancer, bile duct cancer, liver metastases)
     Dr. James Cusack 617-724-6153
     Dr. Kenneth Tanabe 617-724-6153
   • Melanoma and skin cancers
     Dr. Antonia Stephen 617-724-1396
     Dr. Kenneth Tanabe 617-724-1396
   • Thyroid, parathyroid, and endocrine surgery
     Dr. Gregory Randolph 617-726-6316
     Dr. Antonia Stephen 617-726-6316
   • Sarcoma Surgery
     Dr. Sam Yoon 617-726-4241
     
     
8. How long does it take to get an appointment?
   Appointments with the Surgical Oncologists 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 patients by: Scheduling an appointment with another equally qualified physician who can see the patient sooner Seeing a patient on a non-clinic day (schedule permitting).
   
   
9. What information do I need to gather before my appointment?
   If you are a patient whose diagnosis of cancer was made at Massachusetts General Hospital, Brigham and Women’s Hospital, or Dana-Farber Cancer Institute, then MGH Surgical Oncologists will have access to many of your records on the Partners Health Care computerized medical record. 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 that your physician send your pertinent medical records such as operative and pathology reports, colonoscopy reports, clinic/office notes, and 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, the physician’s assistant or secretary will help you determine what type of information to bring.
   
   Once the appointment has been made, please fill out the medical history questionnaire (pdf) and hand carry the original to the office on the day of your visit. If you have access to a fax machine please fax to 617-724-3895 and put the surgeon's name who your appointment is with on the title page.
   
   
10. What is the difference between radiology reports and radiology films?
    Radiology films 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 films 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). Some hospitals may provide to you the films on a CD-ROM, which you should bring with you to your appointment. It is beneficial for your surgeon to see the actual films, rather than relying upon a radiologist’s report.
    
    
11. 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 MGH pathologists. If you mail these slides, you should use a method that can be tracked (e.g. FEDEX).
    
    
12. 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:
    a) Review your prior medical history and perform a physical examination;
    b) Review your x-rays and medical reports;
    c) Discuss a treatment plan;
    d) Answer any questions that you or your family may have.If you are scheduled for a multi-disciplinary 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.
    
    
13. 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 Surgical Oncologist in the Cancer Center. 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 to home 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.
    
    
14. 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 biopsy (e.g. breast biopsy) performed in the operating room at Massachusetts General Hospital on another day.
    
    
15. When will my surgery be scheduled?
    Once you have seen the Surgical Oncologist, your surgery will be scheduled as soon as possible 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.
    
    
16. If I am evaluated at Dana-Farber Cancer Institute by one of the Massachusetts General Hospital (MGH) Surgical Oncologists and need an operation, where will the operation be performed?
    Most of the Massachusetts General Hospital Surgical Oncologists are also on staff and evaluate patients at Dana-Farber Cancer Institute. If you are evaluated at the Dana-Farber Cancer Institute by one of the Cancer Center's Surgical Oncologists, you will have your operation at Massachusetts General Hospital. Dana-Farber Cancer Institute is an outpatient facility that sees patients in an outpatient clinic setting and will administer outpatient chemotherapy, but no surgeries are performed on their campus. Your health records and any tests that are performed at Dana-Farber Cancer Institute are easily accessible to the staff at the Massachusetts General Hospital, making the transition to the Cancer Center seamless.
    
    
17. If I have my surgery at Massachusetts General Hospital (MGH) and need chemotherapy and/or radiation therapy after surgery, do I have to be treated at MGH or can I be treated closer to my home?
    If you have your operation at Massachusetts General Hospital and you 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 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.
    
    
18. Are there moderate-priced accommodations for us close to the Massachusetts General Hospital?
    There are several moderately price accommodations conveniently located near the Massachusetts General Hospital. To get a list of these you may click here. You can also contact the Cancer Center Oncology Resource Specialist Referral Line at 617-726-7664.
    
    
19. What type of insurances do you accept?
    Massachusetts General Hospital accepts most insurances. For those insurances that are HMO or PPO based you will need an insurance referral number from your primary care doctor to the Massachusetts General Hospital physician that you are seeing.
    
    
20. Do I need an insurance referral?
    You will need an insurance referral for the doctor’s visit if you belong to an HMO (Health Maintenance Organization) and some PPO plans. For those patients who have an out of state insurance, you should call your insurance company directly to notify them that you have an appointment scheduled at Mass General Hospital in Boston.If you are unsure whether your insurance requires a referral you should contact your primary care physician or your insurance carrier directly.