The changing role of the surgical oncologist

It is increasingly important for the surgical oncologist and surgeon to hav e a thorough understanding of the advantages and limitations of adjuvant sy stemic chemotherapy, hormonal therapy, and adjuvant radiotherapy for variou s resectable cancers. Enough knowledge has been acquired about these adjunc tive treatments for patients with cancer so that they can be integrated int o an overall management scheme. Too often in the recent past, after the tec hnical surgical resection, surgeons transferred the entire management of pa tients to the medical oncologist or radiotherapist. Surgeons and surgical o ncologists should maintain their voice in management policy so that patient s can be served best by the application of adjuvant treatment or by the avo idance of systemic or local adjuvant treatment when it is not appropriate o r helpful. The overall justification for the field of surgical oncology is that the surgeon not only knows how to use medical treatments in advanced c ancers but also knows how to select minimal surgical procedures in early ca ncers and how to manage and direct the application of regional and systemic adjuvant treatments.