As a result of the progress in the management of patients with malignant disease during the past 20 years, a new type of physician has been created—the oncologist. With the use of chemotherapeutic agents in the treatment of advanced cancer and hematological neoplasms, the internist has evolved as a medical oncologist. The special skills of the physician trained in internal medicine are especially adaptable to this new role.1 As with other disease entities in medicine, in medical oncology the orientation of the internist is on mechanisms of disease and pathophysiology.
Prior to the advances in the chemotherapy of cancer, the surgeon and radiotherapist played the primary roles in the clinical study and treatment of cancer. The internist, though essential to the detection of the disease, did not actively participate in decisions regarding the methods of cancer management. As a result of this unfilled role, currently there is a profound