All radiation oncologists vary in quality due to differences in their training, professional experience and treatment options avilable. These differences become greater, and matter more, when you need sophisticated medical care for a complex condition. A radiation oncologist, who has appropriate training and experience performing a complex treatment, has better success with the treatment than a radiation oncologist who does the same treatment only occasionally. The survival rate for the same treatment may be many times higher with one radiation oncologist than another. The radiation oncologist must be able to determine which radiation treatment technique would be best for your type of cancer, the maximum dosage to be aimed at the tumor, the minimum amount of healthy tissue to expose to the radiation and how to create a plan that will accomplish this task. It's important to note that once you have had radiation to a certain location most of the time, you cannot have radiation there again. Clearly, the doctor that you choose has a direct impact on how well you do. This means choosing a doctor for your radiation treatment is an important decision. No one has more at stake than you; it's one of the most important decisions of your life.

There are many different ways to measure quality care, and there is no universal agreement on which should be used. However, a general good starting point are the following quality indicators to compare health care providers:

Credentials
Professional Experience
Range of services
Availability of physician after hours and while on vacations
Patient Satisfaction
Outcome Indicators

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Credentials have been set by nationally recognized medical professional organizations to verify that doctors meet certain standards in the delivery of health care. Board certification is a sign that doctors are highly trained in their field. Doctors who specialize, such as radiation oncologists, should be board certified in the specialty in which they are practicing.

The American Board of Radiology issues certificates to physicians who have completed five years of approved training and have passed a written and oral examination demonstrating an adequate level of knowledge and ability in Radiation Oncology. The first year of the five years of approved training must be spent in Internal Medicine, Pediatrics, Surgery or surgical specialties, Obstetrics & Gynecology, Family Practice, Transitional or Categorical Radiation Oncology, or any combination of these. The remaining four years must be spent in Radiation Oncology. In order to maintain their certification doctors must take continuing education after passing the written and oral exams.

Due to the advancement of radiation treatment technologies the American Board of Radiology has requested that all radiation oncologists become recertified every 10 years. Older radiation oncologists are not required to recertified, but have been asked to do so, if they plan on continuing to practice radiation oncology, such that their patients will know that they have maintained a minimum level of compentence in their field.

If your radiation oncologist has been practicing for at least 10 years, ask them if they have been recertified.

John T. Gwozdz, M.D. was initially certified in Radiation Oncology in 1997 and recertified in 2007.

Please see Dr. Gwozdz's talk on IMRT to read about some of the advances in radiation oncology.

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In the case of complex, specialized medical care for cancer, the more experience the doctor has with the necessary treatment and equipment, the better the outcome will usually be. Experience and years in practice are important, but the number of patients treated with a particular type of cancer, procedures performed and treatment techniques utilized is more important. When assessing this information you must keep in mind that numbers in treating a particular type of cancer will be dependent somewhat on how common the cancer is within the population.

If your physician went to one of the hospitals affiliated with the National Comprehensive Cancer Network (NCCN) then it is safe to assume they are teaching the recommended guidelines.

Ask your radiation oncologist what training he or she has had using the treatment techniques available and if your course of treatment follows the NCCN recommended treatment guidelines for your type of cancer. There are some reasons why a physician may recommend a modification from the guidelines established by the NCCN. If this is the case in your situation then you should understand the reasons for the modifications.

Dr. John Gwozdz did his entire radiation oncology residency at M.D. Anderson Cancer Center in Houston, Texas, one of the main contributors to the cooperative efforts of the NCCN in creating the recommended guidelines for cancer care.

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There are a wide range of treatment techniques or radiation therapy options. A cancer center equipped with a treatment machine that is most beneficial for treating your specific kind of cancer and a physician trained and experienced in using that particular machine can treat a wider range of medical conditions more effectively. Texas Oncology – Amarillo is the first and only cancer center in the Texas Panhandle to have and utilize the most advanced radiation treatment machine available, the Trilogy linear accelerator.

Dr. John Gwozdz, practices at Texas Oncology – Amarillo. Patients have the convenience of receiving the latest in cancer treatment near home, at this integrated cancer center. Texas Oncology – Amarillo is a comprehensive cancer center which offers all forms of outpatient cancer care, from the most advanced laboratory and radiology diagnostic capabilities to chemotherapy, radiation therapy and patient support services.

Texas Oncology – Amarillo is managed by US Oncology. These associates provide a network of more than 875 physicians at over 440 sites throughout the country who care for more than 500,000 cancer patients a year - more than any other single medical organization in the world. Through this network, they are able to quickly bring the latest advances in therapies, research, and technology to where patients live. As a result, patients access the best possible treatment with the least amount of disruption to their daily lives. Equally important, their nationwide presence enables them to rapidly implement best practices and share new discoveries.

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If complications arise, you want the best care available, and you want it immediately. It is for this reason that you want a competent radiation oncologist to be accessible at all times.

Dr. John Gwozdz is available 24 hours a day, 7 days a week to take your emergency radiation therapy related call. If you have a medical problem that is NOT related to radiation treatment, then you should call either your primary care physician or your medical oncologist.

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There are over 10 million cancer survivors in the United States. Many people know others who have been treated with radiation. Ask them who their doctor was and if they were satisfied with the care that they received. Did the doctor see them in a timely manner or always have them wait? How willing was the doctor and nurse to listen to their concerns? Did they answer their questions and explain their treatments in a way they could understand it? How much time did the doctor spend with the patient? How was the cancer center? Is the cancer center clean? Was the parking convenient?

One of the main reasons Dr. Gwozdz returned to Amarillo was because his patient survivors (from when he practiced in Amarillo from 1997 to 2003), their families, many Amarillo physicians and other residents of the Texas Panhandle wanted him to return. It was their phone calls, emails and letters that he and Texas Oncology received that brought him back to the Texas Panhandle. This is the strongest form of patient satisfaction that a physician could receive.

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The risk of death from cancer can never be 100% eliminated with any treatment. However, the chance for success in curing someone's cancer and/or the opportunity to prolong your life without excessive symptoms from the disease is increased with higher quality care.

Ask your doctor for the survival rates for your type of cancer. Try to compare rates for patients most like yourself. It's important to try to compare apples with apples so that you know what your risks really are. This may be difficult, however, because survival rates may be reported differently. If a doctor can't give you survival rates or is reluctant to give information, from published oncology textbooks or journals, you are encouraged to seek a second opinion from another board certified radiation oncologist.

Survival information must be looked at in light of provider experience, the volume of treatments performed by the doctor. If the sample is too small, statistics lose their significance. A survival rate of 100% may look good at first glance, but it may be meaningless if the result was based on only one patient being treated. A zero mortality rate may be more an indication of good luck than skill if only one patient was seen.

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