Avera’s cancer specialization is a win for patients, physicians

April 2, 2026

This piece is sponsored by Avera Health.

As oncology research and medicine advance, Avera ensures that patients receive the most advanced and individualized treatment possible through specialization of cancer care.

Specialization in cancer care involves oncologists focusing their practice on — and becoming experts in — specific cancer types.

Oncologists can specialize either through a special interest in a specific disease site or through formal fellowship training. In either case, individuals gain a broad base of knowledge in general oncology and then focus on a specific high-complexity area.

What oncology groups are specialized?

Dr. Luis Rojas, clinical vice president of Avera’s oncology service line, joined Avera in 2007 and was among the first subspecialists in gynecologic oncology in Sioux Falls.

“Within cancer, there are some organic, well-established subspecializations,” Rojas said. “As a gynecologic oncologist, I come from the world of obstetrics and gynecology, and I am in a subgroup of individuals who have a formal training program for women’s cancer.”

“In medical oncology, there is a possibility of focusing in general hematology and oncology, but if an area of focus is desired, there are two main branches — those who specialize in solid tumors such as breast cancer, prostate cancer or lung cancer, and those who formally subspecialize in hematologic (blood) cancers such as myeloma, leukemia or lymphoma, mastering complex therapeutic options like bone marrow transplant and cellular therapies,” Rojas said.

Areas where specialization is highly developed at Avera include breast; genitourinary; gastrointestinal; lung; head and neck; skin; hematology; transplant; and cellular therapy and sequencing.

What’s driving specialization 

The trend toward specialization in cancer care is happening largely because the field is developing and the science is evolving so quickly.

“What has driven subspecialization in the past decade in our professional society is the amount of information that comes out every day,” Rojas said.

“To put it into perspective, up until the year 2000, there were about 50 cytotoxic drugs (chemotherapies) available for cancer treatment. According to an American Society of Clinical Oncology 2022 publication in the Journal of Clinical Oncology, from 2003 to 2021, there have been more than 124 new FDA-approved cancer drugs approved, with 374 indications for cancers.”

In addition to medical advancements, patient demand is propelling specialization.

“Our patients are coming asking, ‘Who’s the expert in this area?’ and that is also a driver of the trend,” Rojas said. With expert care, patients have access to clinical trials and the most options for treatment.

Do APPs specialize?

At Avera, specialization sometimes extends to advanced practice providers, many of whom work in particular disease sites, resulting in greater depth of cancer services.

“We have APPs who are becoming subspecialized by default because many are paired with specific physicians who have a primary focus area,” said Katie Van Beek, Avera vice president for oncology. “Because their physician is subspecialized, they inherently become experts in that type of care as well.”

“We have some dedicated navigators for particular disease sites who are working specifically to navigate patient care, working hand in hand with the subspecialized APPs.”

High number of cases key to quality care

It’s important for providers to experience a high number of cases of a specific tumor type because greater exposure leads to greater knowledge about that cancer type and increased skill in treating it.

“When you’re exposed to higher volume, you see the garden-variety cases, and you also see those cases that are unique, where you have to come up with the best multidisciplinary treatment plan,” Rojas said. “And the more I do a procedure, the better I become at it.”

A high volume of cases and focus in a particular area of expertise within oncology also allows providers to get immersed in clinical research specific to those cases and their area of expertise.

“You can participate in that research not only to provide it to the patient but also actively participate as an investigator and go to the meetings that are specific to that discipline so you become proficient,” Rojas said.

General oncologists crucial across the region

General oncologists remain vital for Avera to serve communities across a vast health system as many rural communities don’t have the patient volume to have a subspecialized physician in each area.

“It’s really about the integration and collaboration of one oncology team throughout our entire footprint,” Van Beek said.

This model provides patients:

• High-quality care close to home without excessive travel to a large institution.
• Subspecialized physicians working as direct partners with general oncologists, ensuring continuous communication regarding optimal patient care.
• The option of a formal second opinion from a subspecialized physician.
• Referral to a subspecialized physician if appropriate.

Expert collaboration via tumor conferences

Avera has 13 disease-specific tumor conferences for multidisciplinary teams to collaborate on patient cases. Within breast care, there are three tumor conferences — one that’s local to Sioux Falls, one that’s service-line wide and one dedicated to metastatic breast cancer.

Dr. Ally Higgins and Dr. Jason Jones, breast oncologists, listen to a patient’s case being presented at a tumor-specific conference for breast cancer.

“In those meetings, specialized physicians — the pathologist, the radiologist, all members of the oncology team — and the physician who’s in another region can participate in person or via video call and discuss the best care for that patient and deliver that care locally,” Rojas said.

Specialization spurs physician recruitment

Avera’s subspecialized model not only drives better quality for patient care but also translates to greater satisfaction among Avera’s physician group.

“When you live in a rural state like South Dakota, physician recruitment can be challenging, and as we recruit, we’re seeing more and more physicians who have a strong interest in subspecializing in their practice,” Van Beek said.

In addition to the rapid expansion of the number of drugs available, thousands of new papers come out every year, making it more challenging for oncologists to practice.

“In order for a physician to stay on top of the latest current trends in cancer care, they literally can’t consume all of this information,” Van Beek said. “If you subspecialize, you have a much smaller subset of what you need to know. You can become very good at that.”

Learn more about cancer care at Avera.

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