Overall cancer treatment should be coordinated among a radiation oncologist, surgeon, and medical oncologist, where appropriate. Unfortunately, there were few medical oncologists in Japan mainly because of lack of the academic society like JSMO and divisions in medical schools and hospitals for medical oncology. Therefore, the multidisciplinary approach in treating cancers was inappropriate. Since 2006, more than 700 cancer drug therapy specialists (diplomates, Subspecialty Board of Medical oncology, JSMO) were fostered in Japan, and the medical oncologists with the diplomate are gradually distributed in local cancer core hospitals. The current role of the medical oncologists in the hospitals is diverse and it includes treatment and management of cancer chemotherapy, such as treatment of both common and rare advanced cancers, management of outpatient chemotherapy center, organization of the regimen review committee and tumor board, education of their medical staffs and patients etc. The expanding role of the medical oncologists in the management of cancer patients may contribute to the spread of standard cancer chemotherapy. However, the number of medical oncologist is still limited. Many challenges still exist, both within the hospital and in translating oncological, technological and societal change into the context of local medical society. Because the number of cancer patient is increasing in Japan, wide spread advances in oncology by oncology specialists is urgent matter. In this symposium, current and future roles of the medical oncologists in local cancer core hospitals and their role in medical oncology education should be discussed.