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Background With the recent remarkable developments in anti-cancer agents such as targeted molecular therapies, treating patients with malignancies while keeping a balance among effect, safety, and QOL has become complicated. Methods From the perspective of the role of a board-certified specialist oncology pharmacist, we analyzed the future prospects of medical teams in cancer chemotherapy by examining the current practices of the medical team at our hospital. Results In 2011, our hospital became an authorized base hospital for lung cancer therapy in Osaka Prefecture. The medical team for cancer chemotherapy and supportive therapy at this hospital consists of two medical oncologists, two oncology pharmacists, one certified specialist cancer nurse, one certified cancer chemotherapy nurse, two certified palliative care nurses, and one psychologist. Three departments—thoracic oncology, outpatient chemotherapy, and gynecology—perform cancer chemotherapy. The total number of cancer chemotherapies carried out in 2011 was1433 (thoracic malignancies: 88.4%; breast cancer: 5.1%; gastrointestinal cancer: 6.5%) in outpatients and 1572 (thoracic malignancy: 83.3%; gynecological cancer: 11.8%; gastrointestinal cancer: 4.3%; breast cancer: 0.6%) in inpatients. In 2011, the oncology pharmacist carried out the following important functions in medical team: (i) sitting on a review board four times a year for approval of cancer chemotherapy; (ii) daily management of the ordering system for cancer chemotherapeutic agents; (iii) holding meetings four times a year to educate other specialists about new regimens or anti-cancer agents; (iv) monitoring the dose, schedule and patient's information about cancer chemotherapy to prevent severe toxic effects or treatment death; (v) each day, instructing patients who are receiving cancer chemotherapy; and (vi) consulting daily about side-effects and supportive therapy. Conclusions The oncology pharmacist currently plays an important role in the medical team and will become more important in the future.