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Encyclopedia > Oncology

Oncology is the branch of medicine that studies tumors (cancer) and seeks to understand their development, diagnosis, treatment, and prevention. A Medical professional who practices oncology is an oncologist. The term originates from the Greek ogkos (ογκος), meaning bulk, mass, or tumor and the suffix -ology, meaning "study of". Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Tumor (American English) or tumour (British English) originally means swelling, and is sometimes still used with that meaning. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... For malignant tumors specifically, see cancer. ...


The oncologist often coordinates the multidisciplinary care of cancer patients, which may involve physiotherapy, counselling, clinical genetics, to name but a few. On the other hand, the oncologist often has to liaise with pathologists on the exact biological nature of the tumor that is being treated. Although every disease has its patients, to be a cancer patient has a very specific meaning, both to the patients and their relatives and the general public. ... Physical therapy can help restore lost functionality in many people. ... Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ... This article is about the general scientific term. ... A renal cell carcinoma (chromophobe type) viewed on a hematoxylin & eosin stained slide Pathologist redirects here. ... For malignant tumors specifically, see cancer. ...


Oncology is concerned with:

Contents

In general, diagnosis (plural diagnoses) has two distinct dictionary definitions. ... “Surgeon” redirects here. ... Chemotherapy is the use of chemical substances to treat disease. ... Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... Although every disease has its patients, to be a cancer patient has a very specific meaning, both to the patients and their relatives and the general public. ... Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure. ... For other uses, see Ethics (disambiguation). ... Screening, in medicine, is a strategy used to identify disease in an unsuspecting population. ... Breast cancer is cancer of breast tissue. ...

Diagnosis

The most important diagnostic tool remains the medical history: the character of the complaints and any specific symptoms (fatigue, weight loss, unexplained anemia, fever of unknown origin, paraneoplastic phenomena and other signs). Often a physical examination will reveal the location of a malignancy. The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue. ... This article discusses the medical condition. ... A paraneoplastic phenomenon is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells. ... When normal cells are damaged or old they undergo apoptosis; cancer cells, however, avoid apoptosis. ...


Diagnostic methods include:

Apart from in diagnosis, these modalities (especially imaging by CT scanning) are often used to determine operability, i.e. whether it is surgically possible to remove a tumor in its entirety. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Endoscopic images of a duodenal ulcer A flexible endoscope. ... For other uses, see X-rays (disambiguation). ... CT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... “MRI” redirects here. ... For other uses, see Ultrasound (disambiguation). ... Nuclear medicine is the branch of medicine that uses unsealed radioactive substances in diagnosis and therapy. ... Image of a typical positron emission tomography (PET) facility Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three-dimensional image or map of functional processes in the body. ... Shown above is the bone scintigraphy of a young woman. ... Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Tumor markers are substances found in the blood, urine or body tissues that can be elevated in cancer. ... CT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... “Surgeon” redirects here. ... “Surgeon” redirects here. ...


Generally, a "tissue diagnosis" (from a biopsy) is considered essential for the proper identification of cancer. When this is not possible, empirical therapy (without an exact diagnosis) may be given, based on the available evidence (e.g. history, x-rays and scans.) Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ...


Occasionally, a metastatic lump or pathological lymph node is found (typically in the neck) for which a primary tumor cannot be found. This situation is referred to as " carcinoma of unknown primary", and again, treatment is empirical based on past experience of the most likely origin.


Therapy

It depends completely on the nature of the tumor identified what kind of therapeutical intervention will be necessary. Certain disorders will require immediate admission and chemotherapy (such as ALL or AML), while others will be followed up with regular physical examination and blood tests. For malignant tumors specifically, see cancer. ... Chemotherapy is the use of chemical substances to treat disease. ... Acute lymphocytic leukaemia (ALL), also known as acute lymphoblastic leukaemia is a cancer of the white blood cells, characterised by the overproduction and continuous multiplication of malignant and immature white blood cells (referred to as lymphoblasts) in the bone marrow. ... Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of blood cells. ... Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ...


Often, surgery is attempted to remove a tumor entirely. This is only feasible when there is some degree of certainty that the tumor can in fact be removed. When it is certain that parts will remain, curative surgery is often impossible, e.g. when there are metastases elsewhere, or when the tumor has invaded a structure that cannot be operated upon without risking the patient's life. Occasionally surgery can improve survival even if not all tumour tissue has been removed; the procedure is referred to as "debulking" (i.e. reducing the overall amount of tumour tissue). Surgery is also used for the palliative treatment of some of cancers, e.g. to relieve biliary obstruction, or to relieve the problems associated with some cerebral tumours. The risks of surgery must be weighed up against the benefits. “Surgeon” redirects here. ... For malignant tumors specifically, see cancer. ... For the musical composition, see Metastasis (Xenakis composition). ... Palliative care is any form of medical care or treatment that concentrates on reducing the severity of the symptoms of a disease or slows its progress rather than providing a cure. ...


Chemotherapy and radiotherapy are used as a first-line radical therapy in a number of malignancies. They are also used for adjuvant therapy, i.e. when the macroscopic tumor has already been completely removed surgically but there is a reasonable statistical risk that it will recur. Chemotherapy and radiotherapy are commonly used for palliation, where disease is clearly incurable: in this situation the aim is to improve the quality of and prolong life. Chemotherapy is the use of chemical substances to treat disease. ... Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... In medicine, adjuvants are agents which modify the effect of other agents while having few if any direct effects when given by themselves. ... Chemotherapy is the use of chemical substances to treat disease. ... Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...


Hormone manipulation is well established, particularly in the treatment of breast and prostate cancer. For other uses, see Hormone (disambiguation). ...


There is currently a rapid expansion in the use of monoclonal antibody treatments, notably for lymphoma (Rituximab), and breast cancer (Trastuzumab). Monoclonal antibodies (mAb) are antibodies that are identical because they were produced by one type of immune cell, all clones of a single parent cell. ... This article is about lymphoma in humans. ... Rituximab, sold under the trade names Rituxan® and MabThera®, is a monoclonal antibody used in the treatment of B cell non-Hodgkins lymphoma, B cell leukemia, and some autoimmune disorders. ... Breast cancer is cancer of breast tissue. ... Trastuzumab (more commonly known under the trade name Herceptin) is a humanized monoclonal antibody that acts on the HER2/neu (erbB2) receptor. ...


Vaccine and other immunotherapies are the subject of intensive research. A vaccine is an antigenic preparation used to establish immunity to a disease. ... The term immunotherapy incorporates an array of strategies of treatment based upon the concept of modulating the immune system to achieve a prophylactic and/or therapeutic goal. ...


The application of ultrasound in the form of HIFU to solid tumors is under investigation. HIFU, or high intensity focused ultrasound, also referred to as Focused Ultrasound Surgery (FUS), is a term used describe a minimally or non-invasive method to deposit acoustic energy into tissue. ...


Follow-up

A large segment of the oncologist's workload is the following-up of cancer patients who have been successfully treated. For some cancers, early identification of recurrence, with prompt treatment, can lead to better survival and quality of life. It depends on the nature of the cancer whether the follow-up lasts a number of years or remains "life long".


Palliative care

Approximately 50% of all cancer cases in the Western world can be cured with radical treatment. For pediatric patients, that number is much higher. A large number of cancer patients will die from the disease, and a significant proportion of patients with incurable cancer will die of other causes. There may be ongoing issues with symptom control associated with progressive cancer, and also with the treatment of the disease. These problems may include pain, nausea, anorexia, fatigue, immobility, and depression. Not all issues are strictly physical: personal dignity may be affected. Moral and spiritual issues are also important. “Hurting” redirects here. ... For other uses, see Nausea (disambiguation). ... Anorexia (deriving from the Greek α(ν)- (a(n)-, a prefix that denotes absence) + όρεξη (orexe) = appetite) is the decreased sensation of appetite. ... The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... On the Threshold of Eternity. ...


While many of these problems fall within the remit of the oncologist, palliative care has matured into a separate, closely allied speciality to address the problems associated with advanced disease. Palliative care is an essential part of the multidisciplinary cancer care team. Palliative care services may be less hospital-based than oncology, with nurses and doctors who are able to visit the patient at home. Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure. ...


Ethical issues

There are a number of recurring ethical questions and dilemmas in oncological practice. These include: Medical ethics is primarily a field of applied ethics, the study of moral values and judgments as they apply to medicine. ...

These issues are closely related to the patients' personality, religion, culture, personal, and family life. The answers are rarely black and white. It requires a degree of sensitivity and very good communication on the part of the oncology team to address these problems properly. Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term denoting the doctors prediction of how a patients disease will progress, and whether there is chance of recovery. ... In medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is a research study. ... This article is about incurable disease. ... A DNR/DNI, or Do Not Resuscitate/Do Not Intubate order, is a written order from a doctor that resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. ...


Progress and research in oncology

There is a tremendous amount of research being conducted on all frontiers of oncology, ranging from cancer cell biology to chemotherapy treatment regimens and optimal palliative care and pain relief. This makes oncology an exciting and continuously changing field. Chemotherapy is the use of chemical substances to treat disease. ... Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure. ... For other uses of painkiller, see painkiller (disambiguation) An analgesic (colloquially known as painkiller) is any member of the diverse group of drugs used to relieve pain. ...


Therapeutic trials often involve patients from many different hospitals in a particular region. In the UK, patients are often enrolled in large studies coordinated by Cancer Research UK (CRUK, [1]), Medical Research Council (MRC, [2]), the European Organisation for Research and Treatment of Cancer (EORTC, [3]) or the National Cancer Research Network (NCRN, [4]). Cancer Research UK is a cancer research and awareness-promotion group in the United Kingdom, formed in 2002 by the merger of the Cancer Research Campaign and the Imperial Cancer Research Fund. ... Current MRC logo The Medical Research Council (MRC) is a UK organisation dedicated to promot[ing] the balanced development of medical and related biological research in the UK. // The MRC is one of seven Research Councils and is answerable to, although politically independent from, the Office of Science and Innovation... The European Organisation for Research and Treatment of Cancer or EORTC is an international non-profit organisation that develops, coordinates and stimulates cancer laboratory and clinical research in Europe. ... The National Cancer Research Network (NCRN) is a UK based government funding utility created to provide infrastructure to the UKs National Health Service (NHS) and increase funding for clinical trials. ...


Complementary and alternative therapies

Main article: Alternative medicine

Many cancer patients seek extra help from complementary and alternative therapies, which fall outside of conventional medicine. Most complementary therapies do not have a firm scientific or evidence base. Some patients undoubtedly find complementary therapies helpful while they are undergoing conventional treatment. Alternative medicine is defined as any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain.[1] Complementary medicine is defined as any of the practices (as acupuncture) of alternative medicine accepted...


While most complementary therapies are probably harmless, they can be expensive. They may also be positively harmful if the patient forgoes conventional treatment altogether, in order to follow alternative regimens. Some alternative regimens are undoubtedly hazardous.


Specialities

There are several subspecialties within oncology. Moreover, oncologists often develop an interest and expertise in the management of particular types of cancer.


Oncologists may be divided on the basis of the type of treatment provided.

  • Radiation oncology: treatment primarily with radiation, a process called radiotherapy.
  • Surgical oncology: surgeons who specialize in tumor removal.
  • In the United Kingdom and several other countries, oncologists may be either clinical or medical oncologists. The main difference is that clinical oncologists deliver radiotherapy, while medical oncologists do not.

Gynecologic oncology focuses on cancers of the female reproductive system. Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... Radiation hazard symbol. ... Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... Surgical Oncology is the branch of surgery which focuses on the surgical managment of malignant neoplasms (cancer). ... This article is about the medical specialty. ... Gynecologic oncology is a specialized field of medicine that focuses only on cancers of the female reproductive system, notably ovarian cancer, cervical cancer, endometrial cancer and vulvar cancer. ...


In veterinary medicine, veterinary oncology is the subspecialty that deals with cancer diagnosis and treatment in animals. Veterinary medicine is the application of medical, diagnostic, and therapeutic principles to companion, domestic, exotic, wildlife, and production animals. ... Veterinary oncology is a subspecialty of veterinary medicine that deals with cancer diagnosis and treatment in animals. ...


See also

Ocular oncology is the branch of medicine dealing with tumors relating to the eye and its adnexa. ... Experimental cancer treatments are medical therapies intended or claimed to treat cancer (see also tumor) by improving on, supplementing or replacing conventional methods (surgery, chemotherapy, radiation, and immunotherapy). ... This is a list of terms related to oncology. ... In medicine (oncology and other fields), performance status is an attempt to quantify cancer patients general wellbeing. ... To meet Wikipedias quality standards, this article or section may require cleanup. ...

References

  • Vickers, A., Banks, J., et al. Alternative Cancer Cures: "Unproven" or "Disproven"? CA Cancer J Clin 2004 54: 110-118. Full text online

External links


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