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![]() | This article needs to be updated.(April 2022) |
![]() A coronal CT scan showing a malignant mesothelioma, indicated by the asterisk and the arrows | |
Focus | Cancerous tumor |
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Subdivisions | Medical oncology, radiation oncology, surgical oncology |
Significant tests | Tumor markers, TNM staging, CT scans, MRI |
Occupation | |
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Occupation type | Specialty |
Activity sectors | Medicine |
Description | |
Education required |
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Fields of employment | Hospitals, clinics |
Oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer. A medical professional who practices oncology is called an Oncologist. [1]
Cancer survival has improved due to three main components: improved prevention efforts to reduce exposure to risk factors (e.g., tobacco smoking and alcohol consumption), [2] improved screening of several cancers (allowing for earlier diagnosis), [3] and improvements in treatment. [4] [5]
Cancers are often managed through discussion on multi-disciplinary cancer conferences [6] where medical oncologists, surgical oncologists, radiation oncologists, pathologists, radiologists, and organ-specific oncologists meet to find the best possible management for an individual patient considering the physical, social, psychological, emotional, and financial status of the patient. [7] It is very important for oncologists to keep up-to-date with the latest advancements in oncology, as changes in the management of cancer are quite common.
Because a cancer diagnosis can cause distress and anxiety, [8] clinicians may use a number of strategies such as SPIKES [9] for offering emotional support. [10]
The name's etymological origin is the Greek word ὄγκος (óngkos), meaning 1. "burden, volume, mass" and 2. "barb", and the Greek word λόγος ( logos ), meaning "study". [11] The neoclassical term oncology was used from 1618, initially in neo-Greek, in cognizance of Galen's work on abnormal tumors, De tumoribus præter naturam (Περὶ τῶν παρὰ φύσιν ὄγκων). [12]
Cancer screening is recommended for cancers of breast, [18] cervix, [19] colon, [20] and lung. [21]
Signs and symptoms usually depend on the size and type of cancer.
Diagnostic and staging investigations depend on the size and type of malignancy.
Blood investigations including hemoglobin, total leukocyte count, platelet count, peripheral smear, red cell indices.
Bone marrow studies including aspiration, flow cytometry, [42] cytogenetics, [43] fluorescent in situ hybridisation and molecular studies. [44]
Excision biopsy of lymph node for histopathological examination, [45] immunohistochemistry, [46] and molecular studies. [47]
Blood investigations include lactate dehydrogenase (LDH), serum uric acid, and kidney function tests. [48]
Imaging tests such as computerised tomography (CT scan), positron emission tomography (PET CT). [49]
Biopsy for histopathology and immunohistochemistry. [51]
Imaging tests like X-ray, ultrasonography, computerised tomography (CT), magnetic resonance imaging (MRI) and PET CT. [52]
Endoscopy including Nasopharyngoscopy, Direct & Indirect Laryngoscopy, Upper Gastrointestinal Endoscopy, Colonoscopy, Cystoscopy.
Tumor markers including alphafetoprotein (AFP), [53] Beta Human Chorionic Gonadotropin (β-HCG), [53] Carcinoembionic Antigen (CEA), [54] CA 125, [55] Prostate specific antigen (PSA). [56]
Treatment depends on the size and type of cancer.
It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL):
Includes acute and chronic leukemias. Acute leukemias includes acute lymphoblastic leukemia (ALL), and acute myeloid leukemia (AML). Chronic leukemias include chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML).
Leukemia is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called blasts or leukemia cells. Symptoms may include bleeding and bruising, bone pain, fatigue, fever, and an increased risk of infections. These symptoms occur due to a lack of normal blood cells. Diagnosis is typically made by blood tests or bone marrow biopsy.
Non-Hodgkin lymphoma (NHL) is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss and tiredness. Other symptoms may include bone pain, chest pain or itchiness. Some forms are slow-growing, while others are fast-growing.
Lymphoma is a group of blood and lymph tumors that develop from lymphocytes. In current usage the name usually refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlarged lymph nodes, fever, drenching sweats, unintended weight loss, itching, and constantly feeling tired. The enlarged lymph nodes are usually painless. The sweats are most common at night.
Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system. Symptoms may include a lump in the testicle, or swelling or pain in the scrotum. Treatment may result in infertility.
Chronic lymphocytic leukemia (CLL) is a type of cancer in which the bone marrow makes too many lymphocytes. Early on there are typically no symptoms. Later non-painful lymph node swelling, feeling tired, fever, night sweats, or weight loss for no clear reason may occur. Enlargement of the spleen and low red blood cells (anemia) may also occur. It typically worsens gradually over years.
Anal cancer is a cancer which arises from the anus, the distal opening of the gastrointestinal tract. Symptoms may include bleeding from the anus or a lump near the anus. Other symptoms may include pain, itchiness, or discharge from the anus. A change in bowel movements may also occur.
Tumor lysis syndrome is a group of metabolic abnormalities that can occur as a complication from the treatment of cancer, where large amounts of tumor cells are killed off (lysed) from the treatment, releasing their contents into the bloodstream. This occurs most commonly after the treatment of lymphomas and leukemias and in particular when treating non-Hodgkin's lymphoma (NHL), acute myeloid leukemia (AML), and acute lymphoblastic leukemia (ALL). This is a potentially fatal complication and patients at increased risk for TLS should be closely monitored while receiving chemotherapy and should receive preventive measures and treatments as necessary. TLS can also occur on its own although this is less common.
In the field of medical treatment, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often to treat cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that the dose of protons is deposited over a narrow range of depth, which results in minimal entry, exit, or scattered radiation dose to healthy nearby tissues.
Adult T-cell leukemia/lymphoma is a rare cancer of the immune system's T-cells caused by human T cell leukemia/lymphotropic virus type 1 (HTLV-1). All ATL cells contain integrated HTLV-1 provirus further supporting that causal role of the virus in the cause of the neoplasm. A small amount of HTLV-1 individuals progress to develop ATL with a long latency period between infection and ATL development. ATL is categorized into 4 subtypes: acute, smoldering, lymphoma-type, chronic. Acute and Lymphoma-type are known to particularity be aggressive with poorer prognosis.
Acute promyelocytic leukemia is a subtype of acute myeloid leukemia (AML), a cancer of the white blood cells. In APL, there is an abnormal accumulation of immature granulocytes called promyelocytes. The disease is characterized by a chromosomal translocation involving the retinoic acid receptor alpha gene and is distinguished from other forms of AML by its responsiveness to all-trans retinoic acid therapy. Acute promyelocytic leukemia was first characterized in 1957 by French and Norwegian physicians as a hyperacute fatal illness, with a median survival time of less than a week. Today, prognoses have drastically improved; 10-year survival rates are estimated to be approximately 80-90% according to one study.
Nasopharyngeal carcinoma (NPC), or nasopharynx cancer, is the most common cancer originating in the nasopharynx, most commonly in the postero-lateral nasopharynx or pharyngeal recess, accounting for 50% of cases. NPC occurs in children and adults. NPC differs significantly from other cancers of the head and neck in its occurrence, causes, clinical behavior, and treatment. It is vastly more common in certain regions of East Asia and Africa than elsewhere, with viral, dietary and genetic factors implicated in its causation. It is most common in males. It is a squamous cell carcinoma of an undifferentiated type. Squamous epithelial cells are a flat type of cell found in the skin and the membranes that line some body cavities. Differentiation means how different the cancer cells are from normal cells. Undifferentiated cells are cells that do not have their mature features or functions.
Cancer and Leukemia Group B is a cancer research cooperative group in the United States.
Gynecologic oncology is a specialized field of medicine that focuses on cancers of the female reproductive system, including ovarian cancer, uterine cancer, vaginal cancer, cervical cancer, and vulvar cancer. As specialists, they have extensive training in the diagnosis and treatment of these cancers.
Endoscopic nasopharyngectomy is a form of endoscopic surgery to treat nasopharyngeal carcinoma. This type of cancer is commonly treated with radiation therapy and chemotherapy, but endoscopic operation offers an alternative treatment especially when the radiation therapy fails.
Hodgkin lymphoma (HL) is a type of lymphoma, in which cancer originates from a specific type of white blood cell called lymphocytes, where multinucleated Reed–Sternberg cells are present in the patient's lymph nodes. The condition was named after the English physician Thomas Hodgkin, who first described it in 1832. Symptoms may include fever, night sweats, and weight loss. Often, nonpainful enlarged lymph nodes occur in the neck, under the arm, or in the groin. Those affected may feel tired or be itchy.
Cancer can be treated by surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy and synthetic lethality, most commonly as a series of separate treatments. The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient. Cancer genome sequencing helps in determining which cancer the patient exactly has for determining the best therapy for the cancer. A number of experimental cancer treatments are also under development. Under current estimates, two in five people will have cancer at some point in their lifetime.
Childhood leukemia is leukemia that occurs in a child and is a type of childhood cancer. Childhood leukemia is the most common childhood cancer, accounting for 29% of cancers in children aged 0–14 in 2018. There are multiple forms of leukemia that occur in children, the most common being acute lymphoblastic leukemia (ALL) followed by acute myeloid leukemia (AML). Survival rates vary depending on the type of leukemia, but may be as high as 90% in ALL.
Cancer in adolescents and young adults is cancer which occurs in those between the ages of 15 and 39. This occurs in about 70,000 people a year in the United States—accounting for about 5 percent of cancers. This is about six times the number of cancers diagnosed in children ages 0–14. Globally, nearly 1 million young adults between the ages of 20 and 39 were diagnosed with cancer in 2012, and more than 350,000 people in this age range died from cancer.
A central nervous system tumor is an abnormal growth of cells from the tissues of the brain or spinal cord. CNS tumor is a generic term encompassing over 120 distinct tumor types. Common symptoms of CNS tumors include vomiting, headache, changes in vision, nausea, and seizures. A CNS tumor can be detected and classified via neurological examination, medical imaging, such as x-ray imaging, magnetic resonance imaging (MRI) or computed tomography (CT), or after analysis of a biopsy.
Indolent lymphoma, also known as low-grade lymphoma, is a group of slow-growing non-Hodgkin lymphomas (NHLs). Because they spread slowly, they tend to have fewer signs and symptoms when first diagnosed and may not require immediate treatment. Symptoms can include swollen but painless lymph nodes, unexplained fever, and unintended weight loss.
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