Oncology, fromAncient Greek ὄγκος (ónkos), meaning "tumor, bulk", and λόγος (lógos), meaning "study",[1] is a branch ofmedicine that deals with the study, treatment, diagnosis, and prevention ofcancer.[2][3] A medical professional who practices oncology is anoncologist.
Diagnostic methods[7] in oncology may include abiopsy orresection; these are methods used to remove suspicious neoplastic cells, which can be removed in part or in whole, and examined by a pathologist to assess for malignancy.[8][9] This is essential for determining the next step in the appropriate course of management (active surveillance, surgery, radiation therapy,[10] chemotherapy, or a combination of these).[11]
Apart from diagnoses, these modalities (especially imaging byCT scanning) are often used to determineoperability, i.e., whether it issurgically possible to remove a tumor in its entirety.
A tissue diagnosis (from abiopsy) by a pathologist is essential for the proper classification ofcancer[16] and to guide the next step of treatment. In extremely rare instances when this is not possible, "empirical therapy" (without an exact diagnosis) may be considered, based on the available evidence (e.g., history, x-rays and scans).
Immunohistochemical markers[17] often give a strong indication of the primary malignancy. This situation is referred to as "malignancy of unknown primary", and again, treatment is empirically based on past experience of the most likely origin.[18]
Often,surgery is attempted to remove atumor 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 aremetastases, 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 thepalliative treatment of some cancers, e.g. to relievebiliary obstruction, or to relieve the problems associated with some cerebral tumors. The risks of surgery must be weighed against the benefits.
Chemotherapy andradiotherapy are used as a first-line radical therapy in several malignancies. They are also used foradjuvant therapy,[19] 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 life and to prolong it.
Hormone manipulation is well established, particularly in the treatment of breast andprostate cancer.
Monoclonal antibody treatments are widely used in oncology, with established therapies such asRituximab for lymphoma andTrastuzumab for HER2-positive breast cancer, alongside newer agents targeting various cancers. Cancervaccines and otherimmunotherapies, such as checkpoint inhibitors, CAR-T cell therapy, and cytokine therapies, remain active areas of research and clinical application.[4][20]
Although cancers can be treated toremission with radical treatment. For pediatric patients, that number is much higher.[21] There may be ongoing issues with symptom control associated with progressive cancer, and also with the treatment of the disease. These problems may includepain,nausea,anorexia,fatigue, immobility, anddepression. Not all issues are strictly physical: personal dignity may be affected. Moral and spiritual issues are also important.
While many of these problems fall within the remit of the oncologist,palliative care has matured into a separate, closely allied specialty to address the problems associated with advanced disease. Palliative care is an essential part of the multidisciplinary cancer care team.[22]
These issues are closely related to the patient's personality, religion, culture, and family life. Though these issues are complex and emotional, the answers are often achieved by the patient seeking counsel from trusted personal friends and advisors. It requires a degree of sensitivity and very good communication on the part of the oncology team to address these problems properly.
There is a tremendous amount of research being conducted, ranging from cancer cell biology, and radiation therapy tochemotherapy treatment regimens and optimalpalliative care andpain relief.Next-generation sequencing andwhole-genome sequencing have completely changed the understanding of cancers. Identification of novel genetic/molecular markers will change the methods of diagnosis and treatment, paving the way for personalized medicine.
^Gill, Paula; Grothey, Axel; Loprinzi, Charles (2006). "Nausea and Vomiting in the Cancer Patient". In Chang, Alfred E.; Hayes, Daniel F.; Pass, Harvey I.; Stone, Richard M.; Ganz, Patricia A.; Kinsella, Timothy J.; Schiller, Joan H.; Strecher, Victor J. (eds.).Oncology. pp. 1482–1496.doi:10.1007/0-387-31056-8_83.ISBN978-0-387-24291-0.OCLC262690988.
^ab"Types of Oncologists". Cancer.Net : American Society of Clinical Oncology (ASCO). 2011-05-09.Archived from the original on 2013-06-01. Retrieved25 May 2013.
^Shaw, Peter H.; Reed, Damon R.; Yeager, Nicholas; Zebrack, Bradley; Castellino, Sharon M.; Bleyer, Archie (April 2015). "Adolescent and Young Adult (AYA) Oncology in the United States: A Specialty in Its Late Adolescence".Journal of Pediatric Hematology/Oncology.37 (3):161–169.doi:10.1097/MPH.0000000000000318.PMID25757020.
^Weber, Kristy L.; Gebhardt, Mark C. (April 2003). "What's new in musculoskeletal oncology".The Journal of Bone and Joint Surgery-American Volume.85 (4):761–767.doi:10.2106/00004623-200304000-00029.PMID12672857.
^Benedetti-Panici, P.; Angioli, R. (2004). "Gynecologic oncology specialty".European Journal of Gynaecological Oncology.25 (1):25–26.PMID15053057.
^Manganaris, Argyris; Black, Myles; Balfour, Alistair; Hartley, Christopher; Jeannon, Jean-Pierre; Simo, Ricard (July 2009). "Sub-specialty training in head and neck surgical oncology in the European Union".European Archives of Oto-Rhino-Laryngology.266 (7):1005–1010.doi:10.1007/s00405-008-0832-4.PMID19015865.
