Oncology

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Oncology

A coronal CT scan showing a malignant

mesothelioma, indicated by the asterisk and the
arrows.
Focus
Cancerous Tumor
Subdivisions

Medical oncology, radiation

oncology, surgical oncology

Significant tests

Tumor markers, TNM staging, CT

scans, MRI

Specialist

Oncologist

Oncology is a branch of medicine that deals with tumours. A medical professional who practices oncology is an
oncologist.[1]
Oncology is concerned with:

The diagnosis of any cancer in a person (pathology)

Therapy (e.g. surgery, chemotherapy, radiotherapy and other modalities)

Follow-up of cancer patients after successful treatment

Palliative care of patients with terminal malignancies

Ethical questions surrounding cancer care

Screening efforts:
o of populations, or
o of the relatives of patients (in types of cancer that are thought to have a hereditary basis, such as
breast cancer)

Contents

1 Diagnosis

2 Therapy

3 Palliative care

4 Ethical issues

5 Progress and research

6 Specialties

7 See also

8 References

9 Bibliography

10 External links

Diagnosis
Medical histories remain an important screening tool: the character of the complaints and nonspecific symptoms
(such as fatigue, weight loss, unexplained anemia, fever of unknown origin, paraneoplastic phenomena and
other signs) may warrant further investigation for malignancy. Occasionally, a physical examination may find
the location of a malignancy.
Diagnostic methods include:

Biopsy or Resection; these are methods by which suspicious neoplastic growths can be removed in part
or in whole, and evaluated by a pathologist to determine malignancy. This is currently the gold standard
for the diagnosis of cancer and is crucial in guiding the next step in management (active surveillance,
surgery, radiation therapy, chemotherapy or a combination of these)

Endoscopy, either upper or lower gastrointestinal, cystoscopy, bronchoscopy, or nasendoscopy; to

localise areas suspicious for malignancy and biopsy when necessary.

X-rays, CT scanning, MRI scanning, ultrasound and other radiological techniques to localise and guide
biopsy.

Scintigraphy, Single Photon Emission Computed Tomography (SPECT), Positron emission tomography
(PET) and other methods of nuclear medicine to identify areas suspicious for malignancy.

Blood tests, including tumor markers, which can increase the suspicion of certain types of cancers.

Apart from diagnoses, 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.
Currently, a tissue diagnosis (from a biopsy) by a pathologist is essential for the proper classification of cancer
and to guide the next step of treatment. On 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.)
On very rare occasions, a metastatic lump or pathological lymph node is found (typically in the neck) for which
a primary tumor cannot be found. However, immunohistochemical markers often give a strong indication of the
primary malignancy. This situation is referred to as "malignacy of unknown primary", and again, treatment is
empirical based on past experience of the most likely origin.[2]

Therapy
Depending upon the cancer identified, followup and palliative care will be administered at that time. Certain
disorders (such as ALL or AML) will require immediate admission and chemotherapy, while others will be
followed up with regular physical examination and blood tests.
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 tumors. The risks of surgery must be
weighed against the benefits.
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 life and to prolong it
Hormone manipulation is well established, particularly in the treatment of breast and prostate cancer.
There is currently a rapid expansion in the use of monoclonal antibody treatments, notably for lymphoma
(Rituximab), and breast cancer (Trastuzumab).
Vaccine and other immunotherapies are the subject of intensive research.

Palliative care
Approximately 50% of all cancer cases in the Western world can be treated to remission 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.
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.

Ethical issues
There are a number of recurring ethical questions and dilemmas in oncological practice. These include:

What information to give the patient regarding disease extent/progression/prognosis.

Entry into clinical trials, especially in the face of terminal illness.

Withdrawal of active treatment.

"Do Not Resuscitate" orders and other end of life issues.

These issues are closely related to the patients' 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.

Progress and research

There is a tremendous amount of research being conducted on all frontiers of oncology, ranging from cancer
cell biology, radiation therapy to chemotherapy treatment regimens and optimal palliative care and pain relief.
In the past decade, the advent of next-generation sequencing and whole-genome sequencing has completely
changed our understanding of cancers. Identification of novel genetic/molecular markers will dramatically
change how we diagnose and treat cancer, which will pave the way for personalized medicine.
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),[3] Medical Research Council
(MRC),[4] the European Organisation for Research and Treatment of Cancer (EORTC)[5] or the National Cancer
Research Network (NCRN).[6]

Specialties
There are several sub-specialties 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 or whether their role is primarily
diagnostic.

Radiology: localize, stage and often perform image-guided biopsy in order to obtain the tissue for
preliminary diagnosis.

Anatomical pathology: render the final diagnosis and prognosis of cancer, in order to guide treatment by
oncologists.

Radiation oncology: treatment primarily with radiation, a process called radiotherapy.[7]

Surgical oncology: surgeons who specialize in tumor removal.[7]

Medical oncology: treatment primarily with drugs, that is, pharmacotherapy, which includes
chemotherapy, hormonal therapy, and targeted therapy.[7][8]

Gynecologic oncology: focuses on cancers of the female reproductive system.

Pediatric oncology: concerned with the treatment of cancer in children

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. In North
America, the terms, radiation oncologist and medical oncologist are more frequent.
In most countries it is now common that patients are treated by a multidisciplinary team. These teams meet on a
regular basis and discuss the patients under their care. These teams consist of the medical oncologist, a clinical
oncologist or radiotherapist, a surgeon (sometimes there is a second reconstructive surgeon), a radiologist, a
pathologist, an organ specific specialist such as a gynecologist or dermatologist, and sometimes the general
practitioner is also involved. These disease oriented teams are sometimes in conflict with the general
organisation and operation in hospitals. Historically hospitals are organised in an organ or technique specific
manner. Multidisciplinary teams operate over these borders and it is sometimes difficult to define who is in
charge.
In veterinary medicine, veterinary oncology is the sub-specialty that deals with cancer diagnosis and treatment
in animals.

The following is a list of the branches of biology, with

definitions, pronunciations, and links to related topics.
Note, however, that there are so many subfields within
the general field of biology that they cannot be fully
listed here. There are many named branches of the
discipline that can be found in dictionaries, but that are
little known and have few practitioners. The following
list, then, attempts to name and define only the major
fields:

Fields dealing with animals:

Comparative anatomy (pronunciation) The scientific study of similarities and differences

in the bodily structures of distinct types of animals.

Entomology (pronunciation) The study of insects.

Ethology (pronunciation) The study of animal behavior.

Herpetology (pronunciation) The study of reptiles and amphibians.

Ichthyology (pronunciation) The study of fish.

Mammalogy (pronunciation) The study of mammals.

Ornithology (pronunciation) The study of birds.

Primatology (pronunciation) The study of primates.

Veterinary science (pronunciation) Animal medicine.

Zoology (pronunciation) The study of animals.

Branches of biology relevant to the study of evolution:

Biogeography (pronunciation) The study of the geographic distributions of living

organisms.

Developmental biology The study of the processes by which an organism changes

from a single cell into a mature, multicellular individual.

Evolutionary biology The branch of biology concerned with the modes of origin of
new forms of life.

Ichnology (pronunciation) The scientific study of the fossilized traces of past animal
activity, such as footprints, burrows, trails, and borings.

Morphology (pronunciation) The branch of biology concerned with the form and structure
of living organisms.

Paleontology (pronunciation) The study of prehistoric life by means of fossils.

Fields relating to the environment:

Astrobiology (pronunciation) The branch of biology concerned with the effects of outer
space on living organisms and with the search for extraterrestrial life.

Bioclimatology (pronunciation) The study of the influence of climate on living organisms.

Chronobiology (pronunciation) The study of time-dependent phenomena in living

organisms.

Conservation biology The branches of biology concerned with habitat preservation,

the prevention of extinction, and conservation of biodiversity.

Cryobiology (pronunciation) The study of the effects of low temperatures on living

organisms.

Ecology (pronunciation) The study of the interaction of organisms with each other and
with their environment.

Geobiology (pronunciation) A science that combines geology and biology to study the
interactions of organisms with their environment.

Limnology (pronunciation) The study of the physical and biological conditions of

freshwater, particularly of lakes and ponds.

Chemistry-based branches of biology:

Biochemistry (pronunciation) The study of life at the chemical level, in particular the
chemistry of proteins, carbohydrates, and nucleic acids.

Bioengineering (pronunciation) A hybrid field of scientific research that uses the

principles of biology and the techniques of engineering to produce useful products.

Molecular biology The branch of biology that studies the formation, structure, and
function of macromolecules found in living organisms, particularly nucleic acids and
proteins.

he following is a list of the branches of biology, with

definitions, pronunciations, and links to related topics.
Note, however, that there are so many subfields within
the general field of biology that they cannot be fully
listed here. There are many named branches of the
discipline that can be found in dictionaries, but that are
little known and have few practitioners. The following
list, then, attempts to name and define only the major
fields:

Branches of biology dealing with microorganisms and microscopic

structure:

Cytology (pronunciation) The study of living cells, in particular, their physiological

properties, structures, organelles, and method of division.

Histology (pronunciation) The study of the microscopic structure of cellular tissue.

Microbiology (pronunciation) The branch of biology that studies microorganisms and

their effects on other organisms.

Protistology (pronunciation) The study of protists.

Medical branches of biology:

Anatomy (pronunciation) The study of the macroscopic structure of multicellular

organisms.

Embryology (pronunciation) The study of embryos.

Endocrinology (pronunciation) The study of the endocrine glands.

Epidemiology (pronunciation) The study of the incidence of disease within populations,

and of optimal measures for its control.

Esthesiology (pronunciation) The scientific study of sensation.

Genetics (pronunciation) The study of heredity, especially the mechanisms of hereditary

transmission and variation of inherited characteristics.

Immunology (pronunciation) The study of the structure and function of the immune system,
innate and acquired immunity, the bodily distinction of self from nonself, and laboratory
techniques involving the interaction of antigens with specific antibodies.

Koniology (pronunciation) The study of dust in relation to its effects on health.

Mastology (pronunciation) The scientific study of the breasts.

Medicine The art and study of the prevention, cure, and alleviation of disease, and the
care of the injured.

Neurology (pronunciation) The branch of biology that studies the nervous system and its
diseases.

Parasitology (pronunciation) The study of parasites.

Pathology (pronunciation) The study of the nature of disease and its causes, processes,
development, and consequences.

Physiology (pronunciation) The study of the physical function of living organisms.

Pharmacology (pronunciation) The science and study of drugs.

Psychology (pronunciation) The study of human behavior.

Splanchnology (pronunciation) The study of the internal organs.

Surgery (pronunciation) The branch of medicine dealing with operative procedures.

Toxicology (pronunciation) The study of toxins.

Urology (pronunciation) The study and treatment of disorders of the urogenital organs.

Virology (pronunciation) The study of viruses.

Miscellaneous branches of biology:

Agriculture The science of crop and livestock production.

Bioinformatics (pronunciation) The use of computers to manage and analyze biological

data.

Biomathematics (pronunciation) An interdisciplinary field of study that attempts to

model biological processes using mathematical techniques.

Biophysics (pronunciation) An interdisciplinary science that applies the theories and

methods of physics to biological questions.

Botany (pronunciation) The study of plants.

Marine biology The study of marine organisms.

Mycology (pronunciation) The study of fungi.

Yang berikut adalah senarai cawangan biologi, dengan

definisi, sebutan, dan pautan kepada topik berkaitan.
Bagaimanapun, ambil perhatian bahawa terdapat
banyak submedan dalam bidang umum biologi bahawa
mereka tidak boleh disenaraikan sepenuhnya di sini.
Terdapat banyak dinamakan cabang disiplin yang
terdapat dalam kamus, tetapi yang kurang dikenali dan
mempunyai beberapa pengamal. Senarai berikut,
kemudian, cuba untuk menamakan dan menentukan
hanya bidang utama:

Bidang yang berkaitan dengan haiwan:

Anatomi perbandingan ( sebutan ) - Kajian saintifik persamaan dan perbezaan dalam

struktur badan yang berbeza daripada jenis haiwan.

Entomologi ( sebutan ) - Kajian mengenai serangga.

Etologi ( sebutan ) - Kajian tentang tingkah laku haiwan.

Herpetologi ( sebutan ) - Kajian mengenai reptilia dan amfibia .

Ilmu pengetahuan mengenai ikan ( sebutan ) - Kajian mengenai ikan.

Ilmu pengetahui binatang menyusui ( sebutan ) - Kajian mengenai mamalia .

Ilmu burung ( sebutan ) - Kajian mengenai burung .

Primatologi ( sebutan ) - Kajian mengenai primat .

Sains veterinar ( sebutan ) - ubat Haiwan.

Zoologi ( sebutan ) - Kajian haiwan.

Cabang-cabang biologi yang berkaitan dengan kajian evolusi:

Biogeograf ( sebutan ) - Kajian taburan geografi organisma hidup.

Biologi Pembangunan - Kajian mengenai proses di mana organisma berubah dari satu
sel ke dalam matang, individu multicellular.

Biologi evolusi - Cawangan biologi berkenaan dengan mod asal bentuk baru kehidupan.

Ichnology ( sebutan ) - Kajian saintifik mengenai kesan aktiviti fosil haiwan yang lalu,
seperti tapak kaki, lubang, laluan, dan borings.

Morfologi ( sebutan ) - Cawangan biologi berkenaan dengan bentuk dan struktur

organisma hidup.

Paleontologi ( sebutan ) - Kajian kehidupan prasejarah melalui fosil.

Bidang yang berkaitan dengan alam sekitar:

Astrobiologi ( sebutan ) - Cawangan biologi berkenaan dengan kesan angkasa lepas pada
organisma hidup dan dengan mencari kehidupan di luar bumi.

Bioclimatology ( sebutan ) - Kajian mengenai pengaruh iklim terhadap organisma hidup.

Kronobiologi ( sebutan ) - Kajian fenomena masa yang bergantung pada organisma hidup.

Biologi pemuliharaan - Cabang-cabang biologi berkenaan dengan habitat pemeliharaan,

mencegah kepupusan, dan pemuliharaan biodiversiti.

Cryobiology ( sebutan ) - Kajian kesan suhu rendah pada organisma hidup.

Ekologi ( sebutan ) - Kajian interaksi organisma antara satu sama lain dan dengan
persekitaran mereka.

Geobiologi ( sebutan ) - A sains yang menggabungkan geologi dan biologi untuk mengkaji
interaksi organisma dengan persekitaran mereka.

Limnologi ( sebutan ) - Kajian mengenai keadaan fizikal dan biologi daripada air tawar,
khususnya daripada tasik dan kolam.

Cawangan berasaskan kimia-biologi:

Biokimia ( sebutan ) - Kajian hidup di peringkat kimia, khususnya kimia protein ,

karbohidrat , dan asid nukleik .

Kajian Agama ( sebutan ) - Medan hibrid penyelidikan saintifik yang menggunakan prinsipprinsip biologi dan teknik kejuruteraan untuk menghasilkan produk yang berguna.

Biologi molekul - Cawangan biologi yang mengkaji pembentukan, struktur, dan fungsi
makromolekul terdapat dalam organisma hidup, terutamanya asid nukleik dan protein .