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Oncology

Branch of medicine dealing with, or specializing in, cancer

  • 6 min read
  • 5 chapters
A coronal CT scan showing a malignant mesothelioma Legend: → tumor ←, ✱ central pleural effusion , 1 & 3 lungs , 2 spine , 4 ribs , 5 aorta , 6 spleen , 7 & 8 kidneys , 9 liver
Stevenfruitsmaak · CC BY-SA 4.0

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Cancer was first found in humans in the years 3000 BCE in Egypt. The Edwin Smith papyrus described a form of cancer as "a bulging tumor of the breast." Galen, a Greek doctor who lived from 130–200 CE, was the first to use the word onkos to describe tumors, from which the words "oncologist" and "oncology" are derived.

Oncology is focused on the diagnosis of cancer in a person, therapy (e.g., surgery, chemotherapy, radiotherapy and other modalities), monitoring of people after treatment, palliative care for people with advanced-stage cancers, ethical questions surrounding cancer care, screening of people who may have cancer, and the study of cancer treatments through clinical research.

An oncologist typically focuses on a specialty area in cancer treatment, such as surgery, radiation, gynecological oncology, geriatric oncology, pediatric oncology, and various organ-specific disciplines (breast, brain, liver, among others).

Diagnosis

Medical histories are an important screening tool to assess the concerns and nonspecific symptoms in a patient (such as fatigue, weight loss, unexplained anemia, fever of unknown origin, paraneoplastic phenomena and other signs) that may require further evaluation for malignancy.

Diagnostic methods in oncology may include a biopsy or resection; 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. This is essential for determining the next step in the appropriate course of management (active surveillance, surgery, radiation therapy, chemotherapy, or a combination of these).

Other diagnostic procedures may include an endoscopy, either upper or lower gastrointestinal, cystoscopy, bronchoscopy, or nasendoscopy to localize tissues suspicious for malignancy and biopsy, mammograms, X-rays, CT scanning, MRI scanning, ultrasound and other radiological techniques to localize and guide biopsy. Scintigraphy, single photon emission computed tomography (SPECT), positron emission tomography (PET) and other methods of nuclear medicine are imaging technologies used to identify areas suspicious of malignancy. Blood tests, including tumor markers, can assist diagnosis 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.

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. 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 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.

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