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Oncology

Oncology is a medical speciality that deals with prevention, diagnosis and treatment of all forms of cancer. There are different types of cancer that may affect different parts of the body. Therefore, an oncologist may decide to specialize in a certain branch, such as in breast cancer treatment, prostate cancer treatment or oral cancer.

Oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer. A medical professional who practices oncology is an oncologist. The name’s etymological origin is the Greek word ὄγκος (ónkos), meaning “tumor”, “volume” or “mass” and the word λόγος (logos), meaning “speech”.

The three components which have improved survival in cancer are:

Prevention – by reduction of risk factors like tobacco and alcohol consumption

Early diagnosis – screening of common cancers and comprehensive diagnosis and staging

Treatment – multimodality management by discussion in tumor board and treatment in a comprehensive cancer centre

Cancers are often managed through discussion on multi-disciplinary cancer conferences 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. It is very important for oncologists to keep updated with respect to the latest advancements in oncology, as changes in management of cancer are quite common. All eligible patients in whom cancer progresses and for whom no standard of care treatment options are available should be enrolled in a clinical trial.

Screening
Screening is recommended for cancers of breast, cervix, colon and lung.

Symptoms
Generally Symptoms usually depend on the site and type of cancer. 

Risk Factors

Tobacco: It is the leading cause of cancer and of death from cancer. Smoking is associated with increased risk of cancers of lung, larynx, mouth, oesophagus, throat, bladder, kidney, liver, stomach, pancreas, colon, rectum, cervix and acute myeloid leukemia. Smokeless tobacco (snuff or chewing tobacco) is associated with increased risks of cancers of the mouth, oesophagus, and pancreas.

Alcohol: It can increase your risk of cancer of the mouth, throat, oesophagus, larynx, liver and breast. The risk of cancer is much higher for those who drink alcohol and also use tobacco.

Obesity: Obese individuals have an increased risk of cancers of breast, colon, rectum, endometrium, oesophagus, kidney, pancreas, and gallbladder.

Age: Advanced age is a risk factor for many cancers. The median age of cancer diagnosis is 66 years.

  • Lymphoma
    Fever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
  • Endometrial Cancer
    Bleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
  • Ovary Cancer
    Nonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
  • Head and Neck Cancer
    Non-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
  • Thyroid Cancer
    Lump in the neck.Treatment options include surgery and radioactive iodine.
  • Stomach Cancer
    Vomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
  • Rectum Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
  • Pancreatic Cancer
    Weight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Bladder Cancer
    Blood in urine.Treatment options include surgery, radiation and chemotherapy.
  • Testis Cancer
    Swelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
  • Blood Cancer
    Bleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. 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). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
  • Breast Cancer
    Lump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
  • Cervix Cancer
    Bleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
  • Lung Cancer
    Persistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
  • Brain Cancer
    Persistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
  • Oesophagus Cancer
    Painful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
  • Colon Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
  • Liver Cancer
    Jaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Prostate Cancer
    Urgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
  • Bone Cancer
    Pain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.

Cancer Types

DIAGNOSIS AND STAGING

  • Lymphoma
    Fever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
  • Endometrial Cancer
    Bleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
  • Ovary Cancer
    Nonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
  • Head and Neck Cancer
    Non-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
  • Thyroid Cancer
    Lump in the neck.Treatment options include surgery and radioactive iodine.
  • Stomach Cancer
    Vomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
  • Rectum Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
  • Pancreatic Cancer
    Weight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Bladder Cancer
    Blood in urine.Treatment options include surgery, radiation and chemotherapy.
  • Testis Cancer
    Swelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
  • Blood Cancer
    Bleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. 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). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
  • Breast Cancer
    Lump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
  • Cervix Cancer
    Bleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
  • Lung Cancer
    Persistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
  • Brain Cancer
    Persistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
  • Oesophagus Cancer
    Painful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
  • Colon Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
  • Liver Cancer
    Jaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Prostate Cancer
    Urgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
  • Bone Cancer
    Pain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.

Oncology Specialties

The three main divisions:

  • Lymphoma
    Fever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
  • Endometrial Cancer
    Bleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
  • Ovary Cancer
    Nonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
  • Head and Neck Cancer
    Non-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
  • Thyroid Cancer
    Lump in the neck.Treatment options include surgery and radioactive iodine.
  • Stomach Cancer
    Vomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
  • Rectum Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
  • Pancreatic Cancer
    Weight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Bladder Cancer
    Blood in urine.Treatment options include surgery, radiation and chemotherapy.
  • Testis Cancer
    Swelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
  • Blood Cancer
    Bleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. 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). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
  • Breast Cancer
    Lump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
  • Cervix Cancer
    Bleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
  • Lung Cancer
    Persistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
  • Brain Cancer
    Persistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
  • Oesophagus Cancer
    Painful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
  • Colon Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
  • Liver Cancer
    Jaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Prostate Cancer
    Urgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
  • Bone Cancer
    Pain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.
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