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Medical Oncology
Overview
Oncology is a branch of medicine which specializes in the diagnosis and treatment of cancers. Medical oncology (MO) refers to the treatment of cancer through the use of chemotherapy, hormone therapy, targeted therapy, biological therapy, and other systemic treatments.
A Medical Oncologist is a specialist health care provider for cancer patients, and he works with other oncologists such as his surgical oncology and radiation oncology colleagues to treat cancer patients. They are also responsible for managing the symptoms, reducing the side effects of treatment and providing the supportive care required.
Types
Medical Oncologists specialize in the following types of treatment.
- Chemotherapy: Chemotherapy, commonly used to treat cancer, is a drug treatment that uses chemicals to kill the cancerous cells in a patient's body. The cancerous cells grow and multiply at a faster rate and powerful chemicals are used to stop these cells from spreading to other parts of the body.
Chemotherapy is mostly used as the primary treatment to treat cancer or, in combination, to kill the remaining cancer cells after other treatments such. It is also used to prepare the patient for other treatments or to ease the patient's signs and symptoms.
There are numerous types of chemotherapy drugs, few are used alone, and some are used in combinations. The drugs are in the form of alkylating agents, nitrosoureas, topoisomerase inhibitors, antimetabolites, antitumor antibiotics, mitotic inhibitors, corticosteroids, and many others.
Chemotherapy can cause side effects such as nausea, vomiting, fatigue, hair loss, loss of appetite, mouth sores, pain, constipation, diarrhoea, and bleeding. The medical oncologist who performs the chemotherapy monitors for these side effects and manages them. Depending on the need, the patient may undergo scans and other tests to monitor the progress of the treatment. - Hormone Therapy: Hormone therapy is also known as hormone treatment, hormonal therapy, and endocrine therapy. This is a cancer treatment to slow cancer growth and stop its spread to other body parts. It is mostly used with other treatments to treat cancer and relieve its signs and symptoms.
During this treatment, a dose is given to stop the patient's body from making certain hormones or to prevent them from working. The dose can be in the form of a pill, capsule, or a shot in the arm or leg.
The medications used for this therapy include fulvestrant, toremifene, tamoxifen, letrozole, and exemestane. Hormone therapy is mostly used to treat breast and prostate cancer, and it may cause side effects such as tiredness, nausea, hot flashes, and pain in joints and muscles. - Targeted Therapy: Drugs used in targeted therapy specifically target cancer cells' genes or proteins that promote the cancer cells' rapid growth and division. It targets the faulty products or specific pathway arising out of genetic changes or mutations that turn healthy cells into cancer cells. Oncologists use this therapy as a primary treatment or initial treatment to treat cancer cells without damaging healthy cells. It is often used in combination with chemotherapy, radiation therapy, or surgery. These drugs are advantageous for higher response rates and lesser side effects due to their target specific mechanism of action.
They may however cause a few side effects such as diarrhea, liver problems, changes in the skin, hair, nails, dry skin, and rash that may itch and burn. Targeted therapy is used to treat lung, colon, breast, prostate, chronic myeloid, leukaemia, colorectal, lymphoma, and a few other cancers. - Immunotherapy: It is a cancer treatment that uses the immune system to fight cancer. The immune system, made up of organs, tissues, and the lymph system, is the body's default mechanism that fights against infections and other diseases. The immune system detects and destroys any abnormal cells and prevents the spread and growth of cancer. However, sometimes cancer cells become less visible or turn off the immune system and go undetected. Immunotherapy reactivates the immune system and assist in fighting cancer.
The different types of immunotherapies are T-cell transfer therapy, immune checkpoint inhibitors, monoclonal antibodies, immune system modulators, and treatment vaccines. Immunotherapy drugs are widely used to treat cancer these days. They are also often used in combination with surgery, radiation therapy, and chemotherapy.
Symptoms
The symptoms vary depending on the type of cancer. However, the most common symptoms of cancer include:
- Weight gain or weight loss
- Headaches
- Nausea and vomiting
- Heartburn (pain after eating)
- Difficulty in swallowing
- No or less appetite
- Trouble or pain while urinating
- Blood in the urine
- Lump or swelling
When to see a Medical Oncologist?
A patient needs to visit a medical oncologist for any cancer related complaint. He needs to visit a medical oncologist in case he experiences persistent symptoms, is diagnosed with cancer, or is on recommendation by a local doctor. A medical oncologist helps to understand the diagnosis (stage and type of cancer) and the timeline of treatment.
Diseases that Medical Oncologist treats
Medical oncologists help patients plan their entire treatment and follow up after the treatment is over. They treat the following types of cancers:
- Lymphoma
- Leukemia
- Hodgkin's disease
- Multiple myeloma
- Breast cancer
- Bladder cancer
- Ovarian cancer
- Lung cancer
- Sarcoma
- Prostate cancer
- Pancreatic cancer
- Bone cancer
- Skin cancer
- Cervical cancer
- Gallbladder cancer
- Kidney cancer
- Lung cancer
- Liver cancer
Diagnosis
Medical oncologists may undertake or recommend the following test to diagnose cancer and its stage.
- Physical Exam: Medical oncologists may conduct a complete physical checkup to look for signs and symptoms. The doctor may look for abnormalities like changes in skin colour or lumps under the skin.
- Blood Test: Blood tests are performed to diagnose cancer and manage its spread. The sample is collected and checked in the laboratory for CBC, tumour markers, chemicals, and proteins. The test is used to evaluate the presence and spread of cancer. A blood test is performed to diagnose all types of cancers, specifically useful in blood cancer, such as leukaemia lymphoma, Non-Hodgkin lymphoma, and multiple myeloma.
- Urine Test: In the urine test, a urine sample is collected and checked in the laboratory for abnormal cells in the urine. This test is conducted to diagnose urinary tract cancers such as bladder cancer and other cancers like prostate, kidney, and cervical cancer.
- Imaging Tests: Imaging tests are used to get body images to diagnose cancer and its spread. This test is also used to evaluate the extent to which the treatment is working. X-rays are basic tests and help the doctor to examine the presence and spread of cancer. This test can also detect damage to bones or abnormal bone growth due to cancer.
MRI tests help to diagnose if a tumour is cancerous or not. Also, it detects the spread of cancer from one body to another part. Doctors use MRI to plan treatments like chemotherapy, surgery or radiation therapy.
CT scan tests are commonly used to diagnose cancer. Doctors can easily evaluate the presence of cancer and the size and shape of the tumour. It can detect lung and colorectal cancer. This scan helps to find blockages and other abnormalities. Ultrasound is a diagnostic procedure for cancer that shows the location of a tumour. It helps to diagnose cancer, specifically in the soft tissue. - Biopsy: A biopsy is a diagnostic procedure in which a tissue or cell sample from an organ or skin is collected and checked in the laboratory for any abnormality. The doctor may suggest a specific type of biopsy depending on the symptoms and current diagnosis. This test helps to evaluate if a tumour is cancerous or noncancerous.
- Biomarker Tests: A biomarker test, also called tumour genetic testing, is a diagnostic test that looks for changes in genes, proteins, and other substances (biomarkers). A doctor uses this test to determine cancer treatment. This test is used to diagnose cancer and to monitor cancer during and after treatment.
Last Update
Reviewed by Dr. Bhuvan Chugh, Senior Consultant – Medical Oncology on 21-Nov-2022.
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