Department

Oncology is the field of medicine that deal with the diagnosis, treatment, prevention, and early detection of cancer. Oncologists, in turn, are physicians who treat people with cancer. Cancer has been present through the ages, and is currently the second leading cause of death in the United States.

Fortunately, treatments are improving, and an understanding of cancer on the molecular level has led to improvements in survival as well. We will look at some of the types of oncology professionals, common (and uncommon symptoms), and how it may be diagnosed and treated.

Basics

While the term "Onco" means mass, and "logy" means study, not all cancers cause a mass. There are hundreds of types of cancer that may arise from epithelial cells (such as breast ducts and airways in the lungs), connective tissue (such as sarcomas), or blood cells (such as leukemias and lymphomas).

Even cancers that arise in the same tissue (say, the lungs) differ on a molecular level, such that no two cancers are alike. Unlike benign conditions or tumors, there are several factors that make a cancer cell a cancer cell.

Cancer is caused by the uncontrolled growth and reproduction of a cell that is initiated by a series of mutations in a normal cell. There are hallmarks of cancer that differentiate it from benign conditions. In addition to uncontrolled growth, cancer cells work to create new blood vessels to supply their growth, resist death, and much more.

Cancer cells often lack sticky substances known as adhesion molecules that keep the cells in place. This allows the cells to spread (metastasize) to other regions of the body. It is the metastasis of tumors, in fact, that is responsible for the majority of deaths from cancer (at least solid tumors).

Incidence and Prevalence

Currently ranked as the second leading cause of death, it's thought that cancer will affect roughly 1 in 2 men and 1 in 3 women during their lifetime. Survival rates are improving, yet as more people live with cancer, the prevalence of cancer survivors (and the need for oncology care) will increase.

History

Researchers have noted evidence of cancerous (malignant) tumors in animals even before people inhabited the earth. The earliest written description of the disease was in 3000 BC, but evidence has been noted further back in fossils and mummies.

The Greeks were primarily responsible for the first treatment approaches to the disease, which included the use of a combination of medicine and art.

Types

There are many types of cancer as well as health professionals who treat the disease.

Oncologists

There are three primary types of oncologists or physicians who treat people with cancer. These include:

Medical oncologists treat people with medications such as chemotherapy, targeted therapy, hormonal therapy, and immunotherapy.

Surgical oncologists perform surgeries to remove malignant tumors.

Radiation oncologists use radiation to treat cancer.

Oncologists/hematologists treat not only people who have cancer but also people who are coping with benign blood-based diseases such as anemia.

Oncologists may also be referred to as either community oncologists; oncologists who work at cancer centers in the community and generally treat all types of cancer, and academic oncologists; physicians who work at the larger cancer centers and often specialize in one type (or one subtype) of cancer.

There are also many subspecialties of oncology. Some of these include:

Pediatric oncologists, treating children with cancer

Adolescent and young adult oncology

Gynecologic oncologists, treating tumors such as ovarian cancer, cervical cancer, and uterine cancer

Neurooncologists, addressing cancers such as brain cancer and metastases to the brain from other tumors, as well as central or peripheral nervous system side effects of treatment, such as peripheral neuropathy or cognitive dysfunction

Sarcoma specialists

Gastrointestinal oncologists, who treat tumors of the colon, GIST tumors, etc.

Psychooncologists, addressing the emotional and psychological aspects of living with cancer

Precision oncologists, who address the molecular characteristics (what's happening with a tumor at a genomic level) to guide treatments personalized to a tumor

Integrative oncologists, who look at ways to integrate conventional medicine with alternative therapies (such as yoga and much more) that may improve a person's quality of life while living with cancer

Immunotherapy-oncologists

Oncology rehabilitation specialists

Preventive oncologists

Urologists, who treat prostate cancer

Survivorship specialists, as with more people surviving cancer, often with long term side effects, issues surrounding survivorship have developed into a field of its own.

Oncology can also be broken down by focus into:

Clinical oncology that addresses people living with cancer

Epidemiology that looks into risk factors as well as trends in cancer diagnoses

Cancer biology that looks at the biology behind the growth of tumors to design new treatments

The Oncology Team

The treatment of cancer increasingly requires a "multidisciplinary" approach, and there are many types of physicians as well as other healthcare professionals who may be part of your treatment team. This team may include:

An oncologist as noted above

Diagnostic radiologists, who use imaging techniques to detect and monitor cancer

Pathologists, physicians who diagnose cancer by looking at a tumor (or blood/bone marrow sample) under the microscope and perform studies to determine the molecular characteristics of a tumor. They have become more active as part of the oncology team in recent years with the advent of precision medicine.

Oncology nurses

Oncology social workers

Palliative care specialists who address the symptoms and side effects related to cancer. Palliative care is not the same as hospice, and may be recommended even for people with very curable tumors.

Oncology nutritionists

Supportive specialties such as physical therapy or speech pathology

Rehabilitation specialists

Patient navigators

Types of Cancer

Cancer can affect nearly any type of tissue in the body, but is much more common in some regions than others. The types of cancer can be broken down in many ways, but it can be helpful to look at three basic categories.

Carcinomas: These are cancers that begin in epithelial cells that line the surface of the body (skin) or body cavities (such as breast ducts or airways). They make up the largest group of cancers.

Sarcomas: These are cancers of connective tissue such as bone, blood vessels, cartilage, nerves, and more.

Blood-based cancers: These include leukemias, lymphomas, and multiple myeloma.