Oncology refers to the scientific and medical discipline that deals with tumor diseases, i.e. cancer. It involves both basic research and the clinical subfields of prevention, early detection, diagnosis, treatment and follow-up of cancer.
What is oncology?
Oncology refers to the scientific and medical specialty that deals with tumor diseases, or cancer. Oncology is the specialty that patients instinctively want to have the least to do with at first: namely, the oncologist deals with cancers of all kinds and their various therapies. Among doctors, however, the specialty of oncology is not at all unpopular: cancer can be combated well in many cases nowadays and often also cured permanently. At the same time, research is still making great strides and holds a lot of potential for the future. Oncology is thus a rather interesting specialty. Below is a little insight into how medicine works like this.
Treatments and therapies
Clinically, oncology is a branch of internal medicine; thus, oncologists are always internists. However, the need for coordination with other specialties is in the nature of things: as many options as cancer therapy offers, as many medical specialties collaborate on it. On the one hand, this concerns the surgeon when it comes to operating on a tumor, and on the other hand, the radiation therapist and the physicist when radiation is planned. In the case of special tumor diseases such as breast cancer, on the other hand, it is the gynecologist from whom all treatment branches originate, and in the case of prostate carcinoma, possibly the urologist. The therapy of a cancer disease is therefore strongly networked – in the case of most “internal” cancers, the oncologist “holds the reins”, if you will. In larger hospitals that treat cancer diseases in their entirety, all these specialties work closely together and discuss individual patient cases at so-called “tumor boards,” i.e., weekly conferences at which a physician from each specialty presents the new and current patients in his or her ward to all colleagues. Afterwards, each specialist can make a therapy suggestion from his or her perspective: Then, for example, the surgeon says, “The way the CT image looks, we can’t get to the tumor very well,” and the radiation therapist says, “We can try to shrink the tumor with radiation first, that has quite good prospects with these tumors.” – in the end, a concept is decided upon, which the individual specialties then implement. The oncology department can then refer the patient for radiation therapy and then have him or her returned for a success check, carries out chemotherapy itself, and finally also accompanies the patient during aftercare in order to be able to detect regrowing cancer cells in good time. With the exception of the aforementioned breast and prostate tumors, which are treated by other specialties, the area of responsibility of oncology includes all malignant cancers such as colorectal cancer, stomach cancer, liver tumors, lung cancer, kidney carcinomas, soft tissue tumors and many more.
Diagnosis and examination methods
For the sake of clarity, the means of oncology can be well divided into different levels. The prevention level is primarily concerned with research and identification of risk factors, that is, factors that make the occurrence of cancer more likely – the best-known example being smoking and bronchial carcinoma. With the help of smoking cessation programs and health education, “medical intervention” then takes place at this level. Early detection, for example with the help of cervical smears (cervical carcinoma), mammography (breast cancer) or colonoscopy (colon carcinoma), also belongs to the area of prevention. At the level of diagnostics, the oncologist then has the entire range of modern equipment medicine at his disposal if there is a concrete suspicion of cancer: Depending on the suspected tumor, it is usually a conspicuous finding in the imaging (X-ray, ultrasound, CT, MRI), in addition to the external examination, which substantiates the suspicion. With the aid of colonoscopy, gastroscopy, lungoscopy or CT-guided biopsies, an attempt is then always made to obtain a tissue sample in order to be able to make more detailed statements about the biological appearance and behavior of the tumor (benign/malignant, etc.) and thus “secure” the diagnosis.In the case of malignant tumors, further imaging then follows to search for metastases (X-ray, CT, MRI, skeletal scintigraphy, etc.). At the level of therapy, there is then an interplay of the disciplines; basically, surgery, radiation and chemotherapy are available. Above all, the administration of cytostatics, i.e. chemotherapy, is the territory of oncology. In addition to the established “poisons”, which blindly target all dividing cells and thus cause side effects such as intestinal bleeding, anemia and hair loss, there are now also some very special drugs that specifically intervene in the cell metabolism of certain (fewer) cancer cells and thus achieve very good results in a rather elegant way. This is one of the hottest research areas in medicine, where many achievements can certainly be expected in the near future. Finally, there is the level of aftercare: after surviving cancer, all patients should visit their oncologist regularly in order to be able to detect and in turn treat any recurring cancers at an early stage with the help of external examination, blood tests for so-called “tumor markers” and, in some cases, instrumental diagnostics.