Oncology

Oncology is the term used to define the branch of medicine that studies tumors—cancer—and is involved in the diagnosis, treatment, and prevention of cancer. The word comes from the Greek onkos meaning “tumor,” with –ology meaning “the study of.” The major roles in the discipline of oncology are to work out the best and most accurate forms of the diagnosis of cancer, and develop plans and then carry out methods of therapy. Traditionally, this has been through surgery, with early oncologists known as cancer surgeons. Now, there are many other ways of treating tumors, including chemotherapy and radiotherapy. If there is successful treatment of a patient, then oncology is concerned with follow-up care to ensure that the patient makes a full recovery and does not develop any more cancers (if these can be prevented); but there is also the need for palliative care for patients with terminal malignancies. Oncology has now also moved to cover the prevention of cancer, mainly through raising the awareness of activities that make people develop a higher prevalence of cancer. Combined with this, it has found to be also important to screen many people, especially relatives of those who have cancers that are believed to be hereditary, to ensure that early diagnosis might lead to faster treatment, which then has a much higher level of success.

One of the major methods of diagnosis of cancer has always been a physical examination of a patient. Many people are taught to involve themselves in self-examination on a regular basis and seek medical advice for any lumps or cancer-like tumors they come across. For many others, a biopsy (incisional or excisional) is performed, and the tissue is then studied to form a more accurate diagnosis. There has also been the use of blood tests, including the use of tumor markers which can increase the chances of finding out whether someone has a certain type of tumor. However, for tumors that may be located in parts of the body that cannot be physically examined, endoscopy has been used for many years. There is now also much greater use of X-rays, computed tomography (CT) scanning, magnetic resonance imaging (MRI) scanning, ultrasound, and other radiological techniques, with radiologists being important in both the diagnosis of cancer, and also its treatment. Scintigraphy, positron emission tomography, and other methods of nuclear medicine are also used when appropriate.

The traditional form of therapy has always been surgery, which involves a medical attempt to remove the entire tumor. This is only possible when there is some certainty that a tumor could be removed in its entirety, and it is not able to be done when the tumor is attached to a tissue of which the removal might risk the life of the person, such as the brain; or where it is clear that the cancer has spread extensively within the person and surgery alone will not solve the problem. The concept of surgery to cure people suffering from tumors has been known since ancient times. Certainly, the ancient Greek doctor, Hippocrates from the is [Page 1281]land of Cos in the Mediterranean, was able to identify some medical problems to do with hard swellings and ulcers which tended to become fatal. His theory was that these cancers came from an imbalance in fluids, especially an eruption of black bile. The theory had much superficial logic, and the ancient Greeks did resort to excision of tumors, very quickly discovering that it did not always work, and to achieve any chance of success, a large excision would have to be done to ensure that all the tumor was removed. The Greeks realized that the cancer spread and held on to the body like a crab, with Hippocrates giving it the name karkinos, the word for crab, which still remains the symbol for cancer, and is from where the word carcinoma is derived. The famous Roman medical writer Galen was to later build on this theory for his own views on cancer, and the Romans also used excision. Even the Scythians in eastern Europe from the seventh to the third centuries bce used excision, with many peoples in the ancient world also augmenting surgery with use of herbal treatments and pastes which often did much to calm patients, which sometimes, in itself, helped the treatment of the cancer.

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