Image
Image
Image
Center for Medical and Surgical Oncology

The term oncology deals with the treatment and diagnosis of cancer. Cancer is a common group of diseases which can affect any system of the body and can affect anyone irrespective of gender, race etc.

All Cancers have one thing in common: "uncontrolled cell growth". These cells continue to grow at an accelerated rate if left undetected and practically slow down and inhibit important functions of the body where the cancer cells are most dominant. They even have the ability to spread to other areas of the body through blood stream and most commonly lymph nodes.

If detected early, the patient has an excellent chance of prognosis and a longer life span. Patients who are often diagnosed with cancer in the later stages are often at a higher risk but with the recent advances in state of the art treatments and medications, the disease can be controlled, quality of life improved and the patient can live a normal and comfortable life as long as possible.

Tumours may be benign or malignant

  • Benign: a harmless tumour. Growth is slower and rarely spreads to other parts of the body.
  • Malignant: A malignant tumour on the other hand is more harmful and can destroy organs locally and spread to other parts of the body by a process called metastasis.

Cancers are of different types, depending on the tissue from which they arise: Broadly, 4 types are recognized;

  • Carcinomas - arise from the layers that cover the body[skin] or line the body-mucosa of nose, throat, lungs, food pipe, stomach, intestine etc,
  • Sarcomas - arise from soft tissues such as muscle, fat, blood vessels or from bones,
  • Leukaemia's - arise from the bone marrow and spread into the bloodstream
  • Lymphomas - originate from the lymphnodes and spleen.

Causes of cancer

The cause of cancer is multifactorial - multiple agents may act to produce cancer in a particular person.

The common causative factors may be

  • External: such as dietary (high fat diet, alcohol), tobacco, excessive sun exposure, viral infections like Hepatitis B, industrial chemicals
  • Internal: inherited defective genes (which explains how cancer 'runs' in some families)
  • Reproductive history (late age at first child birth for breast cancer)

Symptoms of cancer

Certain warning signs of cancer, which should be further investigated:

  • Unexplained weight loss
  • Loss of appetite
  • Fatigue
  • Lump in the breast
  • Recent change of bowel habits
  • Vaginal bleeding after menopause
  • Chronic cough

Organs affected by cancer

Cancer can affect every organ and cell type in the body, though some organs such as the eye and heart are rarely affected. Some of the common cancers are:

  • Oral cancers
  • Lung cancer
  • Esophageal and stomach cancer
  • Liver cancer
  • Pancreatic cancer
  • Colon and rectal (Large intestine) cancer
  • Kidney and bladder cancer
  • Prostate cancer
  • Ovarian, uterine and cervix cancers
  • Breast cancer
  • Bone cancers
  • Blood cancer (Leukemias)

Treatment of cancer

The primary aim of cancer treatment is to relieve symptoms, cure the patient and prolong life. Although these aims may not be met in every case,the treatment for each patient is designed to suit an individual and depends on the age of the patient, general condition, type of cancer and stage of disease. There can be one treatment or a combination of treatments.

Surgery

Surgery is the most important part of the cancer treatment. Surgery removes cancer cells from the body by cutting away the tumour and any tissues surrounding it which may contain cancer cells, including the lymphnodes. It is a simple, safe and effective method when the tumour is small and confined to the site of origin. It is best suited for certain cancers like breast cancer, head and neck cancers, early cancers of the cervix and lung, many skin cancers, soft tissue cancers, pancreatic cancers, liver and gastrointestinal. Surgery may also be used in advanced cases to relieve symptoms such as bleeding food pipe obstruction, intestine or urinary passage.

Radiotherapy

Radiotherapy is a form of treatment which uses radiation, a special kind of energy waves or a stream of particles originating from radioactive substances and delivered by special machines. These radioactive x-rays or gamma rays penetrate the cell wall and damage the nucleus of the cell which prevents growth and division of cells. This also affects the normal cells but these cells recover completely compared to cancer cells. Radiotherapy is required in patients, usually before surgery to shrink large tumours, or after surgery to destroy cells left behind after surgery at the site of tumour origin. Radiation is also used in patients with metastases, to relieve pain, bleeding or pressure symptoms, eg.tumours in the spinal cord which compress the spinal cord causing paralysis.

Modern radiotherapy is very safe, and is technology driven. Recent advances include Intensity Modulated Radiation Therapy [IMRT] which is the delivery of radiation with high precision, so as to spare normal tissues, and reduce side effects. Improvements in radiotherapy equipment, technique and applications, have led to an increasing role both in local treatment and also in its use as a whole-body treatment, as part of bone marrow transplantation techniques for leukaemia's and lymphomas.

Chemotherapy

Chemotherapy uses drugs which inhibit the growth and division of malignant cells. Once the drugs are administered mostly intravenously, they circulate throughout the body. It has more advantages over surgery & radiation as it treats cancer that is systemic (spread throughout the body). Chemotherapy is the main modality for cancers such as leukemia (blood cancer), lymphomas, certain lung cancers and paediatric cancers. Chemotherapy can be used before surgery to shrink large tumours, and make surgery easier for removal without affecting neighbouring organs and tissue. Chemotherapy is also used after surgery so as to prevent reappearance of tumours.

The side-effects of the chemotherapy however include nausea, vomiting, hair loss, diarrhoea, weakness etc. which are temporary and completely reversible. Modern chemotherapy is very safe and well tolerated and is often given on an outpatient basis.

Hormonetherapy

Hormonetherapy has limited uses in cancer treatment since only minority of tumours are hormone sensitive e.g. breast and prostate cancer. This therapy provides systemic means of treatmen to the whole body, without the side effects of chemotherapy.

Immunotherapy

Immunotherapy stimulates the body's immune system to destroy cancer cells. It is expensive, and indicated only in a few tumours such as melanomas (type of skin cancer) and renal cancers.


Top