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Oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer. A medical professional who practices oncology is an oncologist.[1] The name's etymological origin is the Greek word (óngkos), meaning 1. "burden, volume, mass" and 2. "barb", and the Greek word (logos), meaning "study".[2] The neoclassical term oncology was used from 1618, initially in neo-Greek, in cognizance of Galen's work on abnormal tumors, De tumoribus præter naturam (? ? ).[3]
Cancer survival has improved due to three main components: improved prevention efforts to reduce exposure to risk factors (e.g., tobacco smoking and alcohol consumption),[4] improved screening of several cancers (allowing for earlier diagnosis),[5] and improvements in treatment.[6][7]
Cancers are often managed through discussion on multi-disciplinary cancer conferences[8] where medical oncologists, surgical oncologists, radiation oncologist, pathologists, radiologists, and organ specific oncologists meet to find the best possible management for an individual patient considering the physical, social, psychological, emotional, and financial status of the patient.[9] It is very important for oncologists to keep updated with respect to the latest advancements in oncology, as changes in management of cancer are quite common.
Because a cancer diagnosis can cause distress and anxiety,[10] clinicians may use a number of strategies such as SPIKES[11] for delivering the bad news.[12]
Alcohol consumption increases risk of cancers of the mouth, throat, esophagus, larynx, liver, and breast. The risk of cancer is much higher for those who drink alcohol and also use tobacco.[15]
Advanced age is a risk factor for many cancers. The median age of cancer diagnosis is 66 years.[17]
Cancer-Causing Substances
Cancer is caused by changes to certain genes that alter the way our cells function. Some of them are the result of environmental exposures that damage DNA. These exposures may include substances, such as the chemicals in tobacco smoke, or radiation, such as ultraviolet rays from the sun and other carcinogens.
Infectious Agents
Certain infectious agents, including oncoviruses, bacteria, and parasites, can cause cancer.
Immunosuppression
The body's immune response plays a role in defending the body against cancer, a concept known mainly because certain cancers occur at a greatly increased prevalence among people with immunosuppression.
Fever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin.[41]
Bleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla, or groin, lump in upper abdomen.[26]
Diagnosis and staging
Diagnostic and staging investigations depend on the size and type of malignancy.
Blood cancer
Blood investigations including hemoglobin, total leukocyte count, platelet count, peripheral smear, red cell indices.
Imaging tests like X-ray, ultrasonography, computerised tomography (CT), magnetic resonance imaging (MRI) and PET CT.[52]
Endoscopy including Naso-pharyngoscopy, Direct & Indirect Laryngoscopy, Upper Gastrointestinal Endoscopy, Colonoscopy, Cystoscopy.
Tumor markers including alphafetoprotein (AFP),[53] Beta Human Chorionic Gonadotropin (HCG),[53] Carcinoembionic Antigen (CEA),[54] CA 125,[55] Prostate specific antigen (PSA).[56]
Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.[79]
Acute myeloid leukemia (AML)
Induction with chemotherapy (Daunorubicin + Cytarabine), followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients.[80]
Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients.[81]
Chronic myeloid leukemia (CML)
Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.[82]
Nuclear medicine oncology: focuses on diagnosis and treatment of cancer with radiopharmaceuticals.
Psycho-oncology: focuses on psychosocial issues on diagnosis and treatment of cancer patients.
Veterinary oncology: focuses on treatment of cancer in animals.[98]
Emerging specialties:
Computational oncology. An example is PRIMAGE. This four-year EU-funded Horizon 2020 project was launched in December 2018. The project proposes a cloud-based platform to support decision making in the clinical management of malignant solid tumours, offering predictive tools to assist diagnosis, prognosis, therapies choice and treatment follow up, based on the use of novel imaging biomarkers, in-silico tumour growth simulation, advanced visualisation of predictions with weighted confidence scores and machine-learning based translation of this knowledge into predictors for the most relevant, disease-specific, Clinical End Points.[99][100]
Research and progress
Leukemia,[101] Lymphoma,[102] Germ cell tumors[103] and early stage solid tumors which were once incurable have become curable malignancies now. Immunotherapies have already proven efficient in leukemia, bladder cancer and various skin cancer. For the future, research is promising in the field of physical oncology.[104]
Survival of cancer has significantly improved over the past years[quantify] due to improved screening, diagnostic methods and treatment options with targeted therapy.
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