Please refer to cancer for the biology of malignant disease, as well as a list of malignant diseases.
Oncology is the medical study and treatment of cancer. A physician who practices oncology is an oncologist. The term is from the Greekonkos, meaning bulk, mass or tumor, and the suffix -ology, meaning "study of".
of the relatives of patients (in types of cancer that are thought to have a heritable basis, such as breast cancer).
The oncologist often coordinates the multidisciplinary care of cancer patients, which may involve physiotherapy, counselling, clincal genetics, to name but a few. On the other hand, the oncologist often has to liaise with pathologistss on the exact biological nature of the tumor that is being treated.
Biopsy (either by fine-needle aspiration or exploratory surgery);
Blood tests are rarely diagnostic but might help in identifying the location and spread of the tumor;
Tumor markers, special blood tests that can increase the suspicion of certain types of tumors.
Apart from in diagnosis, these modalities (especially imaging by CT scanning) are often used to determine operability, i.e. whether it is surgically possible to remove a tumor in its entirety.
Generally, a "tissue diagnosis" (from a biopsy) is considered essential for the proper identification of cancer. When this is an impossibility, empirical therapy (without an exact diagnosis) is the only remaining possibility.
Occasionally, a primary tumor cannot be found. This situation is referred to as "unknown primary". Again, empirical therapy, apart with specialized imaging (such as 18-FDG PET) might prove of some benefit.
Often, surgery is attempted to remove a tumor entirely. This is only feasible when there is some degree of certainty that the tumor can in fact be removed. When it is certain that parts will remain, surgery is often impossible, e.g. when there are metastases elsewhere, or when the tumor has invaded a structure that cannot be operated upon without risking the patient's life. There are a few exceptions: in ovarian carcinoma, surgery can improve survival even if not all tumour tissue has been removed; the procedure it referred to as "debulking" (i.e. reducing the overall amount of tumour tissue).
Chemotherapy and radiotherapy are used as a first-line therapy in a number of malignancies, such as Hodgkin's lymphoma. More often, however, they are used as adjuvans, i.e. when the tumor has already been completely removed surgically but there is a reasonable statistical risk that it will recur. Please refer to the respective articles for details on these treatment modalities.
The oncologist is often faced with ethical questions and dilemmas, e.g. whether to tell a patient about the real prognosis of his/her disease, whether to suggest a highly experimental therapy, and how to properly address the patient's wish to die quickly (with or without euthanasia).
Therapeutic trials often involve patients from many different hospitals in a particular region. In the UK, patients are often enrolled in large studies coordinated by the Medical Research Council (MRC, www.mrc.ac.uk) or the European Organisation for Research and Treatment of Cancer (EORTC, www.eortc.be).
Many other types of therapy have been tried with cancer patients. Some of these have been discredited by the medical community, such as amygdalin, also known as laetrile, an extract of apricot pits. Other herbal preparations are being tried by various practitioners. Some physicians have claimed significant success with a modified means of delivering chemotherapy, termed IPT or insulin potentiation therapy.
Other efforts have centered on trying to bolster the body's immune system's ability to deal with the cancer. Unfortunately, many cancers present surface configurations that exactly mimic their original healthy parent cells, so that most immunotherapies are useless against them.
Some patients also use what are known as "adjunctive therapies", including such practices as visualization. While these are largely not proven to be effective, they are mostly at least harmless and often supportive of the patient's state of mind while they are undergoing medical therapies.