All you need to know about cancer care (Oncology)

Oncology is the branch of medicine that deals with the diagnosis, prevention, and treatment of cancer. Oncology comes from the Greek words: ὄγκος (óngkos), meaning “burden, volume, mass” and λόγος (logos), meaning “study.”

What is an oncologist?

An oncologist is a doctor/physician who is a cancer specialist; has obtained a specialized degree in oncology (study of cancer). Thus, a cancer speciaist specializes in the management and treatment of the different types of cancers covered under oncology. 

What are the super specializations in oncology?

The field of oncology is a wide field, including research, diagnosis, and treatment. Very often, due to the complexity of the disease, multiple oncology specialists work together. Mainly, there are three main specialties – medical oncology, surgical oncology, and radiation oncology. At the same time, there are many other sub-specialties.

What is the scope of oncology? What are the different types of cancers in oncology?

Understanding cancer pathology and treatment is very interesting, although complex. The doctors in oncology see a broad scope of understanding the patient’s condition and treat them accordingly. Cancer is one of the leading causes of death globally, and hence there is a need to address the management. Oncologists are involved in a very rewarding career, but the field is demanding at the same time. 

Cancer can be broadly divided into – lymphoma, biliary duct cancer, breast cancer, brain cancer, prostate cancer, kidney cancer, bone cancer, colon cancer, lung cancer, ovarian cancer, endometrial cancer, cervical cancer, head and neck cancer, and carcinomas of unknown origin. The classification is based on the origin of cancerous growth, it is further subdivided based upon the cell type from which cancer originated.

Oncology/ Cancer Care

What are the co-morbidities, complications, organs affected, signs, and symptoms?

The common clinical examination carried out by an oncologist looks at the visible features of developing cancer. 

Some of the common findings include – 

  1. Skin (irregular shape, abnormal coloration, bleeding, itching/pain in a pre-existing mole
  2. Dehydration 
  3. Calf tenderness
  4. Ascites 

Some of the major emergency complications of cancer need urgent attention. Some of the most encountered complications include –

  1. Spinal cord compression 
  2. Superior vena cava obstruction
  3. Hypercalcemia
  4. Neutropenic fever

The most common cause of death from cancer is the ability to metastasize (spread). The most common metastases include – liver metastases, lung metastases, brain metastases, and bone metastases. The management and treatment for metastatic diseases are palliative and very occasionally curable.

Depending upon the type of cancer and the organ it affects, the manifestation of a problem in different organ systems is commonly noticed. It is also dependent upon the severity and staging of cancer. 

The patients are primarily asymptomatic during the initial phase of cancer development and progression. Localized signs and symptoms are developed due to the extra growth around the local tissues. If metastasis (cancer moving to other regions in the body) occurs as cancer progresses, symptoms occur at different unrelated distant locations. 

The typical features of any malignant cancer are- 

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  1. Hemorrhage   
  2. Lump
  3. Bone pain/fracture
  4. Skin abnormalities
  5. Ulcer
  6. Dysphagia 
  7. Abdominal discomfort, constipation, and pain
  8. Breathing related problems like airway obstruction, cough, recurrent infections
  9. Vomiting 
  10. Ascites (swelling in the abdominal region)

The typical features of cancer incidence can be generalized as – palpable mass, weight loss and fever (for unknown reasons), finger clubbing, ectopic hormone production, cutaneous manifestations of cancer, and neurological paraneoplastic syndromes.

What are the different diagnostic tests?

The people suspected of cancers need detailed investigation. The patient’s entire history is taken, questions about risk factors of cancer (smoking, occupational exposures), clinical examination, and proper identification of metastatic sites are looked at. Diagnosis and further management are determined by understanding thorough information on 

  1. Type of tumor
  2. The extent of disease condition assessed by staging investigations.
  3. Patient’s general condition and any other comorbidities.

Oncology- Diagnostic tests include

  1. Histology – analysis of a biopsy or resected specimen of the tumor. The investigations are combined with the physical clinical condition of the patient. 
    1. Light microscopy is the core method of a cancer diagnosis. It can sometimes help to identify the origins of the tumor.
    2. Immunohistochemistry (IHC) –is used to stain the tumor markers that help with diagnostic information and aid the treatment decisions. 
    3. Electron microscopy –is found to help understand the tumor and condition better. It provides additional resolution in visualization (detailed, clear visualization).
    4. Cytogenic (chromosomal) analysis – this approach investigates chromosomal changes in cells mediated by tumor
  2. Imaging – helps to identify and locate the primary tumor. These imaging techniques also help to understand different stages of cancer. 
    1. Radiography – an initial diagnostic tool, has a limited role in defining the disease.
    2. Ultrasound – useful for characterizing lesions of the kidney, pancreas, liver, and reproductive organs.
    3. Computerized tomography (CT-scan) –is the crucial technique to imaging cancers of the thorax and abdomen. Check CT Scan cost in India.
    4. Magnetic resonance imaging (MRI) –has a high resolution than other techniques. Apart from brain imaging, it is widely used for staging rectal, prostate, and cervical cancers. 
    5. Positron emission tomography (PET scan) is used to visualize the tumor cells’ metabolic activity and is used in combination with PET-CT scans.
  3. Biochemical markers – many tumors produce different unique chemicals in the body. These are investigated for diagnosis and surveillance. Some of the common biochemical markers include – 
    1. Alpha-fetoprotien (AFP)
    2. Cancer antigen 125
    3. Carcinoembryonic antigen
    4. Human chorionic gonadotropin
    5. Prostate-specific antigen etc.

What is the consultation cost for an oncologist?

The average cost for consulting an oncologist in India ranges between INR 1500-3000.

The cost of consultation in major cities of India are as follows –

  • New Delhi – INR 1000-2500
  • Mumbai – INR 1500-3000
  • Chennai – INR 500-2000
  • Bengaluru – INR 900-1200
  • Hyderabad – INR 500-1000

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