Clinical and Medical Oncology

The 3 major specialties of oncology are:

• Medical oncology
• Surgical oncology
• Radiation oncology

There are several sub-specialties in the field of Oncology. The above mentioned specialties deal with the treatment of cancer through Chemotherapy or Immunotherapy, Biopsies and Radiology respectively.

Cancer can be treated by surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy (including immunotherapy such as monoclonal antibody therapy) and synthetic lethality. The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient (performance status). Cancer genome sequencing helps in determining which cancer the patient exactly has for determining the best therapy for the cancer. A number of experimental cancer treatments are also under development. Under current estimates, two in five people will have cancer at some point in their lifetime.

Radiology is the medical discipline that uses medical imaging to diagnose and treat diseases within the bodies of both humans and animals. A variety of imaging techniques such as X-ray radiography, ultrasound, computed tomography (CT), nuclear medicine including positron emission tomography (PET), and magnetic resonance imaging (MRI) are used to diagnose or treat diseases. Interventional radiology is the performance of usually minimally invasive medical procedures with the guidance of imaging technologies such as those mentioned above.

DNA is the repository of genetic information in each living cell, its integrity and stability is essential to life. DNA, however, is not inert; rather, it is a chemical entity subject to assault from the environment, and any resulting damage, if not repaired, will lead to mutation and possibly disease.

Clinical oncologists are doctors who treat patients with a balance of radiotherapy and chemotherapy. They are involved in the management of all types of cancer and use a range of other treatments to treat cancers, without using surgery.

The epidemiology of cancer is the study of the factors affecting cancer, as a way to infer possible trends and causes. The study of cancer epidemiology uses epidemiological methods to find the cause of cancer and to identify and develop improved treatments.

Neuro-oncology is the study of brain and spinal cord neoplasms, many of which are (at least eventually) very dangerous and life-threatening (astrocytoma, glioma, glioblastoma multiforme, ependymoma, pontine glioma, and brain stem tumors are among the many examples of these). Among the malignant brain cancers, gliomas of the brainstem and pons, glioblastoma multiforme, and high-grade (highly anaplastic) astrocytoma are among the worst. In these cases, untreated survival usually amounts to only a few months, and survival with current radiation and chemotherapy treatments may extend that time from around a year to a year and a half, possibly two or more, depending on the patient's condition, immune function, treatments used, and the specific type of malignant brain neoplasm. Surgery may in some cases be curative, but, as a general rule, malignant brain cancers tend to regenerate and emerge from remission easily, especially highly malignant cases. In such cases, the goal is to excise as much of the mass (tumor cells) and as much of the tumor margin as possible without endangering vital functions or other important cognitive abilities.

Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly-inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin.

Nanomedicine is the medical application of nanotechnology. Nanomedicine ranges from the medical applications of nanomaterials and biological devices, to nanoelectronic biosensors, and even possible future applications of molecular nanotechnology such as biological machines. Current problems for nanomedicine involve understanding the issues related to toxicity and environmental impact of nanoscale materials (materials whose structure is on the scale of nanometers, i.e. billionths of a meter).

Molecular pathology is an emerging discipline within pathology which is focused in the study and diagnosis of disease through the examination of molecules within organs, tissues or bodily fluids. Molecular pathology shares some aspects of practice with both anatomic pathology and clinical pathology, molecular biology, biochemistry, proteomics and genetics, and is sometimes considered a "crossover" discipline. It is multi-disciplinary in nature and focuses mainly on the sub-microscopic aspects of disease. A key consideration is that more accurate diagnosis is possible when the diagnosis is based on both the morphologic changes in tissues (traditional anatomic pathology) and on molecular testing.

Pediatric Oncology is the term used to comprise all malignant conditions among neonates & children with cancer. The most common childhood cancers are, Neuroblastoma, Retinoblastoma, Wilms tumor and brain tumors, such as gliomas. Childhood cancers are very rare and may differ from adult cancers in the way they grow, spread, treated, and respond to treatment.

Cancer immunology is a stream of immunology that studies communications between the immune system and cancer cells (also called tumors or malignancies). It is a field of research that intent to discover cancer immunotherapies to treat and decelerate evolution of the disease. The human immune system mounts natural endogenous response to foreign cells. The gamut of genetics and epigenetics changes occurring in tumors provides diverse set of antigenic repertoire that host’s immune system can exploit to distinguish tumour versus their normal healthy counterparts.

Cancer screening aims to detect cancer before symptoms appear. This may involve blood tests, urine tests, DNA tests, other tests, or medical imaging. The benefits of screening in terms of cancer prevention, early detection and subsequent treatment must be weighed against any harms.

An oncolytic virus is a virus that preferentially infects and kills cancer cells. As the infected cancer cells are destroyed by oncolysis, they release new infectious virus particles or virions to help destroy the remaining tumour. Oncolytic viruses are thought not only to cause direct destruction of the tumour cells, but also to stimulate host anti-tumour immune system responses. The potential of viruses as anti-cancer agents was first realised in the early twentieth century, although coordinated research efforts did not begin until the 1960s. A number of viruses including adenovirus, reovirus, measles, herpes simplex, Newcastle disease virus, and vaccinia have been clinically tested as oncolytic agents. Most current oncolytic viruses are engineered for tumour selectivity, although there are naturally occurring examples such as reovirus and the senecavirus, resulting in clinical trials.

Oncology Nursing is a field including practice incorporates the jobs of direct guardian, instructor, specialist, head, and scientist. Oncology nursing care can defined as meeting the various needs of oncology patients during the time of their disease including appropriate screenings and other preventative practices, symptom management, care to retain as much normal functioning as possible, and supportive measures upon end of life. Cancer Summit 2019 will make another transformation in malignancy science and disease nursing field.

A radiation oncologist is a specialist physician who uses ionizing radiation (such as megavoltage X-rays or radionuclides) in the treatment of cancer. Radiation oncology is one of the three primary specialties, the other two being surgical and medical oncology, involved in the treatment of cancer. Radiation can be given as a curative modality, either alone or in combination with surgery and/or chemotherapy. It may also be used palliatively, to relieve symptoms in patients with incurable cancers. A radiation oncologist may also use radiation to treat some benign diseases, including benign tumors.

A microRNA (abbreviated miRNA) is a small non-coding RNA molecule (containing about 22 nucleotides) found in plants, animals and some viruses, that functions in RNA silencing and post-transcriptional regulation of gene expression. miRNAs function via base-pairing with complementary sequences within mRNA molecules. As a result, these mRNA molecules are silenced, by one or more of the following processes: Cleavage of the mRNA strand into two pieces, Destabilization of the mRNA through shortening of its poly(A) tail, and Less efficient translation of the mRNA into proteins by ribosomes.

A single-nucleotide variant (SNV) is a variation in a single nucleotide without any limitations of frequency. SNV differs from SNP because when an SNV is detected in a sample from one organism of a species the SNV could potentially be a SNP but this cannot be determined from only one organism. SNP however means the nucleotide varies in a species' population of organisms. SNVs may arise in somatic cells. A somatic single-nucleotide variation (e.g., caused by cancer) may also be called a single-nucleotide alteration. SNVs also commonly arise in molecular diagnostics. For example when designing PCR primers to detect viruses, the viral RNA or DNA in a single patient sample may contain SNVs.

Cancer is a disease caused by genetic changes leading to uncontrolled cell growth and tumor formation. The basic cause of sporadic (non-familial) cancers is DNA damage [citation needed] and genomic instability. A minority of cancers are due to inherited genetic mutations. Most cancers are related to environmental, lifestyle, or behavioral exposures. Cancer is generally not contagious in humans, though it can be caused by oncoviruses and cancer bacteria. The term "environmental", as used by cancer researchers, refers to everything outside the body that interacts with humans. The environment is not limited to the biophysical environment (e.g. exposure to factors such as air pollution or sunlight), but also includes lifestyle and behavioral factors.

Complementary and alternative are terms used to describe many kinds of products, practices, and systems that are not part of mainstream medicine. You may hear them used to refer to methods to help relieve symptoms and improve quality of life during cancer treatment. We call these “complementary” because they are used along with your medical treatment.

Cancer immunoprevention is the prevention of cancer onset with immunological means such as vaccines, immunostimulators or antibodies. Cancer immunoprevention is conceptually different from cancer immunotherapy, which aims at stimulating immunity in patients only after tumor onset, however the same immunological means can be used both in immunoprevention and in immunotherapy.

Many factors impact the development of cancer. Over the last 25 years, science has displayed that diet,body weight and physical activity —especially being overweight or obese—are leading risk factors for obtaining certain types of cancer. The main behavioral and environmental risk factors for cancer death in the world are related to diet and physical inactivity, use of addictive substances, sexual and reproductive health and exposure to air pollution and use of contaminated needles.

Over 100 types of cancers affect humans. Tobacco use is the cause of about 22% of cancer deaths. Another 10% are due to obesity, poor diet, lack of physical activity or excessive drinking of alcohol. Other factors include certain infections, exposure to ionizing radiation and environmental pollutants.

Instruments are designed to aid in the diagnosis, monitoring or treatment of medical conditions. Several new types of equipment are used in the treatment of cancer such as:

Linear Accelerator (LINAC) – It emits radiation of highly localised (X-rays) and it is useful in the treatment of cancer. The 6 MeV linear accelerator having the capability of surface electron allows treating cancer cells even under the subcutis layer overlying the cranium. The patient can also see his activity through the connected display unit.

Gamma Camera – It is used in the detection of cancer via gamma rays. Here tracers used are introduced into the patient’s body intravenously, thus getting the image on the gamma camera as the tracer emits gamma rays which are detected by the gamma camera.

Radiography and Ultrasound – It is a non-invasive way of getting the image of the internal organs by ultrasound. It is a useful method for cancer patients for examining the abdomen for any enlargement of the lymph or masses.

Cancer research ranges from epidemiology, molecular bioscience to the performance of clinical trials to evaluate and compare applications of the various cancer treatments. These applications include surgery, radiation therapy, chemotherapy, hormone therapy, immunotherapy and combined treatment modalities such as chemo-radiotherapy. Starting in the mid-1990s, the emphasis in clinical cancer research shifted towards therapies derived from biotechnology research, such as cancer immunotherapy and gene therapy.

In medicine, a case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports may contain a demographic profile of the patient, but usually describe an unusual or novel occurrence. Some case reports also contain a literature review of other reported cases. Case reports are professional narratives that provide feedback on clinical practice guidelines and offer a framework for early signals of effectiveness, adverse events, and cost. They can be shared for medical, scientific, or educational purposes.

According to a study done in Italy, 20% of those who died from COVID-19 had active cancer. The NHS of the United Kingdom has warned that those undergoing active chemotherapy or radiotherapy for lung cancer and those with bone marrow cancers are vulnerable to serious illness if they become infected with COVID-19.