What is Medical Oncology?
Medical oncology is the medical specialty concerned with the management of cancer, from diagnosis through to palliative care. A treatment plan is built around a detailed pathology report of the cancer, its development, its risk of spreading, and the parts of the body involved, so that treatment is matched as closely as possible to the specific disease a patient is facing.
Medical oncology is grounded in the principle of individualised treatment, recognising that each patient's cancer journey is unique. Medical oncologists carefully evaluate a patient's specific cancer type, stage, molecular characteristics, overall health, and personal preferences to develop a personalised treatment plan. Beyond treating the cancer itself, medical oncologists provide compassionate supportive care to manage symptoms, treatment side effects, and the emotional and psychological impact of a cancer diagnosis.
Understanding Medical Oncology
Cancer develops when cells in the body begin to grow and divide uncontrollably, eventually forming a tumor that can invade surrounding tissue or spread to other parts of the body. Because the behaviour of cancer, and its response to treatment, can vary enormously depending on where it originates and its underlying molecular characteristics, no two treatment plans in medical oncology are quite the same.
Medical oncologists work closely with pathologists, radiologists, surgeons, and radiation oncologists to build a complete picture of a patient's cancer before recommending treatment. This multidisciplinary approach allows a treatment plan to account not only for the cancer itself, but for how it is likely to respond to different types of therapy, and how a patient's overall health may affect their ability to tolerate treatment.
Treatment Modalities in Medical Oncology
Medical oncologists draw on several distinct treatment modalities, often using them in combination to achieve the best possible outcome:
- Chemotherapy
This systemic therapy employs medications that target and destroy cancer cells throughout the body. Chemotherapy drugs interfere with various cellular processes essential for cancer cell growth and division.
- Targeted Therapy
Medications designed to specifically target molecules or pathways involved in cancer cell growth and survival, offering a more precise approach than conventional chemotherapy.
- Immunotherapy
Treatment that harnesses the patient's own immune system to recognise and destroy cancer cells, either by stimulating the immune response or by removing barriers that prevent the immune system from targeting the cancer effectively.
- Hormonal Therapy
Used for cancers containing receptors for hormones such as oestrogen or progesterone, most notably certain breast cancers. It works by lowering hormone levels in the body or blocking their effects on cancer cells.
- Radiation Therapy
Also known as radiotherapy, this uses beams such as X-rays, gamma rays, or proton and electron beams to destroy cancer cells at a targeted site.
Cancers Managed in Medical Oncology
Because cancer can arise in almost any part of the body, medical oncologists manage a wide range of cancers, grouped here by the body system in which they typically originate:
- Digestive System: Oesophageal cancer, stomach (gastric) cancer, liver cancer, pancreatic cancer, and colorectal cancer.
- Respiratory System: Lung cancer, one of the most common cancers, frequently linked to long-term tobacco smoking, genetic factors, and exposure to chemicals or air pollution.
- Genitourinary System: Kidney cancer and testicular cancer, the latter most often found in men aged 15 to 44.
- Reproductive System: Uterine (endometrial) cancer and other gynaecological cancers affecting the cervix, vagina, vulva, ovaries, or fallopian tubes.
- Blood and Lymphatic System: Lymphoma, a cancer of the lymphocytes, and leukaemia, a cancer involving abnormal overproduction of white blood cells.
- Head and Neck: Nose (nasopharyngeal) cancer and throat cancer, which develops in the throat or voice box.
- Skin: Skin cancer, including melanoma, arising from the epidermis, the skin's outer layer.
Recognising the Warning Signs of Cancer
Because cancer can affect so many different organs, its early symptoms can be subtle and are sometimes mistaken for less serious conditions. Signs that warrant medical evaluation include:
- A new lump or persistent swelling: Particularly one that does not resolve on its own, or that grows or changes over time.
- Unexplained weight loss: A noticeable, unintentional drop in weight without a clear cause.
- Persistent fatigue: Ongoing tiredness that does not improve with rest and is not explained by another cause.
- Changes in bowel or bladder habits: Persistent changes in stool or urinary patterns, including blood in the stool or urine.
- Unusual bleeding: Bleeding that is unexplained or occurs outside of a normal pattern, such as between menstrual periods or after menopause.
- A persistent cough or hoarseness: A cough or change in voice that does not resolve within a few weeks.
- Difficulty swallowing: Ongoing difficulty or discomfort when swallowing food or liquids.
- Changes in a mole or skin lesion: A mole or patch of skin that changes in size, shape, colour, or texture, or that fails to heal.
How Cancer is Diagnosed and Staged
- Biopsy and pathology: A sample of tissue is examined under a microscope to confirm the presence of cancer and identify its specific type and characteristics.
- Imaging studies: CT, MRI, PET, or ultrasound scans are used to determine the size of a tumor and whether the cancer has spread to other parts of the body.
- Molecular and genetic testing: Testing of the tumor's genetic and molecular profile can identify specific mutations, guiding the choice of targeted therapy or immunotherapy.
- Staging: Once diagnosed, a cancer is staged according to its size, depth of invasion, and whether it has spread to lymph nodes or other organs, which helps determine the most appropriate treatment approach.
A cancer diagnosis can be overwhelming, and treatment can be a demanding physical and emotional journey. However, with an individualised treatment plan, ongoing supportive care, and close monitoring throughout treatment, many patients are able to achieve good outcomes, and some cancers, when caught early, can be effectively cured.
Our dedicated teams of experienced multidisciplinary specialists and healthcare professionals work together to provide treatment plans tailored to the needs of our patients on their recovery journey.
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