Medical Oncology – Farrer Park Hospital
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What is Medical Oncology?
​Medical Oncology is a specialty that deals with the treatment of cancers by using drugs rather than surgery and radiotherapy. This administration of drug therapy has come to be known as chemotherapy. The medical oncologist needs to correctly diagnose and assess the stage of your cancer, recommend and implement a treatment plan and carefully monitor your progress and manage symptoms arising from the treatment and from the cancer. In addition, a medical oncologist may coordinate treatment rendered by other specialists, as well as providing counseling and emotional support.

​There are many different types of cancers.  The classification largely depends on the organ it has arisen from and the type of cells seen from either a biopsy or from surgery to remove the affected tissue.  The more common cancers in Singapore are: lung, colorectal, breast, prostate, liver, stomach, uterine and ovarian.  Many of these are called carcinomas.  Other types of cancers include those of lymphatic origin (lymphomas); cancers of connective tissue, fat or muscle origin (sarcomas) amongst many other types.

Cancer is a problem of uncontrolled and unregulated cell growth, often with multiple defects or mutations in genes.  In many cases, it is the accumulation of multiple gene defects that are either acquired over time, from exposure to various environmental agents (e.g. smoking, alcohol, radiation, and certain infections).  These genetic abnormalities then reach a point where the cells continue to divide and grow, without the body’s usual system of checks and balances being able to control this anymore.  Reducing one’s exposure to certain known carcinogenic agents can reduce the possibility of developing cancer, but age itself is a risk factor that cannot be changed.  In some families, there might be an inherited risk that is passed on to some family members.  Such families may have several cancers diagnosed in different family members, often at younger ages.

Not uncommonly, patients may note a slow onset of symptoms and signs. In general, these may arise as a result of the local effect of the primary cancer where it has originated or also at distant sites of disease if it has spread.  Weight loss can occur and tends to be a symptom experienced with advanced cancers.  Some common signs that should serve to raise suspicions could be highlighted as follows:

-Change in bowel or bladder habits
-A sore that does not heal
-Unusual bleeding or discharge
-Thickening or lump in breast or any other part of the body
-Indigestion or difficulty in swallowing
-Obvious change in wart or mole
-Nagging cough or hoarseness
​The treatment of a cancer may involve surgery, radiotherapy or chemotherapy.  Combinations of such treatments (e.g. chemotherapy together with radiotherapy) are also used in selected situations.  Medical Oncologists help select, where appropriate, suitable drugs to treat patients.  These treatments have typically been using hormonal therapy or chemotherapy.  Chemotherapy involves the use of powerful drugs that kill cancer cells.  More recent advances have led to the development of newer ways to inhibit cancer cell growth.  These range from molecular targeted drugs, monoclonal antibodies that inhibit cell growth, block blood vessel growth and also target the immune system.  Significant advances have been made with these newer treatment modalities. 
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