As Oncology ( ancient Greek ὄγκος ONKOS , swelling 'and -logie ), outdated and Cancerologie , one calls the science, the known with the since ancient times and first explored in ancient disease cancer is concerned.
The medical disciplines involved are tumor- operating surgical subjects (e.g. surgery , gynecology , ENT , neurosurgery , dermatology , urology , ...), radiation oncology and internal medicine with additional training in internal oncology / hemato-oncology.
Modern oncology is characterized by the interdisciplinary cooperation of the medical disciplines involved, depending on the tumor disease. Representatives of the following disciplines should always be present on every tumor board: radio-oncology, internal oncology, diagnostic radiology (to assess tumor spread), pathology (to assess the type of tumor disease) and the respective surgical specialist involved.
Many efforts in oncology are directed towards preventing cancer ( cancer prevention ) or suppressing its spread in the patient's body. It is of central importance to identify risk factors . Oncologists work together with epidemiologists and, for example, statistically evaluate medical histories. Knowledge of risk factors is used in two ways:
- If further investigations identify a risk factor as being the cause, attempts are made to reduce this factor, for example by preventing exposure ( e.g. issuing TRK values for cancer-causing substances ) or behavioral interventions ( e.g. health education, smoking cessation ).
- On the basis of risk factors, particularly endangered groups of people can be identified and screening examinations can be carried out. The aim here is to detect and treat malignant cell growth, if possible before cancer breaks out or spreads ( early detection ).
Research into the development of cancer is an essential part of any prevention. This can lead to new approaches in cancer prevention, diagnostics and therapy. In Germany, the international network builds on the German Cancer Research Center (DKFZ) in Heidelberg.
- Laboratory examinations of body fluids ( clinical chemistry )
- Cytology of smears
- Imaging examinations
If the suspicion of cancer is found or confirmed, an attempt is usually made to achieve a definitive diagnosis based on the histological or cytological examination of a tissue sample from the suspicious area. At the same time, the stage of the disease is determined using other diagnostic methods. Because of the often poor prognosis of malignant diseases on the one hand and the risks and side effects of the treatment on the other, this step is particularly important and justifies a lot of effort, including exploratory operations including trial excision .
The main treatment methods in oncology are:
- Surgical tumor removal
- Radiation therapy , in which the tumor tissue is treated with ionizing radiation
- Chemotherapy with cytotoxic drugs
- Drug therapy with relatively new active ingredients such as monoclonal antibodies ( cancer immunotherapy ) or tyrosine kinase inhibitors .
Oncology therapies aim either to remove or destroy the entire tumor tissue ( curative therapy) or, if this is no longer possible, to reduce the size of the tumor tissue with the aim of extending the life span and reducing tumor-related symptoms ( palliation ).
Special therapy schemes have been established for various tumors, which are continuously optimized in large international studies ( therapy optimization studies ). Based on the established stage, possible therapy options are discussed with the patient . The general physical condition and concomitant diseases play an important role here. The most promising form of therapy according to the current state of science is suggested to the patient. Options include single or multiple chemotherapy or radiation, or surgery to remove the tumor tissue. Different chemotherapy drugs can be combined. A combination of all three methods is also possible.
Malignant tumors still pose considerable problems for today's medicine, especially in advanced diseases.
Increasingly gentler methods have been and are being developed to protect the patient. These include:
- HITT, high frequency induced thermotherapy
- Psycho- oncology for the treatment of psychological complications of oncological diseases
- Patient competence to strengthen the mental and emotional state of cancer patients
- Chrono-oncology to improve the efficiency of tumor treatment while reducing undesirable side effects
While oncology has long been concerned with improving survival rates, so great progress has now been made that the long-term consequences of oncological therapies are now being examined. Both chemotherapy and radiation therapy leave traces in the body that can lead to secondary diseases even after many years or decades.
For example, one study looked at the diseases of adults who underwent oncological therapy in their childhood. It was shown here that almost all those affected suffer from at least one chronic illness. At the age of 50, cardiomyopathy , heart valve defects , lung problems, functional disorders of the pituitary gland and hearing loss or deafness were in the foreground. One third is infertile. Despite improved therapies, care should still be taken today to provide long-term care for former oncological patients in order to be able to identify diseases early and treat them.
Pediatric oncology deals with cancers in children and adolescents from 0 to 18 years of age. With timely treatment, three quarters of the roughly 2,000 children and adolescents who become ill each year can lead a life without extensive restrictions.
Advances in cancer research have helped develop new, more effective therapies for cancer and optimize treatment approaches. In this way, the chances of survival and quality of life for cancer patients have been steadily improved over the past few years. Research funding by private organizations is of growing importance. For over 40 years of its existence, the German Cancer Aid has been promoting oncological research projects from donations from citizens.
- German Cancer Aid
- German Cancer Society (DKG)
- German Society for Hematology and Medical Oncology (DGHO)
- German Society of Radiation Oncology e. V. (DEGRO)
- Society for Pediatric Oncology and Hematology (GPOH)
- Union Internationale contre le cancer
- European Society of Gynecological Oncology
- European Organization for Research and Treatment of Cancer (EORTC)
- European Society for Radiotherapy and Oncology
- American Society of Clinical Oncology (ASCO)
- American Cancer Society
- American Society for Radiation Oncology (ASTRO)
- Professional Association of Resident Gynecological Oncologists in Germany V. (BNGO)
- Interest Grouping established quality assurance work uro-oncologists in Germany e. V. (IQUO)
- Paul Obrecht: Clinical Cancerology. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition, ibid. 1961, pp. 352-375.
- Oncology: ICD-O-3: International Classification of Diseases for Oncology, 3rd revision
- www.krebsinformationsdienst.de : The cancer information service of the German Cancer Research Center (DKFZ), Heidelberg.
- Cancer: Patient information from the German Cancer Society on diagnosis and therapy of cancer in general
- Cancer types: patient information from the German Cancer Society on various types of cancer
- Cancer types: Information for doctors: Congress reports of the German Cancer Society on various types of cancer
- Paul Obrecht: Clinical Cancerologie. 1961, p. 352.
- Surgery, exploratory. ( Memento from August 2, 2012 in the web archive archive.today ) In: Medizinlexikon imedo.de
- Melissa M. Hudson, Clinical Ascertainment of Health Outcomes Among Adults Treated for Childhood Cancer. In: JAMA. 309, 2013, p. 2371, doi: 10.1001 / jama.2013.6296 .
- Pediatric Oncology and Hematology. Retrieved June 17, 2019 .
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- degro.org ( Memento of the original from December 25, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.