Basics of Oncology
Department of Oncology, «Astana medical University»
Nur-Sultan, 2019
Oncology
Oncology is a branch of medicine that deals
with the prevention, diagnosis, and
treatment of cancer. A medical professional
who practices oncology is an oncologist.[1]
The name's etymological origin is the Greek
word ὄγκος (ónkos), meaning "tumor",
"volume" or "mass" and the word λόγος
(logos), meaning "study".
Neoplasm
A neoplasm can be benign, potentially malignant, or malignant (cancer).
Benign tumors include uterine fibroids, osteophytes and melanocytic nevi (skin
moles). They are circumscribed and localized and do not transform into
cancer.
Potentially-malignant neoplasms include carcinoma in situ. They are localised, do
not invade and destroy but in time, may transform into a cancer.
Malignant neoplasms are commonly called cancer. They invade and destroy the
surrounding tissue, may form metastases and, if untreated or unresponsive to
treatment, will generally prove fatal.
Secondary neoplasm refers to any of a class of cancerous tumor that is either a
metastatic offshoot of a primary tumor, or an apparently unrelated tumor that
increases in frequency following certain cancer treatments such as
chemotherapy or radiotherapy.
Rarely there can be a metastatic neoplasm with no known site of the primary
cancer and this is classed as a cancer of unknown primary origin
Malignant tumor
A malignant tumor (tumor malignum) - grow quickly, sprout surrounding
tissue (no capsule), affect the general condition (cachexia cause).
Relapse, give metastases.
Surgery does not always lead to recovery.
Malignant tumor cells are polymorphic, atypical in structure, different from
the maternal. Malignant tumors from epithelial tissues are called cancer
(cancer, carcinoma).
For example: bronchial cancer, stomach cancer, prostate cancer.
Malignant tumors of connective tissue are called -sarcoma (osteosarcoma,
liposarcoma), lymphangioma - zl. tumor l/vessel.
Malignant tumor
Malignant tumors include the concepts of metastasis and relapse.
"Metastasis" is the separation of cancer cells from the primary tumor,
their movement through the lymphatic and blood vessels to other
organs and tissues.
"Relapse" is the re-growth of the tumor in place of the removed
because of a violation of elasticity during the first operation.
BASIC THEORY OF THE ORIGIN OF
TUMORS
1.
2.
3.
4.
The irritation theory of Virchow, who regarded the cause of the tumors,
prolonged exposure to irritating substances on the fabric.
The theory of embryonic origin of D. Kongame tumors, according to which
under the influence of mechanical and chemical stimuli dormant embryonic
cells in the tissues of the body begin to multiply rapidly, causing unrestrained
growth of atypical cells to form a tumor.
Viral-immunogenetic theory of A. A. Silber, according to which viruses
introduced into the cell, lead to the formation of oncogenes, which leads to a
violation of the normal regulation of cell division.
Polyetiological theory of malignant tumors: the action of carcinogenic
substances + the action of genetic factors + the influence of tumor viruses. 90%
are carcinogens (physical, chemical) 10% are genetic changes and viruses.
DIAGNOSIS OF MALIGNANT
NEOPLASMS
1) History collection
2) Biopsy with histological examination;
3) Ultrasound diagnostics;
4) Endoscopic examination;
5) x-Ray examination;
6) Radionuclide diagnostics;
7) Computed tomography;
8) Cytomorphological diagnosis;
9) Thermography;
10) Immunodiagnostics - detection of tumor markers in blood and
urine (fetoprotein, cancer embryonic antigen, chorionic
gonadotropin) - is complex and expensive.
Clinical group
The distribution of patients into clinical groups, carried out in Kazakhstan with
dispensary observation to take into account the treatment and the need for further
treatment, is fundamentally different from staging.
Group 1A - patients with a disease suspected of malignant neoplasm;
Group 1B - patients with precancerous diseases;
Group 2A - patients subject to radical treatment;
Group 2 - patients with malignant diseases, subject to special treatments, with
prospects for full recovery;
Group 3 - patients radically treated, i.e. cured;
Group 4 - patients with common forms of malignant tumors, which can not be
radical treatment, but can be palliative or symptomatic treatment.
TREATMENT OF PATIENTS WITH
MALIGNANT TUMORS
Radical, symptomatic and palliative treatment of malignant tumors
is carried out with the help of various effects, which with a
certain degree of conditionality can be divided into three main
groups:
1. anticancer effects of local-regional type - surgical treatment,
radiation therapy;
2. antitumor effect of the General type - chemotherapy, hormone
therapy;
3. auxiliary antitumor effects - immunotherapy, hyperthermia,
hyperglycemia, hyperoxygenation.
Treatment
1. Combined – surgery + radiation therapy;
surgery + chemotherapy;
2. The combined – Radiotherapy on the tumor + RT on the
area of metastasis;
3. Comprehensive surgery + RT + CT