oncology

Oncology

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See Cancer for the biology of malignant diseases, and the list of these diseases.

Oncology or Carcinology or oncology is the medical specialty of study, diagnosis and treatment of cancers. A doctor Who practices this discipline is called an oncologist or oncologist. The term comes from the Greek onkos, meaning bulk, mass or tumor, and the suffix-neurology, meaning "study of".

Diagnosis
Cancer screening may involve the general population (mass screening) or a target population with risk factors.

The suspicion of cancer is based on several elements: the clinic (the symptoms), the biological examinations (blood tests), the imaging exams.

Tumor marker
Medical imaging: Radiography, scanner, magnetic resonance imaging (MRI), positron emission tomography (PET), scan, etc.
Evidence of cancer can only be made (except for rare exceptions) by a tumor collection and microscopic analysis by the Anatomo-pathologist. Anatomo-Pathology is an indispensable specialty for the study of cancerous tissues. This study helps to understand the natural history of cancer cells, the development of tumors and their metastases and to classify cancerous tissues by nature.

Nomenclature of malignant tumors or cancers
In general, the malignant neoplasia are divided into four main classes:

Carcinomas that derive from an epithelial tissue. These are the most common tumors in adults.
Sarcomas that derive from a connective tissue (bone, muscle, adipose tissue, etc.). These are rare tumours (less than 10% of all adult tumours)
Primitive tumours of the central nervous system (CNS)
Lymphomas, myeloma and leukemias that derive from immune-function blood cells.
Classification according to Histology
In histology the terms devoted to the affected tissues are as follows:

Carcinoma Tissue: Squamous carcinoma, basal carcinoma
Glandular tissue: adenocarcinoma
lymphoid tissue or lymph nodes: Lymphoproliferative syndrome or lymphoma
Hematopoietic tissue or blood cells: leukemia, myeloproliferative syndrome and myeloma
Mésothélial Tissue: Mesothelioma
Germinal Fabric: Seminoma
Nævique Tissue: Melanoma
Nervous Tissue: glioma malignant
Connective Tissue: Sarcoma
Bone Tissue: osteosarcoma
cartilaginous Fabric: Chondrosarcoma
Vascular tissue: angiosarcoma, etc.
Classification by device
In medical practice malignant pathologies are classified by specialty and by organs (breast cancer, lung cancer). The classification by specialty corresponds in a pragmatic way to the specialist who diagnoses or supports this type of tumor. The most common histological form serves as a study model for rarer forms. The forms that benefit from a particular support are studied apart. The tumors of the connective tissue sarcoma and hematopoietic tissue (leukemias, lymphomas and myeloma) have the peculiarity of being observable in all organs. It is a matter of distinguishing them during anatomo-pathological analysis because they generally benefit from a specific support.

Tumors of the nervous system

Primitive brain Tumors

Brain metastases

ENT tumors

Throat Cancer

ENT Cancer

Chest Tumors

Lung Cancer

Mesothelioma

Thymoma

Gynecological tumors

Breast Cancer

Endometrial Cancer

Ovarian Cancer

Cervical Cancer

Digestive Tumors

Esophageal Cancer

Stomach Cancer

Colon Cancer

Pancreatic Cancer

Duodenal Cancer

Urological Tumors

Testicular Cancer

Bladder Cancer

Kidney Cancer

Prostate Cancer

Skin Tumors

Melanoma

Epithelial skin cancers

Rare tumors

Sarcomas

Cancer of an indeterminate nature: CAPI in French (carcinoma of unknown primitive) or ACUP in English (adenocarcinoma with unknown primitive)

Staging

The oncologist establishes for each cancerous disease a staging corresponding to the progress of the disease. The stages refer to different severity of the cancerous disease according to different criteria depending on the nature of the cancerous tissue. For each type of cancer, there is one or more stadifications. Generally a rapprochement between them is sought at the international level:

Who stage

Stage established by the Learned societies

This staging is done most of the time according to the TNM classification:

T for tumor: from 1 to 4 depending on the size and extension of the tumor

N for lymph nodes (of English nodes) depending on the number and location

M for metastasis: 0 for the absence of metastasis and 1 for the presence of metastases

Therapies

Several treatment modalities are possible for cancer. Often you have to use several treatments for the same person:

Chemotherapy

Radiotherapy

Brachytherapy

Immunotherapy

Hormone therapy

Surgery is often a prerequisite in many cancer treatments.

Heat therapy: thermoablation or Ablathermie

Cryotherapy

Treatment decisions are taken in a multidisciplinary manner, that is, between doctors and surgeons of the various specialties involved: medical oncologists, radiation therapists, organ specialists (respirologists, Gastro-gastroenterologists, etc.), surgeons, radiologists, Anatomo-pathologists. These decisions are made in multi-disciplinary consultation meetings (RCP).

Followed

It is difficult to define healing after cancer. This can be affirmed only retrospectively when no relapse has been observed. In general, it is estimated that a five-year period without relapse after the end of treatment is necessary to be able to talk about healing. Nevertheless, relapse is still possible beyond five years; It is quite possible to have a second cancer. In Europe, about one in ten women will have breast cancer in their life. Statistically one in a hundred women will have two breast cancers. As long as the healing cannot be affirmed, we are talking about remission. This can be complete, if you don't see any traces of cancer, or partial, if you still see abnormalities in the exams.

So we have to follow up. In general, the most important thing is the clinic: the symptoms of the patient. Further examinations can also be requested: tumor marker, medical imaging. But most of the time, the anomalies seen in the exams when there are no clinical signs should not be treated: this does not bring any benefit to the patient. Nor is there any advantage in discovering an early recurrence: treatment is generally not easier or more effective (which is not the case for the initial tumor, where early treatment is generally preferable.)

Palliative care, support care, coaching

It is very difficult for a patient to undergo this ordeal, which is the announcement of this stigmatizing disease and the treatments that result from it: surgery (sometimes mutilating), radiotherapy and especially chemotherapy. That is why some hospitals are putting in place a support system, volunteers or not who come to see the patients. In order to help patients to live during their illness and also when a curative treatment is no longer feasible, it has been set up palliative care (when an active therapy is no longer feasible) or supportive care (to support patients With severe illness especially in the management of disabling symptoms). The management of palliative care is intended to be holistic, taking care of the physical, psychological and spiritual symptoms, always focusing its attention on the human. Its mission is to accompany the families.

Mobile Oncology Team

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Ethical Aspects

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Progress and research in oncology

New pathways are being opened, always at the stage of basic research, including physical oncology, which allows the measurement of the mechanical parameters that govern the relationship between the extracellular matrix, the cancerous tissue and the normaux1 tissues. 2.

Advances in the Information of occupational physicians to prevent occupational cancer

This cancer prevention goes through a regularly updated knowledge of doctors in the field of occupational medicine. To assist them, as part of the 2009-20133 cancer Plan, the CNIB commissioned two surveys (with more than 600 physicians) to provide an overview of the sources of information on primary prevention of occupational cancers for Occupational physicians (who report that they are facing this risk for 93.5% of respondents) and to highlight specific needs and courses of action, particularly in the building, public works and industry sectors where the demand of doctors from Work is the most marked. "Archives of occupational diseases and the Environment" 4.

More than 60% of the doctors interviewed use the press and books, and increasingly the Internet (45%), continuing education (31%), congresses or symposia (20%), agencies and public bodies (25%), exchanges with confreres (15%), courses and documents Personal (10%) 4

Only 64% of them are "satisfied with their ability to update their knowledge" 4.

95% wish to have access to the scientific knowledge synthesis documents, regularly updated information on the available tools (93%, with e.g. the medical health record in the workplace, the company's departure form, etc.) and Would consider useful recommendations for the monitoring of workers exposed to CMR (95%), and updates to legislation (92.5%) 4.

As a result of this work, a "Document Resource Guide" and a "newsletter" for occupational Physicians and Occupational Health services are announced in 20134.

Alternative treatments

There are many alternative cancer treatments on the Internet. They promise healing and happiness, on unfounded scientists. Oncologists have a great deal to do to convey fair, clear and appropriate information to the patient.