Waging war: Advances in treatment have led to better results

Rita had been suffering from cancer for several years. However, with the right medication for her cancerous tumour, she survived another 20 years. Good treatment from an oncologist, administered in time, literally saved her life.

Oncology is a branch of medicine that studies tumours (cancer) and seeks to understand their development, diagnosis, treatment and prevention. A physician who practises oncology is an oncologist . The term originates from the Greek onkos, meaning bulk, mass or tumour and the suffix -ology, meaning “study of”. Oncology requires expertise in a large number of medical and technical disciplines, from surgery to nutrition, immunology to biochemistry, and diagnosis of symptoms to treatment of tumours with nuclear radiation.

Oncologists are classified on the basis of the type of treatment they provide. Radiation oncologists specialise in the treatment of cancer by radiotherapy. Surgical oncologists are surgeons who specialise in tumour removal. Medical oncologists use medication or chemotherapy to treat cancer. They utilise radiotherapy, chemotherapy, hormone therapy, radioactive isotopes and other special techniques to treat patients with cancer. The clinical oncologist is frequently the only physician, along with the family practitioner, who is involved with a patient throughout the course of his or her treatment.

Advances in cancer treatment have significantly improved outcomes for some tumours, but the overall prognosis for survival remains poor. Restoring hope in women and men and giving them a dignified choice in treatment is the aim of oncologists.

What do I have to do?

Oncologists practise in hospitals and medical centres, and research organisations. They coordinate multidisciplinary care of cancer patients, which may involve physiotherapy, counselling and clinical genetics, and consult with pathologists on the exact nature of a tumour.

Oncology is also concerned with palliative care of patients with terminal malignancies, ethical questions surrounding cancer care, screening of the relatives of patients (in types of cancer that are thought to have a hereditary basis, such as breast cancer), and medical history (the character of the complaints and any specific symptoms such as fatigue, weight loss, unexplained anemia and paraneoplastic phenomena).

Diagnostic methods include biopsy, either incisional or excisional, endoscopy, either upper or lower gastrointestinal, bronchoscopy or nasendoscopy, X-rays, CT scanning, MRI scanning, ultrasound and other radiological techniques, scintigraphy, positron emission tomography and other methods of nuclear medicine, and blood tests, including tumour markers.

Oncologists also give follow-up care to patients who have been successfully treated.

What should I study?

You should pass Plus Two or an equivalent examination with physics, chemistry and biology as the main subjects. After that, you should do your MBBS and specialise in oncology (MS or DM).

What next?

Cancer is a devastating disease, predicted to be a leading cause of death in India, which has an estimated 2.5 million cases with half a million new cases being added every year. There is rising public demand for the services of oncologists. It is estimated that after 20 years nearly 75 per cent of all cancer deaths will be in developing countries. WHO has specified that healthy lifestyles and suitable public health-action plans can control nearly one-third of cancers.

The future holds great promise for anti-apoptotic agents, cancer vaccines, biotherapy/immunotherapy and gene therapy. Companies like AstraZeneca, Zydus, Dr Reddy’s and Torrent apply innovative research, development and commercial excellence in oncology. Psycho-oncology can be used to treat nearly 20-30 per cent of the new patients who have elevated levels of emotional distress. Motivated by the desire to improve their quality of life, many cancer patients are exploring complementary or alternative therapy (prayer, music and art therapy, meditation and relaxation techniques).

The concept of “cure” in cancer has shifted its focus from improvement in the number of years of survival to improvement in quality of survival. Patients no longer say “we want to survive” — they now say “we want to live”.

where to study

• All Indian Institute of Medical Sciences, New Delhi.
• Tata Memorial Hospital, Mumbai.
• Cancer Centre Welfare Home and Research Institute, Calcutta.
• Kidwai Memorial Institute of Oncology, Bangalore.
• Christian Medical College, Ludhiana.
• Cancer Institute, Chennai.