Oncology is the branch of medicine that specialises in the study, treatment, and management of cancer right from the diagnosis of cancer to all the different treatments of cancer and palliative care. A doctor who specialises in oncology is called an oncologist.
A cancer patient is managed and treated by an oncologist. They diagnose cancer and then assign a stage depending on the severity of the disease. The treatment options are discussed and explored. If required the patient is then referred to the care of an oncologist who specialises in particular cancer and its treatment. Most times the treatment involves oncologists from different specialities such as radiation, surgery and chemotherapy working together on treating and managing a patient. Our team of doctors and specialists at Narayana Health provide medical oncology services and treatments through specialised as well as multi-disciplinary teams as and when required to give the best possible treatment and cancer care services for each patient.
The Department of Medical Oncology at Narayana Health's group of hospitals offers cancer treatment provided by a team of qualified medical oncologists experienced in the diagnosis, treatment planning and follow-up with chemotherapy, hormonal, biological and targeted therapy.
Types of Oncology Specialities And Diseases
There are three main classifications of oncology, namely-
Medical: Medical oncology focuses on the treatment of cancer through non-surgical means such as chemotherapy and immunotherapy.
Surgical: Surgical oncology is the area of speciality that treats cancer through surgical means such as removal of tumours. The obtaining of a sample of tissue through biopsy is also classified under surgical oncology.
Radiation: Radiation oncology focuses on treating cancer through radiation therapy.
There are also other classifications of oncology depending on the specialisation of the doctor. At Narayana Health, our cancer care specialities are classified as:
Breast Cancer: Breast cancers are treated through different therapies. Surgical breast cancer treatment involves the surgical excision and removal of cancer and the nearby tissue, in either or both of the breasts or the lymph nodes. Conservative breast surgery, oncoplastic surgery and breast reconstructive surgery are also treatments that are provided under this speciality. Surgery may be used as a treatment with radiation or chemotherapy.
Gynaecology Oncology: The treatment of cancers of the female reproductive system for all age groups. The gynaecology oncologist specializes in diagnosing and treating cancer that starts in women’s reproductive organs.
Head and Neck Surgery- Oncology: Tumours and cancers in the head and neck regions are under this speciality. This includes the sinuses, mouth, nose, and throat. Eighty-five percent of head and neck cancers are linked to tobacco, and 75% are associated with a combination of tobacco and substance abuse.
Integrative Oncology: This speciality has an integrative and holistic approach to inpatient and outpatient cancer care. It aims to use complementary approaches to support the cancer patient’s health in mind, body and spirit. Integrative oncology in the form of additional treatment approaches such as naturopathy aims to reduce the pain and complications related to cancer treatment and to some extent signs also.
Medical Oncology: Medical oncology is focused on the treatment of cancers through non-operative means such as chemotherapy, hormonal therapy, immunotherapy, radiation and all other non-surgical means.
Ortho - Oncology: The treatment of tumours and cancers related to bones and soft tissues is in the scope of this speciality.
Pediatric Oncology: The treatment of children and young adults with cancer. The treatment and management of pediatric cancer patients are very different from that of adults.
Pain and Palliation Oncology: Cancer patients suffer a lot of pain. Pain and palliative care is the most important part of cancer care. It deals with the treatment and management of pain in cancer patients. Narayana Healthcare is a cancer care hospital in India that focuses on providing the best pain and palliative care to cancer patients.
Radiation Oncology: Radiation oncology is a medical speciality that involves the use of radiation to treat or cure cancer or to reduce the symptoms and pain triggered by cancer. Radiation therapy is the treatment of cancer by radiation which is delivered by the qualified radiation oncology team. The treatment of cancer by controlling or destroying cancer cells through the use of ionizing radiation. Narayana Health offers radiation treatment through the latest cutting-edge technology that delivers radiation in a very precise manner to reduce treatment times.
Surgical Oncology: Most cancers are treated with the removal of tumours and marginal tissues. Surgical oncology is usually complemented with radiation therapy or chemotherapy to destroy the remaining cancer cells. Surgical oncology also involves biopsy procedures to obtain samples of tissues. It includes palliative surgery to relieve pain and discomfort, and restorative or reconstructive surgery to improve the appearance of the body, after other oncology surgery. The subspecialties of surgical oncology are -
- Sarcoma Surgery
Sarcomas are a rare type of cancers that affect the connective tissues of the body such as the tendons, bones, muscles, fat, cartilage, nerves, and blood vessels. The arms and legs are usually the most affected; also, sarcomas can rarely occur in the other parts of the body. The surgery is the surgical removal of a sarcoma tumour.
- Paediatric Surgery
The cancer treatment in children is different from adults. Our department of pediatric surgery has a dedicated and experienced team of experts in the surgical treatment of neonates, children, and young adults. Narayana Health has the best pediatric surgical services to treat and manage childhood cancer.
- Melanoma Surgery
Melanomas are skin cancers that are usually caused by exposure to UV radiation. Melanoma surgery removes the affected area of tissue. Treatment may also require the removal of the affected lymph nodes through surgery.
- Hepato-Pancreato- Biliary (HPB) Surgery
Our team of HPB surgeons specialise in the surgical removal of cancer of the liver, pancreas, gallbladder and bile ducts.
HIPEC or Hyperthermic intraperitoneal Chemotherapy is a form of chemotherapy. Instead of treating the patient with chemotherapy through the bloodstream, the drugs are heated and directly delivered to the abdomen. It is a prefered treatment for cancers in the abdomen, such as gastric cancer. It may be used in conjunction with other surgical treatments.
- Endocrine Surgery
Our team of experts treat cancer of the thyroid, parathyroid, and adrenal glands by surgical removal of the affected tissue. Surgery may be performed in conjunction with other treatments such as radiation therapy. Endocrine surgery may be followed by hormonal therapy to balance the hormones in the body.
- Colorectal Surgery
Colorectal cancers of the colon, rectum and the anus are sometimes treated by means of surgery to remove cancerous tissue from the colon wall, rectum, and the anus as well as the affected lymph nodes, if required.
- Acute Care General And Palliative Surgical Oncology
Some cancer patients require additional treatment or even surgery to ease the pain and symptoms of cancer. Our dedicated team provides treatment and surgery if required to improve the comfort level, reduce side effects, improve survival chances, and reduce recovery times for the patients.
- Uro - Oncology
Our team of uro-oncology surgeons diagnose, treat, and perform surgeries of the male and female urinary tract, along with the male reproductive system to remove urologic cancers.
Diagnosis of cancer is usually performed by an oncologist. The type of cancer may be diagnosed and assigned by stage with the help of an oncologist who specialises in that particular type of cancer before being treated non-invasively or referred for surgery.
Diagnosis of each type of cancer is very specific to the type. However, there are a few diagnostic tests that are commonly used. If your doctor suspects that your symptoms could be cancer, further investigation is done through tests such as-
Biopsy: A tissue sample is obtained through a needle or surgery in order to study the suspected tissue for cancerous cells better
Mammogram, Breast MRI or Breast Ultrasound: The study of the breast tissue in order to diagnose or rule out tumours. MRI’s might use contrast dyes to improve the image quality.
Barium Enema or Colonoscopy: These diagnostic procedures are performed to study problems with the colon or rectum.
Bone Scan, Bone Marrow Biopsy or Aspiration: Bone scans are used to study the bones and if there are any cancerous tissue present. They can be full-body scans using radioactive material called tracers. They use CT or CT-PET scans to study the bones. Bone marrow samples may be extracted and studied to diagnose cancers such as leukaemia, lymphoma, or multiple myeloma.
CT Scan: A computed tomography scan takes two-dimensional images of the internal tissues of the body. A contrast dye is used to get clearer images. This scan involves a small amount of radiation but the benefits outweigh the risks. For patients who cannot be subjected to radiation, an MRI might be performed.
Magnetic Resonance Imaging (MRI): Radio waves and a powerful magnetic field are used to get images of the internal structures and tissues of the body. Since magnetic fields are used, people with metallic implanted devices cannot be subjected to an MRI scan.
Positron Emission Tomography (PET): PET scans use radioactive isotopes called tracers injected into the bloodstream to give very clear images of the body.
Endoscopy: This procedure uses a thin flexible tube that has a camera and a light at the end into the body to study the internal structures. It is used to study and diagnose problems with the digestive tract, ears, nose, throat, heart, abdomen, urinary tract and joints.
Tumour Marker Tests: These are tests that look for substances that are found at higher levels in the urine, blood or other body tissues for some cancer patients. These markers are also referred to as biomarkers.
PAP Tests: This test which is also called a PAP smear is used to study samples of tissue scraped from the cervix to check for cervical cancer.
Ultrasound: In addition to studying a tumour ultrasounds can be used to guide the doctor taking a biopsy sample.
Treatment & Preventions
Cancer is assigned a stage by the treating oncologist depending on the severity of the disease, as well as, how far it has spread. Cancer treatment is highly dependent on the stage of cancer. There is much research and newer technology that is being used in the fight against this disease. Some of the most common treatments are as follows:
- Chemotherapy is the treatment of cancer through the infusion of drugs that are harmful to cancer cells.
- Radiation uses high energy x-rays, or other particles, to target cancer and to destroy the cancerous cells.
- Bone marrow transplants or stem cell transplants are used in the treatment of certain cancers such as leukaemia, multiple myeloma, or some lymphomas.
- Immunotherapy uses the body’s own immune system to fight the cancerous cells. Targeted therapies are being used to specifically target specific genes and proteins that are unique to cancer.
Surgery is used to remove the cancerous tissue as well as some marginal tissue that surrounds it. It may be followed by chemotherapy or radiation therapy to eradicate the cancerous cells that might be left behind.
Child cancers are different from adult cancers in the way that they are treated. The way in which pediatric cancer patients respond to treatment is also different from adults. However, childhood cancers are not often caused by lifestyle factors and there are usually no underlying health issues to consider like most adults have. The consideration of long term side effects of the treatment and the lifelong management of the same is also an integral part of pediatric cancer treatment. The chances of making a recovery is also higher in children than in adults.
Your oncologist and their team will study your cancer and give you the line of treatment that is most suitable for your situation. In some cases, this may or may not work. If it does not work, a second line of treatment can be suggested. The possibility of a different treatment option depends on each individuals cancer.
How well your treatment works often varies. Your first-line treatment may not work, can start but then stop working, or may cause serious side effects. Your doctor may then suggest a second-line treatment, also called second-line therapy. It’s a different treatment that is likely to be effective. Depending on the type of cancer you have and the available drugs, you may be able to have third-line therapy, or additional rounds of treatment after that.
- Medical oncologists: They treat cancer using chemotherapy, hormonal and biological therapies and other targeted treatments. Medical oncologists also act as primary cancer doctors and help patients manage side effects and maintain their well-being.
- Radiation oncologists: Radiation oncologists destroy cancer cells by targeting a high-energy photon beam on them. Roughly, half of all cancer patients have to go through radiation therapies as part of their overall cancer care. Radiation therapies can also be delivered by implanting irradiated material in the affected area.
- Surgical oncologists: Primary care doctors usually refer their patients to a surgical oncologist if they suspect they have cancer. Surgical oncologists perform biopsies by taking a small part of the affected tissue to check it for the presence of cancer cells. If cancer cells are present, the surgical oncologist will then help you prepare for and recover from any surgical procedures you need to undergo during cancer treatment.
- Paediatric oncologists: Paediatric oncologists deal with the diagnosis, management and treatment of cancer in children. A vital part of their job is to educate families whose children are undergoing treatment for cancer.
- Gynaecologic oncologists: They specialize in the treatment of cancers affecting women, such as cervical cancers, ovarian cancers, uterine cancers, etc. They are also trained to treat complicated gynaecological conditions like fibroid tumours and endometriosis.
- Haematologist-oncologist: They treat blood cancers like leukaemia and lymphoma.
Cancer fatigue is a term used to describe the feelings of tiredness that often comes with cancer. It is different than the fatigue that happens from the usual fatigue that people experience after having a long day at work or involving in strenuous physical activity.
People describe cancer fatigue as a feeling of listless, drained, and extreme weakness that may subside and come back. The weakness can affect someone’s ability to eat, walk to the bathroom or even use the TV remote. Although resting for a bit can relieve them for a while, but it doesn’t make it go away completely. For some people, this can cause more distress than pain, nausea or depression.
Chemotherapy treatment depends on the individual treatment plan prescribed by the doctor and can vary in length and frequency accordingly. While some sessions may last as long as three to four hours, others may be done in just half an hour.
Your doctor can inform you of an estimate of the time that your treatment or therapy sessions will take during your first consultation. Due to the effects of chemotherapy, patients have to receive regular blood work to make sure a chemotherapy session can be performed. The blood work will usually be performed a day ahead of the scheduled chemotherapy visit. If the blood levels are not appropriate, the chemotherapy visit can also be cancelled.
The survival rates of cancer patients are based on the studies performed during and after their treatment. They provide a rough estimate about the chances of surviving, but cancer survivors often live much longer than these estimates.
Life expectancy numbers can never tell how long someone is going to live. Besides, an individual has all the rights to discuss or not to discuss the issue of life expectancy. They can talk to their healthcare team about it by setting up a separate visit. This gives them the time to openly communicate and ask questions about the statistics and information they receive from the doctor.