MFF0090: Oncology


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Oncology

Oncology is the branch of medicine that involves caring for patients with malignant diseases or what is usually known as cancer. This reminds me that when I was in medical school, my professor of pathology, viz., Dr John Kerr would always pull us up if we used the word cancer rather than carcinoma when describing a malignancy that originates in epithelial cells.

The other malignancy classifications include sarcoma which involves nonhæmatopoietic mesenchymal cells, leucæmias which arise from bone marrow cells that mature in the blood, lymphomas which arise from bone marrow cells that mature in the lymphatic system, and germinomas which are derived from germ cells.

A medical practitioner who practises in oncology is known as an oncologist. A medical oncologist is usually a physician and I urge listeners to go to episode 7 and listen to what the word physician means in Australia. Medical oncologists treat patients with chemotherapy, targeted therapy, immunotherapy and hormonal therapy.

Surgical oncologists will manage patients with surgical skills that now go beyond what was traditionally known as knife work and may involve the use of robots for precision surgery.

Radiation oncologists use ionising radiation to treat malignant disease.

In modern medicine, medical practitioners now tend to subspecialise and so we now have disciplines like:

  • Neurooncology¬†which focuses on the brain
  • Ocular oncology which focuses on the eye
  • Head and Neck oncology which focuses on the oral cavity, nasal cavity, oropharynx,¬†hypopharyx¬†and larynx
  • Thoracic oncology which focuses on the lungs, mediastinum,¬†Ňďsophagus¬†and pleura
  • Breast oncology which focuses on breasts both in women and men
  • Gastrointestinal oncology which focuses on the stomach, colon, rectum, anal canal, liver, gallbladder, and pancreas (check out my colonoscopy experience)
  • Bone and Musculoskeletal oncology which focuses on the bones and soft tissues
  • Dermatological oncology which focuses on the medical and surgical treatment of skin, hair, sweat gland, and nail malignancies
  • Genitourinary oncology which focuses on the genital and urinary systems
  • Gyn√¶cological¬†oncology which focuses on the female reproductive system
  • P√¶diatric oncology is concerned with malignant diseases in children
  • H√¶matooncology¬†which focuses on the blood and stem cell transplantation
  • Preventive oncology focuses on epidemiology and prevention of malignant disease
  • Geriatric oncology which focuses on the elderly population
  • Pain and Palliative oncology which focuses on treatment of end stage malignant disease to alleviate suffering
  • Molecular oncology focuses on molecular diagnostic methods in oncology
  • Oncopathology¬†is the specialty of pathology which focuses on the histopathological diagnosis of malignant disease. As a pathologist, it’s worth saying that pathology and oncology are deeply tied to one another. Oncologists could not function or practice without anatomical and clinical pathologists.
  • Nuclear medicine focuses on the diagnosis and treatment of malignant disease with radiopharmaceuticals

I know a lot of people ask the question, “When will there be a cure for cancer?” I’m not sure it will be in my lifetime. Carcinomas and the other forms of so-called cancers are malignant neoplasms, where a neoplasm is an abnormal growth of tissue. The usual cause is damage to the underlying DNA of the affected cells. Mostly, DNA damage is repaired in our cells, but sometimes, the damage goes unchecked and can be caused by exogenous factors like cigarette smoke. Some infections, including bacterial and viral infections, can lead to DNA damage which cannot be repaired and neoplastic growth occurs. When this growth occurs in an unchecked fashion a tumour may result. If a tumour spreads and causes symptoms of harm to a patient, then the disease is regarded as malignant. The spread of malignant neoplastic disease is usually called metastasis. Malignant tumours are said to metastasise through tissue and metastases can spread far and wide in a patient. For example, prostatic carcinoma often spreads to bones. The spread can occur by way of the lymphatic system and that’s why some treatments require the removal of not only the malignant tumour, the surrounding tissue but also the draining lymph nodes.

Is it possible to prevent and stop DNA damage and the consequences of DNA damage? I don’t know, I’m not an oncology researcher. It’s not my area. Knowing though that there are so many causes of DNA damage finding a solution which prevents all DNA damage is the Holy Grail.

Public Service Announcement

Now to deviate from the norm I have a public service announcement.

I was hanging out in a chat room with other podcasters and we got to discussing phallic health and hygiene and I mentioned when I did some sexual health in my training that I saw a fair bit of cheesy¬†smegma. So, my podcast colleagues are going to do public service announcements on their podcasts about drawing back your foreskins and cleaning every day. Of course, if you’re a woman or a circumcised man, you can ignore this advice.

Podcast shout out

I want to shout out to some podcasting friends. Jennie, Lauren and Peter from Mouthy Broadcast and Freak, Jessi and Micro from Zombie Anonymous.

It was Peter from Mouthy Broadcast and Freak from Zombie Anonymous who did the PSAs on Phallic Health and Hygiene.

Mouthy Broadcast¬†is a free podcast which drops every Tuesday. In the words of the hosts, “It’s perfect for trashy women and the men who love them”. This podcast is¬†NSFW. Check out the latest episode 173 which fits nicely with Medical Fun Facts episode 86 “Be kind to your anus”.

Zombie Anonymous The hosts describe Zombie Anonymous as the 12-step program for your Zombie addiction! Are you a Zombieholic too?? You can attend our meetings and confess to your fellow Zombieholics! Also, NSFW.

Questions for readers and listeners

When someone tells you they have cancer, what’s the best way to respond?

When you see your doctor do you prefer detailed explanations of what’s wrong?

Do you like listening to podcasts?

Please leave your answers in the comments section of the show notes or on the Facebook page or on YouTube.

That’s episode 90 in the can.

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Medical Fun Facts is available in¬†Anchor, the¬†Apple Podcasts app, and in¬†Stitcher. You’ll find the links in the show notes.

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If you have any questions or comments please let me know. If I’ve said anything incorrect I welcome correction.

I’ll catch you next week for episode 91. Something beginning with the letter P. Send me suggestions.

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Stop Press

This just in from the IARC about the burden of malignant disease in young adults. It’s sobering reading.

6 Replies to “MFF0090: Oncology”

  1. This was absolutely fascinating!!!! (your voice is also incredibly soothing) I had no idea ‘cancer’ was a word like Xerox or Kleenex. A phrase used to cover a multitude of carcinomas. Completely appreciated this information. Thank you!

    Liked by 1 person

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