ओन्कोलोजी

नेपाली विकिपीडियाबाट
यसमा जानुहोस्: परिचालन, खोज्नुहोस्


Oncology is the medical subspecialty dealing with the study र treatment of cancer. A physician who practices oncology is an oncologist. The term originates from the Greek onkos (ογκος), meaning bulk, mass, or tumor र the suffix -ology, meaning "study of."

Oncologists may be divided on the basis of the type of treatment provided.

Oncologists may also be categorized on the basis of the patient type.

  • Gynecologic Oncologist: specialize in the treatment of cancer in women. Gynecologic Oncologists can perform र give chemotherapy र assist in radiation therapy for these cancers in women.
  • Pediatric Oncologist: specialize in the care of children with cancer.

Oncology is concerned with:

The oncologist often coordinates the multidisciplinary care of cancer patients, which may involve physiotherapy, counselling, clinical genetics, to name but a few. On the other hand, the oncologist often has to liaise with pathologists on the exact biological nature of the tumor that is being treated.

Diagnosis[सम्पादन गर्ने]

The most important diagnostic tool remains the medical history: the character of the complaints र any specific symptoms (fatigue, weight loss, unexplained anemia, paraneoplastic phenomena र other signs). Often a physical examination will reveal the location of a malignancy.

Diagnostic methods include:

Apart from in diagnosis, these modalities (especially imaging by CT scanning) are often used to determine operability, i.e. whether it is surgically possible to remove a tumor in its entirety.

Generally, a "tissue diagnosis" (from a biopsy) is considered essential for the proper identification of cancer. When this is not possible, empirical therapy (without an exact diagnosis) may be given, based on the available evidence (e.g. history, x-rays र scans.)

Occasionally, a metastatic lump or pathological lymph node is found (typically in the neck) for which a primary tumor cannot be found. This situation is referred to as " carcinoma of unknown primary", र again, treatment is empirical, based on past experience of the most likely origin.

Therapy[सम्पादन गर्ने]

It depends completely on the nature of the tumor identified what kind of therapeutical intervention will be necessary. Certain disorders will require immediate admission र chemotherapy (such as ALL or AML), while others will be followed up with regular physical examination र blood tests.

Often, surgery is attempted to remove a tumor entirely. This is only feasible when there is some degree of certainty that the tumor can in fact be removed. When it is certain that parts will remain, curative surgery is often impossible, e.g. when there are metastases elsewhere, or when the tumor has invaded a structure that cannot be operated upon without risking the patient's life. Occasionally surgery can improve survival even if not all tumour tissue has been removed; the procedure is referred to as "debulking" (i.e. reducing the overall amount of tumour tissue). Surgery is also used for the palliative treatment of some of cancers, e.g. to relieve biliary obstruction, or to relieve the problems associated with some cerebral tumours. The risks of surgery must be weighed up against the benefits.

Chemotherapyradiotherapy are used as a first-line radical therapy in a number of malignancies. They are also used for adjuvant therapy, i.e. when the macroscopic tumor has already been completely removed surgically but there is a reasonable statistical risk that it will recur. Chemotherapyradiotherapy are commonly used for palliation, where disease is clearly incurable: in this situation the aim is to improve र prolong quality of life.

Hormone manipulation is well established, particularly in the treatment of breast र prostate cancer.

There is currently a rapid expansion in the use of monoclonal antibody treatments, notably for lymphoma (Rituximab), र breast cancer (Trastuzumab).

Vaccine र other immunotherapies are the subject of intensive research.

The application of ultrasound in the form of HIFU to solid tumors is under investigation.

Follow-up[सम्पादन गर्ने]

A large segment of the oncologist's workload is the following-up of cancer patients who have been successfully treated. For some cancers, early identification of recurrence, with prompt treatment, can lead to better survival र quality of life. It depends on the nature of the cancer whether the follow-up lasts a number of years or remains "life long".

Palliative care[सम्पादन गर्ने]

Although ५०% of all cancer cases diagnosed achieve curation, a large number of cancer patients will die from the disease. There may be ongoing issues with symptom control associated with progressive cancer. These problems may include pain, nausea, anorexia, fatigue, immobility, र depression. Not all issues are strictly physical: personal dignity may be affected. Moral and spiritual issues are also important.

Whilst many of these problems fall within the remit of the oncologist, palliative care has matured into a separate, closely allied speciality to address the problems associated with advanced disease. Palliative care is an essential part of the multidisciplinary cancer care team. Palliative care services may be less hospital-based than oncology, with nurses र doctors who are able to visit the patient at home.

Ethical issues[सम्पादन गर्ने]

There are a number of recurring ethical questionsdilemmas in oncological practice. These include:

These issues are closely related to the patients' personality, religion, culture, personal, र family life. The answers are rarely black र white. It requires a degree of sensitivity र very good communication on the part of the oncology team to address these problems properly.

Progress र research in oncology[सम्पादन गर्ने]

There is a tremendous amount of research being conducted on all frontiers of oncology, ranging from cancer cell biology to chemotherapy treatment regimens र optimal palliative carepain relief. This makes oncology an exciting र continuously changing field.

Therapeutic trials often involve patients from many different hospitals in a particular region. In the UK, patients are often enrolled in large studies coordinated by the Medical Research Council (MRC, www.mrc.ac.uk) or the European Organisation for Research र Treatment of Cancer (EORTC, www.eortc.be).

Complementary र Alternative therapies[सम्पादन गर्ने]

See main article: Alternative medicine

Many cancer patients seek extra help from complementary र alternative therapies, which fall वाहिर of conventional medicine. Some complementary therapies do not have a firm scientific or evidence base. Some patients undoubtedly find complementary therapies helpful whilst they are undergoing conventional treatment.

Whilst most complementary therapies are harmless र even beneficial, they can be expensive. They may also be positively harmful if the patient forgoes conventional treatment altogether, in order to follow alternative regimens. Some alternative regimens are undoubtedly hazardous.

See also[सम्पादन गर्ने]

References[सम्पादन गर्ने]

  • Vickers, A. Alternative Cancer Cures: "Unproven" or "Disproven"? CA Cancer J Clin २००४ ५४: ११०-११८. Full text online

External links[सम्पादन गर्ने]


स्वास्थ्य विज्ञानचिकित्साशास्त्र
एनेस्थेसियोलोजी | चर्मशास्त्र | आकस्मिक चिकित्सा | साधारण चिकित्सक | आन्तरिक चिकित्सा | स्नायुशास्त्र | प्रसवशास्त्रमहिलारोग शास्त्र | अकुपेसनल् चिकित्सा | रोगशास्त्र | बालरोगशास्त्र | भौतिक चिकित्सा र पूनर्स्थापना | मानसिक चिकित्सा | सामाजिक स्वास्थ्य | रेडियोलोजी | शल्यचिकित्सा
आन्तरिक चिकित्साक हाँगाहरु
हृदयशास्त्र | ग्रन्थिशास्त्र | ग्यास्त्रोएन्टेरोलोजी | रक्तशास्त्र | सरुवा रोग चिकित्सा | ईन्टेन्सिभ केयर चिकित्सा | मृगौलाशास्त्र | ओन्कोलोजी | फोक्सोशास्त्र | रिउम्याटोलोजी
शल्यचिकित्साका हाँगाहरु
हृदयछाती शल्यचिकित्सा | चार्मिक शल्यचिकित्सा | साधारण शल्यचिकित्सा | महिला शल्यचिकित्सा | स्नायुशल्यचिकित्सा | नेत्रशल्यचिकित्सा | मुख तथा अनुहार शल्यचिकित्सा | अंग प्रत्यारोपण | हाडजोर्नी शल्यचिकित्सा | ओटोल्यारिंजियोलोजी (ENT) | बाल्यशल्यचिकित्सा | प्लास्टिक शल्यचिकित्सा | क्यान्सर शल्यचिकित्सा | चोट शल्यचिकित्सा | युरोलोजी | धमनी शल्यचिकित्सा