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Medical oncology ?

Medical Oncology is a branch of oncology that focuses on the treatment of cancer using systemic therapies such as chemotherapy, targeted therapy, immunotherapy, and hormonal therapy. Medical oncologists play a crucial role in the multidisciplinary approach to cancer treatment, often working closely with surgical and radiation oncologists to provide comprehensive care.

Key Roles of Medical Oncologists

Diagnosis and Staging: Assist in confirming cancer diagnosis and determining its stage using imaging, biopsy reports, and molecular studies.

Systemic Therapy: Often used after surgery to kill remaining cancer cells.

  • Chemotherapy: Use of cytotoxic drugs to kill rapidly dividing cancer cells.

  • Targeted Therapy: Drugs designed to target specific molecular pathways or genetic mutations in cancer cells.

  • Immunotherapy: Therapies like immune checkpoint inhibitors that enhance the immune system’s ability to fight cancer.

  • Hormonal Therapy: Used in hormone-sensitive cancers such as breast and prostate cancers.

Treatment Planning: Develop individualized treatment regimens based on tumor type, stage, and patient-specific factors.

Supportive Care: Manage side effects of systemic therapies and provide palliative care for symptom relief.

Survivorship Care: Monitor patients for recurrence and manage long-term effects of treatment.

Chemotherapy

Chemotherapy is a systemic cancer treatment that involves the use of drugs to kill rapidly dividing cells, particularly cancer cells. The administration of chemotherapy can vary based on the type of cancer, its stage, the patient’s overall health, and the specific drugs being used. Here are the main ways chemotherapy is given

Intravenous (IV) Infusion
  • This is the most common method for chemotherapy. Drugs are delivered directly into the bloodstream through a vein. It can be done via a central line (a catheter placed into a large vein) or a peripheral IV (a needle placed in a smaller vein).
  • Chemotherapy may be given over a short period (e.g., minutes to hours) or as a longer infusion (e.g., continuous over several days).
  • This route is particularly used for multi-drug regimens.
Oral Chemotherapy
  • Some chemotherapy drugs are available in pill or liquid form. These are taken by mouth and absorbed through the digestive tract.
  • Oral chemotherapy is typically used in maintenance therapies or for specific cancers like breast and colorectal cancers.
Intra-arterial (IA) Chemotherapy
  • This method delivers chemotherapy drugs directly into an artery that supplies blood to the tumor. It’s often used for cancers in the liver or certain head and neck cancers.
Intrathecal or Intracerebroventricular (ICV) Chemotherapy
  • This involves delivering chemotherapy directly into the spinal fluid. It is used when the cancer has spread to the central nervous system (CNS), such as in leukemias or lymphomas.
Intraperitoneal (IP) Chemotherapy
  • This is used for cancers in the abdomen, such as ovarian cancer, where chemotherapy drugs are delivered directly into the peritoneal cavity (the space around the abdominal organs). This method allows higher concentrations of the drug to be delivered to the tumor site.
Topical Chemotherapy
  • Some chemotherapy drugs are formulated as creams or ointments for direct application to skin cancers or lesions. This route is mostly used for superficial tumors like basal cell carcinoma.
Chemotherapy Regimens
  • Chemotherapy is often given in cycles—several days of treatment followed by a rest period to allow the body to recover. These cycles depend on the specific cancer type and treatment goals. It could be a combination therapy using multiple drugs for a synergistic effect.
Chemotherapy in Combination with Other Treatments
  • Chemotherapy may be combined with radiation therapy, surgery, or immunotherapy. This approach, often called multimodal therapy, helps in improving survival rates and targeting tumors more effectively.

Chemotherapy treatment is highly individualized based on factors such as the type of cancer, its location, the patient’s age, and overall health. Close monitoring of side effects and response to treatment is crucial, as chemotherapy can cause significant toxicities like nausea, hair loss, immune suppression, and fatigue.

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