Oncology is the field of medicine that is dedicated to cancer. Today, there are more than 200 different types of cancer.

Cancer is the uncontrolled growth of abnormal cells that occurs in multiple phases. Most cancers are named after the organ or the type of cell from whence the cancer originates. They can develop in almost any tissue or organ, such as the breast, lung, colon, nerve tissue or bones.

Oncologists are doctors who specialize in the prevention, diagnosis and treatment of cancer. There are three major areas to oncology: a medical oncologist specializes in cancer treatments involving chemotherapy, targeted therapy, immunotherapy and hormonal therapy; while a surgical oncologist specializes in surgery treatments and a radiation oncologist will treat cancer with radiation.

According to the WHO, cancer is the leading cause of death worldwide, causing 8.8 million deaths in 2015. Among the most common causes of cancer-related deaths, include lung cancer, liver cancer, colorectal cancer, stomach cancer and breast cancer. More specifically, according to the Cancer Association of South Africa, prostate cancer is the most common cancer among men, whereas breast cancer is the most common among women.

Causes and Prevention

Cancer occurs from the transformation of normal body cells into tumour cells via a series of stages progressing from a pre-cancerous lesion to a malignant tumour.

This change in the human body results from the collaboration between a person’s genetic factors and 3 types of external factors as explained below:

• Physical carcinogens, such as ionizing and ultraviolet radiation;
• Chemical carcinogens, such as components of tobacco smoke, drinking water contaminants or arsenic, a food contaminant called aflatoxin and asbestos;
• Biological carcinogens, such as infections from bacteria, viruses or parasites.

Another fundamental factor that contributes to the development of cancer is aging. Cancer incidence rises substantially with age, most likely because of the accumulation of risks associated with certain cancers that increase as one ages. A person’s cellular repair mechanisms become less effective with age as well, further increasing one’s risk of developing cancer.

Cancer prevention therefore consist of actions taken to lower one’s risk factor. This includes maintaining a healthy lifestyle, avoiding exposure to known cancer-causing substances, and taking medicines or vaccines that can prevent cancer from developing.

Diagnosis

The role of an oncologist is to first diagnose a cancer, which can be carried out via biopsy, X-ray, endoscopy, CT scanning, MRI scanning, ultrasound, PET scanning and other radiological procedures. Blood tests, nuclear medicine and tumour markers can also be used to diagnose cancer.

Following diagnosis, the oncologist will discuss the stage of the disease with the patient and the appropriate treatment will then be determined.

The patient may also have to see other doctors, depending on his/her case. For example, a haematologist may have to be consulted, if the cancer is associated with disorders of the blood, lymph nodes or bone marrow. ⁠⁠⁠Or perhaps a plastic surgeon should reconstructive surgery be required following the treatment.

A visit to a psycho-oncologist or psychiatrist is usually recommended in order to help patients cope with their cancer psychologically.

Treatment Options

There are several types of cancer treatments available to patients suffering from this ghastly disease. When choosing the type of treatment a patient’s cancer should receive, doctors largely base their decisions on the type of cancer the patient has and how advanced it is. Some cancer sufferers may require one treatment, while others may require a combination treatments. Again, it is up to the medical team to decide what would be most effective.  The main types of cancer treatment include:

Surgery: this is a procedure in which a surgeon removes cancer from your body. Surgery often requires cuts through skin, muscles, and sometimes bone. There are also other ways of performing surgery that do not involve cuts with scalpels (e.g. Cryosurgery, Lasers, Hyperthermia, and Photodynamic Therapy).

Chemotherapy: Chemotherapy is the type of cancer treatment that makes use of drugs to eradicate cancer cells. It works by slowing the growth of the cancer cells, reducing the likelihood of the cancer’s return and decreasing the size of the tumour. Chemotherapy can be administered in many different ways i.e. orally, intravenously, injections etc.

Radiation Therapy: Much like chemotherapy, radiation therapy can be used to prevent cancer from returning, or simply stop or slow its growth. It also lessens problems caused by a growing tumour. In this type of treatment, high doses of radiation are aimed at a specific part of your body from many directions – this is also known as External Beam Radiation Therapy. Conversely, Internal Radiation Therapy is another radiation-based treatment options where the source of radiation is actually placed inside the body. This can be a solid or a liquid source. Where a solid source is utilised, it is known as brachytherapy and radiation emanated from seeds, ribbons or capsules placed in the patient’s body or close to the cancer. If a liquid source is used, it would be received through an IV line where it would travel through the patient’s body seeking and killing cancerous cells.

Immunotherapy: Immunotherapy is the treatment of a disease by inducing, enhancing, or suppressing an immune response. Monoclonal antibodies, Adoptive cell transfer, Cytokines, Treatment Vaccines and Bacillus Calmette-Guérin are different types of immunotherapy used to treat cancer.

Targeted Therapy: Targeted therapy is a type of cancer treatment that targets and block the changes in cancer cells that help them grow, divide, and spread. Most targeted therapies are either small-molecule drugs or monoclonal antibodies.

Hormone Therapy, Stem Cell Transplant and Precision Medicine are some other examples of cancer treatments. Most of these treatments and procedures are available and well executed in South Africa.

Progress in Oncology

There is an incredible amount of research being done in all aspects of oncology, from cancer cell biology to radiation, chemotherapy treatments and palliative care. Thus, the field of oncology is continually changing and progressing for the benefit of the patient.

At BanaHealth, medical centres we team-up with have best in class oncologists who work together with experts in all departments in order to provide superior multidisciplinary care to cancer patients. These specialists have extensive knowledge and experience in the diagnosis and treatment of all types of cancer, ensuring that you are in good hands at all times. The deep connection between research and clinical care allows patients to receive the most advanced treatments using cutting-edge technology and clinical cancer research. This also helps them learn thoroughly about their illness and participate actively in making decisions regarding their treatment.

Milpark Hospital and the Donald Gordon Medical Centre – two examples of hospitals we work with –have internationally renowned Oncology Centres that deal with paediatric and adult cancers. They are devoted to a personal approach to cancer treatment and not only focus on the medical needs of patients.

References

1. World Health Organization (WHO), Cancer Fact Sheet 2017
2. Cancer Association of South Africa, CANSA report 2012
3. NCI (National Cancer Institute)