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онкология

Онкология — это медицинская специальность, которая занимается профилактикой, диагностикой и лечением всех форм рака. Существуют различные виды рака, которые могут поражать различные части тела. Таким образом, онколог может принять решение специализироваться в определенной области, например, в лечении рака молочной железы, лечения рака предстательной железы или рака полости рта.

Онкология – это раздел медицины, который занимается профилактикой, диагностикой и лечением рака. Медицинский работник, который практикует онкологию, является онкологом. Этимологическое происхождение имени происходит от греческого слова ὄγκος (ónkos), означающего «опухоль», «объем» или «масса», и слова λόγος (логос), означающего «речь».

Три компонента, которые улучшили выживаемость при раке:

Профилактика – за счет снижения факторов риска, таких как употребление табака и алкоголя.

Ранняя диагностика – скрининг распространенных видов рака, комплексная диагностика и определение стадии

Лечение – мультимодальное управление путем обсуждения в кабинете онкологии и лечения в комплексном онкологическом центре.

Рак часто лечат путем обсуждения на междисциплинарных конференциях по раку, где медицинские онкологи, хирургические онкологи, радиационные онкологи, патологоанатомы, радиологи и онкологи по конкретным органам встречаются, чтобы найти наилучшее возможное лечение для отдельного пациента с учетом физических, социальных, психологических, эмоциональных и финансовое положение пациента. Для онкологов очень важно быть в курсе последних достижений в области онкологии, поскольку изменения в лечении рака довольно распространены. Все подходящие пациенты, у которых рак прогрессирует и для которых не доступны стандартные варианты лечения, должны быть включены в клиническое исследование.

Скрининг
Скрининг рекомендуется при раке молочной железы, шейки матки, толстой кишки и легких.

Симптомы
Как правило, симптомы обычно зависят от локализации и типа рака. 

Факторы риска

Табак: это основная причина рака и смерти от рака. Курение связано с повышенным риском развития рака легких, гортани, полости рта, пищевода, горла, мочевого пузыря, почек, печени, желудка, поджелудочной железы, толстой кишки, прямой кишки, шейки матки и острого миелоидного лейкоза. Бездымный табак (нюхательный или жевательный табак) связан с повышенным риском развития рака полости рта, пищевода и поджелудочной железы.

Алкоголь: он может увеличить риск развития рака полости рта, горла, пищевода, гортани, печени и молочной железы. Риск заболеть раком намного выше у тех, кто пьет алкоголь, а также курит.

Ожирение: люди с ожирением имеют повышенный риск развития рака молочной железы, толстой кишки, прямой кишки, эндометрия, пищевода, почек, поджелудочной железы и желчного пузыря.

Возраст: пожилой возраст является фактором риска для многих видов рака. Средний возраст постановки диагноза рака составляет 66 лет.

  • Lymphoma
    Fever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
  • Endometrial Cancer
    Bleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
  • Ovary Cancer
    Nonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
  • Head and Neck Cancer
    Non-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
  • Thyroid Cancer
    Lump in the neck.Treatment options include surgery and radioactive iodine.
  • Stomach Cancer
    Vomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
  • Rectum Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
  • Pancreatic Cancer
    Weight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Bladder Cancer
    Blood in urine.Treatment options include surgery, radiation and chemotherapy.
  • Testis Cancer
    Swelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
  • Blood Cancer
    Bleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. Includes acute and chronic leukemias. Acute leukemias includes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Chronic leukemias include chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
  • Breast Cancer
    Lump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
  • Cervix Cancer
    Bleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
  • Lung Cancer
    Persistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
  • Brain Cancer
    Persistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
  • Oesophagus Cancer
    Painful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
  • Colon Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
  • Liver Cancer
    Jaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Prostate Cancer
    Urgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
  • Bone Cancer
    Pain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.

Типы рака

ДИАГНОСТИКА И СТАДИРОВАНИЕ

  • Lymphoma
    Fever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
  • Endometrial Cancer
    Bleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
  • Ovary Cancer
    Nonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
  • Head and Neck Cancer
    Non-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
  • Thyroid Cancer
    Lump in the neck.Treatment options include surgery and radioactive iodine.
  • Stomach Cancer
    Vomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
  • Rectum Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
  • Pancreatic Cancer
    Weight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Bladder Cancer
    Blood in urine.Treatment options include surgery, radiation and chemotherapy.
  • Testis Cancer
    Swelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
  • Blood Cancer
    Bleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. Includes acute and chronic leukemias. Acute leukemias includes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Chronic leukemias include chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
  • Breast Cancer
    Lump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
  • Cervix Cancer
    Bleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
  • Lung Cancer
    Persistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
  • Brain Cancer
    Persistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
  • Oesophagus Cancer
    Painful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
  • Colon Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
  • Liver Cancer
    Jaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Prostate Cancer
    Urgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
  • Bone Cancer
    Pain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.

Онкологические специальности

Три основных подразделения:

  • Lymphoma
    Fever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
  • Endometrial Cancer
    Bleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
  • Ovary Cancer
    Nonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
  • Head and Neck Cancer
    Non-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
  • Thyroid Cancer
    Lump in the neck.Treatment options include surgery and radioactive iodine.
  • Stomach Cancer
    Vomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
  • Rectum Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
  • Pancreatic Cancer
    Weight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Bladder Cancer
    Blood in urine.Treatment options include surgery, radiation and chemotherapy.
  • Testis Cancer
    Swelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
  • Blood Cancer
    Bleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. Includes acute and chronic leukemias. Acute leukemias includes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Chronic leukemias include chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
  • Breast Cancer
    Lump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
  • Cervix Cancer
    Bleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
  • Lung Cancer
    Persistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
  • Brain Cancer
    Persistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
  • Oesophagus Cancer
    Painful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
  • Colon Cancer
    Bleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
  • Liver Cancer
    Jaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
  • Skin Cancer
    Non-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
  • Prostate Cancer
    Urgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
  • Bone Cancer
    Pain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.
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