Medical Oncology

Medical oncology is a subspecialty of internal medicine that provides cancer patients with chemotherapy, and other non-radiation and non-surgical treatments, including hormone therapy and pain medication.

Chemotherapy
Chemotherapy is the use of powerful drugs to treat cancer by killing the rapidly dividing malignant cells. Chemotherapy may involve one drug or a combination of drugs, depending on the type of cancer and its progression. The medicine may be administered with radiation treatment, or taken by itself, either before or after surgery. Chemotherapy has been helping people with cancer since the 1950s and has helped many people with cancer live healthy lives.

Chemotherapy is usually delivered in one of three ways:

• Intravenous (IV) The most common form of delivering chemotherapy drugs is by inserting a needle into a vein; a plastic bag holds the medicine and feeds it into the vein through a tube that is attached to the needle. For some patients, a catheter is inserted into one of the large veins and left in place during the chemotherapy sessions. Other patients have an IV connection device, known as a port, implanted under the skin.

• Injection Some chemotherapy drugs can be delivered with a shot under the muscle, or directly into the cancer lesion.

• Oral Some chemotherapy drugs may be in pill or liquid form that a patient takes orally.

Chemotherapy treatment varies depending on the type of disease and its severity. The medicine may be taken once a day, once a week, or even once a month. There are several side effects, since the anti-cancer drugs also damage or kill healthy cells, but drastic improvements have been made to lessen the severity of symptoms. There are drugs to prevent nausea, and there are drugs, known as growth factors, that help the bone marrow recover and start making new blood cells.

The most common side effects include: temporary hair loss, fatigue, nausea, pain, mouth sores, dry skin and hair, increased risk of infection, depression, increased sun sensitivity, numbness or weakness in the hands and feet, and hormone changes that decrease interest in sexual activity.

Hormone therapy
Hormone therapy uses drugs to slow the growth of endometrial cancer and prostate cancer--diseases that are fueled by hormones. The drugs are usually taken as pills. While hormone therapy does not cure cancer, it can provide relief from symptoms.

• Endometrial cancer patients may be given progesterone to slow the growth of endometrial cancer. They may also be given tamoxifen, an anti-estrogen drug used to fight breast cancer. Tamoxifen can prevent estrogens--which stimulate the growth of cancer cells--from circulating in a woman's body. Many women with endometrial cancer have their ovaries removed, or rendered inactive by radiation, in order to reduce the production of estrogen.

• Prostate cancer male hormones (androgens), which are produced mostly in the testicles, cause prostate cancer cells to grow. To stop the cancer from growing, luteinizing hormone-releasing hormone (LH-RH) agonists are used to decrease the amount of male hormones. Sometimes surgery to remove the testicles (orchiectomy) is done to stop the production of testosterone. This procedure is reserved for men with advanced prostate cancer.

October 2006