OncologyJuly 4, 2012
Oncology is a branch of medical practice that deals with the study and treatment of cancer. The remit is wider than many people imagine, with the palliative treatment of patients with life limiting cancers coming under its umbrella and many oncologists choose to make this their primary area of practice. Others prefer to specialize in the surgical side and then pass on their patients for the later stages of treatment and monitoring, others prefer to be at the diagnostic end of the process, but as in all medical areas, oncologists are all qualified medical practitioners of some experience before they take on the added specialty of oncology.
Oncologists can sometimes work away from the patient interface in the pathology department, diagnosing from blood samples or from pieces of tissue taken at biopsy. This is a very specialized field and the oncologist is assisted at this level by laboratory staff who prepare the specimens. This whole area of diagnostics is very important as often the specimen is examined either as a wet slide or a frozen section while the patient is still under the anesthetic. This save time in urgent cases and also avoids unnecessary surgical procedures if the patient’s condition is not very stable. But the pressure is immense to get the answer right; there is not any opportunity to think things over or to seek another opinion and so this has to be considered medicine at the very edge.
Some oncologists choose to follow the path of treating a cancer once diagnosed and this is another very precise path of training. Chemotherapy and radiotherapeutic treatments are changing all the time, with new drugs coming on to the market and new more precise radiological techniques being developed. The FDA examines all of these innovations but it is the job of the therapeutic oncologist to weigh up the pros and cons of various regimes set against the needs of their particular patients and this can result in some quite difficult ethical decisions. Occasionally the treatment can be very harsh and a balance has to be decided upon between quality of life and the length of it. An oncologist with a difficult moral dilemma will seek the help of his peers and this is certainly a discipline where a close understanding with colleagues is absolutely vital.
Although oncology is a specialty in its own right it is perhaps true to say that the oncologist will have a particularly close relationship with specialists from all walks of medicine. The oncologist is very often the last medical practitioner the patient will have contact with, after the malignancy has been discovered by another department, but it is a pleasure for the oncologist to pass them back when a successful outcome has been reached, as is increasingly the case in these days of drug and surgical research and development. Survival rates for most cancers are very much more favorable than even a few years ago and the role of the oncologist, whilst still often a somber one is now much more likely to be that of one who cures rather than just palliates.