Category Archives: Medical oncology

Principles of biological therapy

The term ‘biological therapy’ encompasses a wide range of treatments and adjuncts to the treatment of cancer. Most are still being evaluated-a few examples are discussed below. Interferons (lFNs)  Interferons are naturally occurring lymphokines that are normally produced in response to viral infection. Their mechanism of action in malignant disease is uncertain; they have specific antiproliferative

Principles of endocrine therapy

It has long been known that oestrogen is capable of stimulating the growth of breast cancer and androgens the growth of prostate cancer. Manipulation of the hormonal environment may result in regression of a number of tumours particularly breast cancer, endometrial cancer and prostate cancer. Hormonal therapy is in general not curative. It may, however, provide control of a tumour for a period of time often

Bone marrow suppression

Suppression of the production of haemoglobin, white cell series and platelets may occur with many cytotoxic drugs and is a dose-related phenomenon. Severely myelosuppressive chemotherapy is only used when treatment is given with curative intent. Anaemia and thrombocytopenia are managed by blood or platelet transfusions but white cell transfusions have not been successful. Neutropenic patients are therefore m

Principles of chemotherapy

The ability to give anticancer treatment via the bloodstream was a major advance as it enabled therapy to potentially reach metastatic disease in any part of the body. The toxicity of chemotherapy determined that drugs could only be given intermittently and that time had to be allowed for normal tissues to recover between each administration of new cytotoxic drugs. Furthermore, it quickly became apparent in

Measuring response to treatment

Response to treatment can be subjective or objective. A subjective response is one perceived by the patient in terms of, for example, relief of pain, dyspnoea or improvement in appetite, weight gain or energy. Quantitative measurements of these subjective symptoms form an increasingly important part of the assessment of response to chemotherapy especially in those situations where cure is not possible and wh

The diagnosis of malignancy

The diagnosis of cancer may be suspected by both doctor and patient but obviously needs to be confirmed. Patients with cancer and their families are likely to be frightened; the very word cancer, often avoided by doctors and patients alike, is, often incorrectly, assumed to imply certain death. Reassurance and advice on therapy can only be given on the basis of a tissue diagnosis obtained via a needle biopsy

Cancer genetics

The development of cancer is associated with a fundamental genetic change within the cell and there is overwhelming evidence that mutations can cause cancer (a mutation being defined as a change in the genome). Mutations Evidence for the genetic origin of cancer is based on the following: • Most known carcinogens induce mutations. • Genetically determined traits associated with a deficiency in the enzymes

Epidemiology

Geographical distribution The incidence of various cancers varies with geographical tion. England, Scotland and Wales in fact have the ighest death rate from malignant disease in the world, mainly as a result of the very high incidence of lung cancer. Breast, colon and prostatic cancer all have a low incidence in Asian countries compared to Europe and North America. In contrast, liver cancer is very common wo

Medical oncology

Introduction The term cancer encompasses a wide range of diseases including common illnesses such as lung cancer and colon cancer, as well as more esoteric ones, such as the acute leukaemias. Malignant disease is widely prevalent and, in the Western world, is second only to cardiovascular disease as the cause of death. Cancer is thus not one illness and the treatment therefore involves multidisciplinary teams