Texas 1in

The final article in our three-part series on different aspects of cancer treatment focuses on medical oncology. Traditionally, medical oncology involved treating cancer with chemotherapy. As Dr. Sanjay Sethi outlines below, medical oncology now involves much more than just chemotherapy. There are many more targeted treatments. This is in keeping with all forms of cancer therapy—more targeted and less debilitating surgery, more focused radiation treatment, and more directed systemic treatments.
-Vivek S. Kavadi, M.D.

By Dr. Sanjay Sethi

Oncology is the study of cancer, and a physician who specializes in treating people with cancer is called an oncologist. There are three main types of oncologist: medical oncologist, radiation oncologist, and surgical oncologist. Medical oncologists are responsible for the care of a patient from the moment of a cancer diagnosis through all phases of the disease. They also coordinate treatment given by other specialists. Other medical professionals also are involved in a cancer patient’s care, including nurses, social workers, pathologists, and radiologists, to name few.

After completing medical school, medical oncologists must first complete postgraduate training and become board certified in internal medicine. For two additional years, they are broadly trained in all areas of oncology. Some medical oncologists further specialize in specific types of cancer, such as lung cancer, prostate cancer, or breast cancer.

Medical oncologists explain the cancer diagnosis and its stage (description of where the cancer is located or spread to other parts of the body), discuss various treatment options, and recommend the best course of treatment. They also manage the side effects of cancer drugs and treat other symptoms, such as fatigue, nausea, vomiting, constipation, and pain.

Medical oncologists specialize in treating cancers with the use of drugs to kill cancer cells, usually by stopping its ability to grow and divide. Depending on each patient’s medical condition, medical oncologists can recommend a treatment plan that may include chemotherapy, hormonal drugs, biological therapy or other medications such as targeted therapy. These drugs are a form of systemic therapy, which means that it covers the whole body. All these drugs can be used one at a time or in combination.

Traditional chemotherapeutic drugs act by killing fast-growing cancer cells in the body, which usually multiply much more quickly than most cells in the body. But these drugs can also harm cells that divide under normal circumstances such as cells in bone marrow or the intestine. The thought of having chemotherapy frightens most people. But knowing how it works and what to expect can often help manage their fears. It can also give a better sense of control over cancer treatment.

Some newer anticancer drugs, such as various monoclonal antibodies, are also referred to as targeted therapies. These do not kill indiscriminately, but rather target abnormally expressed proteins in cancer cells that are essential for their growth.

Research is ongoing in various areas of medical oncology, some of which include:
Targeted or biologic agents, which are more effective by targeting specific molecules in or on cancer cells and at same time are less harmful to normal cells
Tumor profiling, using tests to get information about the genes in cancer cells to help target these cells and predict things like risk of recurrence
Development of vaccines to prevent certain types of cancers
Cancer immunotherapy, which is a type of cancer treatment designed to boost the body’s natural defenses against cancer

All these new developments in drug therapies are helping medical oncologists provide personalized cancer care by basing treatments on the unique biologic features of each patient’s disease. The goal is to deliver high-quality, optimal care with compassion while maintaining quality of life.

Texas 2in

Dr. Sanjay Sethi is a medical oncologist at Texas Oncology–Sugar Land, 1350 First Colony Blvd., Sugar Land, Texas.