Cancer Management in Oncology

Thanks to scientific research and innovation in the therapeutic field, the evolution of tumor and cancerous diseases can increasingly be successfully managed and monitored. Over the years, medicine has identified increasingly effective tools and pathways for the specific management of various neoplastic lesions. These approaches range from prevention to early diagnosis and therapy, aiming to improve each patient's prognosis in terms of lifespan and quality of life.

Survival after a cancer diagnosis is strongly influenced by secondary prevention and therapy. A significant portion of the increase in survival is attributable to the evolution of anticancer therapy, particularly evident in certain tumor types, where therapeutic advancements have improved prognosis. Early diagnosis, mainly thanks to screening campaigns, offers a greater probability of effective cure, with a benefit in terms of reduced specific mortality.

The Diagnostic Stage in Oncology

Recognizing Signs and Symptoms

Signs and symptoms, in themselves, do not allow for a diagnosis but serve to encourage the doctor to investigate further with more specific examinations. For example, a persistent dry cough can be a sign of lung cancer. Changes in the shape and size of moles can lead to a melanoma diagnosis. Changes in urinary or bowel function may reveal a tumor of the urinary tract or intestine. Persistent fever can be a symptom of possible lymphoma, etc.

Further Investigation with a Hematological Laboratory Examination

The parameters generally analyzed are blood count values, liver function, electrolytes, proteinogram, hormonal status, inflammatory indices, and many others.

There are also more specific blood tests performed when the suspicion of neoplasia is higher, namely the dosage of tumor markers. Tumor markers are substances normally produced by the cells of our body, but in the presence of a tumor, their levels are much higher than normal.

Confirming the Presence of Cancer through Instrumental Diagnostic Imaging Examinations

To make a correct cancer diagnosis, the patient must undergo several imaging examinations indicated by the doctors. These examinations include:

• Ultrasound;
• X-ray;
• Computed tomography (CT);
• Positron emission tomography (PET);
• Magnetic resonance imaging (MRI);
• Scintigraphy;

Determining the Nature of the Tumor through Direct Laboratory Examination

This information about the tumor is used to determine the best therapeutic approach. The tumor examination can be of two types:

• Cytological examination: The sample analyzed is an aggregate of cells. The sampling of the cell sample is called needle aspiration;
• Histological examination: The sample analyzed is tissue. The sampling of the tissue sample is called a biopsy;

In both cases, after sampling, the sample is prepared, stained, and observed under a microscope. Microscopic observation of cells and tissues can provide important information on cell physiology and highlight the presence of inflammatory or tumoral processes.

Cancer Treatment and Available Health Services

There is a whole range of anticancer therapies for different types of tumors, which can be adapted to the patient's needs and characteristics. Although anticancer therapies do not guarantee the cure of the tumor, in some cases, they can cure it, keeping it under control and ensuring good prospects and a good quality of life for patients.

Specialized oncology services and centers now have a range of therapies and treatment protocols adapted to each case and the overall clinical picture. These therapies can be:

• Pharmacological, based on the infusion of chemotherapy or other drugs;
• Surgical;
• Hormonal;
• Based on radiotherapy;
• Immunological and biological;
• Based on bone marrow transplantation;
• The main therapeutic pathways for cancer;

Surgical Treatment of Cancer

The decision to use surgical treatment depends on the type of tumor, its location, its extent and stage, its relationship with neighboring organs, and the patient's general health. Surgery can be curative, palliative, or preventive.

Surgery may be followed by another treatment (chemotherapy, radiotherapy, or targeted therapy):

• To eliminate other cancer cells;
• When the surgery was not radical, that is, the entire mass was not removed;
• When the sentinel node is positive;

Radiotherapy

Radiation oncology is a set of techniques and methods that exploit the properties of ionizing radiation directed directly at the tumor area. In this case as well, the choice of treatment depends on a number of factors such as the type of tumor, its location and size, the patient's general condition, etc. Radiotherapy treatment is strictly personalized and includes a simulation phase to establish the correct location of the radioactive sources.

Chemotherapy

Chemotherapy drugs for neoplasms interfere with cell replication mechanisms, preventing their multiplication. Chemotherapy treatment for tumors is a "systemic" treatment, that is, the administered drug is distributed throughout the body and not just in the diseased organ or parts, acting not only on tumor cells but also on healthy cells, particularly those in the active replication phase.

Conclusion

Different therapies are often combined to achieve the best results in patient care. Anticancer radiotherapy, for example, which is essential in many cases of solid tumors with or without metastases, is implemented in conjunction with chemotherapy, often before or after surgical removal of the neoplasm.