Onkoloji
Onkoloji, tüm kanser türlerinin önlenmesi, teşhisi ve tedavisi ile ilgilenen tıbbi bir uzmanlık alanıdır. Vücudun farklı bölgelerini etkileyebilecek farklı kanser türleri vardır. Bu nedenle, bir onkolog meme kanseri tedavisi, prostat kanseri tedavisi veya oral kanser gibi belirli bir dalda uzmanlaşmaya karar verebilir.
Onkoloji, kanserin önlenmesi, teşhisi ve tedavisi ile ilgilenen bir tıp dalıdır. Onkoloji uygulayan bir tıp uzmanı bir onkologdur. Adın etimolojik kökeni Yunanca “tümör”, “hacim” veya “kütle” anlamına gelen ὄγκος (ónkos) kelimesi ve “konuşma” anlamına gelen λόγος (logolar) kelimesidir.
Kanserde sağkalımı iyileştiren üç bileşen şunlardır:
Önleme - tütün ve alkol tüketimi gibi risk faktörlerini azaltarak
Erken tanı - yaygın kanserlerin taranması ve kapsamlı tanı ve evreleme
Tedavi - tümör kurulunda tartışma ve kapsamlı bir kanser merkezinde tedavi ile çok modlu yönetim
Kanserler genellikle tıbbi onkologlar, cerrahi onkologlar, radyasyon onkologları, patologlar, radyologlar ve organa özgü onkologların fiziksel, sosyal, psikolojik, duygusal ve hastanın mali durumu. Onkologların onkolojideki son gelişmelerle ilgili olarak güncel tutulması çok önemlidir, çünkü kanser yönetimindeki değişiklikler oldukça yaygındır. Kanserin ilerlediği ve standart bakım tedavisi seçeneklerinin bulunmadığı tüm uygun hastalar bir klinik araştırmaya kaydedilmelidir.
Tarama
Meme, serviks, kolon ve akciğer kanserleri için tarama önerilir.
Belirtiler
Semptomlar genellikle bölgeye ve kanser türüne bağlıdır.
Risk Faktörleri
Tütün: Kanserin ve kanserden ölümün önde gelen nedenidir. Sigara içmek akciğer, gırtlak, ağız, yemek borusu, boğaz, mesane, böbrek, karaciğer, mide, pankreas, kolon, rektum, serviks ve akut miyeloid lösemi kanser riskinde artış ile ilişkilidir. Dumansız tütün (enfiye veya çiğneme tütünü) ağız, yemek borusu ve pankreas kanseri riskinde artış ile ilişkilidir.
Alkol: Ağız, boğaz, yemek borusu, gırtlak, karaciğer ve meme kanseri riskinizi artırabilir. Alkol ve alkol kullananlarda kanser riski çok daha yüksektir.
Obezite: Obez bireylerin meme, kolon, rektum, endometriyum, özofagus, böbrek, pankreas ve safra kesesi kanseri riskinde artış vardır.
Yaş: İleri yaş, birçok kanser için bir risk faktörüdür. Ortanca kanser tanısı yaşı 66'dır.
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LymphomaFever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
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Endometrial CancerBleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
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Ovary CancerNonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
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Head and Neck CancerNon-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
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Thyroid CancerLump in the neck.Treatment options include surgery and radioactive iodine.
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Stomach CancerVomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
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Rectum CancerBleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
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Pancreatic CancerWeight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
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Skin CancerNon-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
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Bladder CancerBlood in urine.Treatment options include surgery, radiation and chemotherapy.
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Testis CancerSwelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
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Blood CancerBleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. Includes acute and chronic leukemias. Acute leukemias includes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Chronic leukemias include chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
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Breast CancerLump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
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Cervix CancerBleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
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Lung CancerPersistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
-
Brain CancerPersistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
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Oesophagus CancerPainful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
-
Colon CancerBleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
-
Liver CancerJaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
-
Skin CancerNon-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
-
Prostate CancerUrgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
-
Bone CancerPain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.
Kanser Türleri
TEŞHİS VE EVRELEME
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LymphomaFever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
-
Endometrial CancerBleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
-
Ovary CancerNonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
-
Head and Neck CancerNon-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
-
Thyroid CancerLump in the neck.Treatment options include surgery and radioactive iodine.
-
Stomach CancerVomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
-
Rectum CancerBleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
-
Pancreatic CancerWeight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
-
Skin CancerNon-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
-
Bladder CancerBlood in urine.Treatment options include surgery, radiation and chemotherapy.
-
Testis CancerSwelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
-
Blood CancerBleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. Includes acute and chronic leukemias. Acute leukemias includes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Chronic leukemias include chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
-
Breast CancerLump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
-
Cervix CancerBleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
-
Lung CancerPersistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
-
Brain CancerPersistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
-
Oesophagus CancerPainful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
-
Colon CancerBleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
-
Liver CancerJaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
-
Skin CancerNon-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
-
Prostate CancerUrgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
-
Bone CancerPain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.
Onkoloji Uzmanlıkları
Üç ana bölüme ayrılmaktadır.
-
LymphomaFever, weight loss more than 10% body weight in preceding 6 months and drenching night sweats which constitutes the B symptoms, lump in neck, axilla or groin. It includes Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL): Hodgkin lymphoma (HL) : Chemotherapy with ABVD or BEACOPP regimen and Involved field radiation therapy (IFRT). Non-Hodgkin lymphoma (NHL) : Chemo-immunotherapy (R-CHOP) for B cell lymphomas and chemotherapy (CHOP) for T cell lymphomas.
-
Endometrial CancerBleeding per vagina.Treatment options include surgery, radiation and chemotherapy.
-
Ovary CancerNonspecific symptoms like abdominal distension, dyspepsia.Treatment options include surgery, chemotherapy and targeted therapy (VEGF inhibitors).
-
Head and Neck CancerNon-healing ulcer or growth, lump in the neck.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR inhibitors).
-
Thyroid CancerLump in the neck.Treatment options include surgery and radioactive iodine.
-
Stomach CancerVomiting, dyspepsia, weight loss.Treatment options include chemotherapy, surgery, radiation and targeted therapy (Her 2 neu inhibitors).
-
Rectum CancerBleeding per rectum, alteration of bowel habits.Treatment options include chemotherapy, radiation, surgery.
-
Pancreatic CancerWeight loss, jaundice.Treatment options include surgery, radiation and chemotherapy.
-
Skin CancerNon-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
-
Bladder CancerBlood in urine.Treatment options include surgery, radiation and chemotherapy.
-
Testis CancerSwelling of testis, back pain, dyspnoea.Treatment options include surgery, chemotherapy and radiation.
-
Blood CancerBleeding manifestations including bleeding gums, bleeding from nose, blood in vomitus, blood in sputum, blood stained urine, black coloured stools, fever, lump in neck, axilla or groin, lump in upper abdomen. Includes acute and chronic leukemias. Acute leukemias includes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Chronic leukemias include chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Acute lymphoblastic leukemia (ALL): Intensive chemotherapy phase for initial 6 months and maintenance chemotherapy for 2 years. Prophylactic cranial and stem cell transplantation for high-risk patients.Acute myeloid leukemia (AML): Induction with chemotherapy (Daunorubicin + Cytarabine) followed by consolidation chemotherapy (High dose cytarabine). Stem cell transplantation for high-risk patients. Chronic lymphocytic leukemia (CLL): Chemo-immunotherapy (FCR or BR regimen) for symptomatic patients. Chronic myeloid leukemia (CML): Targeted therapy with tyrosine kinase inhibitor (Imatinib) as first-line treatment.
-
Breast CancerLump in breast and axilla associated with or without ulceration or bloody nipple discharge.Treatment options include surgery, radiation, chemotherapy, hormonal therapy and targeted therapy (Her 2 neu inhibitors)
-
Cervix CancerBleeding after sexual intercourse.Treatment options include radiation, surgery and chemotherapy.
-
Lung CancerPersistent cough, breathlessness, blood in the sputum, hoarseness of voice.Treatment options include surgery, radiation, chemotherapy and targeted therapy (EGFR & ALK inhibitors).
-
Brain CancerPersistent headache, vomiting, loss of consciousness, double vision.Treatment options include surgery, radiation, chemotherapy and targeted therapy (VEGF inhibitors).
-
Oesophagus CancerPainful swallowing predominantly to solid food, weight loss.Treatment options include radiation, chemotherapy and surgery.
-
Colon CancerBleeding per rectum, alteration of bowel habits.Treatment options include surgery, chemotherapy and targeted therapy (EGFR & VEGF inhibitors).
-
Liver CancerJaundice, pain and mass in right upper abdomen.Treatment options include surgery, Trans-arterial chemotherapy (TACE), Radio-frequency abalation (RFA) and multi-kinase (Sorafenib).
-
Skin CancerNon-healing ulcer or growth, mole with sudden increase in size, irregular border, induration or pain.Treatment options include surgery, radiation, targeted therapy (BRAF & MEK inhibitors), Immunotherapy (CTLA 4 & PD 1 inhibitors) and chemotherapy.
-
Prostate CancerUrgency, hesitancy and frequency while passing urine, bony pain.Treatment options include surgery, radiation, chemotherapy, anti-androgens and immunotherapy.
-
Bone CancerPain and swelling of bones.Treatment options include surgery, chemotherapy and radiation.