Haematology

Hematology, also spelled haematology , is the study of blood, the blood-forming organs, and blood diseases. Hematology includes the study of etiology, diagnosis, treatment, prognosis, and prevention of blood diseases that affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins, and the mechanism of coagulation. The laboratory work that goes into the study of blood is frequently performed by a medical technologist. Hematologists also conduct studies in oncology—the medical treatment of cancer.

Physicians specialized in hematology are known as hematologists or haematologists. Their routine work mainly includes the care and treatment of patients with hematological diseases, although some may also work at the hematology laboratory viewing blood films and bone marrow slides under the microscope, interpreting various hematological test results and blood clotting test results. In some institutions, hematologists also manage the hematology laboratory. Physicians who work in hematology laboratories, and most commonly manage them, are pathologists specialized in the diagnosis of hematological diseases, referred to as hematopathologists. Hematologists and hematopathologists generally work in conjunction to formulate a diagnosis and deliver the most appropriate therapy if needed. Hematology is a distinct subspecialty of internal medicine, separate from but overlapping with the subspecialty of medical oncology. Hematologists may specialize further or have special interests, for example, in:

• treating bleeding disorders such as hemophilia and idiopathic thrombocytopenic purpura
• treating hematological malignacies such as lymphoma and leukemia
• treating hemoglobinopathies
• in the science of blood transfusion and the work of a blood bank
• in bone marrow and stem cell transplantation

Oncology

The term oncology literally means a branch of science that deals with tumours and cancers. The word “onco” means bulk, mass, or tumor while “-logy” means study.

What is cancer?

Each of the cells of the body have a tightly regulated system that controls their growth, maturity, reproduction and eventual death. Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but they all start because of out-of-control growth of abnormal cells.

How common is cancer?

Today, millions of people are living with cancer or have had cancer. Cancer is the second leading cause of death in the United States. About one-half of all men and one-third of all women in the US will develop cancer during their lifetimes.

How long has cancer existed for?

Some of the earliest evidence of cancer is found among fossilized bone tumors, human mummies in ancient Egypt, and ancient manuscripts. Abnormalities suggestive of thebone cancer called osteosarcoma have been seen in mummies. Among manuscripts the first known description of cancer is seen in the Edwin Smith Papyrus and is a copy of part of an ancient Egyptian textbook on trauma surgery. It describes 8 cases of tumors or ulcers of the breast that were treated by cauterization with a tool called the fire drill. It dates back to about 3000 BC. The papyrus describes the condition as “incurable”.

Role of an oncologist

Medical professionals who practice oncology are called Cancer specialists or oncologists. These oncologists have several specific roles. They help in diagnosis of the cancer, help in staging the cancer and grading the aggressive nature of the cancer.

Oncology diagnostic tools

The most important diagnostic tool remains the clinical history of the patient. Common symptoms that point towards cancer include fatigue, weight loss, unexplained anemia, fever of unknown origin etc.
Oncology depends on diagnostic tools like biopsy or removal of bits of the tumour tissue and examining it under the microscope. Other diagnostic tools include endoscopy for the gastrointestinal tract, imaging studies like X-rays, CT scanning, MRI scanning, ultrasound and other radiological techniques, Scintigraphy, Single Photon Emission Computed Tomography, Positron emission tomography and nuclear medicinetechniques etc.

Common methods include blood tests for biological or tumor markers. Rise of these markers in blood may be indicative of the cancer.

Cancer therapy

Based on the grade and stage of the cancer, oncologists help plan the therapy that is suitable for each of their patients. This could be by surgery, chemotherapy, radiation therapy and other modalities.

Other specialists

Treatment of cancer may involve other specialists as well. This includes a surgeon, a radiation oncologists or a radiotherapist etc. the whole of the cancer therapy however is co-ordinated by the oncologists.

Relapse and remission

Once initial therapy is completed the oncologists is responsible for follow up of the patient to detect relapse and remission. The former means recurrence or return of the cancer while being in remission means remaining cancer-free.

Palliative care

The oncologist is also responsible for palliative or symptomatic care in patients with terminal malignancies. This and other issues of treatment choice have several ethical issues including patient autonomy and choice that the oncologist needs to be concerned about.

Cancer screening

Oncology and cancer research involves screening the general population for cancer and screening the relatives of patients (in types of cancer that are thought to have a hereditary basis. For example, in breast cancer both population screening by regularmammography and familial screening by genetic analysis of the BRCA1 and BRCA2 genesis performed.

Progress in oncology

There is a tremendous amount of research being conducted on all areas of oncology, ranging from cancer cell biology to chemotherapy treatment regimens and optimalpalliative care and pain relief. This makes oncology a continuously changing and developing field. Cancer research is carried out in clinical trials. In the UK, patients are often enrolled in large studies coordinated by Cancer Research UK (CRUK), Medical Research Council (MRC), the European Organisation for Research and Treatment of Cancer (EORTC) or the National Cancer Research Network (NCRN).