What is Oncology?
An oncologist is a physician who is concerned with the treatment of tumors and cancers. Cancer is when cells in the human body grow in an abnormal or out-of-control way. The goal of oncology is to cure a patient’s cancer, or, if the cancer is incurable, to control the cancer and reduce the symptoms for as long as possible.
Oncologists have several roles in their interaction with patients. They diagnose cancer and determine what stage the cancer is in, or to what extent the cancer has grown. They explain the diagnosis and stage to the patient, and they recommend treatment and deliver care. During treatment, oncologists are responsible for maintaining quality of life for their patients by reducing pain and side effects from medications.
There are three main types of oncologists:
Medical Oncologists specialize in the use of medications, especially chemotherapy, to kill cancer cells. In some areas, the term “medical oncologist” refers to the oncologist who is overall in charge of making decisions about a patient’s treatment.
Surgical Oncologists specialize in surgical treatments for cancer, such as biopsies (where small tissue samples are taken and examined), or surgical removal of tumors and surrounding tissue.
Radiation Oncologists specialize in the use of radiation (a kind of high powered x-ray) to kill cancer.
The American Society of Clinical Oncology also recognizes the subspecialties of Gynecological Oncology, which focuses on cancers of the female reproductive tract, and Pediatric Oncology, which deals with cancers that are most common in childhood.
In the United States, nearly one-half of all men and one-third of all women will be diagnosed with cancer in their lifetimes. It is an unfortunately common disease that can sometimes be life-threatening. Oncologists provide care to millions of people facing that diagnosis every year.
The specialty of urology focuses on the structures of the body that produce urine and remove it from the body, such as the kidneys, ureters, bladder, and urethra. Since related structures in men are responsible for both reproduction and the transportation of urine, urologists specialize in men’s sexual health in addition to disorders of the urinary tract. Urologists treat both men and women, as well as patients ranging in age from newborn to elderly.
Certain urologic conditions are specific to male or female patients. Women are especially prone to stress incontinence, recurrent urinary tract infections, interstitial cystitis (a condition causing pain in the bladder), and urethral diverticuli (a structural issue where a small pouch develops from the urethra into the vagina). Some of these conditions may be adequately treated by a gynecologist, but patients may prefer to see a urologist because of their expertise in the urinary tract system. As for men, male infertility and sexual problems can be treated by a urologist. For example, urologists treat erectile dysfunction with medications or prosthetics. They may also perform surgeries such as vasectomies or vasectomy reversals.
Some other conditions that urologists treat include:
Kidney stones, which are mineral deposits that can form anywhere in the urinary tract. The stones can be quite painful, and some large stones may be impossible to expel naturally. Fortunately, kidney stone treatments have advanced quite a bit in recent years, and a urologist may recommend a procedure such as shockwave lithotripsy (where sound waves are used to break down the stones), or percutaneous extraction (where telescopic tools are inserted through tiny incisions in the back to remove the stones). There can be some pain associated with these treatments, but they are far less invasive than the older methods of removal.
Urinary tract infections, which are extremely common. However, if they happen over and over again, there may be an underlying problem within the urinary tract.
Congenital abnormalities, which refers to problems that are present at birth. Congenital abnormalities affect the genitourinary tract more often than any other system of the body, and they range from mild to severe in appearance and effect. The most common abnormality (in male infants) is cryptorchidism, where a testicle does not descend from the body down into the scrotum. Another common problem is hypospadias, where the opening of the urethra appears on the underside of the penis.
Renal disease, which is the loss of kidney function. For patients with renal disease, their urologist may be their primary surgeon or a coordinating member of their care team.
Tumors and malignancies, which are especially common in the case of prostate cancer. Urologists are most often consultants to oncologists in these cases.
The American Urological Association recognizes seven subspecialties of urology:
Pediatric Urology, the treatment of genitourinary tract disorders in children and infants
Urologic Oncology, the treatment of cancers within the genitourinary tract
Renal Transplantation, the treatment of severe kidney disease by replacing a non-functioning kidney with a donor kidney
Male Infertility, the treatment of infertility due to problems with sperm, semen, or male sexuality
Calculi, the treatment of kidney stones
Female Urology, the care of women’s urinary health
Neurourology, the treatment of urinary disorders caused by problems with the nervous system. For example, certain voiding disorders happen when the bladder does not receive signals appropriately, and erectile dysfunction is sometimes due to nerve loss.
Urinary and sexual problems can be especially distressing for many people. Fortunately, urologists are experts at managing these health conditions.