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.
What is Bariatric Surgery?
Bariatric or weight-loss surgery is a surgical procedure performed to help significantly obese patients lose weight when more traditional methods, such as dieting and exercise, have not helped. Depending on the type, these surgeries change the gastrointestinal tract to limit how much food can be eaten and also change how food is absorbed by the body. Of the various bariatric surgeries available, the most common is gastric bypass.
By far the most common of the gastric bypass surgeries is called “Roux-en-Y.” During this surgery, part of the stomach and small intestine are detached from the gastrointestinal tract, in order to make the tract smaller. The surgeon divides the stomach into two parts. The working stomach, at the end of the esophagus, is now tiny - only the size of a walnut. This makes patients feel full after eating a small amount of food. Then the small intestine is also divided, and after bypassing a section of the small intestine to reduce food absorption, the intestine is attached to the small stomach pouch. The patient now has a working stomach and intestine like before, only much smaller.
Because gastric bypass is used to treat extreme obesity, it can reduce the risk of some of the problems associated with obesity. Gastric bypass can help treat or reduce the risk for such conditions as heart disease, high blood pressure, sleep apnea, and type 2 diabetes. However, it is a major surgery and also carries risks itself. Any surgery can lead to infection, bleeding, or blood clots, and weight loss surgery in particular carries risks of leaks in the gastrointestinal system, malnutrition, bowel obstructions, and vomiting.
Typically patients are considered candidates for gastric bypass surgery if they have a BMI greater than 40, or sometimes if they have a BMI between 35 and 40 but are suffering from obesity-related illnesses such as diabetes. The outlook is generally good, with most patients losing between 50-75% of their excess weight in 1-2 years. However, patients must follow strict diet guidelines so that the stomach can heal, starting with no food at all, then followed by a liquid diet for some time. For many severely obese patients who have tried strict diets before without success, gastric bypass surgery is the tool that allows them to finally achieve their weight loss and health goals.
What is Surgical Oncology?
Surgical oncology is the use of surgery to diagnose or treat cancer, or to manage the symptoms of cancer. The Egyptians pioneered the treatment of cancer using surgery, removing breast tumors as early as the seventh century. These days, surgical oncology is much more complex and effective. Most cancer treatments involve surgery, and in some cases it is the only treatment needed.
Surgical oncologists work together with medical oncologists and radiation oncologists to provide care for cancer patients. Along with medical oncologists, surgical oncologists tend to be the primary providers of cancer treatment. Almost every cancer patient will have a medical or surgical oncologist who is in charge of managing their treatment and making decisions about their care.
The specialized knowledge of a surgical oncologist is less about surgical techniques (which may be very similar to techniques used by a general surgeon) and more about an understanding of cancer itself. Surgical oncologists have an advanced knowledge of how cancer presents and changes, and they know the best way to use surgery to treat cancer.
Surgical oncology is a rapidly advancing specialty, and many new techniques and procedures have been developed in recent years, including minimally invasive surgery and robotic surgery. A surgical oncologist is able to safely wield these complicated techniques to remove tumors from the body.