SUBSTANCE REALTED DISORDERS

Disorders Related To Oncology

Substance Realted Disorders And Oncology

Introduction

Oncologists - specialize in the medical treatment of cancer. A clinical oncologist specialises in treating patients with radiotherapy and may also use chemotherapy and hormone therapy. A medical oncologist specializes in treating patients with chemotherapy. Oncologists are physicians who study, diagnose, and treat cancerous tumors. They practice in hospitals and medical centers, university hospitals, and research organizations.

Background

To become certified as an oncologist, a candidate must first graduate from an accredited medical school before entering into training as a specialist (e.g., internist, pediatrician) and subspecialist (e.g., medical oncologist, pediatric oncologist-hematologist). There are several oncology specialties and subspecialties: Gynecological oncology: The American Board of Obstetrics and Gynecology (ABOG) examines and certifies obstetricians and gynecologists who choose to acquire additional education and training to subspecialize in the diagnosis and treatment of cancers of the female reproductive organs (e.g., cervical cancer, breast cancer).

Medical oncology: The American Board of Internal Medicine (ABIM) examines and certifies internists who choose to acquire additional education and training to subspecialize in medical oncology, the use of medical and chemotherapeutic treatments of cancer. Medical oncology and hematology: The American Board of Internal Medicine (ABIM) examines and certifies internists who choose to acquire additional education and training in the dual subspecialty of medical oncology and hematology (the treatment of malignancies of the blood and blood-forming tissues). (Gibbs G. 1988).

Solid Tumours. Cytogenetic analysis can be performed on solid tumour samples, especially childhood tumours, where chromosome changes have been related to prognosis e.g. Wilm's, neuroblastoma, rhabdomyosarcoma, Ewing's sarcoma, synovial sarcoma etc). Fluorescence in situ hybridisation (FISH) is undertaken on touch preparations in cases of neuroblastoma and cultured cells to identify loss of heterozygosity of the short arm of chromosome 1, N-myc amplification, 17q gain, 11q deletion and aneuploidy. Anticipated reporting time: within 28 days. FISH may also be undertaken on other types of tumour if specific disease related chromosome rearrangements are known e.g. N-myc amplification in rhabdomyosarcoma, rearrangements of the long arm of chromosome 18 in synovial sarcoma etc). Lymph Nodes. This laboratory is equipped to carry out analysis on lymph nodes to detect recurrent rearrangements associated with lymphoma. Anticipated reporting time: within 28 days. Bone marrow aspirate from Lymphoma patients are only suitable if more than 20% blasts are present in the bone marrow. Paraffin Embedded Samples - Cancer Referrals. In situ hybridisation studies can be undertaken on paraffin embedded tissues (PETs), for the exclusion of common chromosome rearrangements in a variety of disorders. This technique, although primarily employed on lymph node sections is applicable to a range of tissue types, including some tumours. Consult the laboratory for further information. (Vale, Sherrie. 2008)

HER2 FISH Testing In Breast Cancer. HER2 levels are initially assessed in Histopathology by immunohisto-chemistry. Borderline 2+ cases are then referred to this laboratory for testing for amplification of the HER2 locus by in situ hybridisation.

These samples should be accompanied by a Herceptest slide. Anticipated reporting time: 7-10 days. Molecular Oncology The molecular oncology section works in conjunction with ...