Hematology-oncology Meaning

[Laurence Jabali]

Accordingto a 2017 survey by the American Society of Clinical Oncology (ASCO), more than 2,200 hematology/oncology practices were providing care to adult patients in the United States. While the number of hematology/oncology practices declined from 2013 to 2017, the size of the practices that remained increased. Distribution was often aligned with cancer burden in certain U.S. regions. For instance, the South showed a high number of practices and a higher cancer burden compared to other regions.

The survey also found that more than two-thirds of the oncology practices employed only oncologists in hematology or medical oncology. The remaining third were multispeciality, meaning they employed gynecologic oncologists, radiation oncologists and surgical oncologists as well.

Are all hematologists also oncologists? No, hematologists may study just hematology and focus on blood conditions, or they may study hematology and oncology if they choose to focus their expertise on blood cancers.

City of Hope is one of the top institutions in the field of hematologic oncology. It set the blueprint that other hospitals follow. As soon as the chance to be a part of this group came along, I jumped at the opportunity.

Dr. Rodriguez has more than 20 years of experience in hematologic oncology, with particular emphasis on treating patients with lymphoma, leukemia and multiple myeloma. A key member of the Bone Marrow Transplant Program at City of Hope Chicago, Dr. Rodriguez is a leader in the field, having performed over 2,500 stem cell and bone marrow transplantations during his career. He joined City of Hope Chicago in September 2023, bringing with him a strong background in researching innovative treatments for hematologic malignancies through cellular therapy.

Practicing since 1983, Dr. Slack has decades of experience treating hematologic malignancies, and he plays a key role in the Bone Marrow Transplant Program at City of Hope Phoenix. Dr. Slack, who joined City of Hope in Phoenix in April 2022, started his career as a researcher but transitioned to a clinical setting so he could focus on providing patient-centered care. At City of Hope, Dr. Slack also explores applications of chimeric antigen receptor (CAR) T-cell therapy, which is an emerging type of immunotherapy treatment.

Practicing since 1993, Dr. Schriber is dedicated to providing compassionate and personalized cancer care for patients with many different cancer types, with a focus on hematologic malignancies. He incorporates genomic testing, targeted therapy, immunotherapy, chemotherapy and other advanced treatments that are currently available. Dr. Schriber joined City of Hope Phoenix in December 2020.

Pediatric hematology-oncology is a further specialism of hematology-oncology focused on diagnosing and treating children with hematological cancer.

This is an important medical discipline, as children and teens have unique medical needs. Overall, cancer is more common with older age, but some particularly challenging cancers occur in children, often associated with hematology. Some of the differences in needs are physical as their bodies are still growing. However, many of the medical needs of children and teens are mental and emotional, since they express their concerns and thoughts differently to adults.

Therefore, pediatric hematologist-oncologists are trained to be especially patient and know how to make sure their young patients feel comfortable cooperating with testing and treatment.

There are various symptoms that can be associated with each type of blood cancer or disorder. They can be specific, such as persistent lumps in the neck or groin over several months (at the site of lymph nodes) or they can be quite vague or non-specific, such as persistent tiredness, headaches or nausea. Most of the time, common and vague symptoms are not a sign of serious illness.

However, if your Primary Care doctor refers you to a hematology-oncology specialist, this may be because they wish to be cautious and suspect the possibility of a blood cancer requiring specialist investigation. Being referred to a hematologist-oncology does not necessarily mean you have cancer and much of the time this involves simply ruling out the possibility of malignancy by careful examination, blood testing, examination of bone marrow and imaging, such as scans.

When you visit a doctor who specializes in hematology-oncology, they will assess you and run a range of tests to figure out the root cause of your symptoms. These results may end up being reassuring, but if the results show that there is the possibility of neoplastic change (cancerous change) in the blood, soft tissues or bones, then the hematologist-oncologist will carry out further more detailed tests and begin compiling a treatment plan.

A blood test is an important aspect of diagnosing cancers. A complete blood count helps the hematology-oncology specialist understand if any types of blood cell are at a depleted or elevated level. For instance, an abnormally high white blood cell count can indicate the possibility of leukemia, which is an abnormally excessive production of certain types of white blood cells.

The CBC and other standard tests, such as liver function tests, also give an indication of whether there is any evidence of other effects on the body, such as anemia or liver damage, that may have been caused by a possible cancer.

Following a complete blood count, a doctor may order further, more specific testing to narrow down the cause of the symptoms and to check for certain possibilities. These might include blood protein testing to identify abnormal proteins caused by a cancer. Another frequent analysis is a tumor marker test, which can highlight the possibility of certain types of malignant tumor.

Often, the outcome of a preliminary round of tests can help the doctor know which further tests to order, to follow up on the initial results. Being able to make a diagnosis promptly can be helpful in deciding on a treatment plan. In general, the sooner a diagnosis can be made, the earlier treatment can be started and the better the outlook for the patient.

A pediatrician who specializes in pediatric hematology-oncology is trained in the combination of pediatrics, hematology, and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Oncology is a branch of medicine that deals with the study, treatment, diagnosis, and prevention of cancer. A medical professional who practices oncology is an oncologist.[1] The name's etymological origin is the Greek word ὄγκος (nkos), meaning "tumor", "volume" or "mass".[2] Oncology is concerned with:

Medical histories remain an important screening tool: the character of the complaints and nonspecific symptoms (such as fatigue, weight loss,[3] unexplained anemia,[4] fever of unknown origin, paraneoplastic phenomena and other signs) may warrant further investigation for malignancy. Occasionally, a physical examination may find the location of a malignancy.

Currently, a tissue diagnosis (from a biopsy) by a pathologist is essential for the proper classification of cancer and to guide the next step of treatment. On extremely rare instances when this is not possible, "empirical therapy" (without an exact diagnosis) may be considered, based on the available evidence (e.g. history, x-rays and scans.)

On very rare occasions, a metastatic lump or pathological lymph node is found (typically in the neck) for which a primary tumor cannot be found. However, immunohistochemical markers often give a strong indication of the primary malignancy. This situation is referred to as "malignancy of unknown primary", and again, treatment is empirically based on past experience of the most likely origin.[7]

Depending upon the cancer identified, follow-up and palliative care will be administered at that time. Certain disorders (such as ALL or AML) will require immediate admission and chemotherapy, while others will be followed up with regular physical examination and blood tests.

Often, surgery is attempted to remove a tumor entirely. This is only feasible when there is some degree of certainty that the tumor can in fact be removed. When it is certain that parts will remain, curative surgery is often impossible, e.g. when there are metastases, Occasionally, when the tumor has invaded a structure that cannot be operated upon without risking the patient's life. Occasionally surgery can improve survival even if not all tumour tissue has been removed; the procedure is referred to as "debulking" (i.e. reducing the overall amount of tumour tissue). Surgery is also used for the palliative treatment of some cancers, e.g. to relieve biliary obstruction, or to relieve the problems associated with some cerebral tumors. The risks of surgery must be weighed against the benefits.

Chemotherapy and radiotherapy are used as a first-line radical therapy in several malignancies. They are also used for adjuvant therapy, i.e. when the macroscopic tumor has already been completely removed surgically but there is a reasonable statistical risk that it will recur. Chemotherapy and radiotherapy are commonly used for palliation, where disease is clearly incurable: in this situation the aim is to improve the quality of life and to prolong it.

Approximately 50% of all cancer cases in the Western world can be treated to remission with radical treatment. For pediatric patients, that number is much higher. A large number of cancer patients will die from the disease, and a significant proportion of patients with incurable cancer will die of other causes. There may be ongoing issues with symptom control associated with progressive cancer, and also with the treatment of the disease. These problems may include pain, nausea, anorexia, fatigue, immobility, and depression. Not all issues are strictly physical: personal dignity may be affected. Moral and spiritual issues are also important.

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