Oncology

Oncology

Cells in our body grow, reproduce and die when their function ends. Cancer is the group of malignant diseases caused as the result of an uncontrolled reproduction of cells.

Oncology Diagnosis Processes

Magnetic resonance (MR)

MR is a painless procedure that can display internal organs and tissues in a clear and detailed manner. MR uses radio waves and a strong magnetic field, instead of X-rays.

PET/ CT

One of today’s most effective imaging technique, PET CT ( Positron Emission Tomography) is utilized for diagnosis, staging , treatment response assessment and radiotherapy planning of  many cancers, including particularly lung , colon, head – neck cancers and lymphomas.  PET CT is also informative about the distribution of cancerous cells and allows determination of whether a cancer is benign or malignant.

Mammography

Mammography is widely used as an auxiliary diagnostic test to determine the location and properties of a suspected mass found in the breast. Mammographic examination is performed using X-rays. 

Genetic Screening

It may be possible to prevent some cancer types by gene maps.  These genetic screening must be performed by anyone who carries the following risk factors.

Colonoscopy

It is the most reliable method for large bowel cancer scan in healthy people aged 50 or older. The procedure involves an examination by entering the large bowel using a device with an extremely soft tip. This effective method can provide diagnosis, removal, biopsy of polyps. During the implementation of the method, very small doses of anesthesia are given to the patient to anesthetize him.

Gastroscopy

Gastroscopy is an examination of esophagus, stomach and duodenum using a gastroscopy device with a miniature illuminated camera on its tip. This system allows biopsy, where necessary, and diagnosis of stomach diseases and cancers. During gastroscopy, very small doses of anesthesia are given to the patient to anesthetize him. 

ERCP

ERCP is a successful method in diagnosis and treatment of stones and tumors causing inflammation of bile ducts or pancreatic duct and it can be defined as a procedure involving imaging of bile ducts and pancreatic duct using a special endoscope.

Bronchoscopy

Bronchoscopy can be defined as direct examination of the throat, larynx, trachea and bronchial tree using an endoscopic camera with light on its tip.  It can be used for diagnostic investigations as well as for treatment purposes, including removing foreign objects from airways, invasive removal of benign and malignant tumors arising from trachea and main bronchi and causing extreme shortness of breath in patients, and stenting stenoses of trachea and main bronchi, which have developed for various reasons.

Biopsy

Biopsy is a procedure involving removal of a tiny portion of body tissue for examination. Then the tissue removed is examined under a microscope. Before biopsy material is examined, it  may undergo certain procedures and dying in such a way as to allow a series of microbiological and molecular biological investigations. Biopsies are usually done upon a suspicion of disease.  For example, if a patient has an unexplained swelling, mass, or if a tumor is suspected, the best diagnostic method is to collect samples and examine them to diagnose. 

Oncology Treatment Processes 

Cancer treatments show difference according to the cancer type, its location and general health status of the patient. Personalized treatment plans are prepared by our expert teams under the same roof by taking all such differences into consideration.  

Radiotherapy (Radiation Therapy) 

In radiotherapy, treatment is conducted over the cancerous area with high power energy beams. Such beams which are used in the treatment of the cancerous cells may also harm the healthy cells. For this reason the methods that are used in Radiotherapy are too significant. 

  • IMRT (Intensity Modulated Radiotherapy)

With IMRT high energy beams are sent from different angles and with different intensities in order to reduce the damages to be caused on healthy cells. 

  • IGRT (Image Guided Radiotherapy)

In each stage the diseased area is determined by imaging and direct execution is conducted over such area. It has much shorter clinic durations compared with other applications. 

Chemotherapy

Chemotherapy application is to damage cancerous cells which reproduce without control with the use of drugs. It may be conducted alone or in conjunction with other therapies. 

When it is conducted in conjunction with Surgery and Radiotherapy, it may help such types of therapies to be more efficient. Chemotherapy which is a significant part of the tumour therapies may be applied: 

  • In order to totally damage the tumour and cure the patient;
  • In order to prevent the spreading of the tumour and to cause it to regress; 
  • In order to eliminate the symptoms the tumour causes. 

Hormone Therapy 

It is one pillar of the systematic treatment of breast cancer and it is used in conjunction with other therapy types. 

Immunotherapy

Immunotherapy treatments which support the immune system are therapies which are mainly conducted with phytogenetic drugs. It is very important that not only the triad of surgery – chemotherapy – radiotherapy but also phytogenetic treatment options are presented to the patients. 

Oncologic Surgery

Oncologic surgery applications show the following distinctions

  • Curative (treatment purposes) Surgery: The precondition for curative surgical applications is that the disease should not metastases, i.e. it should be limited with the organ or lymph it had originated. In such interventions the tumour is totally removed and the cancerous tissue may be cleansed. However there are situations where it is not possible to fully remove the tumour. In such a case debulking is applied in order to reduce the mass.
  • Palliative (Abirritant purposes) Surgery: It is the general name of the surgical methods that are conducted in order to eliminate the symptoms and in some cases used in conjunction with treatments that aim to kill cancer. Applications such as placing stents in order to eliminate obstructions that are caused by mass and placing prosthesis over weakening bones are in this category.
  • Prophylactic Surgery: It means removing the organ and the tissue which has cancer progressing risk with surgical means. Formations such as intestine and gall bladder polyps and skin lesions etc. may be treated with prophylactic surgery.

Cancer Types

Brain Tumour 

Brain tumour may be defined as uncontrolled growth of the abnormal brain cells. 

The tumours may be benign (non-cancer producing) or malign (cancer producing). Even benign tumours may be dangerous as they locate in brain. The brain is surrounded with the skull. This means that the tumour stars to exercise pressure over the normal brain tissue while it is growing. And this may cause inflammation and brain panicula. For this reason it is very important that both types of tumours should be cured as fast as possible. 

In brain tumour primarily the tumour is aimed to be removed with surgical methods. In surgical operations, the type of the tumour, its location, age of the patient and other general physical status play determining roles. Surgical interventions on the brain tumours are supported with adjuvant therapies such as Chemotherapy and/or Radiotherapy and/or Immunotherapy. 

Breast Cancer

Although breast cancer is the type of cancer that is most frequently observed in women, it may also be observed in men at a lower rate. Each one among eight women is under the risk of being exposed to breast cancer in her lifetime. In breast cancer the age, sex, age of first menstruation and menopause, number of births and abortions and genetic factors play important role.  

Although today mainly surgical methods are used in breast cancer treatment, Chemotherapy, Radiotherapy and hormone therapy may be applied independently or in conjunction with surgical method. The form of the treatment is shaped according to the degree of the tumour, cancer type, the secondary cancers, if any, and information of menopause. The surgical applications are divided into two main groups as those that aim protecting the breast without removal and that aim removing the entire breast. In applications that aim removing the entire breast, Breast Reconstruction is made again instead of the breast that is removed with plastic surgery techniques. 

Gynaecologic Cancers (Uterus, Ovary etc.)

40% of the cancers that are observed in women are constituted by gynaecologic cancers. 

In order to be protected from gynaecologic cancers that constitute cancers that are observed in cervical, uterus, ovary, vagina, vulva and tubes, it is necessary to meet a gynaecologist expert and to make tests. There is no common reason for the gynaecologic cancers and the risk factors show difference according to each cancer type. 

Cervical cancer: Smoking, sexually transmittable diseases, sexual relation at early age, polygamy and low social-economic status are triggering in cervical cancers. 

Uterine cancer: Fatness, history of diabetes, late menopause age, infertility and oestrogen use not in conjunction with progesterone constitute risk. 

Ovarian cancer: Although a determining reason is not found out, it is thought that environmental and genetic factors like the age, familial factors, diets containing high levels of animal fat and use of powder are influential for the ovarian cancer. 

The gynaecologic cancers may show both vaginal discharges which are specific to the disease and stomach ache etc. which is not specific to the disease. For this reason annual check-ups are very important in for diagnosis. 

In the treatment of the gynaecologic cancers stage of the disease is very important. Surgery is the most frequently used treatment method. Surgical operations may be supported by Chemotherapy and Radiotherapy according to the cancer type. 

Prostate Cancer

Although the reason of the Prostate cancer which is only observed in men is not definitely known, it is found out that age, race and genetic factors play important role. Among these factors, age comes at the first rank. The frequency of prostate observance seriously increases at and over 50 ages. 

As prostate progresses very slowly it can be treated with drugs and with surgical operation. 

Bladder Cancer 

Bladder (urinary) is the organ which enables urine accumulation and excretion, uncontrolled growth of the cells that constitute the bladder is called bladder cancer. In bladder cancers with early diagnosis and treatment generally causes full recovery. 

The definite treatment plan of bladder cancer is arranged according to the depth of the spread and degree of aggressiveness of the cancerous cells. 

In bladder cancer, according to the cancer type, in order to clean the bladder from cancerous tissue and to reduce recurrence rates, a therapy of washing the inner side of the bladder with immunological or chemotherapeutic drugs as well as totally removing the bladder and placing a new bladder made from intestine instead of it in order the urine to be accumulated are used. 

Kidney Cancer 

Kidney cancer is generally observed in between 50-70 ages. It is observed 2-3 times more than women in men. The reason of kidney cancer is not yet fully known. However, factors such as smoking, genetic factors, high blood pressure, fatness, occupational risk factors (steel industry, petroleum, cadmium, lead industry employees) and exposure to radiation increase risk. 

Kidney cancers do not show many symptoms initially. However as the tumour progresses, symptoms such as blood in the urine, pain, inaccetence, weight loss, recurring high fever, high blood temperature and anaemia emerge. 

Surgery constitutes main treatment in kidney tumour. Radiotherapy can be applied as supportive treatment in addition to surgery. 

Testicular Cancer 

It is the most frequently observed cancer type in young men in between 19-44 ages. It constitutes 1% of the cancers observed in men. Its most widespread symptoms are pain and mass or growth in any one of the testicular. In testicular cancer after the surgical operations made by the urologists, chemotherapy treatment may be applied. 

Colon cancer

Bowels which are named as colon, is that part of the digestive system which is 2 metres, coming after the intestine. Colon cancer which is observed with equal rates in women and men is at the third rank in terms of its observance frequency.  The reason of colon cancer is not definitely known, but there are some environmental and genetic reasons that are influential in its formation. Nutrition has an important place in colon cancer; it is determined in research that animal fat consumption has an effect. 

Treatment of colon cancer is surgery. The tumourous section is removed with surgical methods. Then upper and lower parts of the excreted intestine are tied to each other. Radiotherapy is not used in colon cancer. But Chemotherapy (drug therapy) may be applied to the patients after the operation.

Stomach Cancer

Stomach cancer is the cancer type which is observed at the second rank of observance frequency, after lung cancer. Each one of ten cancer patients is stomach cancer. 

In the emergence of stomach cancer, nutrition habits have an important place. Consuming much salty food, malnutrition of vegetable and fruits, are the most frequently observed cancer reasons related with nutrition. Also inherited factors are effective in the progress of stomach cancer.  

In stomach cancer most efficient diagnosis method is endoscopy. 

In the treatment of stomach cancers, surgical methods are used; the stomach is removed with surgery. According to the form of the cancer, radiotherapy and drug therapy are applied after surgery. 

Pancreas Cancer

Pancreas cancer is also a notably serious and hardly cured disease. Risk of exposure to pancreas cancer is considerably higher in men compared with women. At the same time, smokers and people who use alcohol and have an irregular life have much higher possibility of contracting pancreas cancer when compared with other people. 

Treatment process shows difference according to the stage of cancer which the patient is exposed to. Among the treatment methods of the pancreas cancer there are surgery, radiotherapy or Chemotherapy. 

Liver Cancer 

Reasons of the liver cancer are hepatises b and c diseases, extreme alcohol consumption and rarely iron deficiency. In patients who contract with liver cancer, symptoms such as inaccetence, malaise, jaundice on the skin, extreme loss of weight, accumulation of water in the venter, panicula in the venter and rapid exhaustion can be observed. 

According to the status of the disease Radiotherapy, Cryotherapy (it is based on the principle of destructing the abnormal tissue by freezing), and injection of drug in order to kill the tumour and lastly liver transplantation treatments are applied today. 

Oesophagus Cancer 

The oesophagus cancers which spread without showing many symptoms and which emerge generally with swallowing difficulty and weight loss are observed generally in the interval of 50-70 ages. Mainly smoking, consumption of alcohol, smoked meat, hot liquids at high temperature; vitamin-mineral deficiencies play important role in the formation of the cancer. 

In oesophagus cancers, surgical treatment (removal of the oesophagus), Radiotherapy (ray therapy), chemotherapy (drug therapy), laser treatment and palliative procedures (stent application) constitute the treatment options that are applied to patients. 

Skin cancers

Among all cancer types skin cancers are the most frequently observed ones. In order to be protected from skin cancer, what is necessary is to be protected from the sun. Extreme exposure to sun (including bronzing) is the main reason of the skin cancer. 

Early diagnosis is the first most important step of definite treatment. For this reason, it is important for the people to make self-examination on their skin with certain intervals and if there is any change of colour or progressing moles or non-healing scars, to apply a skin doctor. 

The skin-derma cancers are diagnosed by excreting and examining a section of the mass under microscope. There are many treatment methods according to the cancer type, its stage and its location. Primary treatment option is surgical intervention and transplantation of tissue taken from another area instead of the cancerous tissue. If the cancerous section has non-removable dimensions or it had spread to other organs, radiotherapy and chemotherapy may be considerable.  

Bone Tumours 

In bone tumour, growing tumour in time spreads into the health tissues and causes the abnormal tissues to replace the health tissues and it weakens the bone and results with pathological fractures. In most of the bone tumours the reason is not known. If necessary, measures are not taken, they may cause functional dysfunction within the organ system and even to death. 

Most of the bone tumours are benign and benign tumours do not threaten life. In malign tumours the cells may spread into the body and constitute metastasis. Cancers which start over the bone (primary) and cancers which start at another place of the body and locate over the bone (secondary) are different from each other. 

Although treatment of the benign bone tumours change according to the tumour type and age of the patient, in many cases observation is sufficient. In some of them medical treatment heals pain. And some cases they disappear spontaneously (especially in children). In some cases the physician may propose the tumour to be removed; and this prevents the possible pathological fractions. But in some tumour types the mass may re-appear even it is removed. Some of the benign tumours may transform into malign tumours in time. 

In the treatment of the malign bone cancers the type and stage of the tumour is determining. The surgical treatment may be both only removing the tumour and removal of the tumour tissue together with the healthy tissue around it. In the treatment radiotherapy and Chemotherapy may be applied in conjunction with the other treatment methods. 

Spinal Cord Tumours 

The spinal cord tumours are abnormal cell masses which may grow in between the protective sheaths or over the surface of the sheath covering the spinal cord. Although the reason for their formation is not fully known the genetic factors are observed to be effective. 

The most important symptom is the increasing or deteriorating back pain as a result of the pressure at the spinal cord due to the growing tumour. And the other symptoms are generally hypokinesis, tingling or feeling of cold at the body; growing muscle weakness in any one of the arms or legs; loss of control of the intestine or bladder. 

The treatment is usually removal of the tumour from the spinal cord. But it may not be possible to remove some tumour without harming the spinal cord. In this case, in order to delay more growth of the tumour, Radiation Therapy is applied. 

Lymphoma 

Although lymphoma is one of the most rapidly progressing cancer types, treatment success is considerably high. Its most important symptoms are painless adenias at the neck, armpit or crotches, night sweating and non-decreasing and fever with unknown origin. Also constant tiredness and loss of weight may be symptoms of lymphoma. 

Chronicle inflectional diseases, conditions which weaken the immune system and exposure to some chemical materials such as insecticides may be told to cause lymphoma.  

For every lymphoma patient treatment is personal. Because, the form of therapy is determined according to the stage and type of the disease and according to the age and physical condition of the patient. 

Treatment of lymphoma is with drugs (chemotherapy), with rays (Radiotherapy) or with conjunction of the both. Also it is possible to collect the stem cells from the patient and after high dosage Chemotherapy to redeliver these stem cells to the patient. 

Thyroid Cancer

It is a cancer type that forms as the cells of the thyroid gland transform into cancer. The thyroid cancers generally form as a mass at the neck or a node in the thyroid gland.  Most of the thyroid cancers disappear by surgery and radioactive iodine treatment and does not shorten the life time of the patient. 

In all thyroid cancers the thyroid gland and surrounding lymph glands are removed with surgery. After the surgery according to the cancer type, in armoured hospital rooms high dosage radioactive iodine treatment is made. Thus killing the cancer cells surviving at other parts of the body is aimed. 

In some type of cancers radiotherapy and chemotherapy may be applied after the surgery. 

Salivary Gland Cancer

Salivary Gland Cancer is a rare cancer type and it may start from any of the salivary glands in your mouth, neck or throat. Although its reason of formation is not fully known, it is thought that smoking and exposure to radiation is triggering. 

The symptoms of malign and benign cancer are the following. The symptoms of the salivary gland tumour like pain, facial palsy, change of skin colour and rapidly growing panicula are mainly observed in malign tumours. The only symptom of benign salivary gland tumour is panicula. These paniculas do not grow rapidly and cause pain like they do in malign tumours. 

Salivary gland cancer generally requires operation. The other treatments for the salivary gland cancer may include radiotherapy and chemotherapy. 

Leukaemia 

In leukaemia, the leukocytes (white blood cells) which protect the body against the microbes increase uncontrollably. As a result of the uncontrolled increase of the leukocytes they cannot defend the body and cause malfunctioning of the other blood cells like the erythrocytes and trombocytes. 

The reason of leukaemia is not yet fully known. That it is observed in maternal twins, people with Down syndrome and with fanconi anaemia, shows that genetic factors play a role in the disease. Also observance risk increases in people who are exposed to radiation and chemical materials. 

In leukaemia, there are complaints of rapid tiredness, bleedings, malaise, loss of weight, bone pain, articular panicula. After the physical examination the lymph glands grow and the liver and the spleen grow. If there is infection shivering, fever and sweating are observed. 

In leukaemia the treatment starts with chemotherapy. In some cases chemotherapy is supported with radiotherapy. Bone marrow transplantation is a method that may be applied to the patients after chemotherapy, and it is based on the principle of transmitting the healthy stem cells to the patient. 

Lung cancer

Lung cancer emerges as a result of the extreme and uncontrolled increase of the cells in the lung or trachea. One of the most important factors in lung cancers is smoking cigarette and derivatives. Also exposure to asbestos and radon gas and genetic liability play important role in the formation of lung cancer. 

The condition for success is related with the stage of the disease. In the initial stages of the disease surgical method is applied and it is the most effective method which has the chance of full recovery from the illness. Also in early diagnosed lung cancers the method of cryosurgery, i.e. destroying the cancerous cells by freezing may be applied. Surgical treatment may be supported with chemotherapy. In cases where the disease is advanced, chemotherapy and in some cases radiotherapy is applied. In cases where the patient has dyspnoea but it is not suitable to make operation in surgical terms, the tumour may be cleansed by bronchoscopy. 

Head and neck cancers 

In head and neck cancers the most important factor is long term smoking and alcohol consumption. According to the area cancer locates symptoms of panicula at the neck, change of voice, growth in lips, bleeding in the mouth/nose/neck, skin colour change, swallowing difficulties and constant ear pain are observed. 

In head and neck cancers, throat cancer, postnasal cancer, vocal cord cancer, tonsil cancer and upper oesophageal cancer are the most frequently observed cancer types. 

Treatment shows difference according to the location, type and stage of the disease. In the treatment surgery, chemotherapy and radiotherapy methods may be used separately or in conjunction with each other. 

Childhood cancers 

Childhood cancers generally include cancers which are observed under 15 ages, in between 0-14 ages. The childhood cancers differentiate strongly with various features from those of the adults. Cancer is observed less in children than adults. Childhood cancers constitute 1% of the whole cancers. Childhood cancers are today cured with early diagnosis and appropriate therapies. 

The most frequently observed cancer type in children is Acute Leukaemia. In the second rank there are brain tumours and then Malign Lymphomas.   

In the children cancer risk is mainly determined with genetic factors. But also the environmental factors do have an effect. Exposure to radiation and chemicals like pesticides in mother’s womb, cigarette and alcohol consumption of the mother during pregnancy increase cancer risk. 

In childhood cancers there is multi directional treatment; but drug therapy, i.e. chemotherapy has an important place in the treatment. In tumours for excretion of the tumour or biopsy surgery is used. In childhood cancers rapid growth of the cells causes them to be sensitive to chemotherapy. Chemotherapy may be used as adjuvant therapy and also in order to make the tumour smaller and to prevent the possible metastasis before surgery. 

Radiotherapy is not used alone except urgent conditions in childhood cancers. Generally it may be added too chemotherapy in some sensitive tumours. 

Bone Marrow Transplant (BMT) is a method that is especially used in leukaemia, and it is based on the principle of transplanting the normal stem cells to the patient. 

The palliative treatments are treatments that are applied in patients who have serious and terminal stage conditions and in the advanced countries in recent years they are made efficient for eliminating many symptoms mainly the pain. 

Also findings such as anaemia, bleeding, infections and metabolic disorders which accompany cancer should be treated with supportive treatment methods. 

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