^{Immunology and Oncology}

The molecular classification of Tumor is actually arrangement analysis disguised as classification. In a typical gene expression array study, the researcher will look at a cluster of tumors of a specific type. Cluster analysis of the gene expression array values will help discrete the tumors into groups with common expression patterns. Some of these groupings will prove to have a detailed biologic feature (e.g. increased tendency to metastasize, higher response to a chemotherapeutic agent, lengthened existence). Cancers are not just masses of malignant cells but complex ‘rogue’ organs, to which many other cells are recruited and can be degraded by the transformed cells. Interactions between malignant and non-transformed cells create the Tumor microenvironment (TME). Experts stress that these techniques have been tested in only small trials, and they don't always work. But the results have raised hope that immunotherapy may give doctors new options for treatment in the future.

Surgery is the main treatment in nearly every case of cancer, and it is the main treatment for both pheochromocytoma and Merkel cell cancer. During surgery, the doctor removes a tumour along with a small border of healthy tissue around a tumour, called a margin. For pheochromocytoma, laparoscopic surgery may be performed. Laparoscopic surgery is a less invasive type of surgery that uses three or four small incisions instead of one large incision. A thin, lighted tube called a laparoscope that is attached to a video camera is inserted through one opening to guide the surgeon. Surgical instruments are inserted through the other openings to perform the surgery. If removing the tumour using surgery is not possible, it is called an inoperable tumour, and the doctor will recommend another type of treatment. The patient candidate for surgery does not depend on factors such as the type, size, location, grade and stage of the Tumor along with the consideration of the general health factors like age, physical fitness and other coexisting medical conditions. Surgery will be combined with other Cancer treatments, such as chemotherapy, Radiation therapy or hormone therapy in some Cases.

Reproductive Cancers are those Cancers that occur in the reproductive organs of both Women and Men. In Women, these are Cancers that commonly occur in the breast, cervix, vulva, endometrium or Ovaries. In men, reproductive Cancer can be found in the prostate, testicles, and penis.

Radiation medical speciality is to embrace all aspects of analysis which influences the treatment of cancer using radiation. The sphere of radiation medical speciality covers the admixture of action therapy into multimodal treatment approaches. External beam radiation is delivered outside the body. This includes leading high-energy radiation beams at the area being targeted among the body victimization varied radiation machines. Brachytherapy is radiation applied directly to the target. It is extremely effective as the radiation is focused on the target diseased site instead of healthy closed organs. Radioimmune therapy (RIT) uses protein with specificity for a growth- associated substance tagged with a radionuclide to deliver cytotoxic radiation to a tumour cell. General action therapy uses radioactive medication to treat cancer consistently, within which the radioactive substance travels through the bloodstream to achieve cells inside the body.

Cancers of the orbit and adnexa develop from tissues such as muscle, nerve, and skin around the eyeball and are like their counterparts in other parts of the body

Nuclear medicine imaging uses small amounts of radioactive materials called radiotracers that are typically injected into the bloodstream, inhaled or swallowed. The radiotracer travels through the area being examined and gives off energy in the form of gamma rays which are detected by a special camera and a computer to create images of the inside of your body. Nuclear medicine imaging provides unique information that often cannot be obtained using other imaging procedures and offers the potential to identify the disease in its earliest stages.

Neuro-oncology is the study of brain and spinal cord neoplasms, many of which are (at least eventually) very dangerous and life-threatening (astrocytoma, glioma, glioblastoma, multiform, ependymoma, pontine glioma, and brain stem tumours are among the many examples of these). Among the malignant brain cancers, gliomas of the brainstem and pons, glioblastoma multiforme, and high-grade (highly anaplastic) astrocytoma are among the worst. In these cases, if untreated lifespan usually amounts to only a few months, and survival with current radiation and chemotherapy treatments may extend that time from around a year to a year and a half, possibly two or more, depending on the patient's condition, immune function, treatments used.

Neuroimmunology is a field combining neuroscience, the study of the nervous system, and immunology, the study of the immune system. Neuroimmunologists seek to better understand the interactions of these two complex systems during development, homeostasis, and response to injuries. A long-term goal of this rapidly developing research area is to further develop our understanding of the pathology of certain neurological diseases, some of which have no clear aetiology. In doing so, neuroimmunology contributes to the development of new pharmacological treatments for several neurological conditions. Many types of interactions involve both the nervous and immune systems including the physiological functioning of the two systems in health and disease, malfunction of either and or both systems that lead to disorders, and the physical, chemical, and environmental stressors that affect the two systems on a daily basis. We know both the nervous system and the immune system plays a major role in humans life. One as a signal system and one as a protective system.

Medical oncology is the analysis of cancer with medicine, made up of chemotherapy, surgical oncology is the surgical aspects of cancer including biopsy, staging, and surgical resection of tumours, and radiation oncology is the analysis of cancer with therapeutic radiation. Medical Oncology is usually working in conjunction with Surgical Oncology or Radiation Oncology to give the best clinical outcomes. We determine the right treatment plan for each individual based on various factors as a stage of cancer, the extent of the damage, other medical conditions, and location within the body. These treatment plans contain any combination of the following: Chemotherapy, Radiation Therapy and Surgery.

Hematologic cancers affect the production and function of ones’ blood cells. Most of these cancers originate in the bone marrow where blood is produced. Stem cells in the bone marrow mature and develop into three types of blood cells: red blood cells, white blood cells, or platelets. In most blood cancers, the normal blood cell development process is interrupted by uncontrolled growth of an abnormal type of blood cell. These abnormal blood cells, or cancerous cells, prevent the blood from performing many of its functions, like fighting off infections or preventing serious bleeding.

Head and Neck cancers usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck (for example, inside the mouth, the nose, and the throat). These squamous cell cancers are often referred to as squamous cell carcinomas of the head and neck. Head and neck cancers can also develop in the salivary glands, but salivary gland cancers are relatively uncommon. Salivary glands contain different types of cells that can become cancerous, so there are many different types of salivary gland cancer. Cancers of the head and neck are further categorized by the area of the head or neck in which they begin from the Oral cavity, Pharynx, Larynx, Para-nasal sinuses and Nasal cavity, Salivary glands.

Gastro-Intestinal (GI) Cancer is a term for the group of cancers that affect the digestive system. The known risk factors for gastrointestinal cancers currently include smoking, alcohol consumption and obesity, asbestos etc. This includes cancers of the Esophagus, Gallbladder, Liver, Pancreas, Stomach, Small intestine, Bowel (large intestine or Colon and Rectum), and Anus

An endocrine tumour is a growth that affects the parts of the body that secrete hormones. Because an endocrine tumour arises from cells that produce hormones, the tumour itself can produce hormones. These hormones are produced in excessive amounts by endocrine tumours and then released into the blood. The excessive amounts of hormones in the blood produce marked abnormal effects on the body. A neuroendocrine tumour begins in the area showing a combination of hormone-producing endocrine cells and nerve cells. Neuroendocrine cells are found throughout the body in organs such as the lungs and gastrointestinal tract, including the stomach and intestines. Neuroendocrine cells perform specific functions, such as regulating air and blood flow through the lungs and controlling how quickly food moves through the gastrointestinal tract. They are other types of tumours in endocrine and neuroendocrine tumours

Cardio-oncology is the intersection of heart conditions in patients who have been treated for cancer. Cardiologists can assess patients for potential risk of developing heart conditions if patients take certain types of cancer drugs, or following radiation treatment to the chest. They also help oncologists protect their patients during treatment by closely watching the heart and recognizing heart trouble early in treatment.

Doctors and scientists are always looking for better ways to treat patients with a tumour. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches in radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment. There are also clinical trials that study new ways to ease symptoms and side effects during treatment and managing the late effects that may occur after treatment.

Cancer staging is the process of determining how much cancer has spread out inside the body and where it is located. Staging describes the severity of an individual's cancer based on the magnitude of the original (primary) a tumour as well as on the extent cancer has spread in the body. Understanding the stage of cancer helps doctors to develop a prognosis and design a treatment plan for individual patients

The genetic changes that contribute to cancer tend to affect three main types of genes - proto-oncogenes, tumour suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer. Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes) allowing cells to grow and survive when they should not. Tumour suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumour suppressor genes may divide in an uncontrolled manner. DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes. Together, these mutations may cause the cells to become cancerous. The process by which cancer cells spread to other parts of the body is called metastasis. Metastatic cancer spreads from the part of the body where it originated (the primary site) to other parts of the body. A risk factor is anything that increases a person’s chances of developing a Tumor. Although factors often influence the development of a tumour, most do not directly cause it. Some people with several risk factors never develop a tumour, while others with no known risk factors do. Some risk factors are as Age, Gender, Race/Ethnicity, Family history, Immune system suppression, arsenic exposure. Generally, the cause of Cancer is unknown. People who have one of the rare family syndromes have a higher risk of developing Tumors.

In cancer research and medicine, biomarkers are used in three primary ways:

To help diagnose conditions, as in the case of identifying early-stage cancers (Diagnostic)

To forecast how aggressive a condition is, as in the case of determining a patient's ability to fare in the absence of treatment (Prognostic)

To predict how well a patient will respond to treatment (Predictive)

Breast cancer can begin in different areas of the breast; the ducts, the lobules, or in some cases, the tissue in between. In this section, we could include the different types of breast cancer, including non-invasive, invasive, recurrent, and metastatic breast cancers. Breast cancer is a phenomenon that can even occur in men. Breast tissue contains fat and connective tissue, lymph nodes and blood vessels, they are made up of glands called tubules that can produce milk and thin tubes called ducts that carry the milk to the nipple. The most common type of breast Cancer is Ductal Carcinoma. Breast Cancer can also begin in the cells of the lobules in other tissues in the breast.

There is a great deal of research investigating the mechanisms of how drugs are metabolized and absorbed by the body's cells. Growing knowledge in this field provides the foundations for improving the anticancer potential for existing drugs and for developing new 'designer' drugs. Other work includes research into the mechanisms of drug resistance.

Anticancer drug, also called antineoplastic drug, any drug that is effective in the treatment of malignant, or cancerous, disease. There are several major classes of anticancer drugs; these include alkylating agents, antimetabolites, natural products, and hormones. In addition, there are a number of drugs that do not fall within those classes but that demonstrate anticancer activity and thus are used in the treatment of malignant disease. Chemotherapy is the use of anticancer drugs designed to slow or stop the growth of rapidly dividing cancer cells in the body.

Antibody marks the cancer cell and makes it easier for the immune system to find. The monoclonal antibody drug rituximab (Rituxan) attaches to a specific protein (CD20) found only on B cells, one type of white blood cell. Certain types of lymphomas arise from these same B cells. Monoclonal antibodies can also function by attenuating hyperactive growth signals neoangiogenesis. A monoclonal antibody can be conjugated to a radioactive particle that will ensure directed delivery to the cancer cell and slow and long release of the radiation, hence maximizing chances of the positive outcome and minimizing non-specific damaging exposure to radiation.

Targeted therapies act by blocking essential biochemical pathways or mutant proteins that are required for tumour cell growth and survival. These drugs can arrest tumour progression and induce striking regressions in molecularly defined subsets of patients. Indeed, the first small molecule targeted agent, the BCR-ABL kinase inhibitor imatinib, rapidly induced complete cytogenetic responses in 76% of chronic myelogenous leukaemia patients. Further research into the underlying genetic pathways driving tumour proliferation uncovered additional oncoproteins that are critical for tumour maintenance, such as the epidermal growth factor receptor (EGFR), BRAF, KIT, HER (also known as neu and ERBB) and anaplastic lymphoma kinase (ALK). Similar to imatinib, small molecule inhibitors of these kinases have effectuated impressive tumour responses in selected patients, although regressions are commonly followed by the development of progressive disease due to the emergence of drug-resistant variants. Resistance usually involves secondary mutations within the targeted protein or compensatory changes within the targeted pathway that bypass the drug-mediated inhibition. Accordingly, targeted therapies may elicit dramatic tumour regressions, but persistence is generally short-lived, limiting the overall clinical benefit.