Cancer is a complex group of diseases characterized by the uncontrolled growth and spread of abnormal cells. In a healthy body, cells grow, divide, and die in a controlled manner. However, genetic mutation disrupts this regulation, leading to the formation of tumours. While benign tumours are non-cancerous, malignant tumours invade nearby tissues and have the potential to metastasize.
Clinical oncology is a medical speciality that focuses on diagnosing, treating, and managing cancer in patients. Clinical oncologists work closely with a multidisciplinary team of healthcare professionals, including surgeons, pathologists, and other specialists, to provide comprehensive care to cancer patients.

In 2020, Hong Kong recorded a total of 34,179 new cases of cancer. On average, 94 individuals were diagnosed with cancer every day. The most prevalent types of cancers diagnosed in Hong Kong in 2020 were as follows:

• Lung cancer (15.9%)
• Colorectal cancer(14.9%)
• Breast cancer (14.6%)
• Prostate cancer (6.8%)
• Liver cancer (5.1%)
• Stomach cancer (3.5%)
• Corpus uteri cancer (3.5%)
• Non-Hodgkin lymphoma (3.1%)
• Non-melanoma skin cancer (2.9%)
• Thyroid cancer (2.9%)

The top five most prevalent cancers collectively accounted for more than 57% of all new cancers in Hong Kong.

Common symptoms of cancer can vary depending on the type and stage of cancer, as well as the individual’s overall health. It’s important to note that experiencing these symptoms doesn’t necessarily mean a person has cancer, as they can also be caused by other non-cancerous conditions. However, if any of these symptoms persist or cause concern, it’s advisable to consult a healthcare professional for further evaluation. Here are some common symptoms associated with cancer:

1. Fatigue: Persistent and unexplained fatigue that doesn't improve with rest.

2. Unintentional Weight Loss: Significant and unexplained weight loss without changes in diet or physical activity.

3. Pain: Persistent or worsening pain that is not relieved by typical methods.

4. Changes in the Skin: Skin changes, such as darkening, yellowing, redness, itching, or excessive hair growth.

5. Changes in Bowel or Bladder Habits: Persistent changes in bowel or bladder habits, such as blood in the stool or urine, prolonged diarrhea or constipation, or increased frequency of urination.

6. Difficulty Swallowing: Persistent difficulty swallowing or a feeling of food getting stuck in the throat.

7. Persistent Cough: A chronic cough that lasts for an extended period, especially if accompanied by blood.

8. Changes in a Mole: Changes in the size, shape, colour, or appearance of a mole or skin lesion.

9. Abnormal Bleeding: Unexplained bleeding or bruising, such as blood in the urine, stool, coughing up blood, or abnormal vaginal bleeding.

10. Lumps or Thickening: New lumps or areas of thickening that can be felt under the skin.

11. Persistent Indigestion or Discomfort: Chronic indigestion, abdominal pain, or discomfort that doesn't improve with usual treatments.

12. Changes in Voice: Persistent hoarseness or other voice changes.

When patients present with suspicious cancer symptoms, doctors use various diagnostic methods to determine if the symptoms are related to cancer. These diagnostic methods can help doctors confirm whether a person has cancer, identify the origin of cancer cells, determine the stage of cancer, and develop a treatment plan. The following are some commonly used diagnostic methods:

1. Medical history and physical examination: The doctor will review the patient’s medical history, including any risk factors and symptoms. A thorough physical examination will be conducted to assess the presence of any abnormalities or signs of cancer.

2. Imaging tests: Various imaging techniques are used to visualize the internal structures of the body and detect the presence and extent of tumours. These may include X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasound, and positron emission tomography (PET) scans.

3. Biopsy: A biopsy involves the removal of a sample of suspicious tissue for pathological examination to determine the presence of cancer cells and further identify the type and characteristics of the cancer cells.

4. Blood and urine tests: These tests analyze the chemical components in the patient’s blood or urine to infer the health status of the boy’s organs.

5. Endoscopy: Endoscopy uses a flexible tube and a camera to examine the internal organs and tissues of the body. It is commonly used to examine the oesophagus, stomach and colon, among other areas, and to collect tissue samples for further examination.

6. Genetic testing: Persistent difficulty swallowing or a feeling of food getting stuck in the throat.

Clinical oncologists utilize a range of treatment options for cancer, depending on factors such as the cancer type, stage, and individual patient characteristics. Standard treatment options employed by clinical oncologists include:

Radiation Therapy

This treatment employs high-energy radiation beams to destroy cancer cells or inhibit their growth. It is typically delivered externally (external beam radiation) or internally (brachytherapy). Radiation therapy may be used as a primary treatment or in conjunction with other therapies.

Chemotherapy

Chemotherapy involves the use of drugs to kill cancer cells or impede their ability to multiply. It can be administered orally or intravenously and may be used alone or in combination with other treatments. Chemotherapy is effective against cancers that have spread throughout the body.

Immunotherapy

Immunotherapy utilizes medications that enhance the body's immune system to recognize and attack cancer cells. It can include immune checkpoint inhibitors, T-cell therapy, monoclonal antibodies, cytokines and therapeutic vaccines.

Targeted Therapy

Targeted therapy utilizes medication to target specific molecules (targets) that help cancer cells survive and grow, which can be genes or proteins. Unlike traditional chemotherapy, targeted therapy only acts against all actively dividing cells and thus may have fewer side effects than conventional chemotherapy.

Hormone Therapy

Hormone therapy is employed for hormone receptor-positive cancers, such as breast or prostate cancer. It aims to block or interfere with hormones that promote cancer growth.

Precision Medicine

Precision medicine refers to the customization of treatment plans based on a patient’s gene expression, tumour molecular characteristics and personal health condition, in addition to traditional routine examinations. It can help make a more accurate diagnosis and medication, improving treatment outcomes and reducing unnecessary side effects.

Palliative Care

Palliative care focuses on improving the quality of life for individuals with advanced or metastatic cancer. It aims to manage symptoms, provide pain relief, and offer physical and emotional support.

Treatment plans are developed on a case-by-case basis, considering the specific characteristics of the cancer and the patient's overall health. Clinical oncologists work closely with other healthcare professionals to determine the most appropriate treatment options and provide comprehensive care to cancer patients.

Virtus Clinical Oncology

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