Overview

White blood cells, red blood cells, platelets, and plasma are the four components of blood that assist oxygenate our organs and tissues, fight infections, and form clots to stop bleeding. These components, however, may also signal the existence of anomalies, which can lead to blood malignancies. This is where hematology-oncology comes in.

Different types of cancers and blood-related disorders are the most chronic and life-threatening health conditions. They can develop in both children and adults and can alter the overall wellness or trigger other diseases. As such, early diagnosis and taking preventive measures is essential in preventing more damages. 

Hematology-oncology medical specialty is concerned with such issues. It focuses on various conditions ranging from minor to severe cases affecting patients of all ages. The primary aim of this field is to restore standard health and enhance the quality of life. 

What is a Blood Disorder?

Your blood is made up of plasma (a liquid containing water, salt, and protein), red blood cells, white blood cells, and platelets. While white blood cells aid in infection resistance, red blood cells transport oxygen to your organs and other tissues. Meanwhile, platelets aid in the formation of blood clots. Your bone marrow, the sponge-like substance inside your bones, is responsible for the production of new blood cells.

You may have a blood condition if you have a persistent problem with your red blood cells, white blood cells, or platelets.

What is Hematology-Oncology?

Hematology-oncology is a medical branch that combines hematology and oncology practices. The hematology branch involves the study of blood and related disorders, while oncology is concerned with types of cancers. 

Although hematology (blood) and oncology (cancer) are two independent medical subspecialties of internal medicine, the two fields frequently overlap since many tumors influence the blood and vice versa. As a result, many physicians obtain training and skill in both fields, resulting in the development of a merged medical specialty. Because of the intricacy of these conditions, hematologists and oncologists are frequently contacted by other physicians and specialists.

What is Heme Onc specialist?

Hematologists and oncologists are physicians who specialize in diagnosing and treating blood disorders and cancers. Sometimes, they work with specialists from various fields such as radiologists, rheumatologists, surgeons, geneticists, and radiation oncologists. 

They also help manage various conditions and come up with a suitable treatment plan. For instance, they can perform surgeries; administer chemotherapy, immunotherapy, radiation therapy, and transfusions. 

• Duties of an Oncology Doctor

Cancer can be treated with pharmacological therapy, surgery, or targeted radiation, and many patients receive all three at the same time. Medical oncologists oversee the patient's entire care, detecting the kind of cancer and developing a treatment plan. They deliver chemotherapy and other therapies that impede the reproduction of malignant cells, as well as pain and side effect medications.

Oncologists can remove well-defined solid tumors, sometimes eradicating the illness before it spreads. Radiation oncologists utilize X-rays, gamma rays, or radioactive chemicals implanted in the body to destroy malignant cells or inhibit their capacity to multiply.

• Duties of a Hematologist

Hematologists treat a wide variety of blood problems, including anemia, sickle cell disease, and clotting abnormalities like hemophilia. They also treat patients suffering from blood malignancies such as leukemia, as well as tumors of blood-related bodily systems like as the bone marrow and lymph nodes.

Hematologists take the lead in treating myeloma and lymphomas, including Hodgkin's disease and non-Hodgkins lymphoma, using the same pharmacological and therapy pool as medical oncologists. Chemotherapy or bone marrow transplants are used to treat leukemias, which remove the marrow that produces defective blood cells and replace it with healthy marrow.

Heme-Onc Subspecialties 

There are several other specialized fellowship training possibilities for heme/onc cancer specialists to pursue in order to further specialize in the field of heme-onc medicine. The further training, still referred to as a fellowship, occurs following internal medicine residency and heme/onc fellowship. Other fellowships available to these blood and cancer specialists include, but are not limited to

Gynecological Oncology

Gynecological malignancies account for 10-15% of all cancers in women, primarily affecting women past reproductive age but posing fertility risks in younger patients. The most prevalent treatment method is combination therapy, which consists of a mixture of surgical and non-surgical therapies.

A gynecologic oncologist is a doctor who specializes in the diagnosis and treatment of tumors that affect a woman's reproductive organs.

Gynecologic oncologists have completed an obstetrics and gynecology residency, followed by a gynecologic oncology fellowship. A residency program lasts four years, whereas a fellowship program lasts three to four years and includes intense training in surgical, chemotherapeutic, radiation, and research procedures critical to delivering the best treatment for gynecologic malignancies. Physicians who finish this course are qualified to sit for the obstetrics and gynecology board exam as well as the gynecologic oncology board test.

Pediatric Oncology

The Pediatric Oncology Branch is committed to improve the outcomes of children and young people suffering from cancer and hereditary tumor predisposition disorders. We carry out translational research ranging from fundamental science through clinical trials.

We hope that this website will offer you with the information you need to access our programs, whether you are a referring physician, family member, or patient with pediatric cancer or neurofibromatosis, or if you are interested in training at the Pediatric Oncology Branch.

Neuro-Oncology

Neuro-oncology is the study of neoplasms of the brain and spinal cord, many of which are (at some point) extremely hazardous and life-threatening (astrocytoma, glioma, glioblastoma multiforme, ependymoma, pontine glioma, and brain stem tumors are among the many examples of these). Gliomas of the brainstem and pons, glioblastoma multiforme, and high-grade (very anaplastic) astrocytoma are among the most malignant brain malignancies.

Survival with current radiation and chemotherapy therapies may prolong that period from roughly a year to a year and a half, potentially two or more, depending on the patient's health, immune function, treatments employed, and the exact form of malignant brain tumor. Surgery may be curative in certain situations, but malignant brain tumors, especially very malignant ones, tend to regenerate and return from remission quickly.

The objective in such circumstances is to extract as much of the bulk (tumor cells) and tumor margin as feasible without jeopardizing key functioning or other important cognitive abilities.

• Neuro-Oncology Diagnosis and Treatment

We provide the most advanced diagnostic tests and medicines for persons with common and unusual brain tumors, metastases to the brain or spinal cord, and neurological problems caused by cancer and its treatment. Our diagnostic services include modern imaging technology and tumor pathology analysis.

Our neuro-oncologists plan and provide the necessary chemotherapy, targeted treatment, angiogenesis inhibitors, and immunotherapy. Additionally, our team organizes tailored patient treatment, which may involve the expertise of neurosurgeons, neuroradiologists, neuropathologists, radiation oncologists, oncologists, oncology nurse practitioners, and social workers. Because we recognize the stress and concern that these disorders may create in our patients, our staff goes above and beyond to bring hope and comfort to the families in our care.

Pediatric Hematology

A pediatric hematologist/oncologist is a doctor that specializes in diagnosing and treating blood diseases and malignancies in children, adolescents, and young adults. 

Diagnostic Procedures

Other procedures they perform to diagnose the hematologic and oncologic condition include; 

• Bone marrow biopsy: This involves removing a small sample of the solid part of the bone marrow. The sample is then used for the diagnosis of diseases such as leukemia and other cancers. 
• Bone marrow aspiration: This is the removal of a sample of the liquid part of the bone marrow to diagnose conditions such as lymphoma and leukemia. 
• Hemoglobin electrophoresis: This is a blood test to check for disorders such as sickle cell disease or the inherited conditions that alter the red blood cells. 
• Positron emission tomography (PET): This is an imaging test involving a radioactive substance known as tracers. These tracers help detect the parts of the body invaded with cancer. 
• Human leukocyte antigen (HLA) testing: This is a blood test to check if the bone marrow donor matches with the patient or recipient. 
• Lumbar puncture or spinal tap: Involves the removal of cerebrospinal fluid to check and analyze if there are any cancerous cells in the sample. 
• Stem cell and bone marrow transplants: This is a procedure to address disorders such as lymphoma, leukemia, and benign blood conditions. It involves removing the damaged or non-functional stem cell or bone marrow and replacing it with a healthy one. 
• Magnetic resonance angiography (MRA): Involves the use of radio waves and magnetic fields to generate cross-sectional pictures of the blood vessels. These images help with the diagnosis of stroke or vascular disorders. 

Hematology and Oncology Diseases 

There are several hematologic and oncologic diseases affecting both children and adults. Some of these conditions are minor, while other chronic and require immediate medical attention or sometimes a surgical procedure. 

The common hematology and oncology diseases include; 

Blood-related disorders (hematology)

• Hemophilia: A condition where blood does not clot due to insufficient clotting factors or blood-clotting proteins. A person with hemophilia usually bleeds for a longer period after sustaining an injury. 
• Anemia: This is a blood-related disorder that occurs when there is insufficient production of the red blood cells in the body. Anemia also limits the supply of oxygen throughout the body. 
• Neutropenia: This arises when a certain type of white blood cells (neutrophils) is insufficient. Neutrophils form part of the immune system that helps fight against foreign organisms invading the body. Therefore, a person with neutropenia has weak immunity and is prone to various infections. 
• Bone marrow failure syndromes: This is a rare condition where the bone marrow cannot produce sufficient blood. It can be the white blood cells that fight off infections, red blood cells that transport oxygen, or the platelets that influence blood clotting. Bone marrow failure condition can be inherited or acquired. 
• Sickle cell disease: This is mostly an inherited condition whereby there is insufficient production of red blood cells carrying oxygen in the body. Unlike the normal flexible and round-shaped red cells, red cells of patients with this condition are sickles or crescent moon shapes. 

Cancer disorders (oncology):

• Lymphoma (Hodgkin’s and non-Hodgkin's): This is a type of blood cancer that affects the microorganism-fighting cells known as lymphocytes of the body's immune system. These are usually present in the lymph nodes, bone marrow, thymus, spleen, and various body parts. Lymphoma causes uncontrollable growth of the lymphocytes. 

• Leukemia: This is a cancer disorder that affects the body tissues producing blood, including the lymphatic system and the bone marrow. It triggers these blood-producing tissues to manufacture excessive white blood cells. This eventually overcrowds the platelets or red blood cells and alters their normal functions. 

• Sarcoma: This is a malignant tumor that develops in the connective tissues. These are the cells that support and link other types of tissues in the body. Sarcomas are mostly common in the blood vessels, muscles, bones, cartilages, tendons, nerves, and fats. They can sometimes develop in other parts of the body. 

• Neuroblastoma: This is a type of cancer that arises due to immature nerve cells in various parts of the body. It mainly begins from one of the adrenal glands but can sometimes develop in the spine, chest, neck, or abdomen. 

• Retinoblastoma: This is a type of eye cancer that develops in the retina area. The retina is a sensitive part of the inner lining of the eyeball. Retinoblastoma mainly affects the minors but can sometimes occur in adults. 

Signs and Symptoms of Hematologic and Oncologic Conditions 

Hematologic and oncologic disorders are often associated with varying signs and symptoms. Some symptoms indicate a minor disease, while others can signify chronic disorders such as cancer. Overall, these are the common signs and symptoms you need to watch out for;

• High frequency of infectious diseases 
• Frequent weakness, tiredness, and night sweats 
• Common colds, fever, coughing, or chest pain 
• Skin itchiness and rashes 
• Loss of appetite and recurring nausea 
• Breathing difficulties 
• Swollen but painless lymph nodes around the neck, groin, and armpits 

Treatment Options for Hematology and Oncology Conditions 

Treatment options for cancer and blood-related disorders usually depend on the type of condition and the actual cause. However, the medical practitioner can recommend treatment options such as; 

Surgery 

Surgery is helpful in both the diagnosis and treatment of tumors, especially for patients with lymphoma or solid tumors. It’s thus a cancer treatment option that involves an operation to remove the tumor. Surgery can also be performed before, during, or after administering other forms of treatment that shrinks the tumor. 

Chemotherapy

Chemotherapy is a cancer treatment option that uses anticancer drugs to slow down or prevent the growth and spread of cancer cells. Chemotherapy can be applied in various ways, including;

• The main treatment alternative to kill the cancerous cells
• Administered before the main treatment to shrink the cancer cells or tumor
• Administered to alleviate chronic symptoms like pain and inflammation in advanced cancer
• After the main treatment to kill the remaining tumors

Chemotherapy is usually delivered in different methods. It can be through injections, intravenously into the vein, orally, or direct placement through the lumbar puncture or implanted device. 

Radiation therapy

Radiation therapy is a treatment alternative that uses high doses of radioactive energy. It's used to kill the cancerous cells, ease cancer-related symptoms, and shrink the tumors before a surgical procedure. 

Hematology-oncology doctors can sometimes use radiation therapy in x-rays under low doses. It helps them view the inside part of the body and check for any abnormal growth and blood disorders. 

Blood transfusion therapy 

Blood transfusion therapy is a treatment procedure to restore blood in the body. It’s administered through an intravenous line into the veins. Blood transfusions are essential after an injury or a surgical procedure that causes excessive loss of blood. Also, patients suffering from disorders such as hemophilia and any blood-related cancer may require a regular transfusion. This procedure is referred to as blood transfusion therapy. 

Basically, there are different types of blood transfusion therapies that doctors opt for to address cancer and blood-related concerns. They include;

• Red blood cell transfusions: This is mainly done if the patient is suffering from a blood-related disorder such as iron deficiency anemia. 
• Platelet transfusion: This is mostly administered to patients with low platelet count due to a certain blood disorder or after a chemotherapy procedure. 
• Whole blood transfusion: Sometimes, the patient can receive a whole blood transfusion, especially if he or she has a severe traumatic hemorrhage. In such cases, the doctor can administer red blood cells, white blood cells, and platelets. 

Targeted therapies 

This is a type of cancer treatment alternative that involves using drugs and other substances to diagnose and destroy the cancerous cells. Doctors can also apply targeted therapy alongside other treatment forms, including surgical procedures, radiation therapy, and chemotherapy.

Does seeing a hematologist-oncologist mean I have cancer?

The short answer is that seeing a hematologist-oncologist does not automatically imply that you have cancer. Although Heme/Onc specialists primarily treat cancer, they also provide a wide range of other medical services. Cancer screening tests may be administered by hematologist-oncologists to individuals who are in remission or have completed treatment for cancer.

They may also offer specialist care to people suffering from high-risk cancer syndromes such as Von Hippel-Lindau or Lynch syndrome. They treat and transfuse patients with blood problems and monitor their well-being throughout radiation therapy and after surgery. Finally, they collaborate with other medical professions to provide cancer and non-cancer patient care. 

Conclusion

Hematology-oncology is a medical subspecialty concerned with cancer and blood-related disorders. On the other hand, hematology oncology specialists help diagnose and treat such disorders affecting infants, young children, and adults.