Oncology in Finland
Oncology is a branch of medicine that deals with malignant tumours. A medical professional who practises oncology is called an oncologist. According to World Health Organization data, the incidence of malignant tumours is unfortunately steadily increasing. The prevalence of cancer in the world will double by 2020 in comparison with 1999.
In Finland, diagnostics for different tumours are provided by various highly specialized doctors, depending on in which area of the body the tumour is located.
Surgery is chosen as the primary treatment for most cancers, with the exception of haematological cancers (cancers of the blood and lymphatic systems), which are primarily treated with postoperative chemotherapy.
After the primary diagnosis and radical surgical treatment, oncological care of cancer patients is continued.
The two main types of oncological treatment are postoperative chemotherapy and radiation therapy. In addition, oncologists use hormone therapy, immunotherapy and radionuclide therapy.
The objective of cancer care is to make an accurate diagnosis, perform radical surgery and provide tailor-made oncological treatment for every patient. Scientific research in medical oncology in Finland is of a high standard, and the WHO statistics indicate that the diagnostics and treatment of cancer in Finland are among the best in the world.
Diagnosis of oncological diseases in Finland
When cancer is suspected, a patient is referred to a specialized clinic that can provide the best diagnosis and treatment of the disease. Clinic Helena works in cooperation with specialists at the best clinics in Finland and makes every effort to refer each patient to the best possible care.
Methods such as ultrasound medical imaging techniques, X-ray diagnostic techniques (e.g. mammography), computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine imaging (scintigraphy), and positron emission tomography (PET) play an important role in the diagnosis and dynamic monitoring of patients.
Endoscopic examinations make it possible to identify and obtain the necessary material for a correct diagnosis, especially in gastroenterology and pulmonology.
Histological and immunohistochemial examinations of a biopsy from the tumour assist in arriving at a definitive cancer diagnosis. In order to take a biopsy of the tumour accurately, the biopsy procedure is guided by ultrasound, x-ray (e.g. in a stereotactic breast biopsy performed on a mammogram) or a CT. A biopsy is usually performed under local anaesthesia. The small piece of biopsy tissue is processed and cut into slices. A pathologist is a specialist doctor who examines the slices under a microscope and draws conclusions about the nature of the changes in the tumour cells. For a more accurate and specific analysis of the tumour, an immunohistochemical examination of the slices is conducted. The slices are treated with sera specific to different variants of the cancer formation, and thus the origin and classification of the tumour can usually be determined.
Patients are also tested for the presence of tumour markers, i.e. specific substances in the blood and/or urine and associated with tumours. These include antigens, hormones, proteins and metabolites of proteins, and enzymes.
Molecular genetic studies and DNA-testing are topical areas of scientific research at the moment, and we are expecting new methods of diagnostics and treatment in the near future.
The treatment of oncological diseases includes:
- Postoperative chemotherapy
- Radiation therapy
- Immunotherapy - target therapy with special antibodies
- Radionuclear therapy - target therapy with special isotopes
Radical (curative) surgical removal of the cancerous tumour using an organ-sparing approach is the first objective in the treatment of cancer. The advancement of reconstructive plastic surgery techniques has expanded the possibilities of radical surgery. Even if radical tumour excision is not possible, palliative resection of the tumour and excision of metastases can result in a long tumour-free period and improve the patient’s quality of life.
Postoperative chemotherapy in oncology refers to the treatment of cancer with toxins that are capable of destroying cancer cells but have a relatively low impact on the patient’s normal cells. These drugs are called cytostatics.
Cytostatic chemotherapy can be chosen as the primary method of treatment for malignant cancer, or as a supplementary treatment after surgery or radiation therapy (adjuvant chemotherapy). In some cases, it is applied before the planned surgery to reduce the tumour to an operable size (neoadjuvant chemotherapy).
The administration of a course of chemotherapy requires great care because the agents used have a strong effect on tumour cells and, although to a lesser extent, also on the healthy cells of the body.
In some cases, hormone therapy is effective, and it is especially used in breast and prostate cancer treatment.
Yet another method of cancer treatment is immunotherapy, the purpose of which is to restore the ability of the immune system to fight tumour cells. To restore and enhance the immune system when treating oncological diseases, particularly lymphomas or breast cancer, special agents are used, including monoclonal antibodies.
Radiation therapy is a special branch of oncology. Some cancerous tumours are especially sensitive to radiation (e.g. some lung cancers). Before starting radiation therapy, the area to be treated is carefully defined dusing computer tomography (CT) and a medical physicist calculates the dose of radiation.
The principle of conventional radiation therapy (radiotherapy) is based on the different ability of normal cells and pathological tumour cells to repair DNA damage after radiation. The main mechanism involves the ionization of water molecules, leading to the formation of reactive free radicals that damage DNA and then cells.
Radionuclide therapy (radioisotope therapy) is given to a patient mainly intravenously. It is a targeted therapy. Radiation is delivered to cancer cells with the help of a special carrier substance. For example, radioactive iodine is used in the treatment of thyroid cancer.
The advantage of treating tumours with ionizing radiation is that it is effective against abnormal cells while damage to healthy cells can be minimised.