Oncology(redirected from Cancer care)
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the science of the etiology, clinical course, prevention, and treatment of tumors.
Progress in oncology is closely related to advances in the natural sciences, including biology—especially cytology and genetics—and chemistry—especially biochemistry. Other closely related fields are pathology and clinical disciplines, including surgery, radiology, and gynecology. Oncology was not an independent biomedical discipline until the 20th century, although much was already known about tumors in antiquity. Tumors were studied by such prominent 19th-century pathologists as R. Virchow and J. Cohnheim.
The rise of oncology as a science is associated with the development of experimental oncology. The Russian veterinarian and student of M. M. Rudnev, M. A. Novinskii, was the first to transplant malignant tumors from adult dogs to puppies (1876). Subsequently, other scientists transplanted tumors, including K. Jensen and P. Ehrlich in Germany, E. F. Bashford in Great Britain, and N. N. Petrov. Studies on transplanted tumors helped elucidate many characteristics of tumor tissues and cells.
At the beginning of the 20th century, the most important advances in oncology were the attempts to induce tumors in animals by using a variety of external agents. F. P. Rous succeeded in inducing (1911) sarcomas in chickens by injection with a cell-free filtrate. A pathological principle is usually considered viral when it can be obtained by filtration. The Japanese scientists K. Yamagiwa and K. Itikawa induced (1915) skin cancer in rabbits by prolonged application of coal tar to the ears. In the 1930’s the carcinogenic effect of several chemically pure aromatic hydrocarbons was demonstrated. For example, E. Ken-newe showed that benzapyrene is carcinogenic, while estrogens and some types of ionizing radiation were proven carcinogenic by A. Lacassagne (1932).
Theories of the origin of tumors were based mostly on the studies of German pathological anatomists, including D. Von Hansemann, H. Ribbert, M. Borst, and B. Fischer-Wasels and subsequently on the experimental work of biologists and biochemists. The German pathological anatomists proposed the existence of an embryonic or regenerative tumor rudiment, a concept that is partly reflected in the view of the contemporary oncologists J. Ewing in the USA and R. A. Willis in Great Britain. The Frenchman A. Borrel proposed (1903) that tumors might be of a viral nature. In accordance with the types of carcinogens, three basic directions in experimental and theoretical oncological research have gradually been established: viral, chemical, and radiation.
The diagnosis and treatment of malignant neoplasms were rapidly improved as a result of advances in surgery and radiology. Noteworthy contributors to these improvements in clinical oncology were the oncologists K. Regaud in France, K. Bauer in Germany, and G. Pack in the USA.
Russian scientists made important contributions to the growth of theoretical, experimental, and clinical oncology. N. N. Petrov published the first Russian handbook on oncology, General Studies on Tumors. E. Metchnikoff, V. V. Podvysotskii, and N. F. Gamaleia assumed that tumors are viral in nature. V. G. Korenchevskii and his co-workers studied oncology from an endocrinological viewpoint. A. A. Krontovskii, N. G. Khlo-pin, and A. D. Timofeevskii explanted tumor tissues. The surgeons P. A. Gertsen, Petrov, and A. I. Savitskii made many advances in clinical oncology.
Major advances in oncology were made after the 1917 October revolution. Petrov, N. A. Krotkina, G. V. Shor, N. G. Soboleva, L. F. Larionov, and L. M. Shabad pioneered the experimental induction of tumors with coal tar and chemically pure carcinogens. In 1937, Shabad induced tumors in animals by injecting the animals with extracts from the tissues of human beings who had died of cancer. Shabad also proposed the existence of endogenous blastomogenic substances. E. V. Shpol’skii, among others, developed precise quantitative methods for detecting carcinogenic hydrocarbons in the environment. This work made it possible to trace the paths by which environmental carcinogens travel, to determine the possibility of these carcinogens’ accumulating in any particular location, and to elucidate the mechanism by which such carcinogens are destroyed—particularly by soil bacteria.
Some recommendations on cancer prevention were formulated and carried out on the basis of research on environmental carcinogens. In 1956 the Soviet Ministry of Public Health organized the Committee on Carcinogens.
A new branch of oncology—tumor epidemiology—has emerged; a noteworthy contribution to this new field was made by the Soviet scientist A. V. Chaklin (1963). M. K. Petrova and students of A. D. Speranskii focused on the role of the whole organism as well as the nervous system in tumorigenesis. A. A. Bogomolets, R. E. Kavetskii, and I. M. Neiman studied the significance of the mesenchyma in the origin of tumors and the relationship between tumors and the body as a whole. Iu. M. Vasil’ev obtained new data on the participation of connective tissue in tumor formation. Soviet pathological anatomists, including M. F. Glazunov and N. A. Kraevskii, emphasized the morphological study of tumors. The present-day understanding of the properties and behavior of tumor cells has been advanced by cytological studies and by the histochemical studies of V. V. Portugalov and N. T. Raikhlin.
L. A. Zil’ber and G. Ia. Svet-Moldavskii induced (1957) tumors in mammals with such avian tumor viruses as the Rous sarcoma virus. Many tumor-causing viruses are known today. Zil’ber developed the viral-genetic theory of the origin of tumors. His work on the immunology of tumors resulted in the discovery of specific tumor antigens (1948). This approach made it possible to detect the presence in liver tumors of a peculiar embryonic protein, α-fetoprotein (1962). G. I. Abelev devised a useful diagnostic test for liver cancer that was based on the immunological approach (1968).
Experimental and clinical research on the surgical, radiological, and pharmaceutical treatments of tumors has expanded considerably. Especially noteworthy contributors have been N. N. Blokhin, L. F. Larionov, G. A. Zedgenidze, V. I. Astrakhan, and E. B. Vermel’. New antitumor agents have been developed and simultaneously tested in many clinics under strictly controlled conditions.
In the USSR, oncological care is provided through a system of oncological centers. The purpose of a center is the prevention, early detection, and effective treatment of tumors. The centers have outpatient facilities and hospitals equipped to diagnose and treat tumors. The centers engage in mass screenings and, together with health education centers, organize popular educational programs. The centers also record and analyze cancer morbidity and mortality rates and advise physicians on the diagnosis and treatment of tumors.
The first scientific oncological institution in Russia, called the Morozove Institute for the Treatment of Tumors, was organized in Moscow with private funds in 1903. The institute was subsequently completely reorganized and renamed the P. A. Gertsen Institute. In 1926 the Institute of Oncology was organized in Leningrad by Petrov, after whom the institute is now named. In 1952 the Institute of Experimental and Clinical Oncology of the Academy of Medical Sciences of the USSR was organized in Moscow. Institutes of oncology exist in several cities, including Kiev, Minsk, Alma-Ata, Tashkent, Yerevan, Tbilisi, Baku, and Rostov-on-Don. Besides providing research and treatment facilities, the institutes of oncology along with institutes of radiology offer guidance on scientific methods and train specialists through postgraduate and internship programs. Physicians receive advanced training at oncology departments of institutes of postgraduate medicine. Many medical institutes have departments of oncology or special advanced courses in oncology.
The All-Union Scientific Society of Oncologists was founded in 1954; that year it joined the International Union Against Cancer, which had been established in 1933. International cancer congresses have been held regularly since 1933; the eighth congress was held in Moscow in 1962. The monthly journal Voprosy onkologii (Problems of Oncology) has been published in Leningrad since 1955. The leading foreign periodicals dealing with oncology are Cancer Research (Philadelphia, Pa., 1941), Journal of the National Cancer Institute (Washington, D. C, since 1940–41), Zeitschrift für Krebsforschung (Berlin, since 1904), Bulletin de l’Association française pour l’étude du cancer (Paris, since 1908), and Neoplasma (Bratislava, 1954).
REFERENCESModeli i metody eksperimental’noi onkologii. Edited by A. D. Timofeevskii. Moscow, 1960.
Neiman, I. M. Osnovy teoreticheskoi onkologii. Moscow, 1961.
L. M. SHABAD