ONCOLOGY

From Big Medical Encyclopedia

ONCOLOGY (grech, onkos the weight, a tumor + logos the doctrine) — the field of medicine studying the reasons, mechanisms of development and clinical displays of tumors, and also developing methods of their diagnosis, prevention and treatment.

Existence of malignant tumors was known to mankind in an extreme antiquity what numerous archeological finds and medical literature of antiquity and the Middle Ages convincingly testify to. At the same time until the end of 19 century of a tumor considered rather rare disease, and ideas of the reasons and mechanisms of their development, a structure and prevalence were very inexact. Throughout many centuries an original scourge of mankind were inf. diseases. Considerable prevalence inf. diseases and high mortality from them reduced average life expectancy of the population. As malignant tumors meet hl. obr. at elderly people, naturally, that their prevalence was small. The last does not mean that then people had no tumoral diseases and did not perish from them. But it is almost impossible to imagine true prevalence of tumors at that time. Imperfection of diagnostic methods, a comparative rarity of surgical treatment, lack of openings do not allow even to estimate approximately in what percent of cases «edema», «jaundice» and to that similar causes of death were a consequence of malignant tumors.

Development of microbiology, the hygiene and epidemiology which laid the strong foundation for fight with inf. diseases, promoted reduction of incidence of them and to increase in life expectancy of the population.

Since the end of 19 century infectious diseases gradually cease to come to the forefront in structure of incidence and causes of death of the population of the developed countries. Their place along with cardiovascular diseases is taken by malignant tumors. So, according to WHO data (1974), in 27 developed countries mortality from onkol, diseases of various form and localization at persons is more senior than 45 years among men fluctuated ranging from 411 to 843 on 100 thousand (on average — 600), among women — from 313 to 601 on 100 thousand (on average — 450) and made in structure of the reasons of mortality of the population of these countries from 13 to 24% (on average 19,2%).

The expressed tendency to growth of incidence onkol, diseases comes to light.

Researches in the area O. are among the most urgent and important medicobiological and medico-social problems of the present. In the majority of the countries of the world complex researches onkol are conducted, problems, to-rykh scientists of various specialties — biologists, geneticists, clinical physicians, biochemists, physicists, pharmacologists and many others actively participate in development. In the USSR researches in the area O. are among the major national objectives. In program documents of the CPSU and Soviet government, in particular in the Program of the CPSU, decisions XXIII, XXIV, XXV and XXVI of congresses of the CPSU, the main objectives of fight with onkol, diseases are reflected in our country. As a result of snowballing of O. in our country the network onkol, scientific institutions and special is created oncological service (see), routine maintenances for early identification and timely treatment of patients with malignant new growths are systematically performed, means of early diagnosis and complex treatment onkol, diseases are developed. The USSR lives apprx. 2 million people suffering various onkol. diseases. From them apprx. 500 thousand were treated 10 and more than years ago, i.e. can be considered as with firmness cured.

Descriptions of symptoms and even surgical treatment of tumors contain in medical literature of Ancient Egypt, China, India, works Gippokratak. Galen, Strike, Ibn-Sina. Surgical treatment nek-ry onkol, patients was carried out in Europe in 15 — 18 centuries. Early studies in the area O. are connected with development patol, anatomy and a mikroskopirovaniye. Separate data on a structure of tumors are available in M. Malpigi's works, To. Rokitansky, R. Virkhov, etc. The first observations testimonial of possibility of tumors under the influence of adverse exogenous factors were important. In 1775 P. Pott described a carcinoma cutaneum of a scrotum at chimney sweeps, in 1795 S. Th. Soemmerring — cancer of a lip at smokers of a tube, in 1820 — 1822 A. Paris — a carcinoma cutaneum of a scrotum at workers honey - and olovoplavilny production.

O.'s emergence as scientific discipline belongs to 20 century though in the second half of 19 century the first theories appeared carcinogenesis (see) — the theory of irritation of R. Virkhov and the theory of embryonal rudiments of Yu. Kongeym, and also the first attempts of experimental studying of tumors. In 1876 M. A. Novinsky for the first time in the world made transplantation of tumors on dogs, having created thus the first pilot models onkol, diseases.

Studying of oncogenous substances allowed to receive models of the induced tumors, and development virusol. researches — models of viral tumors (see. Oncology experimental ). In 1937 K. M. Shabad experimentally proved a possibility of education in an organism of oncogenous substances. It was established that tumors arise only at long and systematic impact of oncogenous substances on an organism. The large number of the chemical connections having oncogenous activity is known and nek-ry recommendations about the prevention of their influence are developed (see. Oncogenous substances ). In 1956. The m3 of the USSR was created the Committee on carcinogenic substances exercising control for by the new chemical connections entered into production, and also released for domestic needs and limiting use of the chemical connections constituting danger in connection with their possible oncogenous action.

At the beginning of 20 century I. I. Mechnikov, D. I. Ivanovsky and F. Raus stated the idea about a possible role of viruses in a carcinogenesis which received experimental confirmation in researches F. Raus (1911 — 1912), R. Shoup (1933), J. Bittner (1936). The viruses inducing tumors at experimental animals were allocated (viruses of sarcoma of hens of Raus, Shoup's papilloma, cancer of mammary glands of Bittner, etc.). In the 60th of K. A. Ziljber formulated the virusogenetichesky theory of a carcinogenesis, according to a cut Oncogenous viruses (see), being built in the genetic device of cells, break its functioning that leads to transformation of normal cells in tumoral. Researches in this area are intensively conducted in various laboratories of the world for clarification of a role of viruses in an origin of tumors at primacies and the person. From 40th 20 century researches on clarification of a role immunol, factors in a carcinogenesis are conducted. Existence at animals and the person of specific atrepsy is established (see. atrepsy ), and also communication of an immunosuppression with tumoral growth.

Perspective was a studying of prevalence of a number of forms of malignant new growths which began with the middle of 20 century in connection with various climatic, social, living conditions, addictions and national traditions of these or those ethnic groups laid the foundation for the new section O. — epidemiology of malignant tumors. As a result epidemiol, researches correlations between prevalence of cancer of lung and smoking, a breast cancer and disturbances of hormonal balance of a female body (especially in connection with frequent abortions), cancer of a liver and proteinaceous and scarce food in combination with parasitic damages of a liver, etc. were established. In 60 — the 70th convincing data on correlations of incidence onkol, by diseases with the level and the nature of environmental pollution are obtained, to-rye connect with existence and accumulation in free air, water and the soil of various mutagens (see). Therefore, the governmental activities held on purpose environmental controls (see), are directed including and to the prevention onkol. diseases.

Thus, by 60th 20 century various factors which are, apparently, releasers of a carcinogenesis — nek-ry chemical substances and viruses, ionizing radiation, hron, inflammatory processes, social conditions were established. Though complete idea of releasers and necessary conditions of a carcinogenesis in modern science does not exist, achievements of fundamental sciences — biology, geneticists, chemistry, etc. — allow to determine the fact of consistency of the available theories of emergence and development onkol, diseases today. So, it is possible to consider established that tumoral growth is caused by disturbance of the genetic device of a cell and often proceeds against the background of manifestations of an immunosuppression. As all listed above factors are capable under these or those conditions to have the damaging effect on the genetic device of cells and to oppress immunol, reactions of an organism, therefore, influence of each of them can become an origin onkol, process.

Clinical O. long time developed irrespective of experimental and theoretical. Surgeons at the end of 19 and the beginning of 20 century offered a large number of methods of operational treatment of malignant tumors of various localizations. Long time operative measures were considered as the main method of treatment of malignant new growths. The diagnostic means and receptions used in various areas a wedge, medicine were applied also to diagnosis onkol, diseases therefore a wedge. The lake it was enriched with methods radiological, radio isotope, endoscopic and other researches of patients. After implementation of diagnostic by M. M. Rudnev biopsies (see) it began to apply widely in onkol, practice. In several years after opening x-ray emission (see) clinical physicians, including domestic (N. A. Velyaminov, P. I. Dyakonov, L. L. Levshin), began to apply it to treatment and diagnosis onkol, diseases. It served development of radiodiagnosis and radiation therapy (see).

Further began to apply radioisotopes to the same purposes (see. Radio isotope diagnosis ) and different types ionizing radiation (see). Researches in this area promoted and promote development of methods of radiodiagnosis and radiation therapy, expansion of an arsenal of their means.

Use in 1941 by Ch. Haggins of oestrogenic hormones for cancer therapy of a prostate laid the foundation for development of methods of medicinal treatment of tumors. Further antineoplastic properties of nitrogenous iprit were found that stimulated broad search of others antineoplastic means (see). Except the alkylating connections, working on to-rymi was carried out to the USSR by L. F. Larionov with sotr., a number of active drugs among antimetabolites, antibiotics, alkaloids, enzymes is found. Hormonal drugs (androgens, estrogen, progestins, corticosteroids) also remain in an arsenal of medicinal therapy tumors (see). Perspective were methods of a combination therapy and use of medicinal therapy in a complex with radiation and operational treatment.

In pre-revolutionary Russia organized onkol, the help did not exist, and scientific work in the area O. was conducted by scientists - entuzia-stami. In 1903 at the initiative of K. K. Levshina on private donations the first in Russia was organized by in-t for onkol, patients. In 1906 in St. Petersburg Eleninskaya would be open for contempt of the women sick with malignant tumors. In 1910 work H was published. N. Petrov, one of the most visible founders of domestic oncology — «The general doctrine about tumors», in Krom for the first time O. was allocated in the special field of medicine. In 1908 in St. Petersburg the committee on creation of Society of fight with onkol was formed, diseases, in work to-rogo active participation V. F. Snegirev, V. V. Podvysotsky, N. A. Velyaminov, H accepted. N. Petrov. The task about-va included distribution among the population of data on cancer, the organization of anticarcinogenic service, scientific research and treatment onkol, patients.

Necessary conditions for O.'s development were created in our country only after a victory of Great October. In 1918 at the initiative of M. I. Nemenov it was organized State radiological and radiological by in-t, played a considerable role in development onkol, researches.

In 1920 under the leadership of II. A. Herzen, one of founders of domestic school of oncologists, work Moscow in-that for treatment of tumors, interrupted during war and revolution was resumed. In 1926 under the direction of H. N. Petrova in Leningrad Ying t of oncology — one of the largest research institutions in our country was organized. The big contribution to domestic O.'s development was made by the Ukrainian scientists A. A. Bogomolets, A. V. Melnikov, R. E. Kavetsky. In 1920 were open oncological and radiological in-you in Kiev and Kharkiv.

In 30 — the 50th in the country the network of research radiological and oncological in-t, number to-rykh in 1980 is created made 19. In 1951 Ying t of experimental pathology and therapy of cancer (since 1959 was organized — Ying t of experimental and clinical oncology of the USSR Academy of Medical Sciences), on base to-rogo in 1975 is open the All-Union Oncological Scientific Center (AUOSC) of the USSR Academy of Medical Sciences which is one of the world's largest onkol, research establishments of the world (see. research centers ). It performs functions of head establishment on onkol, science in the USSR. On the basis of VONTs the Scientific council on malignant new growths at presidium of the USSR Academy of Medical Sciences works, responsible for planning and coordination of all researches on O. in the country and for coordination of the international scientific relations on oncology. Here the Coordination center for oncology of member countries of SEV works, and also joint researches with the scientific USA, France and other countries under interstate agreements are coordinated. Ying-you of oncology are created also in many federal republics, they exist in Kiev, Minsk, Tashkent, Yerevan, Baku, Tbilisi and other cities. Specialized research oncological and X-ray radiological in-you are engaged in studying of problems of tumoral growth. Onkol, in-you are the scientific, diagnostic, health and organizational centers. They perform management onkol, network, study the long-term results of treatment, incidence and mortality from malignant tumors, and also features of their distribution, develop methodical recommendations about new, most effective diagnostic methods and treatments of tumors, the organizations of anticarcinogenic fight, to perfect forms of routine maintenances, but anticarcinogenic promotion. Attaching huge significance to fight against malignant new growths, the Council of People's Commissars during the Great Patriotic War issued the resolution «About Actions for Improvement of the Oncological Help to the Population» (on April 30, 1945). Narkomzdrava the USSR (of July 28, 1945) creation state onkol, the organization designed to head all actions for the account onkol, patients, to prevention and early diagnosis of cancer, treatment and dispensary observation for onkol, patients was a main objective of this resolution and the order issued on its basis. All subsequent work was directed to expansion and strengthening of network onkol, institutions, training of oncologists and radiologists, attraction to anticarcinogenic fight of doctors of the general to lay down. networks and increase in their qualification in the area O.

A fundamental unit in system of the anticarcinogenic organization became onkol. clinic (see), to-ry carries out diagnostic and to lay down. work, makes the account and dispensary observation for patients, will organize actions for prevention and early detection of cancer. A dispensary method (see. Medical examination ) provides lifelong overseeing by patients in O. even when at them already many years neither a recurrence, nor metastasises of a tumor is observed. Clinics perform methodical management according to O. in all to lay down. institutions, are base of specialized training of doctors and training of students of medical institutes. By the beginning of 1976 in the USSR functioned 250 onkol, clinics and 3193 onkol. dispensary department and office. The resolution of Council of ministers of the USSR on improvement published in 1976 onkol, the help to the population and the order of the Minister of Health of the USSR «About measures for further improvement of the oncological help to the population» provide further construction new large onkol, clinics with hospitals and boarding houses for patients, enlargement of the existing clinics and the organization in them of radio-gramophones, departments, and also creation onkol, dispensary departments in-tsakh. Researches in the area O. are conducted in various specialized scientific institutions, and also at departments of medical institutes and in-t of improvement of doctors.

The main directions of development of O. are connected first of all with further basic researches of questions of an etiology and pathogeny of tumors. Studying of a role of viruses, exogenous and endogenous oncogenous agents in developing of tumors of the person, essence of a carcinogenesis and processes of a malignancy, relationship of an organism and a tumor, features of spread of tumors and values of environmental factors, and also developing of tumors in the prof. groups concerns to them. On the basis of basic researches new, more perfect diagnostic methods are developed (immunological, cytologic, endoscopic), methods of treatment of tumors are improved, selectively operating antineoplastic drugs are created, radiation therapy, a cryosurgery develop, laser beams, ultrasound and an immunotherapy are applied.

Training of oncologists since 1934 is conducted at departments of oncology of in-t of improvement of doctors, and also in research in-ta of oncology and a radiology (a postgraduate study, an internship). Since 1975 also departments and courses of oncology at medical institutes are organized. Since 1954 in the USSR works All-Union scientific about-in oncologists, departments to-rogo are available in many large cities of the country. It about-in holds congresses and conferences. It is a part of the International anticarcinogenic union combining oncologists of the majority of the countries of the world. The Soviet oncologists participate also in work of the International Agency for Research on Cancer (MAIR) organized in 1965 in Lyon (France), which is engaged in basic researches in the area O. (see. International anticarcinogenic organizations ).

For successful and more bystry decision onkol, problems the developing and becoming stronger international cooperation in this area is of great importance. The international association of oncologists was created at the beginning of our century when wide-ranging studies on a problem began cancer (see). Even before World War I in Europe three international conferences on a problem of cancer — in Heidelberg (1906), in Paris (1910) and in Brussels (1913) were organized. However it were rather not numerous scientific conferences. Separate conferences gathered also after World War I, but systematic work on the international cooperation began only in 1933 when on the I International anticarcinogenic congress in Madrid the International anticarcinogenic union was organized. In 1935 in Paris the organizational General Assembly of the International anticarcinogenic union took place. In the next years the congresses of oncologists were repeatedly carried out in various cities of the world, including in Moscow (1962). The international anticarcinogenic union is connected with In seven r-ache the organization of health care, edges in the 70th years organized a number of researches on cancer, special department of oncology and several international centers in the different countries for studying of pathology of separate types of tumors. It annually brings together councils of experts in single questions of O., recruiting in them representatives of the different countries, promotes studying of epidemiology of cancer.

Communication between scientists - onkolo-gami many countries is carried out, of course, not only within the International anticarcinogenic union. The Soviet Union, e.g., has special bilateral agreements about the USA providing exchange of the young scientific specialists working on a problem of cancer in number of other questions. Joint scientific activity of the Soviet scientists and oncologists of the socialist countries develops according to the uniform program developed in SEV. Contacts between scientists of the different countries help to bring closer the solution of the questions of oncology which are not studied still today.

The largest in-ta of oncology in other countries are National cancer in-t, Sloan Kettering of in-t, Anderson hospital in the USA, Chester-Beatty of in-t in England, Ying t of oncology of G. of Russia in France, the Center for oncology in Heidelberg (Germany) and some other.

In the USSR the Questions of Oncology magazine is issued, abstract magazines are issued, in to-rykh questions O. are taken up (the short list of periodicals according to O. — see the bibliography).

Bibliography:

History — Kazan V. I. Ways of the Soviet oncology, Owls. zdravookhr., No. 3, page 49, 1947; A. V. U Prussian of sources of the Russian oncology, Vopr, onkol., t. 2, No. 6, page 763, 1956; Development of oncology in the USSR in 1971 — 1975 years, under the editorship of H. N. Blochina and N. P. Napalkov, M., 1977; P at the h to about Sunday to and y B. S., M. Rudnev and M. Novinsky — founders of experimental oncology, the Doctor, business, No. 6, Art. 481, 1949; it, the Role of domestic scientists in development of experimental oncology, t. 1, Kiev, 1953; it, Sketches of development of the Soviet experimental oncology, Kiev, 1959; Fedyushinm. P. Some materials to history of the Russian oncology, in book: Vopr, onkol., under the editorship of A. I. Serebrov, century 6, page 278, M., 1953, bibliogr.

Textbooks, guides, reference media — Virkhov R. The doctrine about tumors (oncology), the lane with it., t. 1 — 2, SPb., 1866 — 1867; And r and A. M N. Facts, achievements and failures of modern oncology, Alma-Ata, 1980; Diagnosis of malignant tumors, under the editorship of N. N. Blochin, M., 1978, bibliogr.; Zilber L. A. Virus theory of an origin of malignant tumors, M., 1946; Zilber L. A. and * And belev G. I. Virusologiya and immunology of cancer, M., 1962; Zilber L. A., etc. Evolution of the viruso-genetic theory of developing of tumors, M., 1975; Kavets-to and y R. E. Interaction of an organism and tumor, Kiev, 1977, bibliogr.; Clinical oncology, under the editorship of H. N. Blochina and B. E. Peterson, t. 1 — 2, M., 1979; Kozlova A. V. Radiation therapy of malignant tumors, M., 1971; Conrad P. N. and Ertl Dzh. E. Children's oncology, the lane with English, M., 1981; Larionov L. F. Chemotherapy of malignant tumors, M., 1962, bibliogr.; Treatment of generalized forms of tumoral diseases, under the editorship of H. N. Blochina and Sh. Ekhardta, M., 1976, bibliogr.; Masson P. Tumors of the person, the lane with fr., M., 1965; Tumoral growth as a problem of developmental biology, under the editorship of V. I. Gelyiteyn, M., 1979; Petrov H. H. The general doctrine about tumors, SPb., 1910; it, the Short sketch of comparative pathology of tumors at animals and the person, L., 1941; it, the Short sketch of base materials for development of the theory of tumoral growth, L., 1954; Problems of oncology, under the editorship of A. I. Serebrov, etc., L., 1962; Anticarcinogenic fight in member countries of SEV, under the editorship of N. P. Napalkov and Sh. Ekhard, M., 1980; The Guide to the general oncology, under the editorship of H. N. Petrova, L., 1961; The Guide to pathoanatomical diagnosis of tumors of the person, under the editorship of N. A. Krayevsky and A. V. Smolyannikov, M., 1976, bibliogr.; The guide to cytologic diagnosis of tumors of the person, under the editorship of A.S. Petrova and M. P. Pto-hov, M., 1976, bibliogr.; Herd grasses and y A. D. Eksplantation of tumors of the person, M., 1947; Chemotherapy of malignant tumors, under the editorship of H. N. Blochina, M., 1977; Shabad L. M. Sketches of experimental oncology, M., 1947; it, Evolution of concepts of a blastomogenesis, M., 1979, bibliogr.; FRIDAY I-p about V. S t. Biochemical aspects of tumoral growth, M., 1975, bibliogr.; Epidemiology of cancer in the USSR and the USA, under the editorship of H. N. Blochina and M. A. Schneiderman, M., 1979; Antiviral mechanisms in the control of neoplasia, ed. by P. Chandra, N. Y., 1979; Ashley D. J. B. Evans'histolo-gical appearances of tumors, Edinburgh a. o., 1978; Cancer medicine, ed. by J. F. Holland a. E. Frei III, Philadelphia, 1973; Clayson D. B. Chemical carcinogenesis, L., 1962; Ewing J. Neoplastic diseases, Philadelphia, 1940; F i-scher-Wasels B. Allgemeine Gesch-wulstlehre, Handb, norm. u. path. Physiol., hrsg. v. A. Bethe u. a., Bd 14, T. 2, S. 1341, B., 1927; Foulds L. Neoplastic development, v. 1—2, L. — N. Y., 1969 — 1975; Greenstein J. P. Biochemistry of cancer, N. Y., 1947; Pathology of tumors in laboratory animals, ed. by V. S. Turusov, v. 1 — 2, Lyon, 1973 — 1979.

Periodicals — Questions of oncology, M. — L., 1928 — 1937 and since 1955; Medical abstract magazine. The section VI — Oncology clinical, Radiology medical, the Radiology, M., since 1957; Abstract magazine, Biology, Section XI. The general questions of pathology, Oncology, M., since 1961; Soviet medical abstract review, Oncology, M., 1949 — 1956; Experimental oncology, Kiev, since 1979; Acta oncologica, Madrid, since 1962; Acta Unionis internationalis contra cancrum, Louvain and. the lake, since 1936; Archiv fiir Geschwulstforschung, Dresden — Lpz., since 1949; British Journal of Cancer, L., since 1947; Bulletin du Cancer, P., since 1966 (1908 — 1965 — Bulletin de l’Association frangaise pour 1’etude du cancer); Cancer, N. Y., since 1948; Cancer Research, Baltimore, since 1941 (1916 — 1930 — Journal of Cancer Research, 1931 — 1940 — American Journal of Cancer); European Journal of Cancer, Oxford — N. Y., since 1965; Excerpta medica, Section 16 — Cancer, Amsterdam, since 1953; Gann: the Japanese Journal of Cancer Research, Tokyo, since 1907: Indian Journal of Cancer, Bombay, since 1963; International Journal of Cancer, Geneva, since 1966; Journal of the National Cancer Institute, Washington, since 1940; Krebsarzt, Wien, since 1946; Neoplasma, Bratislava, since 1957 (1954 — 1956 — Ceskoslovensk^ oncologia); Nowotwory, Warszawa, since 1950; Oncologia, Basel — N. Y., since 1948; Oncologia §i Radiologia, Bucure^ti, since 1962; Progress in Clinical Cancer, N. Y — L., since 1965; Revista espanola de oncologia, Madrid, since 1952; Tumori, Milano, since 1911; Zeitschrift fiir Krebsforschung', V., since 1904. See also bibliogr, to St. Tumours .


H. H. Blochin.

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