Medical Oncology & Hematology Services
Medical oncology is a critical component of any cancer program. Our medical oncologists are part of a team that treats patients affected by a wide range of cancers and blood disorders. These include solid-tumor cancers such as melanoma, colon, breast and prostate cancer, as well as malignancies of the blood such as leukemia and lymphoma.
Our oncologists work together with other specialists to diagnose, evaluate and treat all malignant disorders. They direct and manage the patients’ medical needs as they relate to systemic cancer therapies, including chemotherapy, immunotherapy, and the management of treatment side effects as well as of cancer complications such as pain, malnutrition and others.
In addition to conventional treatments, our oncologists are also active in the clinical testing of novel therapies. These include state-of-the-art drugs and new biological and immunological modifiers under investigation in clinical trials. They use the most current FDA-approved therapies and the most recent discoveries in cancer therapies. Additionally, the oncologists participate in nationwide clinical research trials.
We also offer inpatient medical oncology services in a nursing unit specializing in the care of oncology patients. This unit is supported by oncology-trained nurses, social workers and dietitians. All the nurses are certified in chemotherapy administration and the majority of them have obtained national oncology nursing certification.
To select a Medical Oncologist or Hematologist, visit our Find A Doctor search tool.
Chemotherapy may be given before or after surgery. Most chemotherapy drugs are administered by intravenous infusion over minutes to several hours. Other types of chemotherapy are administered by injection or in pill form. The duration of treatment depends on the type of the cancer and the treatment regimen. Chemotherapy is given in cycles, allowing a rest period between treatments.
Recently, tremendous strides have been made in the management of side effects associated with chemotherapy. A variety of options now exist to eliminate or minimize chemotherapy-induced side effects such as nausea, vomiting, diarrhea, constipation, temporary hair loss, and/or weight changes. Each person has unique responses to treatment, so Alta Bates Summit doctors and staff will work with you to prevent and minimize your side effects. You will also be taught how to manage side effects using nutritional strategies, complementary therapies and prescribed medications.
Like chemotherapy, hormone therapy – also called "endocrine-based therapy" – is a systemic treatment. But unlike chemotherapy, endocrine-based therapy was developed to interfere with certain natural body chemicals – hormones – which may stimulate cancer growth. Cancer types which characteristically may be sensitive to hormones include breast, prostate, ovarian, and endometrial cancers. To slow or prevent the growth of these sensitive cancer cells, hormone therapy drugs are chemically structured to interfere with the growth of such types of cancer, for example by decreasing the amount of hormone that the body produces or by blocking its action on the cancer cells directly.
Where chemotherapy agents may affect many other general cell types such as white blood cells, hormonal agents are more limited in their effects. They are the first type of systemic treatment directed at a specific target – the hormone-dependent cancer cell – and may be referred to as "targeted therapy." Their benefits and their side effects relate only to the natural effects of the hormone itself and the hormone-cancer cell interaction. For that reason, the typical side effects seen with chemotherapy are not present with hormone or endocrine-based therapies. Hormone therapy may be used alone or in combination with radiation therapy. It is rarely used simultaneously, but is often used following chemotherapy.
Targeted or Molecular Therapies
Normal cell growth and division are mostly under the control of a network of chemical and molecular signals that give instructions to cells. When this signaling process is disrupted, cells no longer grow, divide, or die normally when they should. Scientific discoveries related to these biochemical signals and their targets have resulted in numerous advances in the treatment of cancer. Cancer therapy that is directed to a specific target or signaling pathway is commonly called "targeted therapy" or "molecular therapy."
Targeted cancer therapies use drugs that block the growth and spread of cancer by interfering with cancer cell growth and division in different ways and at various points during the development, growth, and spread of cancer. By focusing on molecular and cellular changes that are specific to cancer, targeted cancer therapies provide effective treatment for cancer while sparing healthy tissues.
The medical oncologists at Alta Bates Summit Medical Center use the most current FDA-approved therapies and are committed to using the most recent discoveries in cancer therapies on behalf of their patients. Some of the common targeted therapies are monoclonal antibodies and “small-molecule” inhibitors that block specific targets found on the surface of various cancer cells. These drugs are often better tolerated than chemotherapy, without the common toxic side effects of chemotherapy.
Colony-stimulating factors (CSFs) do not directly affect tumor cells, but instead encourage bone marrow stem cells to divide and develop into white blood cells, platelets, and red blood cells. Some examples of CSFs and their use in cancer therapy are as follows:
- G–CSF (filgrastim) and GM–CSF (sargramostim) can increase the number of white blood cells, thereby reducing the risk of infection in patients receiving chemotherapy. G–CSF and GM–CSF can also stimulate the production of stem cells in preparation for stem cell or bone marrow transplants.
- Erythropoietin (epoetin) can increase the number of red blood cells and reduce the need for red blood cell transfusions in patients receiving chemotherapy.
- Interleukin-11 (oprelvekin) helps the body make platelets and can reduce the need for platelet transfusions in patients receiving chemotherapy.
In addition to CSFs, researchers are evaluating the effectiveness of certain antibodies made in the laboratory called monoclonal antibodies (MOABs or MoABs). These antibodies are specific for a particular target and researchers are examining ways to create MOABs specific to the targets found on the surface of various cancer cells. MOABs may be used in cancer treatment in a number of ways:
- MOABs that react with specific types of cancer may enhance a patient’s immune response to the cancer.
- MOABs can be programmed to act against cell growth factors, thus interfering with the growth of cancer cells.
- MOABs may be linked to anticancer drugs, radioisotopes (radioactive substances), or other toxins. When the antibodies latch onto cancer cells, they deliver these poisons directly to the tumor, helping to destroy it.
- MOABs carrying radioisotopes may also prove useful in diagnosing certain cancers such as colon/rectum, ovarian, and prostate.
Some monoclonal antibodies that are currently in use at Alta Bates Summit Medical Center include:
- Rituxan® (rituximab)
- Herceptin® (trastuzumab)
- Erbitux® (cetuximab)
- Vectibix® (panitumumab)
- Avastin® (bevacizumab)
"Small-molecule" drugs block specific enzymes and growth factors involved in cancer cell growth. These drugs are also called signal-transduction inhibitors. Targeted agents may block a variety of pathways that promote cancer growth, such as: EGFR (epidermal growth factor); TK (tyrosine kinase) and VEGF (vascular endothelial growth factor).
Small molecule drugs that are commonly used by Alta Bates Summit oncologists include:
- Iressa® (gefitinib)
- Tarceva® (erlotinib)
- Sutent® (sunitinib malate)
- Some medical descriptions above are from the National Cancer Institute website.