Medical Oncology

Medical oncology is one of the most dynamic and rapidly evolving specialties in modern medicine, encompassing the management of cancer through pharmacological treatments. Responsible for the planning and administration of systemic treatment approaches such as chemotherapy, immunotherapy, targeted therapies, and hormone therapy, medical oncology plays an active role at every stage of the cancer patient's treatment journey. The Koru Hospital Department of Medical Oncology aims to provide the most effective treatment services to cancer patients with its expert staff and current treatment protocols.

What is Medical Oncology?

Medical oncology is a sub-specialty of internal medicine that focuses on the systemic treatment of cancer, namely treatment with medication. While surgical oncology deals with the surgical removal of tumors and radiation oncology focuses on radiotherapy, medical oncology manages systemic treatment approaches such as chemotherapy, immunotherapy, targeted therapies, hormone therapy, and supportive care.

A medical oncologist acts as a coordinator from the moment of cancer diagnosis, involved in creating the patient's treatment plan, administering the treatment, managing side effects, and overseeing the post-treatment follow-up process. Through multidisciplinary tumor boards, they work in collaboration with surgeons, radiation oncologists, pathologists, radiologists, and other relevant specialists to ensure the determination of the most appropriate treatment strategy for each patient.

Types of Cancer Treated at Koru Hospital Department of Medical Oncology

The Koru Hospital Department of Medical Oncology treats all solid (organ-based) tumors and hematological (blood-based) cancers. The primary types of cancer treated include:

• Breast cancer: As the most common type of cancer in women, early-stage, locally advanced, and metastatic stage treatments are managed comprehensively.
• Lung cancer: Current treatment protocols are applied at all stages of small-cell and non-small-cell lung cancers.
• Colorectal cancer: Adjuvant, neoadjuvant, and palliative treatments for colon and rectal cancers are performed.
• Stomach and esophageal cancers: Treatment of gastrointestinal system cancers is provided through a multidisciplinary approach.
• Liver and bile duct cancers: Treatments for hepatocellular carcinoma and cholangiocarcinoma are administered.
• Pancreatic cancer: Treatment is conducted with current chemotherapy regimens and supportive care protocols.
• Kidney and bladder cancers: Systemic treatment of urological cancers is provided.
• Prostate cancer: Treatment approaches including hormone therapy and chemotherapy are applied.
• Gynecological cancers: Treatments for ovarian, endometrial, and cervical cancers are performed.
• Head and neck cancers: Treatments for laryngeal, pharyngeal, oral cavity, and thyroid cancers are provided.
• Brain tumors: Systemic treatment of primary and metastatic brain tumors is applied.
• Melanoma and skin cancers: Managed with immunotherapy and targeted therapies.

Chemotherapy Treatment

Chemotherapy is a systemic treatment method that uses drugs to prevent the growth and multiplication of cancer cells. Chemotherapy, which can be administered intravenously, orally, or intrathecally (into the cerebrospinal fluid), constitutes one of the cornerstones of cancer treatment.

Chemotherapy can be administered to shrink a tumor before surgery (neoadjuvant), to reduce the risk of recurrence after surgery (adjuvant), or for palliative purposes in advanced-stage disease. The treatment protocol is individualized based on the cancer type, stage, the patient's general condition, and accompanying comorbidities.

The chemotherapy unit at Koru Hospital features a modern design that prioritizes patient comfort. During treatments administered by experienced oncology nurses, patients are kept under close observation, and potential side effects are managed proactively.

Immunotherapy

Immunotherapy is an innovative treatment approach that activates the body's own immune system against cancer cells. Leading to a paradigm shift in cancer treatment over the last decade, immunotherapy has enabled striking treatment responses in many cancer types, particularly thanks to immune checkpoint inhibitors.

PD-1, PD-L1, and CTLA-4 inhibitors work by disabling the "brake mechanisms" that prevent the immune system from recognizing and destroying cancer cells. Immunotherapy has become a part of standard treatment for many cancer types, primarily melanoma, lung cancer, kidney cancer, bladder cancer, and head and neck cancers.

Immunotherapy has a unique side effect profile, and autoimmune-like side effects may develop due to overactivation of the immune system. Early recognition and appropriate management of these side effects are of great importance for the safe continuation of treatment.

Targeted Therapies (Smart Drugs)

Targeted therapies are drugs that act by blocking specific molecular targets in cancer cells. Unlike traditional chemotherapy, they provide a more selective antitumor effect by causing less damage to normal cells. Tyrosine kinase inhibitors, monoclonal antibodies, CDK4/6 inhibitors, PARP inhibitors, and anti-angiogenic agents are the primary representatives of this group.

For targeted therapy to be administered, the presence of the relevant molecular target in the tumor tissue must be demonstrated. Therefore, molecular pathology tests (such as immunohistochemistry, FISH, PCR, and next-generation sequencing) play a critical role in treatment planning. The Koru Hospital Department of Medical Oncology personalizes treatment by ensuring comprehensive molecular profiling for every patient.

Hormone Therapy

Hormone therapy is a treatment method used in hormone receptor-positive cancer types to block the stimulating effect of hormones on tumor growth. Widely used especially in breast and prostate cancer, hormone therapy can be administered alone or in combination with other treatment methods.

In breast cancer, tamoxifen, aromatase inhibitors, and combination therapies with CDK4/6 inhibitors; in prostate cancer, androgen deprivation therapy and new-generation hormonal agents are the primary treatment options used. Hormone therapy is generally administered for a long duration, and the management of its side effects is important for increasing treatment adherence.

Personalized Cancer Treatment and Precision Medicine

In today's oncology practice, the "one size fits all" principle has been abandoned, and treatment is planned according to the unique molecular characteristics of each patient's tumor. With next-generation sequencing (NGS) technology, the genomic profile of the tumor is extracted, and treatment options are determined based on this profile.

Liquid biopsy (analysis of tumor DNA from blood) has entered clinical practice as an innovative method used in monitoring treatment response and early detection of resistance mechanisms. Biomarkers such as tumor mutation burden (TMB) and microsatellite instability (MSI) provide valuable information in predicting immunotherapy response.

Multidisciplinary Tumor Boards

Making the most accurate decision in cancer treatment is possible through the coming together of different disciplines to evaluate the patient collectively. Multidisciplinary tumor boards, which meet regularly at Koru Hospital, ensure that each patient's treatment plan is created according to the most current evidence-based data.

In tumor boards, medical oncologists, surgeons, radiation oncologists, pathologists, radiologists, and other relevant specialists come together to ensure that each case is discussed in detail and consensus-based treatment decisions are made. This approach increases treatment quality and minimizes errors.

Supportive Care and Palliative Treatment

Cancer treatment is not limited to tumor-directed therapies. Management of side effects arising during the treatment process, pain control, nutritional support, psychological support, and the preservation of quality of life constitute the fundamental components of supportive care.

A proactive approach is adopted in areas such as nausea and vomiting control, management of bone marrow suppression, infection prophylaxis, thrombosis prevention, neuropathy treatment, and mucositis care. Palliative care services are offered to control symptoms and maintain the highest level of quality of life for advanced-stage cancer patients.

Cancer Screening and Early Diagnosis

Catching cancer at an early stage is one of the most important factors directly affecting treatment success. The Koru Hospital Department of Medical Oncology contributes to increasing public awareness regarding cancer screening programs. Evidence-based screening methods such as mammography for breast cancer, colonoscopy for colorectal cancer, low-dose CT for lung cancer, and PAP smear and HPV testing for cervical cancer are recommended.

Individuals with a family history of cancer are evaluated for genetic predisposition, and genetic counseling services are provided when necessary. Identification of BRCA1/2 mutations, Lynch syndrome, and other hereditary cancer syndromes allows for the implementation of risk-reducing strategies.

Clinical Research and Innovative Treatments

Medical oncology is a constantly developing and renewing field, and clinical research forms the main engine of this progress. The evaluation of the efficacy and safety of new drugs, combination therapies, and treatment strategies is carried out through clinical trials. The Koru Hospital Department of Medical Oncology aims to provide its patients with access to innovative treatment options by participating in national and international clinical research.

Promising treatment approaches such as CAR-T cell therapy, bispecific antibodies, antibody-drug conjugates, and cancer vaccines form the focus of research in the field of oncology. These innovative treatments open new doors of hope, especially for patients resistant to standard treatments.

Psychosocial Support and Patient Communication

A cancer diagnosis is a challenging process for patients and their families, not only physically but also emotionally and socially. The Koru Hospital Department of Medical Oncology offers psychological support to patients and their relatives at every stage of the treatment process. Establishing open and transparent communication with the patient, conveying treatment options in an understandable way, and supporting the shared decision-making process are the fundamental principles of the patient-centered care approach.

At the Koru Hospital Department of Medical Oncology, our expert physicians continue to stand by our patients with the most current scientific data and personalized treatment approaches in cancer care. You may apply to our department for a cancer diagnosis, the treatment process, or to obtain a second opinion.