19.9: Oncology

Here we begin one of the most specialized and emotionally challenging areas of medical interpreting: oncology, the branch of medicine that deals with the prevention, diagnosis, and treatment of cancer.

As interpreters, you may be called into encounters where patients are learning about a new cancer diagnosis, discussing treatment options, or facing end-of-life decisions. These are high-stakes moments. Your role is crucial, not just because the terminology is complex, but because the conversations themselves are emotionally charged and involve multiple parties—patients, families, and entire medical teams.

Our goal in this chapter is to help you build both the knowledge and the professional strategies needed to interpret effectively in oncology.

What Is Cancer?

Let’s begin with the basics. Cancer is not a single disease. It is a collection of diseases in which abnormal cells grow uncontrollably, invade nearby tissues, and can spread (or metastasize) to other parts of the body.

Normally, cells in the human body follow an orderly cycle: they grow, divide, and eventually die when no longer needed. Cancer cells disrupt this cycle. They ignore the signals that tell cells when to stop dividing or when to die. Instead, they keep multiplying, forming a mass of tissue we call a tumor.

There are two kinds of tumors:

• Benign tumors, which are non-cancerous and usually do not spread.
  

• Malignant tumors, which are cancerous and can invade and destroy healthy tissue.
  

Different types of cancer are named based on where they begin. A carcinoma starts in the skin or the lining of organs. A sarcoma develops in connective tissues such as bone or muscle. Leukemia affects the blood-forming tissues, while lymphoma involves the lymphatic system.

📌 As interpreters, pay attention to this vocabulary. Patients often hear these terms for the first time in your presence. Your task is to faithfully transmit them, even if they sound frightening or unfamiliar. Do not simplify or replace them with “easier” words. That responsibility belongs to the provider, not the interpreter.

Diagnostic Processes in Oncology

How do providers detect cancer? There are several common methods:

• Biopsy: This is the gold standard. A doctor removes a small piece of tissue so a pathologist can examine it under a microscope. Patients may hear about different biopsy methods—needle biopsy, surgical biopsy, or endoscopic biopsy.
  

• Blood tests: Some cancers release substances called tumor markers into the blood. Others cause general changes, such as abnormal counts of white or red blood cells.
  

• Imaging tests:

  • An X-ray might be the first step if something suspicious appears.
    

  • A CT scan takes detailed cross-sectional pictures of the body.
    

  • An MRI uses magnets and radio waves to create very detailed images.
    

  • A PET scan highlights areas of high metabolic activity, often used to detect cancer spread.
    

Once cancer is confirmed, doctors classify it using staging and grading.

• Staging describes how much the cancer has spread, often from Stage I (localized) to Stage IV (widely spread).
  

• Grading describes how abnormal the cancer cells look under a microscope, which can predict how aggressively the cancer might behave.
  

📌 Interpreter note: In many languages, “stage” and “grade” may sound similar or may not have clear equivalents. Be very precise. Confusing the two could lead to misunderstanding about the seriousness of the disease.

Treatment Modalities

📌 Your role as interpreter is critical here. Treatment discussions are often full of jargon, and patients must weigh life-changing decisions. Your task is to deliver the information exactly as it is spoken, in the same register, without omission or addition.