The proposal of a new concept: Onco-neurology

Onco-neurology, as a pioneering multidisciplinary subspecialty, stands at the forefront of transforming our understanding and management of the intricate and often underestimated interactions between tumors and the nervous system. Unlike traditional neuro-oncology, which primarily focuses on the direct effects of tumors, such as invasion or compression of neural structures, the core of onco-neurology lies in unveiling the complex pathophysiological processes through which tumors induce neurological dysfunction via non-metastatic mechanisms.

Onco-neurology encompasses three pivotal and interconnected domains. The first is paraneoplastic neurological syndromes (PNS), a group of disorders where remote effects of the tumor, mediated by immune responses or secreted factors, manifest as neurological symptoms. These syndromes often precede the diagnosis of the underlying malignancy, serving as crucial early warning signs. The second domain involves iatrogenic neurological injuries that arise as complications from diagnostic or therapeutic procedures aimed at treating the tumor. These can range from physical trauma during biopsy to neurological deficits induced by radiation or chemotherapy. The third domain focuses on neurological impairments triggered by tumor-secreted factors, such as hormones, cytokines, or exosomes, which can disrupt neural signaling and function even in the absence of direct tumor invasion.

A key strength of onco-neurology lies in its holistic and patient-centered approach. By integrating expertise from neurology, oncology, radiology, pathology, and other specialties, it offers a comprehensive evaluation and management plan tailored to each patient's unique condition. This multidisciplinary collaboration ensures that all aspects of the patient's care are seamlessly coordinated, from accurate diagnosis to the implementation of personalized treatment strategies. Early detection of specific antibody markers and other biomarkers plays a pivotal role in guiding targeted therapies and monitoring treatment response.

The ongoing research in onco-neurology within the fields of molecular biology, immunology, and neuroscience is providing unprecedented and profound insights into the underlying mechanisms of tumor-induced neurological dysfunction. It holds the promise of revolutionizing the field by transitioning from symptom management to precision medicine. With the advent of cutting-edge technologies such as next-generation sequencing, liquid biopsies, and advanced neuroimaging, clinicians will be able to diagnose and treat tumor-related neurological complications with unprecedented accuracy and personalization. This heralds the dawn of a new era in which onco-neurology will play a central role in delivering customized interventions, improving prognoses, and ultimately enhancing the well-being of patients affected by tumor-related neurological challenges.