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Cancer 101

Cancer 101. Ann Broderick, M.D. MS Director, Palliative Care University of Iowa Hospitals and Clinics. Cancer. Abnormal cells divide without control Can invade “locally” or metastasize (spread) via the blood or lymph system Benign tumors can grow larger, but do not spread.

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Cancer 101

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  1. Cancer 101 Ann Broderick, M.D. MS Director, Palliative Care University of Iowa Hospitals and Clinics

  2. Cancer • Abnormal cells divide without control • Can invade “locally” or metastasize (spread) via the blood or lymph system • Benign tumors can grow larger, but do not spread

  3. Diagnosis of cancer • Screening tests: mammogram, PSA, colonoscopy, PAP • Biopsy • Incisional • Excisional • Needle (core or fine needle aspirate) • Need “tissue” to look at under the microscope to decide how to treat: the pathology report.

  4. Symptoms of cancer • None • Weight loss • Dyspnea or shortness of breath • Nausea • Anorexia, or lack of appetite • Fatigue

  5. Cancer type based on which cell type is dividing abnormally • Carcinoma • Sarcoma • Leukemia • Lymphoma • Central nervous system tumors • Melanoma

  6. Carcinoma • begins in skin or lining cell • Adenocarcinoma starts in the skin cells and the gland cells. • Adenocarcinoma of the breast, pancreas, prostate, thyroid

  7. Wait! Prostate

  8. Metastasis • Plural is metastases • Cancer cell travels via blood or lymph tissue to a distant organ, but maintains characteristics of the primary tumor. • Cancers have tendencies: prostate to bone, breast to liver, brain and lung, colon to liver

  9. Stages of cancer • Stage 1: small and confined to the organ • Stage 2: beyond the organ +/- lymph nodes • Stage 3: locally spread, greater than 2. • Stage 4: spread to another organ

  10. Sarcoma begins in the cells muscle, bone, blood vessels, cartilage

  11. Leukemia begins in the cells found in the bone marrow (red blood cells, white blood cells, platelets)

  12. Bone marrow • Myelo is the prefix: myelosuppression, myelodysplastic • Bone marrow is aspirated, and biopsied in the hip bone • Bone marrow transplant: harrowing procedure in which the bone marrow cells are destroyed by chemo, then replaced with banked bone marrow.

  13. Lymphoma and multiple myeloma • begins in the cells of the immune system that fight infection (B cells, T cells, plasma cells)

  14. Melanoma • Originates in the melanocytes, which make pigment. These cells can be found in the skin, the eyes.

  15. Treatment: local • Surgery • Radiation

  16. Treatment: systemic • Principle of treatment to kill the fastest growing cells: earliest days of chemo and radiation. • Hormonal manipulation in cancers such as prostate and breast. • Little variation from center to center on the treatment of cancers. Protocols are standard throughout the country. • Clinical trials are well-monitored large scale efforts to determine the best treatment regimen

  17. Complementary and alternative therapies • Acupuncture proven to be effective for chemotherapy induced nausea and vomiting • Current clinical trials for acupuncture for symptoms of colon cancer, for shark cartilage and small cell lung cancer, and for massage therapy for cancer-related fatigue.

  18. Remission • Decrease or disappearance of signs and symptoms of cancer

  19. Palliative Care-usually inpatient • Treatment of symptoms from the time of diagnosis • Grief specialists in the hospital • Allowing the patient and family voice to be heard

  20. Hospice Dame Cicely SaundersYou matter because you are you.You matter to the last moment of your life,And we will do all we can,Not only to help you die peacefully,But also to live until you die.

  21. Take home points • It is a new language: write down the words that you do not know and learn them for the next time. • Ignorance is an opportunity to learn.

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