Neoplasms
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Neoplasms. Definitions:. Neoplasm New growth No new purpose Tumor Swelling, enlargement, mass. Types of Neoplasm. Benign vs. Malignant Varies with: Cell characteristics Potential for spread Local , regional, distant spread Degree of anaplasia Cellular differentiation and specificity.

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Neoplasms

Neoplasms


Definitions

Definitions:

  • Neoplasm

    • New growth

    • No new purpose

  • Tumor

    • Swelling, enlargement, mass


Types of neoplasm

Types of Neoplasm

  • Benign vs. Malignant

  • Varies with:

    • Cell characteristics

    • Potential for spread

      • Local , regional, distant spread

    • Degree of anaplasia

      • Cellular differentiation and specificity


Benign neoplasms

Benign Neoplasms

  • Slow growing

  • Well defined, less anaplastic cells

  • Often encapsulated

  • No infiltration of local tissue

  • Unlikely recurrence


Malignant neoplasms

Malignant Neoplasms

  • Rapidly growing

  • Anaplastic

  • Metastasize via blood or lymphatics

  • May/often recur after excision

  • Fatality possible

  • Called cancers


Cancer growth spread

Cancer Growth & Spread

  • Localized

    • Stays at the site of the original tumor (primary)

    • Invades the local tissues

  • Metastases

    • Spreads beyond the site of the primary tumor

    • Regional spread (local lymph nodes often)

    • Distant mets (other organs or organ systems)


Risk factors prevention

Risk Factors & Prevention

  • No single cause of malignancy

  • Some risk factors:

    • Carcinogen exposure

      • Substance that increases the risk of cancer development

      • Radiation, chemicals, tobacco, sun exposure

    • Genetics

    • Diseases that increase cancer risk

      • Example: ulcerative colitis, familial adenomatous

        polyposis


General preventative measures

General Preventative Measures

  • Stop smoking

  • Limit alcohol consumption

  • Protect skin from UV exposure

  • Limit X-rays

  • Limit exposure to harmful chemicals

    • Asbestos, aniline dyes, vinyl chloride, benzene

  • Limit HRT (estrogen therapy)


General preventative measures1

General Preventative Measures

  • Limit exposure to air pollution, solvent cleaners, paint thinners, pesticides, etc.

  • Eat diet rich in fibrous fruits & vegetables, bran, whole grains. Moderate caloric intake.

  • Exercise

  • Regular medical screening exams

  • Limit salt- & nitrate-cured & smoked foods.


Medical screening exams and tests

Medical Screening Exams and Tests

  • Rectal exams (prostate Ca)

  • Colonoscopy (colon Ca)

  • Mammography (breast Ca)

  • Pap smear (cervical Ca)

  • PSA (prostate specific antigen)

  • CEA (carcinoembyronic antigen)(colon cancer)

  • Skin exam


Cancer stats 2008

Cancer Stats (2008)

US cancer deaths: 565,650

-Decreasing 1.1%/yr from 1993-2002

-Decreasing 2.1%/yr from 2002-2004

New cases: 1,437,180 (not including nonmelanoma skin cancers)


Cancer stats 20081

Cancer Stats (2008)

  • Most common Ca types in US (new cases per year):

    • Nonmelanoma skin cancer (over 1 million)

      • About 50% all Ca diagnosed in US

    • Lung (215,000)

    • Prostate (186,000)

    • Breast (182,000 females)

    • Colorectal (148,000)


Classification of neoplasms

Classification of Neoplasms

  • According to type of body tissue involved

    • Carcinomas

    • Sarcomas

    • Blood and lymph neoplasms


Carcinomas

Carcinomas

  • Most common type

  • Solid tumors of epithelial origin

  • Examples: adenocarcinoma


Sarcomas

Sarcomas

  • Less common than carcinomas

  • Cancers of connective and supportive tissues

  • Examples: osteosarcoma


Blood lymph neoplasms

Blood & Lymph Neoplasms

  • Leukemias

  • Hodgkin’s Disease

  • Non-Hodgkin’s lymphoma


Leukemias

Leukemias

  • Not a solid tumor

  • Increased number of abnormal WBC

  • Acute Type

    • Acute myeloblastic leukemia

  • Chronic Types

    • Chronic myelocytic leukemia

    • Chronic lymphocytic leukemia


Hodgkin s disease

Hodgkin’s Disease

  • A type of lymphoma

  • Painless enlargement of lymph nodes in neck at first

  • Reed-Sternberg cell is characteristic giant cell in this disease


Non hodgkin lymphoma

Non-Hodgkin Lymphoma

  • Malignant lymphomas

  • More common than Hodgkin’s

  • Increasing in incidence

  • Also has painless LN enlargement

  • May involve other non-lymphatic tissues

  • No Reed-Sternberg cells


Etiology of neoplasms

Etiology of Neoplasms

  • No single etiology

  • Reflects a change in chromosomal material

  • Cell growth is independent & uncontrolled

  • Generally considered a failure of immune system


Etiology of neoplasms1

Etiology of Neoplasms

  • Heredity

    • Breast cancer (female relatives)

    • Colon carcinoma (polyposis coli)

    • Retinoblastoma (dominant trait)

  • Most neoplasms are not inherited disorders


Etiology

Etiology

  • Viral etiology

    • Epstein-Barr virus (Burkitt’s lymphoma)

    • Herpes simplex virus (cervical Ca)

    • Human papilloma virus (cervical Ca)

  • Carcinogens

    • UV light, X-rays, radiation therapy, tobacco smoke, chewing tobacco, formaldehydes, asbestos, nickel & zinc ores, pesticides, etc.


Cancer progression

Cancer Progression

  • Hyperplasia

    • Increased growth of cells

  • Dysplasia

    • Cells become abnormal in appearance

  • Carcinoma in situ

    • Remains in one place, a primary

  • Metastases

    • Distant spread via the circulation


Grading and staging

Grading and Staging

  • Grading

    • Describes the degree of anaplasia

    • Grade I (well differentiated cells) to Grade IV (difficult to tell tissue of origin)

  • Staging

    • Degree to which a cancer has spread

    • TNM system

    • Tumor size, # regional LN, metastases


Treatments

Treatments

  • Surgery

    • Specific, palliative, preventative

  • Radiation Therapy

    • Electromagnetic type (x-rays, gamma rays)

    • Particle type (electrons, neutrons, protons, etc)

    • Given externally or internally

    • Radioisotopes

    • Radiation affects DNA & cell replication of both cancer and normal cells


Treatments1

Treatments

  • Chemotherapy

    • Most effective against cancers that spread widely

    • Affect both cancer & normal cells

    • Frequent adverse effects on bone marrow, GI tract, and skin

    • Most common side effects: nausea, vomiting, anemia, leukopenia, alopecia


Treatments2

Treatments

  • Immunotherapy (Biotherapy)

    • Stimulation & strengthening of immune system

    • Used early in the course of the disease

    • Examples: interferon, bone marrow & stem cell transplantation, cord blood transfusion

  • Hormonal Therapy

    • Adds, blocks, or removes hormones that affect the growth of certain cancers (breast, prostate)


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