Chapter 5 Neoplasms Hybrid 2009

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Neoplasms

Chapter 5



Benign vs Malignant



Benign Tumor

Found in a localized area

Grows slowly

Cells closely resemble normal cells or arewell differentiated.

Often tumor is encapsulated

Usually does not recur after surgery or treatment.



Types of Benign Tumors

Glandular – adenoma

Fatty – lipoma

Muscle – myomaVascular – angiomas

Epithelial – papilloma

Brain – meningiomas





Biology of Cancer

Normal regulation of cell growth Growth factors, growth inhibitors, cell cycle

proteins & cell death (apoptosis)

Change in genetic material prepares cells to

become cancerous

Cells lose their specialized structure &

function Cell division proceeds indefinitely; no regulatory

mechanisms



Cancer’s Progressive

EvolutionHyperplasia – excessive cell growthDysplasia – abnormal cell growth

Carcinoma in situ – cancer that remains in

placeMetastasize – carcinomas that spread



Cancer Risk Factors &

Preventive Measures

Hereditary Inherited gene mutations, tumor-suppressor genes

and/or tumor-promoting genes (Oncogenes) Breast cancer – BRCA 1 & 2

Ovarian cancer – Kiras

Bladder cancer – RB

Inherited chromosomal disorders Fanconi’s Aplasia

Down Syndrome




Preventive Measures

Tobacco Smoking damages nearly every organ in the

human body

linked to at least 10 different cancers

accounts for some 30% of all cancer deaths

one in four Americans still smoke

costs billions of dollars each year cancer from smoking is preventable

STOP Smoking




Preventive Measures, cont’d

SUN sun tanning caused by too much exposure to

ultraviolet (UV) rays. exposure from the sun

some may come from manmade sources, such as

tanning beds.

sunburn will fade, but damage to deeper layers of

skin remains and can eventually cause cancer

Use Sun Screen





Environmental Carcinogens Certain chemicals might increase your cancer risk Lead, asbestos, benzene, tetrachloroethylene,

diazamine are just some Polluted air Exposure to house hold products Exposure to pesticides, fungicides, & lawn

chemicalsUse caution & protective clothing when

dealing environmental carcinogens





Infections Infections are linked to 15 – 20% of cancers

Hepatitis C linked to liver cancer

Helicobacter pylori is linked to stomach cancer Chronic infections suppresses immune system or directly affect a

cell’s DNA.

Viral infections can affect cell mutations causing cancer

AIDS & Kaposi’s sarcoma

Maintain a healthy lifestyle to keep immune system intact





Radiation Limit the amount of x-rays being taken

Nutrition & Physical Activity Overweight is linked to Esophagus Colon & rectum Breast Endometrium Kidney

Follow the “Dietary Goals of Americans”





Preventive Measures

Have regular physicals after age 50Have yearly mammograms & perform self-breast

checks

Have yearly Pap Smears (Papanicolaou test) &PSA (Prostate Specific Antigen test)

Watch for skin changes; especially raiseddiscolored lesions

Eat healthy foodExercise regularly



Classification of Neoplasms

Classified according to body tissue

Classified into three categories

Carcinomas Sarcomas

Blood & lymph neoplasms



Carcinomas

Any malignant cancer that arises from epithelial cells

Classified by anatomical entitiy & pathological entity

Thyroid carcinoma

Breast carcinoma

Colon carcinoma

Hepatocarcinoma

Skin carcinomas



Sarcomas

Arise from supportive & connective tissue Soft Tissues Liposarcoma

Leiomyosarcomas

Neurofibrosarcoma

Kaposi sarcoma

Bone Osteosarcoma





Lymphomas

Lymphomas – arise from the

lymph nodes, spleen or bone

marrow

Hodgkin’s Disease Diagnosed by Lymph node

biopsy & the finding of Reed-

Sternberg Cell in bone

marrow/lymph node biopsy

Non-Hodgkin’s Lymphomas Diagnosed the same as above

Reed-Sternberg Cell





Diagnosis of Neoplasms Medical history & physical exam

Ultrasonography

Radiography

Endoscopy

Computed tomography (CT Scans)

Magnetic resonance imaging (MRI) Blood Tests (Peripheral & Bone Marrow)

Blood Tests for Tumor Markers

CEA – carcinoembryonic antigen/ colonrectal cancer

PSA – prostatic specific antigen/ prostate cancer

CA-125 – ovarian, uterus, breast, colon

Tissue Biopsy

Fine needle biopsy/core biopsy

PAP Smear



Grading & Staging Neoplasms

TNM Staging System T: extent of primary tumor

N: absence/presence of lymph node involvement

M: absence/presence of distant metastasis

To determine the degree of anaplasia Grade I – well differentiated

Grade II & III – moderately or poorly differentiated

Grade IV – undifferentiated; doesn’t resemble

original tissue



Treatment of Neoplasma

Surgery

Radiation Therapy

Chemotherapy

Immunotherapy (Biotherapy) Interferon

Hematopoietic Growth Factors

Monoclonal Antibodies

Hormonal Therapy

Alternative Therapy



Case Study 1

Kai Simpson has surfed since he was a young

teenager through his young adulthood years off

the coast of Maui, where he was born and

raised. Every time the surf was up and the sun

was out, he was on his board. Twenty years

later, he is diagnosed with malignant

melanoma.

1. What protective measure might Kai have taken as a

young surfer?2. What is malignant melanoma?

3. Identify possible treatment measures that might betaken?



Case Study 2

A 72-year-old man, Keith Wilson, was diagnosed with lungcancer and died less than a year later. In reviewing his

history, it was noted that he remembered aspirating

peanuts, husks and all, when he was a child; no treatment

was available. Keith was a heavy smoker since his

teenage years and smoked cigars into his 50s. Keith’s wife

and son vividly recall taking many family automobile trips

to Canada and Mexico, crisscrossing the nation, with Keith

smoking in the enclosed automobile.

1. What is the effect of secondary smoke to Keith’s wife andson?

2. What preventative measures could have Keith taken early inlife?

3. Describe how debilitating lung cancer can be.

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Chapter 5 Neoplasms Hybrid 2009

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