ANDREA R SALINS

EFFECTS OF TUMOR ON HOST

INTRODUCTION

Tumors cause problems by:-Location and impingement on adjacent structures-functional activities like hormone synthesis-bleeding and infection-rupture and infarction-cachexia

Complications of tumor Local effects Hormonal effects Systemic effects

Local effects1)Compression:*pituitary adenoma-compress the normal gland leading to hypopituitarism

*benign tumor of ampulla of vater-cause biliary obstruction

*compression of svc by mediastinal tumors cause svc syndrome.*compression of lumbar plexus in cervical cancer

2)Mechanical obstruction: Gut tumours produce intestinal obstruction3)Tissue destruction: malignant tumours infiltrate and destroy vital structures

4)Infarction,ulceration,and haemorrhage:.ulcerate to natural surface(mucosa,epidermis).cause bleeding(melena,hematuria).undergo necrosis and predispose infection

Hormonal effects-Common in benign tumors*Adenoma of islet of langerhans cause fatal hypoglycemia*Thyroid adenoma-hyperthyroidism*Parathyroid adenoma-hypercalcemia and osteoporosis

Systemic effects

CANCER CACHEXIA

Kakos-badHexia-conditionAlso called wasting syndrome

DefinitionIn cancer patients there is progressive loss of body weight and lean body mass accompanied by profound weakness,anorexia,and anemia referred to cachexia

-Predominantly seen in cancer,AIDS.Also seen in CCF,TB etc.

-seen in end stage of cancer

-positive risk factor for death.

-more seen in upper git and pancreatic cancer.

Pathogenesis-not clearly understood

-Thought to be related to cytokine production by the tumor and the host rather than reduced food intake.

TNF α (Cachexin) Excess mobilisation Supress appetite of fat from tissue stores

C A C H E X I A

Other factors- -proteolysis inducing factor -lipid mobilising factorincrease the catabolism of muscle and adipose tissue.

Lipid mobilising factor extracted from urine of cachectic patients,were suspected to induce protein degradation in skeletal muscle by upregulation of ubiquitin –proteasome pathway and lipolysis in adipocytes.

Normal:factors regulating = factors regulating muscle hypertrophy muscle catabolism

Cachexia:Factors regulating < factors regulatingmuscle hypertrophy muscle catabolism

Treatment-Current strategy is to improve appetite using appetite stimulants to ensure adequate intake of nutrients.-These have limited effects and are under trials-At present there is NO treatment for cancer cachexia other than removal of tumor

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