Cancer MedicineCancer MedicineChapter 19Chapter 19

OncologyOncology

CancerCancer

• Abnormal and excessive growth of cells Abnormal and excessive growth of cells in the body.in the body.

• Cells accumulate as growths called Cells accumulate as growths called malignant tumors which compress, malignant tumors which compress, invade and ultimately destroy normal invade and ultimately destroy normal tissue.tissue.

Tumors/NeoplasmsTumors/Neoplasms

• Masses or growths that arise from Masses or growths that arise from normal tissue.normal tissue.

• May be malignant or benignMay be malignant or benign

• Malignant tumors multiply rapidly and Malignant tumors multiply rapidly and are invasive.are invasive.

Malignant TumorsMalignant Tumors

• Cells can detach themselves from the Cells can detach themselves from the primary tumor site and penetrate a primary tumor site and penetrate a blood vessel or lymphatic vessel and blood vessel or lymphatic vessel and travel to establish a new tumor at a travel to establish a new tumor at a distant site.distant site.

• Secondary growth is called a Secondary growth is called a metastasis.metastasis.

What causes cancer?What causes cancer?

• Carcinogenesis:Carcinogenesis: transformation of transformation of a normal cell to a cancerous onea normal cell to a cancerous one

• Damage to genetic materialDamage to genetic material

Carcinogenesis- page Carcinogenesis- page 773-774773-774

• Environmental AgentsEnvironmental Agents• Chemical carcinogens (cigarette Chemical carcinogens (cigarette

smoke)smoke)• RadiationRadiation• Viruses (RNA and DNA)Viruses (RNA and DNA)• Oncogenes – cause normal cells to Oncogenes – cause normal cells to

become malignant if they are become malignant if they are activated by mutationsactivated by mutations

• Heredity Heredity

Classification of Classification of Cancerous Tumors – Cancerous Tumors –

page 799page 799CarcinomasCarcinomas

epithelial cell origin, 90% of all epithelial cell origin, 90% of all malignancies are carcinomasmalignancies are carcinomas

largest group of solid tumorslargest group of solid tumors

Carcinomas and the Carcinomas and the epithelial tissues from epithelial tissues from

which they derivewhich they derive

Carcinomas and the Carcinomas and the epithelial tissues from epithelial tissues from which they derive which they derive (cont.)(cont.)

Classification of Classification of Cancerous TumorsCancerous Tumors

Sarcomas:Sarcomas: connective tissue origin, 5% connective tissue origin, 5% of all malignanciesof all malignancies

Sarcomas and the Sarcomas and the connective tissues from connective tissues from

which they derivewhich they derive

Sarcomas and the Sarcomas and the connective tissues from connective tissues from which they derive which they derive (cont.)(cont.)

Classification of Classification of Cancerous TumorsCancerous Tumors

Mixed Tissue Tumors:Mixed Tissue Tumors: tissues capable tissues capable of differentiating into epithelial and of differentiating into epithelial and connective tissue.connective tissue.

Grading and Staging of Grading and Staging of Tumors – page 805Tumors – page 805

Grade:Grade: Degree of maturity or Degree of maturity or differentiation under the differentiation under the microscopemicroscope

Stage:Stage: Extent of spread in the Extent of spread in the bodybody

International TNM International TNM Staging System for Staging System for

Lung CancerLung Cancer

International TNM International TNM Staging System for Lung Staging System for Lung

Cancer Cancer (cont.)(cont.)

Cancer Treatment – Cancer Treatment – page 806page 806

• 4 major approaches4 major approaches

• SurgerySurgery• Radiation TherapyRadiation Therapy• ChemotherapyChemotherapy• Biological Therapy – using body’s own Biological Therapy – using body’s own

defensedefense

Brachytherapy – Radiation Brachytherapy – Radiation SeedsSeeds

Combining Forms – page Combining Forms – page 818 818

• alveol/o – small sac (alveolar)• cac/o – bad (cachexia)• carcin/o – cancer (carcinoma)• cauter/o – burn, heat (cauterization)• chem/o – chemical drug (chemotherapy)• cry/o – cold (cryosurgery)• cyst/o – sac of fluid (cystic tumor)• fibr/o – fibers (fibrosarcoma)

CryosurgeryCryosurgery

Combining Forms – Combining Forms – page 819page 819

• follicul/o – small glandular sacs

• fung/I – fungus, mushroom

• medull/o – soft , inner part (medullary tumor)

• mucos/o – mucous membrane

Combining Forms – Combining Forms – page 819page 819

• mut/a – genetic change (mutation)

• mutagen/o – causing genetic change

• onc/o – tumor (oncology)

• papill/o – nipple like (papillary)

Combining Forms – Combining Forms – page 819page 819

• pharmac/o – chemical drug (pharmacy)

• plas/o – formation (dysplastic)

• ple/o – many, more (pleomorphic)

Combining FormsCombining Forms

• polyp/o - polyp

• radi/o – rays, x-ray (radiotherapy)

• sarc/o – flesh, connective tissue (sarcoma)

Suffixes – page 820Suffixes – page 820

--blastoma- blastoma- immature tumorimmature tumor

-genesis - -genesis - formationformation

-oma – -oma – mass, tumormass, tumor

--

Suffixes – page 820Suffixes – page 820

plasia – plasia – formation, growth formation, growth (hyperplasia)(hyperplasia)

-plasm – -plasm – formation, growth formation, growth (neoplasm)(neoplasm)

-suppression – -suppression – to stopto stop

therapy - treatmenttherapy - treatment

Prefixes – page 820Prefixes – page 820

ana- ana- backward (anaplasia)backward (anaplasia)

brachy- brachy- short (brachytherapy)short (brachytherapy)

epi- epi- uponupon

Prefixes – page 820Prefixes – page 820

meta- meta- beyond, change beyond, change (metastasis)(metastasis)

tele- tele- far far (teletherapy)(teletherapy)

Protein Markers – page Protein Markers – page 821821

• Measure the levels of proteins in the Measure the levels of proteins in the blood or on a surface of a tumor.blood or on a surface of a tumor.

• Presence of these markers tells they Presence of these markers tells they type of cancer.type of cancer.

• See text for specific markersSee text for specific markers

Clinical Procedures to Clinical Procedures to Detect or Treat Detect or Treat

Malignancies – page Malignancies – page 821-822821-822• Bone marrow biopsyBone marrow biopsy

• Bone marrow or Bone marrow or stem cell transplantstem cell transplant

• CT scansCT scans• Fiberoptic Fiberoptic

colonoscopycolonoscopy• Exfoliative cytologyExfoliative cytology

• LaparoscopyLaparoscopy• MammographyMammography• MRIMRI• Needle biopsyNeedle biopsy• Radionuclide scansRadionuclide scans• UltrasoundUltrasound• X-raysX-rays