oncology: study of cancer. when normal cells go “rogue” cancer is a disease by unrestrained and...
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ONCOLOGY: STUDY OF CANCER
When Normal Cells go “Rogue” Cancer is a disease by unrestrained and
excessive multiplication of body cells
Or in simpler terms
Cancer is normal cells that have begun to divide at a rapid and non organized rate
Rogue cell division
Put another way
Cancer is a group of disease in which cells are: aggressive (grow and divide without respect for
normal cellular limits) invasive (invade and destroy adjacent tissues) sometimes metastatic (spread to other location
in the body
Nearly all cancers are caused by abnormalities in the genetic material of the transformed cell
Cancer cells compared to Normal
Breast Cancer cells
Probability of Developing or Dying from cancer Increase with age
43% of new cancer cases and 60% of deaths will occur among those who are at least 70 years of age
40% of women and 45% of men will develop cancer in their life time 1 in 4 Canadians will die of cancer
62% of those diagnosed will survive for 5 years
(depends on the type of cancer)
Definitions: sorry there are a few Anaplasia:
Loss of differentiation of cells Return to a more primitive cell type Lack of orderly arrangement
Tumors Masses or growths that arise from normal
tissue Neoplasm
New growth, benign or malignant tumors
Sorry still on Definitions
Remissions Lessening of Symptoms of a disease
Carcinogens: agents that cause cancer Chemicals, drugs, radiation, viruses
Mutations Change in the DNA of a cell May be caused by exposure to a carcinogen or
spontaneously
And two more
Differentiation Specialization of cells
Prognosis Expected outcome of disease Mortality Morbidity
Now we can move into our discussion on Cancer
Defining a Tumor
Malignant Tending to become worse and results in
death Benign
Non cancerous still can cause death depending on location ie in the brain, heart, kidney
Defining a Tumor Encapsulated (Good)
Surrounded by a capsule
Infiltrative (Bad) Extending beyond normal tissue boundaries
Invasive (Very Bad) Having the ability to enter and destroy
surrounding tissue
Metastases (Worst) Spread of malignant tumor to a secondary
site
Causes of Cancer: not well understood Environmental Heredity: Retinoblastoma Viruses: HPV, HIV Spontaneous
Retinoblastoma
Environmental
Chemicals & Drugs Hydrocarbons
(Smoke) Insecticides Industrial cleaners Insulations Hormones Steroids Mercury
Radiation UVA,UVB
Skin cancer X-rays
Damage to cell DNA
Nuclear fusion Chernobyl in the
Ukraine Hiroshima Result: Leukemia
Viruses
HIV AIDs Kaposi Sarcoma
Human Papilloma Virus Four strains 6,11,16,18 that cause cervical
cancer
Epstein-Barr virus Causes Burkitt’s lymphoma
Classification of Cancers
Types of tumors Malignant Benign
Types of Cancers1. Carcinomas2. Sarcomas3. Mixed-tissue tumors
Benign
Grows slowlyEncapsulated
Fibrous capsule
Differentiated cells Resemble normal mature tissue
Do not metastasis Do not form secondary tumors
Malignant: usually grows rapidlyInfiltrative & Invasive
May be initially encapsulated
Anaplasia Resemble primitive or embryonic cells Not capable of mature cellular function Lack orderly arrangement
Metastasis Travel through bloodstream or lymphatic
system Create secondary tumors
Carcinomas vs Sarcomas
Epithelial tissue Lining of external &
internal body surfaces
Skin Glands Digestive, urinary Reproductive
50% of tumors in women are carcinomas
Supportive & connective tissue Bone Adipose Muscle Cartilage Bone marrow Lymphatic/immune
Rare form of cancer Is increasing
Carcinomas: Solid tumors Sarcomas
Mixed Tissue Tumors
Can contain both epithelial and supportive and connective tissue
Kidney Ovaries Testes
Factors to determine Prognosis1. Location of tumor2. Microscopic appearance
Grading Degree of differentiation
3. Extent of spread Metastases
Number of secondary tumors Location of secondary tumors
Microscopic Grading: Four gradesGrade I
well differentiated closely resembles original tissue cells
Grade II less differentiated still can determine parent cells
Grading:III-IV
Grade III Even less differentiated
Grade IV Anaplasia Difficult to determine tumor tissue site of
origin
Example is used in Papanicolaou tests (Pap smears)
Degree of Spread Staging 0-5Stage I
very early cells localized to few cell layers
Stage 2 spread to deeper cell layers ? Infiltrate to surrounding tissue
Stage 3-4
Stage 3 infiltrated surrounding tissue contained in the primary cancer site
Stage 4 invasive to near by sites
Stage 5-recurrences
Stage 5 metastases to other organs of the body via
the bloodstream or lymphatic system
Recurrent cancer cells have reappeared after
treatment
In Canada stage 5
Lymphatic Involvement
Spread to lymph nodes is indicated by the number of nodes involved
N1 infiltrate one lymph node
N3 infiltrate three lymph nodes
Metastases
M1: one site of metastasis M2: two sites of metastasis M3: three sites of metastasis Mx: more than four sites
Tumor size can also by stagedT1 small tumor presentT2 larger tumorT3 progressive increase in tumor
sizeTx tumor so invasive unable to
determine size
Cancer Coding
Grade 3 Stage 4 N3 Tx M3What does this mean?What is the prognosis?
Grade I Stage 2 N0 TI M0What does this mean?What is the prognosis?
Treatment
1. Surgery2. Radiation3. Chemotherapy4. Biological Therapy
Surgery
Encapsulated with limited infiltration and limited metastases
Example: stomach, breast, uterus, prostrate
Sometimes done to decrease the size of the tumor for palliative reasons
Example: decrease pain from tumor pressing on nerve
Radiation Therapy
Maximal dose of ionizing radiation to the tumor cells
Minimal dose to the surrounding cells Targeted at non-differentiated cells
What is the difficulty?Where would this be difficult to do?Solution can be pellets. Say what?
Chemotherapy
Drugs target rapidly dividing cells (non differentiated)
Block replication to decrease growth Given by Intravenous (IV) and oral route Often used with other treatments Used in T1-4N1-4M1-3 Carcinomas, Sarcomas & Mixed-Tissue
TumorsWhich body system has cells that normal
divide rapidly? (hint SE of chemo)
Biological Agents
Using immune cells to target and fight tumor cells
Researchers are focusing on NKC and T-cells
Hormones: Estrogen is used to treat prostate cancer
Creating vaccinations ie Gardasil to boost the immune response
Utilizing the MHC on phage cells to create antibodies against cancer cells
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