Cancer Introduction PDF

CONCEPT OF CELLULAR ABERRATION. Rommel L. Salazar, RN, MAN, DrPH De La Salle Medical and Health Sciences Institute R  Objectives At the end of the session, the learners will be able to : a) define cellular aberration b) define terminologies...

CONCEPT OF CELLULAR ABERRATION. Rommel L. Salazar, RN, MAN, DrPH De La Salle Medical and Health Sciences Institute R  Objectives At the end of the session, the learners will be able to : a) define cellular aberration b) define terminologies related to cancer c) differentiate between normal cells vs cancer cells d) classify cancer according to cellular origin e) characterize benign and malignant neoplasm f) differentiate between cancer staging and grading R  What is cancer ? Cancer is many different disease involving uncontrolled growth of body cells. A cancer fails to respond to the signals that maintain orderly growth in normal cells. R  What is cancer? ❖ A disease process whereby cells proliferate abnormally, ignoring growth- regulating signals in the environment surrounding the cell R  Naming Cancers Cancer Prefixes Point to Location Prefix Meaning adeno- gland chondro- cartilage erythro- red blood cell hemangio- blood vessels hepato- liver lipo- fat lympho- lymphocyte melano- pigment cell myelo- bone marrow myo- muscle osteo- bone R R  Different Types of Cancer Leukemias: Some common carcinomas: Bloodstream Lung Lymphomas: Lymph nodes Breast (women) Colon Some common Bladder sarcomas: Prostate (men) Fat Bone Muscle R  Carcinoma Carcinomas are the most common type of cancer. They are formed by epithelial cells. R Adenocarcinoma Cancer that forms in epithelial cells that produce fluids or mucus. R  Basal Cell Carcinoma Cancer that begins in the lower or basal (base) layer of the epidermis R Squamous Cell Carcinoma Cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. R Transitional Cell Carcinoma Cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. R  Sarcoma Cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissues. R Leukemia Cancers that begin in the blood-forming tissue of the bone marrow R  Lymphoma Cancer that begins in lymphocytes ( T cells or B cells). R Multiple Myeloma Cancer that begins in plasma cells , another type of immune cell. R  Melanoma Cancer that begins in cells that become melanocytes, which are specialized cells that make melanin. R R R R  Loss of Normal Growth Control Normal cell division Cell Suicide or Apoptosis Cell damage— no repair Cancer cell division First Second Third Fourth or mutation mutation mutation later mutation R Uncontrolled growth  Example of Normal Growth Dead cells shed from outer surface Epidermis Cell migration Dividing cells in basal layer Dermis R The Beginning of Cancerous Growth Underlying tissue R Tumors (Neoplasms) Underlying tissue R Invasion and Metastasis 1 Cancer cells invade surrounding tissues and blood vessels 2 Cancer cells are transported by the circulatory system to distant sites 3 Cancer cells reinvade and grow R at new location  What Is Metastasis? 1. Cancer cells Blood invade surrounding vessel tissues and vessels 2. Cancer cells are transported by the circulatory system to distant sites 3. Cancer cells reinvade and grow at new location R Metastasis Requires Angiogenesis Angiogenesis ( formation of new network of blood vessels) R  What Is Tumor Angiogenesis? Small localized tumor Tumor that can grow and spread Angiogenesis Blood vessel Signaling molecule R  Malignant versus Benign Tumors Benign (not cancer) Malignant (cancer) tumor cells grow cells invade only locally and cannot neighboring tissues, spread by invasion or enter blood vessels, metastasis and metastasize to different sites Time R  Characteristics of Benign and Malignant Neoplasms Characteristics Benign Malignant Cell Well- differentiated cells Undifferentiated cells with Characteristics that resemble normal little resemblance to cells normal cells Mode of growth Tumor grows by Grows at periphery and expansion; does not sends out processes that infiltrate the surrounding infiltrate and destroy the tissues; usually surrounding tissues encapsulated Rate of growth Slow Variable.The more anaplastic the tumor, the faster its growth R  Characteristics of Benign & Malignant Neoplasms Characteristics Benign Malignant Metastasis Does not spread by Gains access to blood and metastasis lymphatic channels; metastasizes to other parts General Effects Localized effects Generalized effects i.e. anemia, weakness, weight loss Tissue Does not cause tissue Often causes extensive tissue Destruction damage damage Ability to Does not usually Usually causes death unless Cause Death cause death growth can be controlled R Tissue changes that are not cancer R  Hyperplasia Normal Hyperplasia R  Hyperplasia Tissue growth based on an excessive rate of cell division, leading to a larger than usual number of cells. e.g. hand callus R  Dysplasia Normal Hyperplasia Mild dysplasia R  Dysplasia An abnormal type of excessive cell proliferation characterized by loss of normal tissue arrangement and cell structure. Cells revert back to normal behavior, but occasionally they gradually become malignant , needing treatment. R  Carcinoma in Situ Normal Hyperplasia Mild Carcinoma in dysplasia situ (severe dysplasia) Cancer (invasive) R  Carcinoma in Situ In Latin, the term “in situ” means “in place,” so carcinoma in situ refers to an uncontrolled growth of cells that remains in the original location. Carcinoma in situ may develop into an invasive, metastatic malignancy and, therefore, is usually removed surgically, if possible. R R  Identification of the type of tissue from which the tumor originated Grading Degree to which tumor cells retain functional and structural characteristics The process of determining the size and spread, or metastasis of Staging the tumor Process of finding out how much cancer is in the person’s body R Clinical staging is an estimate of extent of cancer based on the results of the physical exam, imaging tests and endoscopy exams done before treatment starts. Pathologic / Surgical staging is an estimate of the extent of the cancer based on the microscopic examination of the tumor after surgery. R TNM Staging (Used for solid tumors) umor size (carries a no. of 0-4) odal involvement (carries a no. of 0-3) etastasis, distant (carries a no. of 0-1) R  Tumor Nodal Involvement Metastasis T0 – No evidence of N0 – No regional lymph M0 – No distant primary tumor node involvement metastasis T1S – Carcinoma in N1- N3 – Increasing M1 – Distant situ involvement of metastasis regional lymph nodes T1-T4 – Progressive NX – Cannot be assessed MX – Presence of increase in metastasis tumor size & cannot be involvement. assessed TX – tumor cannot be assessed R T1: The cancer is no larger than 3 cms., has not spread to the visceral pleura and does not affect the main branches of the bronchi. N0: No spread to lymph nodes M1: Distant spread is present. R  Roman Numeral Staging/ Stage Grouping Stage I - cancers are localized to one part of the body. Stage II - cancer has spread into surrounding tissues, but not beyond the location of origin Stage III - or "regional" cancer has spread the nearby lymph nodes Stage IV - or "distant" cancers have metastasized or spread to other parts of the body R  Cancer grading reflects how abnormal the cancer cells look under the microscope. GX- grade can’t be determined G1- well differentiated G2- moderately differentiated G3- poorly differentiated G4- undifferentiated R Ad Majorem Dei Gloriam R R