Oncology Disorders Textbook PDF

Pathophysiology (2) (MBS 214) Oncology Disorders Textbook ;Pathophysiology for the Health Professions, 4th edition, 2011  Oncology Disorders Lecture Outline: Female Reproductive System tumors Lung cancer Blood tumors Lecture Objectives: After studying this...

Pathophysiology (2) (MBS 214) Oncology Disorders Textbook ;Pathophysiology for the Health Professions, 4th edition, 2011  Oncology Disorders Lecture Outline: Female Reproductive System tumors Lung cancer Blood tumors Lecture Objectives: After studying this lecture, the student is expected to describe : tumors of the cervix, uterus, and ovaries. Breast tumors Lung cancer. Leukemia lymphomas  Tumors of Female Reproductive System BENIGN TUMORS – Uterus; Leiomyoma (Fibroids) – Ovary; Ovarian Cysts – Breast; Fibrocystic Breast Disease MALIGNANT TUMORS – Carcinoma of the Cervix – Carcinoma of the Uterus – Ovarian Cancer – Carcinoma of the Breast  BENIGN TUMORS of UTERUS; Leiomyomas Description: Commonly called “uterine fibroids” or myomas Hormone dependent (estrogen and progesterone sensitive) Common occurs during the reproductive years but will shrink postmenopausal Location: Develop from smooth muscle cells in the myometrium – developing inside the muscle (intramural), – Develop under the endometrium into the uterine cavity (submucosal), or – Grow outside under the serosa (subperitoneal).  BENIGN TUMORS of UTERUS; Leiomyomas Possible Clinical Manifestations : Small fibroids are often asymptomatic Abnormal bleeding, heavy menstrual cycles Pressure symptoms on nearby structures (urinary frequency or constipation) Large fibroids may interfere with implantation of the fertilized ovum (infertility)or the course of pregnancy and also mode of delivery. Diagnosed by ultrasonography Uterine Fibroid  BENIGN TUMORS of THE OVARY 1- Benign Ovarian Cysts: (Benign functional tumor) Description: – Fluid-filled sacs located under the serosa covering the ovary – Often during reproductive years, especially during puberty and near menopause due to changes in hormone levels Most common types: – Follicular cysts; failure of dominant follicle to rupture or non-dominant follicle to shrink, – Corpus luteum cysts Diagnosis: Ultrasound examination or laparoscopy can be used to identify a cyst. 2- Polycystic ovarian syndrome, or Stein-Leventhal syndrome, Large ovaries containing usually many cysts and covered with a thick capsule. Associated hormonal abnormalities include elevated androgen, and LH levels with increase ratio of LH to FSH levels. – Ovulation does not occur. (anovulation) Manifestation – Menstruation abnormalities: Menarche occurs at the average age of 12 to 13 years, Irregular menses with oligomenorrhea , amenorrhea and infertility. – Clinical hyper-androgenism; young women manifest hirsutism (excess body and face hair ), may also obesity.  BENIGN BREAST DISEASE Fibrocystic Breast Disease Fibrocystic disease refers to the presence of nodules or masses in the breast tissue that change during the menstrual cycle in response to fluctuating hormone levels, particularly estrogen. The connective tissue of the breast is gradually replaced by dense fibrous tissue. Increasing fluid in the breast during the secretory phase of the menstrual cycle accumulates in cysts bound by fibrous tissue, unable to escape. The epithelial cells in the ducts proliferate in response to hormones. The cysts enlarge over time, often causing more degeneration of normal tissue. Any age within the reproductive years, more common under the age of 35 Potential cause is high estrogen level  BENIGN BREAST DISEASE First category: Non proliferative: Fibrocystic Disease; – microcysts surrounded by fibrous tissue(collagen)with dilated ducts – Multiple locations within a breast – No pain, no risk of developing cancer Fibroadenomas: – Singular, movable masses – Estrogen dependent: pre-menopause Second category: Proliferative : epithelial hyperplasia in the ducts in which there are no atypical cells. Third category: show proliferative changes with atypical cells. Breast biopsy can detect atypical cells and can differentiate benign from malignant cells  MALIGNANT TUMORS Carcinoma of the Cervix Carcinoma of the Uterus (Endometrial Carcinoma) Ovarian Cancer Carcinoma of the Breast  Carcinoma of the Cervix Etiology : Most cases are caused by Human Papilloma Virus (HPV) – Types 16&18 ;most oncogenic strains Defines as a sexually transmitted infection. It is a cancer of young women (by age 20 or in the year sexual intercourse begins)  Carcinoma of the Cervix Signs and symptoms Asymptomatic in the early stage, but can be detected by Papanicolaou (Pap) smear for screening and early diagnosis while the cancer is still in situ. The late or invasive stage is indicated by – Abnormal vaginal bleeding , spotting or discharge Anemia or weight loss may accompany the local signs. Carcinoma of the Cervix Invasive carcinoma of the cervix  Carcinoma of the Cervix Cancer of the cervix. A, Positive Pap smear indicative of cervical cancer. B, Early invasion (microscopic) occurring in a cervical neoplasm (stage I). C, the advanced stage, a protruding mass..  Carcinoma of the Uterus (Endometrial Carcinoma- cancer of epithelium of uterus) Occur most common after menopause (postmenopausal women55- to 65-year age range) The most common type is adenocarcinoma (arise from glandular epithelium) which grows inside uterine cavity Important risk factor: hyperestrogenism Age