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Oncology

Oncology. Chapter 19. Learning Outcomes. Define cancer. Describe cell differentiation. Identify the staging system that evaluates the spread of a tumor. Contrast the characteristics of benign and malignant tumors. List the seven warning signals of cancer. Overview of Cancer.

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Oncology

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  1. Oncology Chapter 19

  2. Learning Outcomes • Define cancer. • Describe cell differentiation. • Identify the staging system that evaluates the spread of a tumor. • Contrast the characteristics of benign and malignant tumors. • List the seven warning signals of cancer.

  3. Overview of Cancer • Cancer refers to any malignant tumor. • Incidence of cancer is five times higher than 100 years ago. • Strikes 1 of every 3 Americans. • Has become one of the more treatable of the major diseases in the U.S. • Highly advanced surgical techniques • Chemotherapy and radiation therapy • Immunotherapy and photodynamic therapy

  4. Top 10 Cancers by Death RATE in US • https://nccd.cdc.gov/uscs/toptencancers.aspx

  5. https://nccd.cdc.gov/uscs/toptencancers.aspx

  6. http://www.cancer.gov/about-cancer/what-is-cancer

  7. Types of Cancer • Four broad types of cancer: • Carcinomas: arise from epithelialtissue (skin, lining of the intestines and body cavities, surface of body organs, outer portion of glands) • Sarcomas : arise from connective tissue (bone, tendon, cartilage, muscle, fat tissues) • Leukemias: cancers of the blood which originate in the bone marrow or the lymphatic system • Lymphomas: cancers that originate in lymph nodes and glands

  8. Classification of Cancer • Helps determine appropriate treatment and prognosis. • Tumors are classified according to: • Anatomic site of origin • Grading- determined by pathologists to describe cell division • Staging – how the disease is spreading through the body • http://www.cancer.gov/types

  9. Classification of Cancer • Anatomic Site • Indicates where the cancer originated in the body. • Carcinomas make up the great majority of all cancers. • Malignant tumors of epithelial tissues • The opposite of malignant is benign (Etymology: L, benignus, kind)

  10. Table 19.1 Characteristics of Benign and Malignant Tumors

  11. Classification of Cancer • Anatomic Site • Carcinomas make up the great majority of all cancers. • Examples • Squamous carcinoma (squamous epithelium) • Basal cell carcinoma (skin cancer) • Bronchogenic carcinoma (bronchus of respiratory tract) • Sarcomas – sarc/o and omas • Leukemia • Lymphomas • Myelomas (look up in book now, noticed the combining form myel/o

  12. Figure 19.2Squamous cell carcinoma.

  13. Cell Differentiation and Grading • Normal cells • Reproduce themselves through mitosis (mit/thread, osis/condition), an orderly process that assures growth, tissue repair, and cell reproduction. • Have a distinct appearance and a specialized function. • In normal cell development, immature cells undergo normal changes as they mature and assume their specialized functions. • This process is called differentiation.

  14. How cancer cells behave differently • http://ed.ted.com/lessons/how-do-cancer-cells-behave-differently-from-healthy-ones-george-zaidan#review

  15. Cell Differentiation and Grading • In cancer, a cell or group of cells undergoes changes and no longer carries on normal cell functions. • This failure of immature cells to develop specialized functions is called dedifferentiation. • It is believed that this process involves a disturbance in the DNA of the affected cells.

  16. Cell Differentiation and Grading • Malignant cells • Usually multiply rapidly, forming a mass of abnormal cells that enlarges, ulcerates, and sheds malignant cells that invade surrounding tissues. • These malignant cells take the place of normal cells.

  17. Cell Differentiation and Grading • Malignant cells • Under the microscope, a malignant cell reveals: • a loss of differentiation • Anaplasia (ana (up and apart)/plasia (formation) • nuclei of various sizes that are hyperchromatic (hyper/chromatic (color)) • cells in the process of rapid and disorderly division.

  18. Cell Differentiation and Grading • Based on microscopic analysis, malignant tumors are classified as: • Grade 1 • The most differentiated and the least malignant tumors. • Only a few cells are undergoing mitosis; however, some abnormality does exist. • Grade 2 • Moderately undifferentiated. • More cells are undergoing mitosis, and the pattern is fairly irregular.

  19. Cell Differentiation and Grading • Based on microscopic analysis, malignant tumors are classified as: • Grade 3 • Many undifferentiated cells. • Tissue origin can be difficult to recognize. • Many cells are undergoing mitosis. • Grade 4 • The least differentiated and high degree of malignancy.

  20. Cell Differentiation and Grading • Tumor grading is used to: • Report the prognosis of the disease. • Determine whether the tumor is likely to respond to radiation therapy or chemotherapy. • Determine the prognosis for surgery.

  21. Invasive Process • Invasive Growth • Active migration • The malignant cells: • Break away from the neoplasm. • Invade surrounding tissue. • Divide. • Form secondary neoplasms. • Then reunite with the primary tumor as growth continues.

  22. Invasive Process • Metastasis • Cancer cells spread from a primary site to distant secondary sites by: • invading the bloodstream or lymph system. • becoming lodged at a secondary site where they form a neoplasm. • Development of a secondary neoplasm depends on the viability and the receptivity of the organ.

  23. Figure 19.3How cancer cells invade normal tissue.

  24. Staging • The staging system that indicates the spread of a tumor uses the letters: • T (tumor) • N (node) • M (metastasis) • Uses numerical subscripts to indicate degree of tumor involvement. • Example: T2N1M0

  25. Staging • Numerical system to classify the staging of cancer: • Stage 0: Cancer in situ. • Stage I: Cancer limited to the tissue of origin. • Stage II: Limited local spread of cancerous cells, sometimes to lymph nodes. • Stage III: Extensive local and regional spread of cancer, usually to draining lymph nodes. • Stage IV: Distant metastasis.

  26. Characteristics of Neoplasms • The American Cancer Society lists seven warning signals of cancer using the first letters of the word CAUTION: • Change in bowel or bladder habits. • A sore that does not heal. • Unusual bleeding or discharge. • Thickening or lump in breast or elsewhere. • Indigestion or difficulty in swallowing. • Obvious change in a wart or mole. • Nagging cough or hoarseness

  27. Diagnosis • A variety of diagnostic tools and procedures is used to detect the possible presence of cancer: • Examination • Visualization by endoscopy • Laboratory analysis • Biopsy (Bx) • Diagnostic radiology

  28. Diagnosis • Examination • American Cancer Society recommends certain cancer detection tests be included in an annual physical examination. • Visualization by endoscopy • Provides the physician a direct view of certain portions of the body.

  29. Diagnosis • Visualization by endoscopy-679 • Sigmoidoscopy • Laryngoscopy • Bronchoscopy • Gastroscopy • Cystoscopy • Colposcopy • Proctoscopy • Colonoscopy • Laparoscopy

  30. Diagnosis • Laboratory analysis • Plays a key role in detecting specific types of cancer. • Pap smear/test • Cytologic screening test used to detect the presence of abnormal or cancerous cells from the cervix and vagina. • Fecal occult blood test • Test to detect occult (hidden) blood. • If blood is present, check for possible cancer of the colon.

  31. Diagnosis • Laboratory analysis (listed on page 679) • Sputum cytology test • Microscopic examination of sputum to detect abnormal or cancerous cells of the bronchi and lungs. • Blood serum test • Analysis of blood serum to obtain useful information about certain proteins synthesized by cancer. • Two such tests are the AFP and hCG.

  32. Diagnosis • Biopsy • The surgical removal of a small piece of tissue for microscopic examination. • Method to positively diagnose cancer. • Excisional • Surgical removal of a piece of tissue from the suspected body site.

  33. Diagnosis • Diagnostic radiology • Encompassing a wide range of tests and procedures that can reveal tumors that were not detected by other diagnostic procedures.

  34. Treatment • Methods of cancer treatment • Surgery • Chemotherapy • Radiation therapy • Immunotherapy • Photodynamic therapy • http://www.cancer.gov/about-cancer/treatment/types

  35. Look at pages 704-705 • Prefixes • Combining Forms • Suffixes • Medical Terms

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