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Prof. Dr. Pratiwi TS

Veterinary oncology. Prof. Dr. Pratiwi TS. What kind of cancer. Cancerous cells divide repeatedly out of control even though they are not needed, they crowd out other normal cells and function abnormally. They can also destroy the correct functioning of major organs. What is cancer?.

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Prof. Dr. Pratiwi TS

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  1. Veterinary oncology Prof. Dr. Pratiwi TS onkologi-interna-pts -2013

  2. What kind of cancer • Cancerous cells divide repeatedly out of control even though they are not needed, they crowd out other normal cells and function abnormally. • They can also destroy the correct functioning of major organs. onkologi-interna-pts -2013

  3. onkologi-interna-pts -2013

  4. What is cancer? • Cancer is a group of neoplastic diseases in which there is a transformation of normal body cells into malignant ones. onkologi-interna-pts -2013

  5. Some basic terminology: Oncogenesis = process of initiation of tumors (cancer) in an organism (onkos = mass; genesis = birth) Tumor = tissue composed of cells that deviate from normal program of cell division and differentiation. Benign tumor = tumor cells remain together in a single mass and do not invade or disrupt surrounding tissues onkologi-interna-pts -2013

  6. Some basic terminology: Malignant tumor = tumor cells invade and disrupt surrounding tissues (diagnosed as cancer, and such cells can transform other cells to the cancerous state). Metastasis = spread of malignant tumor cells throughout the body (typically through the blood and lymphatic system) onkologi-interna-pts -2013

  7. What causes cancer? • Cancer arises from the mutation of a normal gene. • Mutated genes that cause cancer are called oncogenes. • It is thought that several mutations need to occur to give rise to cancer • Cells that are old or not functioning properly normally self destruct and are replaced by new cells. • However, cancerous cells do not self destruct and continue to divide rapidly producing millions of new cancerous cells. onkologi-interna-pts -2013

  8. A factor which brings about a mutation is called a mutagen. • A mutagen is mutagenic. • Any agent that causes cancer is called a carcinogen and is described as carcinogenic. • So some mutagens are carcinogenic. onkologi-interna-pts -2013

  9. What causes neoplasms (1)? • All neoplasms, whether benign or malignant (cancer) are caused by mutation of critical genes that control cell growth, maturation and organization • Mutation is irreversible, cell-to-cell inherited gene dysfunction • Exposure to certain viruses, excessive radiation, and some chemicals can cause mutation onkologi-interna-pts -2013

  10. What causes neoplasms (2)? • There are many inherited factors which increase the risk of developing neoplasms • Mutated, inherited genes • Genes linked to phenotype • Patterns of metabolism • Sensitivity to environmental exposures • Male/female gender • Increasing age • Concurrent diseases (immunosuppression) onkologi-interna-pts -2013

  11. Carcinogens • Ionising radiation – X Rays, UV light • Chemicals – tar from cigarettes • Virus infection – papilloma virus can be responsible for cervical cancer. • Hereditary predisposition – Some families are more susceptible to getting certain cancers. Remember you can’t inherit cancer its just that you maybe more susceptible to getting it. onkologi-interna-pts -2013

  12. Benign or malignant? • Benign tumours do not spread from their site of origin, but can crowd out (squash) surrounding cells eg brain tumour, warts. • Malignant tumours can spread from the original site and cause secondary tumours. This is called metastasis. They interfere with neighbouring cells and can block blood vessels, the gut, glands, lungs etc. onkologi-interna-pts -2013

  13. Benign or malignant? • Why are secondary tumours so bad? • Both types of tumour can tire the body out as they both need a huge amount of nutrients to sustain the rapid growth and division of the cells. onkologi-interna-pts -2013

  14. Normal cell cycle is controlled by signal transduction: • Growth factors bind to surface receptors on the cell; transmembrane proteins relay signals into the cell. • Two types of growth factors: • Growth factors stimulate cell division. • Growth-inhibiting factors inhibit cell division. • Healthy cells divide only when growth factor and growth-inhibiting factor balance favors cell division. • Cancer cells divide without constraint • So cancer is caused by mutations in growth and growth-inhibiting factor genes. onkologi-interna-pts -2013

  15. Oncogenesis arises from: Spontaneous gene or chromosome mutations. Exposure to mutagens or radiation. Activity of genes introduced by tumor viruses. Some cancers are inherited (individuals may be predisposed). Some cancers are inherited (individuals may be predisposed). onkologi-interna-pts -2013

  16. Cell cycle and cancer: Cell differentiation occurs as cells proliferate to form tissues. • Cell differentiation correlates with loss of ability to proliferate; highly specialized cells are terminally differentiated. • Terminally differentiated cells have a finite life span, and are replaced with new cells produced from stem cells. • Stem cells are capable of self-renewal; cells divide without undergoing terminal differentiation. onkologi-interna-pts -2013

  17. Tumors, neoplasms, cancer • Tumor – literally a swelling, but common term for a neoplasm • Neoplasm – ‘new cells’; a mass of tissue derived from normal tissue that grows without normal regulation of growth • Cancer – ‘The Crab’; a malignant neoplasm that grows by infiltration and which may spread to distant sites onkologi-interna-pts -2013

  18. Oncogenesis arises from: Spontaneous gene or chromosome mutations. Exposure to mutagens or radiation. Activity of genes introduced by tumor viruses. Some cancers are inherited (individuals may be predisposed). Some cancers are inherited (individuals may be predisposed). onkologi-interna-pts -2013

  19. Cancer Statistics • Cancer is the major cause of death in pets greater than 10 years old • 45% of all dogs older than 10 years of age die of cancer • 23% of all dogs die of cancer onkologi-interna-pts -2013

  20. Feline Cancer Facts • Lymphoma is the most frequently diagnosed tumor in cats • Spaying female cats decreases the incidence of lymphoma by 40-50% onkologi-interna-pts -2013

  21. Canine Cancer Facts • Skin cancers are the most frequently diagnosed tumors of dogs. • Mastocytomas account for 23% • Mammary tumors are the most common tumors in female dogs. • Spaying a dog prior to her first heat cycle will decrease the risk of developing mammary cancer by 7-fold. onkologi-interna-pts -2013

  22. Breed predispositions in purebred dogs to cancer • Brachycephalic breeds (Boston Terriers, Boxers, Bulldogs, Mastiffs) – primary brain tumors • Golden Retrievers – malignant lymphoma, hemangiosarcoma • German Shepherds – hemangiosarcoma • Giant breeds – appendicular osteosarcoma • Scottish breed terriers – transitional cell carcinoma of urinary bladder onkologi-interna-pts -2013

  23. Therapies for malignancies in dogs • Surgery is the primary modality for therapy of all canine tumors • Chemotherapy is used to treat canine malignant lymphoma (about 25% of cases receive multiagent therapy) • Radiation therapy is effective for some tumors • Combination therapy is common onkologi-interna-pts -2013

  24. Surgery-Indications • Mammary tumors (except inflammatory mammary cancer) • Prostate tumors • Oropharyngeal tumors • Skin cancers • GI tumors • Lung tumors • Bone tumors onkologi-interna-pts -2013

  25. Methods of Treatment • Surgery • Radiation therapy • Chemotherapy • Hyperthermia • Photodynamic therapy • Others • Gene therapy • Anti-angiogenic drugs • Immunotherapy • Alternative therapies onkologi-interna-pts -2013

  26. Multicentric melanoma – Arabian Horse onkologi-interna-pts -2013

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  28. How is cancer detected? • The owner is the first person to know if a neoplasm is developing! • Changes in normal routine (loss of appetite, for example) (convulsions) • Detection of a growth (skin tumors are very common) • Persistent illness accompanied by discharges (vomiting, diarrhea, blood in urine are examples) • Weight gain, weight loss (in a relatively short time) onkologi-interna-pts -2013

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  30. Therapies for malignancies in dogs • Surgery is the primary modality for therapy of all canine tumors • Chemotherapy is used to treat canine malignant lymphoma (about 25% of cases receive multiagent therapy) • Radiation therapy is effective for some tumors • Combination therapy is common onkologi-interna-pts -2013

  31. Radiation onkologi-interna-pts -2013

  32. Biopsy • Excisional • Complete removal of the tumor • Feasible if mass is < 3 cm in diameter and freely moveable • Lymph nodes, small cutaneous nodules, mammary gland and CNS tumors, and tumors found during exploratory surgeries • Nonexcisional • Removal of only a portion of the tumor • Cytology from a fine-needle aspirate, brush samples, or impression smears or effusions • Histopathology of cutting forcep biopsies, cutting needle biopsies, punch biopsies, and incisional biopsies onkologi-interna-pts -2013

  33. AVMA’s Signs of Cancer • Abnormal swelling that persists or cont. to grow • Sores that do not heal • Unexplained weight loss • Loss of appetite • Bleeding or discharge from any body opening • Bad odor, especially from the mouth • Difficulty eating or swallowing • Reluctance to exercise or loss of stamina • Difficulty breathing, urinating, defecating • Change in behavior onkologi-interna-pts -2013

  34. Diagnostic Tests and Procedures • CBC • Serum chemistry profile • Urinalysis • Radiographs • CAT scan • MRI • Ultrasonography • Biopsy • Tumor staging onkologi-interna-pts -2013

  35. Contributors to an IncreasingIncidence of Cancer • Larger population of geriatric pets • Advances in health care • An improved recognition and diagnosis of cancer • Increased willingness of both veterinarian and owner to treat cancer • Environmental changes onkologi-interna-pts -2013

  36. Feline Cancer Facts • Lymphoma is the most frequently diagnosed tumor in cats • Spaying female cats decreases the incidence of lymphoma by 40-50% onkologi-interna-pts -2013

  37. Canine Cancer Facts • Skin cancers are the most frequently diagnosed tumors of dogs. • Mastocytomas account for 23% • Mammary tumors are the most common tumors in female dogs. • Spaying a dog prior to her first heat cycle will decrease the risk of developing mammary cancer by 7-fold. onkologi-interna-pts -2013

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  39. Other Treatment Options • Gene therapy • Anti-angiogenic drugs • Immunotherapy • Alternative therapies • Acupuncture • Massage • Herbal and botanical medicine onkologi-interna-pts -2013

  40. Surgery-Indications • Mammary tumors (except inflammatory mammary cancer) • Prostate tumors • Oropharyngeal tumors • Skin cancers • GI tumors • Lung tumors • Bone tumors onkologi-interna-pts -2013

  41. As sole agent Systemic cancers hematologic malignancies metastatic carcinomas Metastatic sarcomas As adjunct therapy Given to patients with no overt evidence of residual cancer following surgery or radiation Chemotherapy-Indications onkologi-interna-pts -2013

  42. Chemotherapy-Limitations and Complications • Toxicities are particularly against cells of the bone marrow, GI lining, and hair follicles and can result in: • Immunosuppression • Anemia • Nausea and vomitting • Delayed wound healing • Hair loss onkologi-interna-pts -2013

  43. Onkology – question ?? onkologi-interna-pts -2013

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