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Cancer

Cancer. Classification Causes Diagnosis Grading Staging Effects/Surgical Tx. Objectives. Discuss the pathophysiology of cancer. Differentiate between benign and malignant neoplasms Discuss causes of cancer Describe the lab and diagnostic tests used to diagnose cancer. Pathophysiology.

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Cancer

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  1. Cancer Classification Causes Diagnosis Grading Staging Effects/Surgical Tx

  2. Objectives • Discuss the pathophysiology of cancer. • Differentiate between benign and malignant neoplasms • Discuss causes of cancer • Describe the lab and diagnostic tests used to diagnose cancer

  3. Pathophysiology • Normal cell growth review • The Cell Cycle: 4 phases • A malfunction of any of the regulators of cell growth can result in rapid proliferation of immature cells • Differentiation • Etiology

  4. Known Causes • Viruses • Drugs and Hormones • Chemical Agents • Physical Agents

  5. Benign Neoplasms • Localized growths • Form a solid mass • Well-defined borders • Frequently encapsulated • Response to homeostatic controls • Grow slowly; same size • Destructive with crowding/pressure

  6. Malignant Neoplasms • Grow aggressively • Response to homeostatic controls • Noncohesive; irregular shape • Cut through surrounding tissues; Rapid • Cells may travel thru blood or lymph • Not always easy to remove • Can recur

  7. Characteristics of Malignant Cells • Loss of regulation of mitotic rate • Loss of cell specialization • Loss of contact inhibition • Progressive acquisition of the cancerous phenotype & immortality • Irreversibility of cancerous phenotype to greater aggressiveness • Altered cell structure; diff in cell nucleus & cytoplasm • Simplified metabolic activity • Transplantability (metastasis) • Ability to promote own survival

  8. How Cancer Invades Normal Tissue Fig. 09.05

  9. Diagnostics • X-ray imaging • Computed Tomography • Ultrasonography • Magnetic Resonance Imaging • Tissue Samples • Screening: PSA

  10. Grading and Staging • Grading • Amt of differentiation (level of functional maturity) of the cell • Estimates rate of growth based on the mitotic rate • Staging • Use to classify solid tumors • Refers to relative size of tumor and extent of disease • TNM classification system

  11. TNM Classification System

  12. Effects of Cancer • Disturbed or loss of physiologic functioning, from pressure to obstruction • Hematologic Alterations: Impaired function of Blood Cells • Infections: Fistula development & tumors may become necrotic; erode skin surface • Hemorrhage: Tumor Erosion, bleeding, severe anemia • Anorexia-Cachexia Syndrome: wasting away

  13. Effects of Cancer • Paraneoplastic Syndromes: ectopic sites w/excess hormone production • Pain: major concern • Physical Stress: body tries to respond and destroy neoplasm • Psychological Stress

  14. Surgical Tx • Surgical Tx isused for Dx and staging of more than 90% of all cancers and for primary TXx of more than 60% of cancers • If possible, tumor is removed in entirety; may necessitate mutilation of body • Less distressing results • Remove nonessential portion of organ or tissue containing tumor, such as in situ bowel tumors • Remove organ whose function can be replaced chemically, such as thyroid • Resect a pair of organs when the unaffected organ can take over the function of the missing one, such as a lung

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