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Neoplasms Cell Terms ► Atrophy- Decrease in the SIZE of cells resulting in reduced tissue mass ► Hypertrophy- Increase in the SIZE of cells resulting in enlarged tissue mass ► Hyperplasia- Increase in the NUMBER of cells resulting in enlarged tissue mass. ► ► ► Rapidly growing cells Can be indication of cancer. Neoplasm- ”new growth” commonly known as a tumor. Can be either: ► ► Malignant=Cancer. They can spread. Benign-Typically harmless since they do not spread. They can become malignant Neoplasms ► ► ► Neoplasm- class of diseases in which a group of cells display uncontrolled growth Invasion that intrudes upon and destroys adjacent tissues, And sometimes metastasis, or spreading to other locations in the body via lymphatic and circulatory system. It is growth that is no longer responding to normal body controls keeping it in homeostasis. These cells become atypical, meaning they do not function as normal tissues. They also begin to deprive other cells of nutrients Every tumor is different Differentiation ► Differentiation It is the specialization required for a particular cell’s function ► Myocardium and Neurons are highly developed and specialized ► When cells become disorganized, or undifferentiated, or their growth becomes uncontrolled, their specialized function is lost. Nomenclature (“Nom” means ?) ► ► Oncology-study of cancer Tumor names are first based on their origin Chondro, Nephro, Hepato, etc “oma” is standard suffix for tumor Special terms ► Carcinoma-malignant epithelial tissue. ► Sarcoma-malignant connective tissue. ► Lipoma-benign fatty tissue ► Adeno- Gland Vocabulary To don (v) – to put something on ► To doff (v)- to take something of ► To besmirch (v)- to stain someone’s reputation ► To prevaricate (v) (prevarication)- to stray or evade from the truth; to lie ► To befuddle (v) befuddled (adj)- to confuse ► Enigma (n)- something/something that is puzzling, riddle-like, or mysterious ► To propagate (v) (propagation)- to spread or multiply ► Prerogative (n) – a special right or privilege given to a person/organization ► To augment (v) – to make larger in size; to grow ► Abbreviations ► ► ► ► ► ► ► ► ► ► cxr- Chest X-ray KUB- Abdominal X-ray ASA- Aspirin APAP – Acetaminophen (Tylenol) BP – blood pressure OS- left eye OD- right eye BS- blood sugar gtt- drop (gtts-drops) po – by mouth Benign vs. Malignant ► ► Neoplasms are classified into 2 major groups. Benign- usually are still differentiated cells, but begin producing at a higher rate. It is encapsulated but does not spread. Only one place in body where benign can kill you. ► Brain! ► Malignant-usually are undifferentiated, non-functioning cells and are NOT encapsulated. They grow at a faster rate and may invade nearby cells and later metastasize to other organs. ► Neoplasms=Malignant=Cancer “crab-like” Benign vs Malignant Etiology Carcinogenesis-process by which normal cells transform into cancer ones ► Etiology for many cancers is unknown (ideopathic) ► However, certain risk factors increase chances ► Genetic Radiation (medical, solar, terrestial, cell phones) Chemicals (smoking, asbestos, plastics) Diet (high fat, low fiber, MSGs, sugar-free items, Age Virus ► ► HPV (Cervical) Hepatitis (Lung Cancer) Tumor Progression ► ► ► ► ► Malignant cells begin growing They compress against nearby blood vessels, thus leading to necrosis of nearby tissue This leads to increased inflammation of the organ, thus leading to reduction of organ function Some cancers stimulate angiogenesis The development of new blood vessels in the tumor thus promoting more tumor growth While some neoplastic cells metastizise quickly others remain in situ for a long time In Situ- neoplastic cells that remain in a pre-invasive stage for months to years Effects of Tumors Pain Typically not an early symptom of cancer. Due to increased pressure on sensory nerves by growing tumor. ► Obstruction Occurs when tumor compresses a duct or passageway ► Infection Normally seen in digestive tract Tumor cuts off blood to neighboring tissues; tissue necrotizes and then becomes infected, typically by the flora that is already inhabiting the digestive tract ► Macro Effects Weight loss Anemia and Fatigue Bleeding (GI) ► Diagnostic Testing ► ► The early the better Most are not 100% reliable except for which one? Blood work ► Low RBC and WBC may reveal leukemia Tumor markings-substances produced by the tumor that circulate in the blood stream ► PSA-prostate cancer ► BRAC-1-breast cancer ► CA125-ovarian cancer Diagnostic Imaging (Xray, CT, MRI) Cytologic/Histologic tests ► Biopsy! ► The only guaranteed ► Pap Smear test Lymphatic System The sister system to the Cardiovascular. Wherever there is a blood vessel, there is a lymph one too. ► Picks up cellular debris and delivers it back to the Subclavian veins through its own network of lymph vessels ► Lymph nodes-”stations” along the way where WBCs hang out ► Spreading of Cancer Primary-origin site ► Secondary-where it spreads ► 1. Invasion-(see Figure 1) ► ► Local spreading normally in adjacent tissue 2. Metastasis Spreading of cancer to different sites in the body through CV and lymphatic systems First, they appear in the local lymph nodes ► ► Liver, Brain, and Lungs common 2nd sites. Why? 3. Seeding (See Figure 2) Spreading of cancer within the same body cavity. ► Abdominal cavity Stages of Cancer ► ► ► ► ► Staging system based on 3 factors: (T)-Size of Tumor, (N) Involvement of Lymph Nodes, and (M) How much has it metastasized. Stage 1 Tumor <2 cm, no lymph nodes involved N-0, and no metastasis M0 Stage 2 T0-T2 <5 cm, nodes involved N-1, no meta M-0 Stage 3 T-3 >5 cm, nodes involved, tumor present in them N1-2, no metastasize M-0 Stage 4 T-4 tumor any size but fixed to chest wall or skin N-3- multiple tumors in nodes and spreading M-1-metastasis present Treatment ► Treatment may be either curative or palliative (treating symptoms-----death!) 3 basic types: “cut it,” “burn it,” or “poison it.”-All 3 may be ► 1. Surgery ► used together Removal of tumor and nearby lymph nodes ► ► ► Laparoscopy Radiofrequency Ablation 2. Radiation Therapy The radiation stops the mitosis of the neoplastic cells, or kills the cells altogether, or kills nearby blood vessels so the tumors starves to death It also does this to the nearby healthy cells. ► Adverse Effects (depends on location and dosage) Alopecia-hair loss, skin burning Bone marrow depression- WBCs, RBCs and platelets may decrease thus increasing chance of infection Sterility Epithelium of GI tract is damaged leading to excessive vomiting, diarrhea Treatment (cont) ► Chemotherapy (Pills) Most effective on rapidly-producing tumors ► The drugs interfere with DNA replication in the mitosis of the neoplastic cell, thus killing it. Different cocktails of drugs given months apart ► Adverse Effects-kills healthy cells too Alopecia Bone Marrow Depression Infection Vomiting Prognosis Prognosis is not judged by a cure, only a remission. ► Remission-Term used to describe period post-cancer when symptoms have disappeared. ► Cancer may return. Terminal-Cancer is too far advanced it will kill the person. ► “Cures” are defined as a 5-year survival rate ► Early diagnoses is CRUCIAL, regardless some cancers are worse than others. ► Good ones ► Sarcoma, Lymphoma, ► Bad ones Pancreatic, Ovarian 5-Year Survival Rates (White) Prostate-100% ► Testicular-95% ► Skin- 91% ► Breast-90% ► Bladder-78% ► Kidney-71% ► Cervical-69% ► Colorectal-61% ► Throat-60% ► Leukemia- 55% ► ► ► ► ► ► ► ► Ovarian-43% Spinal Cord (Myeloma)40% Brain-32% Stomach-25% Lung-16% Liver-15% Pancreas-6% Most Common Cancers ► Breast-24% ► Lung-19% ► Uterus/Cervical► Prostate-12% ► Ovary-6% ► Bladder-6% ► Thyroid-5% ► Pancreas-5% ► Colon-5% ► Other-4% 14%