1. Neoplasms

2. Definitions: Neoplasm Tumor New growth No new purpose
Swelling, enlargement, mass

3. Types of Neoplasm Benign vs. Malignant Varies with:
Cell characteristics
Potential for spread
Local , regional, distant spread
Degree of anaplasia
Cellular differentiation and specificity

4. Benign Neoplasms Slow growing Well defined, less anaplastic cells
Often encapsulated
No infiltration of local tissue
Unlikely recurrence

5. Malignant Neoplasms Rapidly growing Anaplastic
Metastasize via blood or lymphatics
May/often recur after excision
Fatality possible
Called cancers

6. Cancer Growth & Spread Localized Metastases
Stays at the site of the original tumor (primary)
Invades the local tissues
Metastases
Spreads beyond the site of the primary tumor
Regional spread (local lymph nodes often)
Distant mets (other organs or organ systems)

7. Risk Factors & Prevention
No single cause of malignancy
Some risk factors:
Carcinogen exposure
Substance that increases the risk of cancer development
Radiation, chemicals, tobacco, sun exposure
Genetics
Diseases that increase cancer risk
Example: ulcerative colitis, familial adenomatous
polyposis

8. General Preventative Measures
Stop smoking
Limit alcohol consumption
Protect skin from UV exposure
Limit X-rays
Limit exposure to harmful chemicals
Asbestos, aniline dyes, vinyl chloride, benzene
Limit HRT (estrogen therapy)

9. General Preventative Measures
Limit exposure to air pollution, solvent cleaners, paint thinners, pesticides, etc.
Eat diet rich in fibrous fruits & vegetables, bran, whole grains. Moderate caloric intake.
Exercise
Regular medical screening exams
Limit salt- & nitrate-cured & smoked foods.

10. Medical Screening Exams and Tests
Rectal exams (prostate Ca)
Colonoscopy (colon Ca)
Mammography (breast Ca)
Pap smear (cervical Ca)
PSA (prostate specific antigen)
CEA (carcinoembyronic antigen)(colon cancer)
Skin exam

11. Cancer Stats (2008) US cancer deaths: 565,650
-Decreasing 1.1%/yr from
-Decreasing 2.1%/yr from
New cases: 1,437,180 (not including nonmelanoma skin cancers)

12. Cancer Stats (2008) Most common Ca types in US (new cases per year):
Nonmelanoma skin cancer (over 1 million)
About 50% all Ca diagnosed in US
Lung (215,000)
Prostate (186,000)
Breast (182,000 females)
Colorectal (148,000)

13. Classification of Neoplasms
According to type of body tissue involved
Carcinomas
Sarcomas
Blood and lymph neoplasms

14. Carcinomas Most common type Solid tumors of epithelial origin
Examples: adenocarcinoma

15. Sarcomas Less common than carcinomas
Cancers of connective and supportive tissues
Examples: osteosarcoma

16. Blood & Lymph Neoplasms
Leukemias
Hodgkin’s Disease
Non-Hodgkin’s lymphoma

17. Leukemias Not a solid tumor Increased number of abnormal WBC
Acute Type
Acute myeloblastic leukemia
Chronic Types
Chronic myelocytic leukemia
Chronic lymphocytic leukemia

18. Hodgkin’s Disease A type of lymphoma
Painless enlargement of lymph nodes in neck at first
Reed-Sternberg cell is characteristic giant cell in this disease

19. Non-Hodgkin Lymphoma Malignant lymphomas More common than Hodgkin’s
Increasing in incidence
Also has painless LN enlargement
May involve other non-lymphatic tissues
No Reed-Sternberg cells

20. Etiology of Neoplasms No single etiology
Reflects a change in chromosomal material
Cell growth is independent & uncontrolled
Generally considered a failure of immune system

21. Etiology of Neoplasms Heredity
Breast cancer (female relatives)
Colon carcinoma (polyposis coli)
Retinoblastoma (dominant trait)
Most neoplasms are not inherited disorders

22. Etiology Viral etiology Carcinogens
Epstein-Barr virus (Burkitt’s lymphoma)
Herpes simplex virus (cervical Ca)
Human papilloma virus (cervical Ca)
Carcinogens
UV light, X-rays, radiation therapy, tobacco smoke, chewing tobacco, formaldehydes, asbestos, nickel & zinc ores, pesticides, etc.

23. Cancer Progression Hyperplasia Dysplasia Carcinoma in situ Metastases
Increased growth of cells
Dysplasia
Cells become abnormal in appearance
Carcinoma in situ
Remains in one place, a primary
Metastases
Distant spread via the circulation

24. Grading and Staging Grading Staging Describes the degree of anaplasia
Grade I (well differentiated cells) to Grade IV (difficult to tell tissue of origin)
Staging
Degree to which a cancer has spread
TNM system
Tumor size, # regional LN, metastases

25. Treatments Surgery Radiation Therapy
Specific, palliative, preventative
Radiation Therapy
Electromagnetic type (x-rays, gamma rays)
Particle type (electrons, neutrons, protons, etc)
Given externally or internally
Radioisotopes
Radiation affects DNA & cell replication of both cancer and normal cells

26. Treatments Chemotherapy
Most effective against cancers that spread widely
Affect both cancer & normal cells
Frequent adverse effects on bone marrow, GI tract, and skin
Most common side effects: nausea, vomiting, anemia, leukopenia, alopecia

27. Treatments Immunotherapy (Biotherapy) Hormonal Therapy
Stimulation & strengthening of immune system
Used early in the course of the disease
Examples: interferon, bone marrow & stem cell transplantation, cord blood transfusion
Hormonal Therapy
Adds, blocks, or removes hormones that affect the growth of certain cancers (breast, prostate)