Cancer Medicine Oncology Chapter 19 Pages 799 848

Cancer Medicine (Oncology) Chapter 19 Pages 799 – 848

Page 800 Introduction v Cancer = abnormal and excessive cell growth. v More than ½ of all patients who develop cancer are cured. v Most common causes of cancer death: • Women: Lung, followed by breast and colorectal cancers • Men: lung, colorectal, and prostate cancers

Pages 800 – 801 Characteristics of Tumors

Page 801 Characteristics of Tumors (cont’d)

Page 802 What Causes Cancer? v Only partly understood v Malignant v Must transformation = damage to DNA understand DNA and its functions in a normal cell

Pages 802 – 803 v DNA has two main functions in a normal cell.

Pages 803 – 804 Carcinogenesis v DNA mutations lead to higher-than-normal rates of growth or keep them from dying. v Malignant cells are anaplastic. v Carcinogens • Chemicals, drugs, and tobacco smoke • Radiation • Viruses • Oncogenes

Pages 804 Translocation

Pages 804 – 805 Heredity

Page 805 Classification of Cancerous Tumors

Page 806 Carcinomas v This is the largest group • Benign → gastric adenoma = a benign tumor of the glandular epithelial cells lining the stomach • Malignant → gastric adenocarcinoma = a cancerous tumor arising from glandular cells lining the stomach

Page 806

Page 807 Sarcomas v From connective tissues in the body • Benign → osteoma = a benign tumor of bone • Malignant → osteosarcoma = a malignant tumor of the bone

Page 807

Page 808 Mixed–Tissue Tumors v Capable of differentiating into both epithelial and connective tissue. v Uncommon v Examples testes. tumors are found in the kidney, ovaries, and

Pages 808 – 809 Pathologic Descriptions: Gross Descriptions v Cystic v Fungating v Inflammatory v Medullary

Pages 808 – 809 Pathologic Descriptions: Gross Descriptions (Cont’d) v Necrotic v Polypoid v Ulcerating v Verrucous

Pages 809 – 810 Pathologic Descriptions: Microscopic Descriptions v Alveolar v Carcinoma in situ v Diffuse v Dysplastic v Epidermoid v Follicular

Pages 809 – 810 Pathologic Descriptions: Microscopic Descriptions (Cont’d) v Papillary v Pleomorphic v Scirrhous v Undifferentiated

Page 811 Grading & Staging Systems v v Doctors classify tumors on the basis of • Grade: degree of maturity or differentiation under the microscope • Stage: extent of spread in the body These two properties influence the diagnosis, treatment, and prognosis for cancer patient.

Page 812 Cancer Treatment v Major approaches to cancer treatment are: • Surgery • Radiation therapy • Chemotherapy • Molecularly targeted therapy • Immunotherapy

Page 812 Cancer Treatment: Surgery v Many patients with cancer may be cured by surgical excision. v If it metastases, • Dubulking procedure • Then adjuvant (assisting) radiation therapy and/or chemotherapy

Page 812 Cancer Treatment: Surgery v cauterization v exenteration v core v fine needle biopsy needle aspiration v cryosurgery v fulguration v en v incisional bloc resection v excisional biopsy

Page 812 Cancer Treatment: Radiation Therapy v Goal → maximal dose of radiation to the tumor and minimal dose to the surrounding tissue. v Newer techniques

Page 813 Cancer Treatment: Radiation Therapy v Brachytherapy v Electron beams v External beam radiation (teletherapy) v Fields

Page 813 Cancer Treatment: Radiation Therapy v Fractionation v Gray (Gy) v Linear accelerator v Photon therapy v Proton therapy

Page 813 Cancer Treatment: Radiation Therapy v Radiocurable tumor v Radioresistant tumor v Radiosensitive tumor v Radiosensitizers v Simulation v Stereotactic radiosurgery

Page 815 Radiation Therapy Side Effects v Alopecia v Nausea v Fibrosis v Pneumonitis v Infertility v Secondary v Mucositis v Xerostomia v Myelosuppression and vomiting tumors

Page 816 Cancer Treatment: Chemotherapy v Treatment of cancer using chemicals v Chemotherapy may be used alone or in combination v Combination chemotherapy

Page 817 Categories of Chemotherapeutic Agents v Alkylating agents v Antibiotics v Antimetabolites v Antimitotics v Hormonal agents

Page 819 Cancer Treatment: Molecularly Targeted Therapy v Attack specific mutations that drive cancer growth • Cancer cells dies • Not found in normal tissues v Little or no effect on normal cells

Page 819 Cancer Treatment: Immunotherapy v Use of immune cells or antibodies, to kill tumors. Examples: • Modified T cells • Herceptin that blocks a receptor then attacks a growth factor • Nivolumb blocks a protein on tumor cells

Page 826 Laboratory Tests v cytogentic analysis v immunohistochemistry v protein marker tests

Pages 826 – 828 Clinical Procedures v Bone marrow biopsy v Bone marrow or stem cell transplant v Core needle biopsy v Exfoliative cytology v Fiberoptic colonoscopy v Laparoscopy

Pages 826 – 828 Clinical Procedures (Cont’d) v Mammography v PET-CT Scan v Radionuclide scans