10 Cancer

CANCER
.
Male: Causes of Cancer
1. Bronchogenic (r/t smoking)
/ Lung Cancer (s/sx: non
productive)
2. Liver Cancer (r/t alcoholic
drinking)
3. Prostate Cancer
• Common: middle age (40 y/o
and up)
• BPH – 50 above
Female
1. Breast Cancer
- r/t hormone
- if with breast mass: check axillary nodes
- BSE: 7 days post menstruation
2. Cervical Cancer
- 90% d/t multiple sexual partner
- 5% early pregnancy
3. Ovarian Cancer
Classification of Cancer:
(Based on Tissue Typing/ Site Origin)
1. Carcinoma
• arises from surface epithelium and glandular tissues (i.e., tissue that lines organs and
tubes)
• refers to a malignant neoplasm of epithelial origin or cancer of the internal or external
lining of the body.
• malignancies of epithelial tissue, account for 80 to 90 percent of all cancer cases.
CANCER CLASSIFICATION
Cancers are classified in two ways:
• by the type of tissue in which the cancer originates (histological type) and
• by primary site, or the location in the body where the cancer first developed.
The international standard for the classification and nomenclature of

histologies is the International Classification of Diseases for Oncology, Third
Edition (ICD-O-3).
1. Carcinoma
• most carcinomas affect organs or glands capable of secretion, such as the breasts, which
produce milk, or the lungs, which secrete mucus, or colon or prostate or bladder.
• into two major subtypes: adenocarcinoma and squamous cell carcinoma
Carcinoma
Epithelial tissue
• is found throughout the body
• It is present in the skin, as well as the covering and lining of organs
and internal passageways, such as the gastrointestinal tract.
Adenocarcinoma
• originates in glandular tissue
• develops in an organ or gland
• generally occur in mucus membranes and are first seen as a thickened
plaque-like white mucosa.
• they often spread easily through the soft tissue where they occur.
Squamous Cell Carcinoma
• originates in the squamous epithelium
• occur in many areas of the body
2. Sarcoma
• arises form connective tissue or supportive tissue (e.g., bone,
cartilage, muscle and fat)
• generally occurring in young adults, the most common sarcoma often
develops as a painful mass on the bone
• sarcoma tumors usually resemble the tissue in which they grow
Examples of sarcomas are:
• Osteosarcoma or osteogenic sarcoma (bone)
• Chondrosarcoma (cartilage)
• Leiomyosarcoma (smooth muscle)
• Rhabdomyosarcoma (skeletal muscle)
• Mesothelial sarcoma or mesothelioma (membranous lining of body
cavities)
• Fibrosarcoma (fibrous tissue)
• Angiosarcoma or hemangioendothelioma (blood vessels)
• Liposarcoma (adipose tissue)
• Glioma or astrocytoma (neurogenic connective tissue found in the
brain)
• Myxosarcoma (primitive embryonic connective tissue)
• Mesenchymous or mixed mesodermal tumor (mixed connective
tissue types)
3. Leukemia
• ("liquid cancers" or "blood cancers")
• cancers of the bone marrow (the site of blood cell production).
• the word leukemia means "white blood" in Greek.
• the disease is often associated with the overproduction of immature
white blood cells.
3. Leukemia
• these immature white blood cells do not perform as well as they
should, therefore the patient is often prone to infection.
• leukemia also affects red blood cells and can cause poor blood
clotting and fatigue due to anemia.
3. Leukemia
Examples of leukemia include:
• Myelogenous or granulocytic leukemia (malignancy of the myeloid
and granulocytic white blood cell series)
3. Leukemia
• Lymphatic, lymphocytic, or lymphoblastic leukemia (malignancy of
the lymphoid and lymphocytic blood cell series)
3. Leukemia
• Polycythemia vera or erythremia (malignancy of various blood cell
products, but with red cells predominating)
4. Lymphoma
• lymphomas develop in the glands or nodes of the lymphatic system, a
network of vessels, nodes, and organs (specifically the spleen, tonsils,
and thymus) that purify bodily fluids and produce infection-fighting
white blood cells, or lymphocytes.
4. Lymphoma
• unlike the leukemias which are sometimes called "liquid cancers,"
lymphomas are "solid cancers."
• may also occur in specific organs such as the stomach, breast or brain.
• referred to as extranodal lymphomas.
4. Lymphoma
• the lymphomas are subclassified into two categories: Hodgkin
lymphoma and Non-Hodgkin lymphoma.
• the presence of Reed-Sternberg cells in Hodgkin lymphoma
diagnostically distinguishes Hodgkin lymphoma from Non-Hodgkin
lymphoma.
5. Myeloma
• bone marrow / plasma cells
• cancer that originates in the plasma cells of bone marrow
• the plasma cells produce some of the proteins found in blood
6. Blastoma–originates in embryonic tissue of organs
Mixed Types
The type components may be within one category or from different
categories. Some examples are:
• adenosquamous carcinoma
• mixed mesodermal tumor
• carcinosarcoma
• teratocarcinoma
TUMOR LIST
• Different body tissue types give rise to different tumors, both benign
and malignant.
• Connective Tissue
• Endothelium and Mesothelium
• Blood and Lymphoid Cells
• Muscle
• Epithelial Tissues
• Neural
• APUD System (APUD - Amine Precursor Uptake and Decarboxylation)
• Other Neural Crest-Derived Cells
• Tumors
• Gonadal Tumors
Connective Tissue
Tissue Benign Tumors Malignant Tumors
Adult fibrous tissue Fibroma Fibrosarcoma
Embryonic (myxomatous) fibrous

Myxoma Myxosarcoma
tissue
Fat Lipoma Liposarcoma
Cartilage Chondroma Chondrosarcoma
Bone Osteoma Osteosarcoma
Notochord — Chordoma
Connective tissue, probably fibrous Fibrous histiocytoma Malignant fibrous histiocytoma

Endothelium and Mesothelium
Hemangioma,
Blood vessels Hemangiosarcoma, angiosarcoma
hemangiopericytoma
Lymph vessels Lymphangioma Lymphangiosarcoma
Mesothelium — Mesothelioma
Blood and Lymphoid Cells
"Preleukemias", Leukemia, of various types;

Hematopoietic cells
"myeloproliferative disorders" aleukemic leukemia
Plasmacytoma; multiple myeloma;

Lymphoid tissue Plasmacytosis Hodgkin lymphoma and Non-
Hodgkin lymphoma
Muscle
Smooth muscle Leiomyoma Leiomyosarcoma
Striated muscle Rhabdomyoma Rhabdomyosarcoma

Epithelial Tissues
Papilloma Squamous cell carcinoma;
Stratified squamous Seborrheic keratosis and some epidermoid carcinoma and some
skin adnexal tumors malignant skin adnexal tumors
Adenocarcinoma
Glandular epithelium Adenoma Hepatoma: hepatocellular
1.Liver Hepatic adenoma carcinoma
2.Kidney Renal tubular adenoma Renal cell carcinoma;
3.Bile duct Bile duct adenoma hypernephroma
Cholangiocarcinoma
Transitional epithelium Transitional cell papilloma Transitional cell carcinoma
Placenta Hydatidiform mole Choriocarcinoma
Seminoma; embryonal cell
Testis —
carcinoma
Neural
Glioma, grades I-III, anaplastic; glioblastoma

Glial cells (of several types) —
multiforme (grade IV)
— Neuroblastoma
Nerve cells — Medulloblastoma
Ganglioneuroma —
Meninges Meningioma Malignant meningioma
Malignant meningioma
Schwannoma, neurilemmoma
Nerve sheath Malignant schwannoma
Neurofibroma
Neurofibrosarcoma
APUD System (APUD - Amine Precursor Uptake
and Decarboxylation)
• The APUD system is a recently defined series of cells which have
endocrine functions in that they secrete one of a variety of small
amine or polypeptide hormones. The stored forms of these hormones
located in the cytoplasm are small, dense-core membrane-bound
granules visible by electron microscopy. Some of these cells appear to
be derived from neural crest cells which migrate into a variety of
organs. APUD system tissues give rise to the benign and malignant
tumors outlined in Table G
APUD System (APUD - Amine Precursor Uptake
and Decarboxylation)
Basophilic adenoma —
Pituitary Eosinophilic adenoma —
Chromophobe adenoma —
Parathyroid Parathyroid adenoma Parathyroid carcinoma
Thyroid (C cells) C cell hyperplasia Medullary carcinoma of thyroid
Bronchial lining Bronchial carcinooid; oat cell
—
(Kultschitzky cells) carcinoma
Adrenalmedulla Malignant
Pheochromocytoma
Pheochromocytoma Pheochromocytoma
Islet celladenoma;
Pancreas Islet cell carcinoma
Insulinoma; gastrinoma
Stomach and intestines Carcinoid Malignant carcinoid
Carotid body and chemo-receptor Malignantcarcinoid
Chemodectoma; paraganglioma
system Malignant paraganglioma
Other Neural Crest-Derived Cells
Pigment-producing cells in skin,

Nevus Melanoma
eyes, and occasional other sites
Schwann cells of peripheral nervous

Schwannoma, or neurilemmoma Malignant schwannoma
system
Merkel cells in squamous Merkel cell neoplasm (similar to

—
epithelium (unknown function) oat cell)
Tumors
Breast Fibroadenoma Cystosarcoma phylloides
Renal anlage — Wilms tumor

Gonadal Tumors
• Terminology for Gonadal tumors or tumors of the ovary and testis is somewhat more confusing. One general
class of tumors arises from multi-potential cells that give rise to tumors containing a variety of tissue types,
often within the same tumor. These "germ cell" tumors include seminoma (dysgerminoma in women),
choriocarcinoma, embryonal carcinoma, endodermal sinus tumor, and teratocarcinoma. Although all of
these tumors are most common in the ovaries or testes, they also occur in extragonadal sites.
• Another group of Gonadal tumors arises from the connective tissue stroma. In males, these include Sertoli-
Leydig cell tumors (homologous tumors in females may be arrhenoblastoma, although most pathologists use
"Sertoli-Leydig cell"), and in females, granulose-theca cell tumors, hilar cell tumors, and lipid cell tumors.
Although all of these tumors technically arise from the connective tissues, they are given separate names
because of the specialized nature and function of the Gonadal stromal cells.
• A number of epithelial tumors occur in the ovary. It will be easy to distinguish benign from malignant tumors
because they are named in exactly the same way as other epithelial lesions. However, in some lesions, the
pathologist may call a tumor "borderline" or "of low malignant potential." These terms are applied to a
group of potentially malignant lesions that metastasize much less frequently than the carcinomas.
CANCER TYPES BY SITE
The most common sites in which cancer develops include:
• Skin
• Lungs
• Female Breasts
• Prostate
• Colon and Rectum
• Cervix and Uterus
CANCER TYPES BY SITE
• Compared with those based on histological type, cancers named after the
primary site may not be as accurate. Take lung cancer for example; the
name does not specify the type of tissue involved. It simply indicates where
the cancer is located. In fact, depending on how the cells look under a
microscope, there are two major types of lung cancer: non-small cell lung
cancer and small cell lung cancer. Non-small cell lung cancer can be further
divided into various types named for the type of cells in which the cancer
develops, typically: squamous cell carcinoma, adenocarcinoma, and large
cell carcinoma.
• However, it's important to know that cancer can be classified either by the
cell type or its primary site. Saying that a woman has uterine carcinoma or
uterine cancer is the same thing as saying that she has cancer (or
carcinoma) of the uterus.
CANCER TYPES BY SITE: Skin
• There are three primary types of skin cancer: basal cell, squamous
cell, and melanoma. These cancers are derived from the epidermal
layers with the same names. Melanomas are derived from the
melanocytes, or pigment cells, in the deepest level of the epidermis.
• Basal cell and squamous cell cancers usually occur on parts of the
body exposed to the sun, such as the face, ears, and extremities.
These cancers are highly curable, especially if detected and treated
early. Melanomas, which form dark moles that spread over the
surface of the skin, are more lethal because they metastasize very
quickly
CANCER TYPES BY SITE: Lung
• Lung cancer is very difficult to detect at an early stage because the
symptoms often do not appear until the disease has advanced. The
symptoms include persistent cough, sputum streaked with blood,
chest pain, and repeated attacks of pneumonia or bronchitis
CANCER TYPES BY SITE: Female Breast
• It has been estimated that in the U.S., about 1 in 8 women will eventually develop
breast cancer in her lifetime. Most breast cancers are ductal carcinomas. Women
most likely to develop the disease are those over the age of 50; those who have
already had cancer in one breast; those whose mother or sister had breast
cancer; those who never had children; and those who had their first child after
the age of 30. Other risk factors include obesity, a high-fat diet, early menarche
(age menstruation begins) and late menopause (age menstruation ceases).
• Monthly breast self-examination is recommended as a way to detect breast
cancer early. Most of the lumps found in the breasts are not cancerous, but
women should see their physicians to find out for sure. The American Cancer
Society also recommends periodic mammograms (or breast X-rays) for all women
over the age of 40 as well as physical examinations of the breast by a physician
for all women over the age of 20, even if they have no symptoms of breast cancer.
CANCER TYPES BY SITE: Prostate
• Cancer of the prostate is found mainly in older men. As men age, the
prostate may enlarge and block the urethra or bladder. This may
cause difficulty in urination or interfere with sexual functions. This
condition is called benign prostatic hypertrophy (BPH). Although BPH
is not cancerous, surgery may be needed to correct it. The symptoms
of BPH, or of other problems in the prostate, may be similar to
symptoms for prostate cancer.
• Individuals should consult a physician if any of the following
symptoms appear: weak or interrupted flow of urine; urinating often
(especially at night); difficulty urinating; pain or burning during
urination; blood in the urine; or nagging pain in the back, hips, or
pelvis. Often there are no symptoms of early cancer of the prostate.
CANCER TYPES BY SITE: Colon and Rectum
• Of the cancers that affect the large intestine, about 70 percent occur
in the colon and about 30 percent in the rectum. These cancers are
the third most common cancers overall. Symptoms include blood in
the stool, which can be tested for by a simple fecal occult blood test,
or a change in bowel habits, such as severe constipation or diarrhea.
CANCER TYPES BY SITE: Uterus (Corpus Uteri)
• The uterus is the sac in a woman's pelvis which allows a baby to develop from a fertilized egg and
protects it until birth.
• Cancer of the uterus is the most common gynecologic malignancy. This cancer occurs infrequently
in women under 40 years of age. It occurs most frequently after the age of 60. The presenting
symptom is usually abnormal uterine bleeding. An endometrial biopsy or D&C is often performed
to confirm the diagnosis.
• Currently, there has been little insight into the exact causes for uterine cancer. However, 10-25
percent of malignancies occur in women who received pelvic radiation five to 25 years earlier for
benign bleeding. As in other cancers of its type, risk factors for uterine cancer include diabetes,
hypertension, obesity, and improper estrogen levels.
• In addition to cancer types named after the primary site discussed above, there are many other
examples such as brain cancer, testicular cancer, bladder cancer, and so on
CATEGORIES OF CANCER
• Cancers can be classified based either on histological type or their primary site
(the location where the cancer originated).
• Derivation of cells and tissues starts with cell differentiation, which refers to the
process of cells becoming arranged into three distinct germ layers: an outer
ectoderm, an inner endoderm, and a mesoderm in between.
• All of the organs of the body develop or differentiate from these three primary
germ layers.
• Tissue is composed of a group of cells that are similar in structure and perform
one or more common functions.
• Five major categories of cancer, based on their histological characteristics, are:
carcinoma; sarcoma; myeloma; leukemia; and lymphoma. In addition, there are
also some mixed types.
• The most common sites in which cancer develops include the skin, lungs, female
breasts, prostate, colon and rectum, and uterus.
CANCER DIAGNOSIS
• The diagnosis of cancer entails an attempt to accurately identify the anatomical
site of origin of the malignancy and the type of cells involved. Cancer can arise in
any organ or tissue in the body except fingernails, hair, and teeth.
• The site refers to the location of the cancer within the body. The body part in
which cancer first develops is known as the primary site. A cancer's primary site
may determine how the tumor will behave; whether and where it may spread
(metastasize) and what symptoms it is most likely to cause. The most common
sites in which cancer develops include the skin, lungs, female breasts, prostate,
colon and rectum, and corpus uteri.
• Secondary site refers to the body part where metastasized cancer cells grow and
form secondary tumors. A cancer is always described in terms of the primary site,
even if it has spread to another part of the body. For instance, advanced breast
cancer that has spread to the lymph nodes under the arm and to the bone and
lungs is always considered breast cancer (and the spread to the lymph nodes,
bones, and lungs describe the stage of the cancer).
CANCER DIAGNOSIS
• A biopsy (removal of tissue for microscopic evaluation) is preferred to
establish, or rule out, a diagnosis of cancer.
• Usually, a biopsy, together with advanced imaging technologies, can not
only confirm the presence of cancer, but also pinpoint the primary site and
secondary site(s) of the cancer, if any. A cancer's primary site may
determine how the tumor will behave; whether and where it may spread,
or metastasize; and what symptoms it is most likely to cause. A secondary
site refers to the body part where metastasized cancer cells grow and form
secondary tumors.
• Once a cancer has been confirmed, the pathologist often assigns a
pathological grade to a tumor according to how malignant the tissue looks
under the microscope. Cancers are further classified according to stage.
Warning Danger Signal signs of Cancer:
C – changes in bladder / bowel habits – more frequent stools, as well as a feeling that bowels are not emptying
completely or chronic “acid stomach” or feeling full after a small meal
A – a sore that does not heal – usually sore should heal; like the oral sores, usually it is self limiting and should
heal within two weeks
U – unusual bleeding / discharge – blood in urine or semen; excessive bruising or bleeding that does not stop
T – thickening of a lump in the breast or elsewhere – scaly or painful nipple or chest, nipple discharge; swollen
lymph nodes or lumps on the neck, underarm or groin
I – indigestion or difficulty of swallowing – frequent feeling of needing to clear your throat or that food is stuck
in your chest
O – obvious change of wart / mole – change in size, color, characteristics and sensation should be a concern
N – nagging cough/hoarseness in voice – problems persist, or go away and come back again in a repeating cycle
U – unexplained anemia – especially when it is accompanied with frequent fevers or infections
S – Sudden weight loss
Tumor Grading
Grading involves examining tumor cells that have been obtained through
biopsy under a microscope. The abnormality of the cells determines the
grade of the cancer. Increasing abnormality increases the grade, from 1–4.
Cells that are well differentiated closely resemble mature, specialized cells.
Cells that are undifferentiated are highly abnormal, that is, immature and
primitive.
Grade 1 Cells slightly abnormal and well differentiated

Grade 2 Cells more abnormal and moderately differentiated
Grade 3 Cells very abnormal and poorly differentiated
Grade 4 Cells immature and undifferentiated
Cancer Staging
• Staging is the classification of the extent of the disease. There are several types of staging methods. The tumor, node, metastases (TNM) system classifies cancer by tumor size (T),
the degree of regional spread or node involvement (N), and distant metastasis (M).
• Tumor (T)
• T0
• No evidence of tumor
• Tis Carcinoma in situ (limited to surface cells)
• T1-4 Increasing tumor size and involvement
• Node (N)
• N0 No lymph node involvement

• N1-4 Increasing degrees of lymph node involvement
• Nx Lymph node involvement cannot be assessed
• Metastases (M)
• M0 No evidence of distant metastases

• M1 Evidence of distant metastases
Cancer Staging
A numerical system also is used to classify the extent of disease.
• Stage 0 Cancer in situ (limited to surface cells)

• Stage I Cancer limited to the tissue of origin, evidence of tumor
growth
• Stage II Limited local spread of cancerous cells
• Stage III Extensive local and regional spread
• Stage IV Distant metastasis

10 Cancer

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

10 Cancer

Uploaded by

Copyright:

Available Formats

CANCER

The international standard for the classification and nomenclature of

Adult fibrous tissue Fibroma Fibrosarcoma

Embryonic (myxomatous) fibrous

Fat Lipoma Liposarcoma

Cartilage Chondroma Chondrosarcoma

Bone Osteoma Osteosarcoma

Connective tissue, probably fibrous Fibrous histiocytoma Malignant fibrous histiocytoma

Lymph vessels Lymphangioma Lymphangiosarcoma

"Preleukemias", Leukemia, of various types;

Plasmacytoma; multiple myeloma;

Tissue Benign Tumors Malignant Tumors

Smooth muscle Leiomyoma Leiomyosarcoma

Striated muscle Rhabdomyoma Rhabdomyosarcoma

Glioma, grades I-III, anaplastic; glioblastoma

Meninges Meningioma Malignant meningioma

Pigment-producing cells in skin,

Schwann cells of peripheral nervous

Merkel cells in squamous Merkel cell neoplasm (similar to

Tissue Benign Tumors Malignant Tumors

Breast Fibroadenoma Cystosarcoma phylloides

Renal anlage — Wilms tumor

Grade 1 Cells slightly abnormal and well differentiated

• N0 No lymph node involvement

• M0 No evidence of distant metastases

• Stage 0 Cancer in situ (limited to surface cells)

You might also like