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INTRODUCTION

CANCER, is a class of disease or disorders characterized by


uncontrolled division of cells and the ability of these cells to
invade other tissues, either by direct growth into adjacent tissue
through invasion or by implantation into distant sites by
metastasis.
Metastasis, the stage in which cancer cells are transported
through the bloodstream or lymphatic system.
Cancer may affect people at all ages but risk tends to increase
with age due to the fact that DNA damage becomes more
apparent in aging DNA.

There are many types of cancer, & severity of symptoms depend on:
1. Site
2. Character of the malignancy
3. Whether there is metastasis or not
Many forms of cancer are associated with exposure to
environmental factors such as:
1.
2.
3.
4.
5.

Tobacco
Smoke
Radiation
Alcohol
Certain viruses, bacteria & other microorganisms

Some of these factors can be avoided or reduced, but there is no


known way to entirely avoid the disease.

NOMECLATURE and CLASSIFICATION


Definition of terms:
Neoplasia & neoplasm are scientific designations for
cancerous diseases. Neoplasm can be benign or malignant.
Cancer is a widely used word that is usually as synonymous
with malignant neoplasm. It is occasionally used instead of
carcinoma (a sub-group of malignant neoplasms)
Tumor in medical language simply means swelling or lumps,
either neoplastic, inflammatory or other. This is sometimes
synonymous with neoplasms (benign or malignant). However,
this is inaccurate because some neoplasms usually do not
form tumors, example leukemia or carcinoma-in-situ.

Cancer are classified by the types of cell that resemble the


tumor, therefore the tissue presumed to be the origin of the
tumor:
Carcinoma malignant tumors derived from epithelial cells;
represents the most common cancers
Lymphoma & Leukemia malignant tumors derived from
blood & bone marrow cells
Sarcoma malignant tumors derived from connective tissue
or mesenchymal cells
Mesothelioma tumors derived from the mesothelial cells
Glioma tumors derived from the glial cells in the brain
Germ cell tumors tumors derived from germ cells
Choriocarcinoma malignant tumors derived from the
placenta

Adult Cancers:
MALE

FEMALE

Most Common

Cause of Death

Most Common

Cause of Death

Prostate
Cancer

Lung Cancer

Breast or
Cervical CA

Lung Cancer

Lung Cancer

Prostate
Cancer

Lung Cancer

Breast or
Cervical CA

Colorectal
Cancer

Colorectal
Cancer

Colorectal
Cancer

Colorectal
Cancer

Bladder Cancer Pancreatic


Cancer

Endometrial
Cancer

Ovarian Cancer

Cutaneous
Melanoma

Non-Hodgkins
Lymphoma

Pancreatic
Cancer

Leukemia

Childhood Cancers:
Cancer can also occur in young children & adolescents, but it is
RARE.

Leukemia (usually ALL) most common infant malignancy


CNS cancers & neuroblastoma
Wilms tumor
Lymphomas
Rhabdomyosarcoma
Retinoblastoma
Osteosarcoma
Ewings sarcoma

NINE WARNING SIGNS OF CANCER


C change in blood bowel or bladder habits
A a sore that does not heal
U unusual bleeding or discharge
T thickening or lump in breast or elsewhere
I indigestion or difficulty in swallowing
O obvious change in wart or mole
N nagging cough or hoarseness
U unexplained anemia
S sudden unexplained weight loss

CANCER RISK FACTORS


AGE cancer can occur in all ages, but the incidence
increases with age
SEX variations exist between the incidence in men & in
women
RACE racial characteristics such as skin color, diet &
custom do affect cancer incidence
OCCUPATIONAL certain occupations are prone to the
incidence of certain cancers
HEALTH HABITS people who do not smoke, who protect
themselves from the sun, and who have a sensible diet are
likely to have a lower incidence of cancer

CANCER RISK FACTORS (cont.)


FAMILY HISTORY certain individuals have an increased risk
of developing certain cancers if a family member has that
cancer
SOCIO-ECONOMIC STATUS statistic shows that a persons
economic status may be associated with the incidence and
mortality of some cancers
LIFESTYLE believed to contribute to a number of cancers
smoking, alcohol, betel nut chewing, diet, sexual activity,
pregnancy, and sun exposure

HOW CANCER DEVELOPS?


A. Safety System Fails
A.1 Proto-Oncogenes Become Oncogenes
A.2 Tumor Suppressor Genes Stop Working
A.3 Cell Cycle Clock Malfunctions
A.4 Cells Achieve Immortality
B. Cells Break Free and Spread
B.1 Tumor Forms
B.2 Tumors Spread

The Development & Spread of Tumors:

CAUSES OF CANCER
A. Carcinogens one of the greatest risk for cancer
A.1 Tobacco Smoke
A.2 Diet
A.3 Pathogens
A.4 Radiation
A.5 Environmental & Occupational Chemicals
B. Hereditary Factors
C. Steroid Hormones
D. Population Demographics

The Progression of Cancer requires


multiple mutations of the DNA

TYPES/KINDS OF CANCER
A. Prostate Cancer
B. Breast Cancer
C. Lung Cancer
D. Colorectal Cancer
E. Lymphoma
F. Bladder Cancer
G. Uterine Cancer
H. Skin Cancer
I. Kidney Cancer
J. Leukemia
K. Pancreatic Cancer
L. Ovarian Cancer
M. Stomach Cancer

Factors that affect the development of cancer:


Smoking

Cigarette smoking is responsible for 87% of lung cancer cases


and for about 30% of all cancer deaths.

Nutrition

Risk for colon, breast and uterine cancers increases in obese


people. High-fat diets may contribute to the development of
certain cancers such as breast, colon, and prostate. High-fiber
foods may help reduce risk of colon cancer. A varied diet
containing plenty of vegetables and fruits rich in vitamins A
and C may reduce risk for cancers of larynx, esophagus,
stomach, and lung. Salt-cured, smoked, and nitrite-cured foods
have been linked to esophageal and stomach cancer.

Sunlight

Sun exposure is also a major factor in the development of


melanoma, and the incidence increases for those living near
the equator.

Alcohol

Oral cancer and cancers of the larynx, throat, esophagus, and


liver occur more frequently among heavy drinkers of alcohol.

Smokeless
Tobacco

Use of chewing tobacco or snuff increases risk for cancers of


the mouth, larynx, throat, and esophagus.

Radiation

Excessive exposure to ionizing radiation can increase cancer


risk. Most medical and dental X rays are adjusted to deliver
the lowest dose possible without sacrificing image quality.

Occupation

Exposure to a number of industrial agents (nickel, chromate,

SIGNS and SYMPTOMS


Roughly, cancer symptoms can be divided into three (3) groups:
Local symptoms unusual lumps or swelling (tumor);
hemorrhage (bleeding); pain and/or ulceration
Symptoms of metastasis (spreading) enlarged lymph nodes;
cough & hemoptysis; hepatomegaly; bone pain; fracture of
affected bones; neurological symptoms; pain
Systemic symptoms weight loss; poor appetite; cachexia
(wasting); excessive sweating; anemia; paraneoplastic
phenomena (like hormonal changes)

DIAGNOSIS
1. Detection & Screening
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

Physical Examination
Digital Rectal Examination
Breast Examination
Endoscopy
Pap Smear
Stool Exam and Fecal Occult Blood Test
Blood Tests
Biopsy
Other Tests (Tumor Marker Tests)
Imaging Techniques
CT Scan
MRI
X-ray
Mammography
Ultrasound Scanning
Computer-aided technology

Cancer Screening Recommendations:


Cancers of the thyroid, oral cavity, skin, lymph nodes, testes,
and ovaries
General cancer-related
physical examination

Every three years for people aged 20


to 40; yearly after age 40

Prostate cancer
Digital rectal examination

after age 50,


yearly

Blood test measuring levels of prostatespecific antigen

after age 50 ,
yearly

Colorectal cancer
Stool examination for the presence of
occult (hidden) blood

Yearly after age 50

One of the following:


Sigmoidoscopy examination and
digital rectal examination
Colonoscopy and digital rectal
examination
Double-contrast barium enema and
digital rectal examination

Every five years after


age 50
Every ten years after
age 50
Every five to ten years
after age 50

Breast cancer
Breast selfexamination
Breast examination
by a physician
Cervical
cancer
Mammography
Pelvic
examination and
Pap smear

Monthly after age 20


Every three years for women aged 20 to
40; yearly after age 40
Yearly after age 40
Yearly for women who are or have been
sexually active or have reached age 18.
After three or more consecutive normal
exams, a Pap smear may be performed less
frequently at the physician's discretion.

2. Staging indicates how far cancer spread and the key factor in
determining both cancers treatment and prognosis
Staging System used today:
A. Stages denoted by Roman numerals I to IV
i. Stage I small localized cancers that are usually curable
ii. Stage II & III tumors are usually locally advanced &
may or may not have invaded the nearby lymph nodes
iii. Stage IV tumors have usually metastasized, there is
spread to distant tissues in the body
B. TNM System this system uses numbers between zero (0)
& three (3); the stage of cancer depends on the
combination of these numbers

TREATMENT
1. Surgery the most effective & fastest treatment for tumors
that are caught at an early stage and have not metastasized
to other parts of the body; but it is not a guarantee that all
microscopic extensions of the tumor have been removed
2. Radiation Therapy the total dose & number of treatments
depend on the size, location, type of cancer, & general health
of the patient
S/E: fatigue; skin changes; loss of appetite; hair loss
3. Chemotherapy make use of a powerful anticancer drugs
that travel through the bloodstream
S/E: reduced resistance to infection; internal bleeding;
diarrhea; nausea; vomiting; hair loss; insufficient oxygen in
the blood

4. Hormone Therapy prevents cancer cells from receiving or


using the hormones they need; this type of therapy relies on
drugs to stop hormone production or change the way
hormones work
5. Immunotherapy sometimes called as biologic therapy; uses
the bodys own immune system to fight cancer cells or protect
the body from side effects; this type of therapy relies on
antibodies naturally occurring in the body to defend from
foreign substances.
6. Symptom Control palliative/supportive care
7. Cancer Vaccines
8. Complementary & Alternative Medicine

Palliative/Supportive Care:
Directed towards the patients symptoms-free existence.
General categories include all the various possibilities
Relief of symptoms (i.e., pain, bleeding, etc.)
Prevention of symptoms that would have occurred if
treatment were withheld
Prolongation of comfortable life
Sees the patient and family as unit of care
Integrates psychological, social and spiritual aspects of
care possible until death
Offers a support system to help families cope during
and patients illness and in bereavement

List of Chemotherapeutic Agents:


Alkylating Agents:

Cyclophosphamide
Mechlorethamine
Chlorambucil
Melphalan

Anthracyclines:

Daunorubicin
Doxorubicin
Idarubicin
Mitoxantrone

Cytosketal Disruptors:
Paclitaxel
Docetaxel

Inhibitors of Topoisomerase II:

Nucleotide & Precursor Analogs:

Etoposide
Teniposide
Tafluposide

Cytarabine
Azathioprine
Fluorouracil
Mercaptopurine
Methotrexate
Tioguanine

List of Chemotherapeutic Agents (cont.):


Peptide Antibiotics:

Platinum-based Agents:

Vinca Alkaloids:

Bleomycin

Carboplatin
Cisplatin
Oxaliplatin

Vinblastine
Vincristine
Vindesine

Retinoids:
All-trans retinoic acid
Note:

This list is incomplete

PREVENTION
Cancer prevention is defined as active measures to decrease the
incidence of cancer. This can be accomplished by,
1. Avoiding carcinogens or altering their metabolism
2. Pursuing a lifestyle or diet that modifies cancer-causing
factors
3. and/or Medical Intervention
4. Genetic testing

Safeguard for Cancer Prevention and Early Detection


Type of Cancer

Prevention

Detection

Lung

Do not smoke

Uterine
Cervix

Having one sexual partner Regular PAP Smear


lowers risk; clean safe sex every 1-3 years

Liver

Vaccination vs. Hepatitis B None


virus; minimal alcohol
intake; avoid moldy foods

Colon and
Rectum

Prudent diet of a variety of


foods also with high fiber
& low fat intake

None

Regular medical
check-ups after 40
years of age, yearly
occult blood test in
stools; digital rectal
exam; sigmoidoscopy

Safeguard for Cancer Prevention and Early Detection


Type of Cancer

Prevention

Detection

Mouth

Avoid smoking tobacco,


Through dental checkbetel quid chewing; modify ups each year
consumption of alcohol;
cavity & dental hygiene

Breast

No conclusive evidence

Monthly self-exam &


annual doctor exam;
mammography for
high risk groups

Skin

Avoid excessive sun


exposure

Skin self exam

Prostate

No conclusive evidence

Digital trans-rectal
exam (early diagnosis)

Next Images/Pictures

Hepatocellular Carcinoma (Liver Cancer)

Colorectal Cancer

Bone Cancer

Brain Cancer seen on CT Scan

Colon Cancer

Skin Cancer - Melanoma

Bladder Cancer

Bladder Cancer

Next Common Female Cancer

COMMON CANCERS IN FEMALES


BREAST CANCER

CERVICAL CANCER

Incidence and
Prevalence

Rise after age 40


Invasive cases over age 50

middle aged & older women


Poor socioeconomic status

Causes

Unknown

Unknown

Risk Factors

Gender Female
Age (over 50)
First pregnancy after age 30
Long-term hormone replacement therapy
(HRT)
Menstruation before age 12
Menopause after age 50
Nulliparity
Family history of the disease
History of breast biopsy or radiation to
the chest
Moderate alcohol use
Obesity
Personal history of the disease
Race
Sedentary lifestyle

Infection with HPV (human


papilloma virus), transmitted
sexually is the primary risk
factor and HIV/AIDS infection as
well
Having multiple sexual partners
Having sex with a promiscuous
partner
History of sexually transmitted
disease (STD)
Sexual intercourse at a young
age
Age
Race
Smoke cigarettes twice as
likely to develop cervical cancer

COMMON CANCERS IN FEMALES (cont.)


BREAST CANCER
Signs &
Symptoms

Presence of lump or mass in the breast


Dimpling of the breast
Lump in the underarm (lymph node)
Nipple discharge, pain, or inversion
Skin irritation of the breast or nipple
Swelling

CERVICAL CANCER
Early cervical cancer is often
asymptomatic
Abnormal PAP Smear Test
Abnormal vaginal bleeding
(spotting after sexual contact;
bleeding between menstrual
periods; increased menstrual
bleeding)
Abnormal (yellow, odorous)
vaginal discharge
Dyspareunia
Dysuria
May cause constipation,
hematuria, abnormal opening in
the cervix, and ureteral
obstruction

COMMON CANCERS IN FEMALES (cont.)


BREAST CANCER

CERVICAL CANCER

Diagnosis

Clinical Examination
Imaging Procedures (Mammogram;
Ultrasound; MRI; others)
Biopsy

Papanicolaou Test (PAP Smear)


Pelvic Examination (Visually &
Bimanually)
Colposcopy
Test for HPV infection
Biopsy
Endocervical Curettage
Blood Tests (CBC; Serum
Chemistry)
Imaging Procedures (Chest Xray; CT Scan; Cystoscopy;
Proctoscopy)

Treatment

Surgery
Radiation Therapy
Anti-estrogen Therapy
Chemotherapy
Immunotherapy

Loop electrode excision


Cone biopsy
Cryosurgery
Laser ablation
Surgery
Radiation
Chemotherapy

COMMON CANCERS IN FEMALES (cont.)


BREAST CANCER

CERVICAL CANCER

Screening

Breast self-examination at age 20


Ages 20-39 clinical breast
examination by a physician every 3 years
Age 40 & older clinical breast
examination & mammogram annually
Older women with serious health
problems consult physician
Women with family history consult for
early detection testing with physician;
including mammogram, ultrasound, and
MRI

Pelvic examination
PAP Smear

Prognosis

Depends on the size of the tumor & the


stage of the disease at the time of
diagnosis

Can be cured if detected &


treated early
Depends on the stage of the
disease at the time of diagnosis

COMMON CANCERS IN FEMALES (cont.)


BREAST CANCER

CERVICAL CANCER

Prevention

Breast cancer can not be prevented.


Performing monthly breast selfexamination, regular clinical
examinations by physician, and
following recommendations regarding
mammograms can increase early
detection of the disease especially those
50 years old & older.
Genetic risk for the disease can be
determined, and those who are at high
risk can or may choose preventive
measures.

Avoid sexual activity that


increases the risks of HPV
infection, not smoking, and
having regular PAP smears can
help prevent most cases of
cervical cancer.
Using condoms & limiting the
number of sexual partners may
prevent HPV infection.
Cervical Cancer Vaccine ages
9-26 can avail this vaccine and
has been shown to protect
against HPV.

Types of
Cancer

Carcinoma-in-situ of the Cervix


Squamous Cell Carcinoma of the
Cervix
Adenocarcinoma of the Cervix

Carcinoma-in-situ
Invasive Ductal Carcinoma
Inflammatory type of Breast Cancer
Medullary & Mucinous Carcinoma
Pagets Disease of the Nipple
Phyllodes Tumor & Tubular Carcinoma
Sarcomas (rare condition)

Next Images/Pictures

Mammogram
(Breast Cancer)

Thermogram
(Breast Cancer)

Breast Cancer

PAP Smear

Normal Cervical Cells

Abnormal Cervical Cells

Cervical Cancer

Cervical Cancer

Next Common Male Cancer

COMMON CANCERS IN MALES


PROSTATE CANCER

LUNG CANCER

Incidence and
Prevalence

Most common in men (1 out of 6)


Suggesting environmental connection
(high-fat diet & smoking)
Rises significantly with age & especially
those over age 70

The population segment most


likely to develop lung cancer is
the over 50s who also have
history of smoking

Causes

Unknown

Tobacco smoking causes 80% of


lung cancer deaths in men &
75% in women

Risk Factors

Cigarette smoking
Environmental Risk Factors
(Alcohol, Asbestos, Radon,
Occupational Exposure,
Secondhand smoke, Dietary
habit, Radiation, others)
Age, Race, & Sex
Genetic
Infections from microorganisms
History of Lung Cancer

Family history of prostate cancer


55 years old & older
Diet high in saturated fat
Exposure to heavy metal (e.g., cadmium)
Race
Sedentary lifestyle
Smoking

COMMON CANCERS IN MALES (cont.)


PROSTATE CANCER
Signs &
Symptoms

Often similar to Benign Prostatic


Hyperplasia
Blood in the urine or semen
Frequent urination especially at night
Inability to urinate
Nagging pain or stiffness in the back,
hips, upper thighs, or pelvis
Painful ejaculation & Dyspareunia
Dysuria
Weak or interrupted urinary flow

LUNG CANCER

Cough, Dyspnea, & Wheezing


Chest pain
Hemoptysis
Loss of appetite & Weight loss
Pneumonia
Weakness & Chills
Swallowing difficulties
Speech difficulties or change
Finger/nail abnormalities
Skin paleness or bluish
discoloration
Muscle contractions or atrophy
Joint pain or swelling
Facial swelling or paralysis
Eyelid drooping
Bone pain or tenderness
Breast development in men
(gynecomastia)

COMMON CANCERS IN MALES (cont.)


PROSTATE CANCER

LUNG CANCER

Diagnosis

Digital Rectal Examination (DRE)


Prostate-specific Antigen (PSA) Test
Prostatic Acid Phosphatase (PAP) Test
Tumor Biopsy
Imaging Procedures (CAT or CT Scan &
Bone Scan)
Staging of Cancer

Physical Examination
Chest Radiograph
CT or CAT Scan
MRI Scan
Bronchoscopy
Biopsy & Sputum Cytology
Bone Scan
Blood tests & Staging of Cancer

Treatment

Depends on stage, age, & health


Use of Luteinizing Hormone Releasing
Hormone (LHRH) Analog
Use of Anti-Androgen Drug Therapy
Use of Female Hormone Estrogen
Chemotherapy
Radiation Therapy
Surgery (good health, no spread to bone,
tumor confined to the gland, under age
70, & to live another 10 years or so)
Cryosurgery

Depends upon a variety of


factors type of tumor & stage
Surgical resection no spread
Chemotherapy
Radiation Therapy
Photodynamic Therapy
Electrosurgery
Cryotherapy

COMMON CANCERS IN MALES (cont.)


PROSTATE CANCER

LUNG CANCER

Screening

Digital Rectal Examination (DRE)


Prostate-specific Antigen (PSA) Test
Prostatic Acid Phosphatase (PAP) Test

Chest Radiography
CT Scan (Chest) for people age 50
or older & having a significant
smoking history even they
(smokers) quit some time ago

Prognosis

Usually curable if cancer is confined to


the prostate gland
If the cancer is locally spread, a
number of patients die within 5 years
Once cancer spread to distant organs
or areas of the body, life expectancy is
usually less than 3 years

Depends upon the histological


type of cancer and the stage
(degree of spread)
Cancer is still localized, 5-year
relative survival rate about 50%
Once cancer is massive & spread
to distant organs or areas of the
body, life expectancy is usually
less than 2-3 years

COMMON CANCERS IN MALES (cont.)


PROSTATE CANCER

LUNG CANCER

Prevention

Prostate cancer can not be prevented


Important for men if over 40 years of age
to have an annual prostate examination
when identified & treated early, this
type of cancer has a high cure rate

Types of
Cancer

Adenocarcinoma of the prostate

Non-Small Cell Lung Carcinoma


(Squamous Cell Carcinoma;
Adenocarcinoma; Large Cell
Carcinoma)
Small Cell Lung Carcinoma
Broncho-alveolar Carcinoma
Mixed and undifferentiated
pulmonary carcinoma

Next Images/Pictures

Eliminating tobacco smoking


Smoking cessation
Decreasing passive smoking
Quit smoking and/or never start,
smoking
Smoke-free community

Prostatic Carcinoma