Transcript Neoplasms

Human Diseases
A Systemic Approach
Sixth Edition
Mary Lou Mulvihill
Mark Zelman
Paul Holdaway
Elaine Tompary
Jill Raymond
Chapter 4
Neoplasms
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Chapter 4
Neoplasms
Multimedia Asset Directory
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Slide 29
Genetics of Cancer
Leukemia
Breast Examinations
Skin Cancer
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Human Diseases: A Systemic Approach, 6e
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Neoplasia
 Uncontrolled growth of cells
 Neoplasm or tumor: a mass of cells that
grow more rapidly than normal cells
– Benign: noncancerous
– Malignant: consists of rapidly dividing cells
that accumulate uncontrollably and invade
normal tissue and have the ability to
metastasize or generate independent tumors
at distant sites.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
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Characteristics of Benign Tumors
 Classified according to tissue of origin
 Encapsulated with clearly defined edges
 Do not metastasize or recur following
surgery
 Differentiated; resembles the tissue from
which it grew
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Benign Tumors
 Glandular – adenoma
 Fatty – lipoma
 Muscle – myoma
 Vascular – angioma
 Epithelial – papilloma
 Brain – Menigioma
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Cancer Statistics
 Cancer is the second most common leading cause of
death in the United States.
 More than 10 million people are diagnosed with cancer
every year (WHO).
 It is estimated that there will be 15 million new cases
every year by 2020.
 Cancer causes six million deaths every year or 12% of
the deaths worldwide.
– Lung, colorectal, and stomach cancer are among the five most
common cancers in the world for both men and women. Among
men, lung and stomach cancer are the most common cancers
worldwide. Cervical and breast cancer are the most common
cancers among women.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
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Cellular Regulation
Growth
Factors
Apoptosis
Regulators
Growth
Inhibitors
Cyclins
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Human Diseases: A Systemic Approach, 6e
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Cancer Progression
Transformation
Initiation
Promotion
Change in
genetic
material prepares
the cell to
become
cancerous
Progression
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Causes of Cancer
 Heredity
 Environment
 Tobacco
 Chemicals
 Radiation
 Nutrition and physical activity
 Infections
 Immune disorders
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Click on the screenshot to view a video on the topic of the
genetics of cancer.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Classification of Cancer
 Carcinoma – epithelial cells
 Sarcoma – connective tissue
 Mixed Cancer – epithelial and connective
tissue
 Lymphoma – Lymphoid tissue
 Leukemia – white blood cells
 Melanoma – melanin
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Upper Saddle River, New Jersey 07458
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Click on the screenshot to view a video on the topic of
leukemia.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Causes of Cancer
 Vary with the site of the primary tumor and
extent of metastasis
 Pain and nutritional wasting are signs of
advanced disease.
 Cancer pain results from the effects of treatment
or secondary syndromes caused by the
mechanical and pathological effects of cancer.
 Several metabolic abnormalities play a role in
nutritional wasting or cancer cachexia.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Upper Saddle River, New Jersey 07458
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Non-specific Warning Signs of
Cancer
 Changes in bowel or bladder habits
 A sore that does not heal
 Unusual bleeding or discharge
 Thickening or lump in the breast or any other
part of the body
 Indigestion or difficulty swallowing
 An obvious change in a wart or mole
 A nagging cough or hoarseness
– (American Cancer Society)
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Head and Neck Cancer
 Heterogeneous cancers
 Symptoms: throat pain, mucosal ulcers,
persistent nasal bleeding, hearing loss, or
swallowing difficulties
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Lung Cancer
 A new or changing cough, hoarseness
 Hemoptysis or bloody sputum
 Shortness of breath and chest pain
 Common tumors of the lung include small
cell carcinoma, squamous cell carcinoma,
and adenocarcinoma.
 Adenocarcinoma is the most common type
of lung cancer that occurs in nonsmokers.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Gastric Cancer
 Anorexia
 Distaste for meat
 Weight loss
 Weakness
 Dysphagia
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Human Diseases: A Systemic Approach, 6e
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Colorectal Cancer
 Intestinal polyps
 Right-sided tumors – dull abdominal pain,
bleeding, weakness, anemia
 Left-sided tumors – changes in bowel
habits, bleeding, gas, constipation,
obstruction, and increased use of laxatives
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Liver Cancer
 Vague abdominal pain, fever, anorexia
 Jaundice, ascites, cachexia
 Abdominal mass
 Number and size and portal vein
involvement determine prognosis
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Upper Saddle River, New Jersey 07458
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Breast Cancer
 Breast lumps, spontaneous discharge
 Serous, blood, or water discharge
 Life threatening with extensive lymph node
involvement, and metastasis to the lungs
and liver
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Click on the screenshot to view a video on the topic of
breast examinations.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
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Copyright ©2006 by Prentice-Hall, Inc.
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Cancer of the Uterine Cervix
 Early stages: vaginal discharge, bleeding,
postcoital spotting
 Physical findings: appearance of gray
discolored areas; appearance of obvious
masses
 Invasive spread to the pelvic structures
and along lymph node chains
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Ovarian Cancer
 Asymptomatic early
 Any pelvic mass suspicious after
menopause
 Nonspecific symptoms: irregular
menstruation, urinary frequency,
constipation, abnormal vaginal bleeding,
and abdominal bloating and discomfort
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Prostate Cancer
 Difficulty passing urine
 Pain in lower abdomen
 Presence of tumor markers – PSA
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
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Testicular Cancer
 Painless enlargement
 Occurs in younger ages
 Germ cell involvement
 Higher risk if testes are retained in the
abdomen
 Tumor marker – alpha-feto protein and
beta human chorionic gonadotropin
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
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Renal Cancer
 Kidney is a frequent metastatic site for
cancer in the lungs, ovary, colon, or breast
 Hematuria
 Steady dull flank pain
 Weight loss
 Leg edema due to obstruction of lymphatic
tissue
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Lymphoma
 Single site or many
 Hodgkins and non-Hodgkins lymphoma
 Lymphadenopathy
 Fevers, night sweats, weight loss
 Pain in the abdomen – splenomegaly
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Diagnosis of Cancer
 Screening recommendations
 Tumor markers
 Scans (MRI)
 Endoscopy
 Ultrasound
 Biopsy
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Click on the screenshot to view a video on the topic of
skin cancer.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Return to Directory
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Cancer Staging
 T – the extent of primary tumor
 N – absence or presence of lymph node
involvement
 M – the presence of distance metastasis
 Stages: I, II, III, IV
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Cancer Treatment
 Prevention
 Chemoprevention
 Screening
 Chemotherapy
 Radiation Therapy
 Surgery
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
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Table 4-5: American Cancer Society Guidelines on Nutrition
and Physical Activity for Cancer Prevention
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
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Table 4-6: American Cancer Society Prevention Measures
for Melanoma and Other Skin Cancers.
Mulvihill, Zelman, Holdaway, Tompary, and Raymond
Human Diseases: A Systemic Approach, 6e
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.