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 Slide 10 Slide 12 Slide 21 Slide 29 Genetics of Cancer Leukemia Breast Examinations 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 All rights reserved. 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. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Human Diseases: A Systemic Approach, 6e Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Cellular Regulation Growth Factors Apoptosis Regulators Growth Inhibitors Cyclins 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. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 All rights reserved. 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 Return to Directory Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 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 leukemia. 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 All rights reserved. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gastric Cancer Anorexia Distaste for meat Weight loss Weakness Dysphagia 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. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 Return to Directory Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 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 All rights reserved. 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 All rights reserved. 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. Upper Saddle River, New Jersey 07458 All rights reserved. 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. Upper Saddle River, New Jersey 07458 All rights reserved. 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 All rights reserved. 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 All rights reserved. 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 All rights reserved. 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 All rights reserved. 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 All rights reserved. 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. Upper Saddle River, New Jersey 07458 All rights reserved. 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.