Oncology Chapter 21
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| Neoplasia | Development of an abnormal growth of new cells that is unresponsive to normal growth control mechanisms
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| Neoplasm | Any abnormal growth of new tissue that serves no useful purpose
Neoplasm = tumor
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| Differentiation | Cells become specialized and differentiated both physically and functionally
Cells look and act like the parent cell, or tissue of origin
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| Anaplasia | Loss of cellular differentiation and reversion to a more primitive form
Anaplasia = undifferentiated
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| Malignant | Tending to become worse and cause death
Malignant tumor = malignant neoplasm
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| Metastasis | Process by which malignant cells spread to other parts of the body
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| Benign Tumor | Usually encapsulated
Cells similar in structure to cells from which they originate
Well-defined borders
Slow growing and limited to one area
Possible growth displacement (but not invasion) to adjacent tissue
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| Malignant Tumor | Not encapsulated; not cohesive, and irregular pattern of growth
No resemblance to cell of origin
No well-defined borders
Growth into adjacent cells rather than displacing or pushing them aside
Rapid growth through cell division and multiplication
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| Benign tumor suffix = | oma
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| Malignant tumor suffix = | carcinoma or sarcoma
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| Carcinomas | Solid tumors that originate from epithelial tissue
Tissue that covers external and internal body surfaces, lining of vessels, body cavities, glands, and organs
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| Sarcomas | Originate from supportive and connective tissue
Bone, fat, muscle, and cartilage
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| Grading of Neoplasms | Measures extent to which tumor cells differ from their parent tissue
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| Grade 1 of Neoplasms | well-differentiated cells, function most like the parent tissue
Least malignant
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| Grade 4 of Neoplasms | least-differentiated cells, not like the parent tissue
Most rapidly increasing in number
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| Staging of Neoplasms | Extent of disease and relative size of tumor
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| TNM staging classification system | Internationally recognized system used for staging neoplasms
T: (0-4) = tumor size (primary)
N: (0-3) = degree of regional lymph node involvement
M: (0-3) = presence or absence of distant metastases
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| Risk Factors of Neoplasms | Lifestyle and environmental risk factors
Tobacco
Alcohol
Diet
Sunlight
Radiation
Industrial agents and chemicals
Hormones
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| Lifetime risk | Probability that an individual, over the course of his or her lifetime, will develop cancer or will die from cancer
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| Relative risk | Measures the strength of the relationship between risk factors and particular types of cancer
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| Intracranial Tumors | Tumors occurring in any structural region of the brain
May be malignant or benign
Classified as primary or secondary
Named according to tissue from which they originate
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| Metastatic Intracranial Tumors (Secondary) | Tumors occurring as a result of metastasis from a primary site such as the lung or breast
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| Primary Intracranial Tumors | Tumors that arise from gliomas and meninges
Gliomas = malignant glial cells that are a support for nerve tissue
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| Glioblastoma multiforme | Most rapidly growing of the gliomas’ most common and most malignant glial tumor
Also known as Grade IV astrocytomas
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| Astrocytomas | Low-grade (I and II) astrocytomas usually nonmalignant
Grade III (anaplastic) and Grade IV are malignant and most likely to invade surrounding structures
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| Ependymomas | Occur more commonly in children and adolescents
Usually encapsulated and benign
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| Primary Intracranial Tumor -Oligodendrogliomas | Usually slow growing
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| Primary Intracranial Tumor - Medulloblastomas | Occur most frequently in children between 5 and 9 years of age
Rapid growing; poor prognosis
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| Primary Intracranial Tumor - Meningiomas | Occur most often in adults
Slow growing
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| Lipoma | Benign tumor of fatty/adipose tissue
Most common benign soft tissue tumor
Can occur anywhere in the body
Idiopathic, but with inherited tendency
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| Liposarcoma | A malig. tumor of fatty/adipose tissue
Most common soft tissue sarcoma in adults
Chromosomal abnormalities lead to dysfunctional fusion proteins
Most common locations: deep soft tissues of limbs and retroperitoneum
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| Papilloma | a small solid growth on the skin or on a mucous membrane, with a clear-cut border that projects above the surrounding tissue
classic fingerlike or cauliflowerlike appearance
Derived from epidermis and usually benign
E.g., a raised wart
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| Papilloma | Can be benign or malignant and can be found in numerous anatomical locations
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| Squamous Cell Carcinoma | Malignancy of the squamous cells of the epithelial tissue of the skin.
Much faster growing than basal cell carcinoma
Greater potential for metastasis if not treated
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| Squamous Cell Carcinoma Risk Factors | UVR exposure
Immunosuppression
Exposure to ionizing radiation or chemical carcinogens
Human papillomavirus (HPV) infection
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| Basal Cell Carcinoma | Most common malig. epithelial tumor; begins as a slightly elevated nodule w/a depression or ulceration in the ctr that becomes more obvious as the tumor grows; tissue breaks down, crusts, and bleeds
Occurs most often on skin exposed to the sun
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| Carcinoma of the Breast: Breast Cancer | Malignant tumor of the breast tissue
Most common type, ductal carcinoma, originates in the mammary ducts
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| Bronchogenic Carcinoma | Malignant lung tumor that originates in bronchi
Lung cancer
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| Cervical Carcinoma | Malignant tumor of the cervix
One of the most common malignancies of female reproductive tract
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| Colorectal Cancer | Presence of a malignant neoplasm in large intestine
Most are adenocarcinomas
At least 50% originate in the rectum, causing bleeding and pain
3rd. most common type of cancer in both men and women
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| Endometrial Carcinoma | Malignant tumor of inner lining of uterus
Aka adenocarcinoma of uterus
Classic symptom is abnormal uterine bleeding
Most common cancer of female reproductive tract after menopause
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| Lymphoma | Lymphoid tissue neoplasm that is typically malignant
Painless enlarged lymph node(s)
Progressing to anemia, weakness, fever, and weight loss
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| Kaposi’s Sarcoma | Rare malignant lesions that begin as soft purple-brown nodules or plaques on feet and gradually spread throughout the skin
Most often associated with AIDS
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| Malignant Melanoma | Malignant skin tumor originating from melanocytes in preexisting nevi, freckles, or skin with pigment
Darkly pigmented tumor with irregular surfaces and borders
Variable colors
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| ABCDs of Malignant Melanomas | Asymmetry
Borders
Color
Diameter
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| Neuroblastoma | Highly malignant tumor of the sympathetic nervous system
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| Oral Leukoplakia | Precancerous lesion occurring anywhere in the mouth
Elevated gray-white or yellow-white leathery surfaced lesions have clearly defined borders
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| Ovarian Carcinoma | Malignant tumor of the ovaries
Most commonly occurring in women in their 50s
Rarely detected in early stage
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| Pancreatic Cancer | Life-threatening primary malignant neoplasm typically found in head of pancreas
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| Carcinoma of the Prostate | Malignant growth within the prostate gland, creating pressure on upper part of urethra
Most frequently diagnosed cancer in men
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| Carcinoma of the Prostate Symptoms | Urinary frequency, especially at night
Difficulty starting or stopping urine flow
Inability to urinate
Weak or interrupted flow of urine when urinating
Pain or burning urination
Pain or stiffness in lower back, hips, or thighs
Painful ejaculation
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| Renal Cell Carcinoma | Malignant tumor of the kidney, occurring in adulthood
Patient is asymptomatic until latter stages of the disease
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| Carcinoma of the Testes | Malignant tumor of the testicle that appears as a painless lump
Also called testicular cancer
Rare type of tumor
Usually occurs in men under the age of 40
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| Cancer, Thyroid Gland | Malignant tumor of the thyroid gland
Leads to dysfunction of the gland and thus inadequate or excessive secretion of the thyroid hormone
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| Wilms’ Tumor | Malignant tumor of the kidney occurring predominately in childhood
Most frequent finding is palpable mass in the abdomen
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| Chemotherapy | Use of cytotoxic drugs and chemicals to achieve a cure, decrease tumor size, provide relief of pain, or slow metastasis
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| Radiation therapy | Delivery of ionizing radiation to accomplish:
Destruction of tumor cells
Reduction of tumor size
Decrease in pain
Relief of obstruction
To slow or stop spread of cancer cells
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| Radiation therapy | Destroys rapidly multiplying cells regardless of whether they are cancerous
Goal is to reach maximum tumor control with no, or minimum, normal tissue damage
May be delivered by teletherapy (external) or brachytherapy (internal)
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| Tumor Surgery | Tumor removal through surgery
In more than 90 percent of all cancers, surgery is used for diagnosing and staging
In more than 60 percent of all cancers, surgery is the primary treatment
When feasible, the primary tumor is excised in its entirety
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| Incisional biopsies | Used to remove a piece of a tumor for examination and diagnosing
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| Excisional biopsies | Used to remove the tumor and a portion of normal tissue
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| En bloc resection | Removal of a tumor and a large area of surrounding tissue that contains lymph nodes
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| Cryosurgery | Destruction of tissue by freezing the malignant tissue
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| Exenteration | Wide resection that removes the organ or origin and surrounding tissue
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| Immunotherapy | Agents capable of changing the relationship between a tumor and the host are known as biological response modifiers (BRMs)
Agents are used to strengthen individual’s immune responses
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| Mohs surgery | Surgical procedure, tumor is removed in stages
Tissue is examined for evidence of cancer
Additional tissue is removed until negative boundaries are confirmed
Most often used to treat basal cell carcinoma and squamous cell carcinoma
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| Fulguration | Destruction of tissue with electric sparks
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| Electrocauterization | Destruction of tissue by burning
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