Unformatted text preview: Oncology Prof. Ricki Bialstock AHS 151 CANCER A group of diseases characterized by uncontrolled growth and spread of abnormal cells Also known as malignancy or neoplasm Cells picture Differentiation The process by which normal cells undergo physical and structural changes as they develop to form different tissues in the body Undifferentiated tumors look nothing like the parent tissues Undifferentiated tumors have worse prognosis Dysplasia picture Changes or disorganization in cells May be pre-cancerous Hyperplasia picture Increase in number of cells in a tissue Primary Tumor picture Arises from local cells Secondary Tumor picture Comes from cells of a distant site Benign Growth A non-cancerous tumor May cause symptoms from pressure on a vital organ or blood vessel Remove for symptomatic or cosmetic reasons Malignant vs. Benign picture Malignant vs. Benign picture Nomenclature of Tumors Carcinoma epithelial cancers Sarcoma tumors of mesenchymal origin Tumors are also named for the tissue from which they arise Staging and Grading This identifies the extent and differentiation of the tumor The higher the stage, the worse the tumor Example: Non Hodgkin's Lymphoma Stage 1 primary tumor only Stage 2 primary tumor has metastasized to another location, but on the same side of the diaphragm Stage 3 Metastases on both sides of the diaphragm Stage 4 Metastases to the bone marrow Cancer and Aging picture Exercise and Cancer Although exercise contributes to general good health, it has not been proven that exercise prevents cancer. Therapeutic Exercise and the Cancer Patient Patient may have generalized weakness Brain cancers CVA-like symptoms Some chemotherapy drugs affect the heart monitor vital signs Contraindications to aerobic exercise Platelet count less than 50,000/ul Hemoglobin less than 10 g/dl WBC count less than 3,000/ul Absolute granulocytes less than 2,500/ul Incidence of Cancer Over 1,000,000 new cases per year 1 in 4 people will have some form of cancer in their lifetime 1 in 3 will survive their cancer more than 5 years ("Five year survival rate") 2nd leading cause of death (after heart disease) 500,000 deaths annually Leading Causes of Death of Cancer chart Energy Conservation Teaching energy conservation techniques is recommended for patients who fatigue easily Etiology of Cancer Genetics breast, ovarian, colon Viruses some lymphomas and leukemias Chemical agents dyes, tar, soot Physical agents radiation, asbestos Etiology of Cancer Drugs some chemotherapy drugs are linked to leukemia many years later Alcohol consumption cancer of mouth, throat Hormones ovarian, prostate Environmental pollution, smoking Causes of Cancer Pie chart Risk Factors Race higher incidence in African-americans Geography example Long Island has a high incidence of breast cancer Pre-cancerous lesions moles, scars, polyps Stress thought to decrease the immune system Personal behaviors diet, smoking, alcohol, sexual behaviors, never pregnant (increases risk of ovarian) Pathogenesis/Oncogenesis Somatic Mutation Theory a cell is mutant and replicates Oncogenes transform normal cells into malignant cells Metastasis picture Infiltration of adjacent tissues Through blood vessels Through the lymphatic system Metastasis picture Common Metastasis of Cancer Metastases to the liver lung, breast, colon and all others Metastases to the CNS lung, breast, lymphoma, other Metastases to the bone lung, breast, prostate, other PT precautions no vigorous stretching, or heavy resistive exercise, easily fractured picture Cancer Pain Patients describe pain as worse at night and awakening them from a sound sleep Bone Metastases Referred pain Pressure Organ Blood supply Nerve Diagnostic Tests X-ray CAT Scan MRI Biopsy smear, needle, aspiration, excision Tumor markers genetic testing, blood tests Routine colonoscopy, mammogram, etc. Tests chart Interventions Curative vs. Palliative Palliative to make the patient feel more comfortable if the patient can not be cured Treatment Methods Surgery Radiation therapy Chemotherapy Interventions Biotherapy Bone marrow/stem cell transplant Monoclonal antibodies Colony stimulating factors ex - neupogen ( to increase WBC) Hormonal therapy Breast cancers Prostate cancers Prognosis The earlier the detection, the better the prognosis The lower the stage, the better the prognosis Survival rates expressed in terms of five year survival Implications for the PTA See textbook Reference guide for modalities indications, contraindications and effectiveness Classification of Tumors nothing Pavement Epithelium Benign Papilloma picture Pavement epithelium picture Malignant Squamous cell carcinoma Basal cell carcinoma Transitional cell carcinoma Glandular Epithelium picture Benign Adenoma Cystadenoma Polyp Glandular Epithelium picture Malignant Adenocarcinoma Fibrous Tissue picture Benign Fibroma Fibrous Tissue picture Malignant fibrosarcoma Embryonic Fibrous tissue Benign Myxoma Malignant myxosarcoma Adipose Tissue picture Benign - Lipoma Adipose Tissue picture Malignant Liposarcoma Cartilage Benign Chondroma Malignant Chondromosarcoma Bone Benign Osteoma Osteochondroma Malignant Osteosarcoma Osteogenic sarcoma Synovial Membrane Benign Synovioma Malignant Synovial Sarcoma Smooth Muscle Benign leiomyoma Malignant leiomyosarcoma Striated Muscle Benign rhabdomyoma Malignant Rhabdomyosarcoma (seen in pediatric cases) Peripheral Nerves Benign Neuroma Neurofibroma Neurinoma Malignant Neurogenic sarcoma neurofibrosarcoma Sympathetic Nervous System Benign ganglioneuroma Malignant Neuroblastoma Neuroglia Malignant Glioma Retinoblastoma (congenital in pediatrics) Meninges Benign Meningioma Blood Vessels Benign hemangioma Malignant Hemangioendothelioma Angiosarcoma Lymph Vessels Benign lymphangioma Malignant Lymphangiosarcoma Lymphangioendothelioma Bone Marrow Malignant Multiple Myeloma plasma cells Ewing's Tumor Leukemia Lymphoid Tissue Malignant Hodgkin's Lymphoma Non-Hodgkin's lymphoma Burkitt's lymphoma Melanin cells in the skin Benign Nevus (birthmark) Ovary Benign Dermoid cyst Malignant Teratoma (also called teratoma in the testes) Side Effects of Chemotherapy Leukopenia dec WBC Anemia dec RBC Thrombocytopenia dec platelets GI - nausea, vomiting, anorexia, constipation, Integumentary alopecia, ulcerations (esp mouth) Nervous system peripheral neuropathy Side effects of Chemotherapy Musculoskeletal generalized weakness, fatigue Cardiovascular EKG changes, cardiomyopathy Respiratory dyspnea on exertion, pulmonary fibrosis Renal renal failure, altered lab values Chemotherapy Medications and side effects Methotrexate motor dysfunction, seizure Bleomycin pulmonary fibrosis Adriamycin alopecia, cardiovascular Vincristine neuropathy Other thrush infection in mouth ...
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- Fall '09
- Benign Myxoma Malignant, Benign leiomyoma Malignant, Benign rhabdomyoma Malignant, Benign ganglioneuroma Malignant, Benign hemangioma Malignant