Oncology_Review - Oncology Review Vic V Vernenkar D.O Dept...

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Unformatted text preview: Oncology Review Vic V. Vernenkar, D.O. Dept. Of Surgery St. Barnabas Hospital Definitions Neoplasms : abnormal growth of tissue characterized by excessive cell division unresponsive to normal control mechanisms. Impair normal function by local tissue invasion and destruction, mets to distant sites. Differentiates it from benign. Definitions Carcinoma-in-situ : cytologic characteristics of malignancy, but no BM invasion. There are 4 mechanisms in the dissemination of cancer cells : tissue infiltration, lymphatic invasion,vascular invasion, direct implantation. The Metastatic Process Inefficient, multistep process. Called the metastatic cascade. Detachment and invasion : pass in to lymphatic or venous system. Transport : to a distant site of growth. Has to survive a bunch of host defenses on the way. Arrest and extravasation : Stuck up in target organ. Digestion of BM to invade. Establishment of new growth . Cancer Spread Supraclavicular : breast, lung, stomach (Virchow’s), pancreas. Axillary : lymphoma (#1), breast, melanoma. Periumbilical : pancreas (SMJ node). Ovarian : stomach (Krukenberg tumor), colon. Bone mets : Breast (#1), prostate. Skin mets : breast, melanoma. Tumor Markers CEA- Colon cancer elevated in 60% preop. Also elevated in cirrhosis, COPD, pancreatitis, cholecystitis, diverticulitis, UC, breast cancer too. AFP- Liver cancer (also a oncofetoprotein) Elevated in cirrhosis, other non-malignant things. 80% sens for hepatocellular ca, 60% sens for testicular cancer. CA 19-9 – Pancreatic cancer Tumor Markers CA125- Ovarian ca. Not useful as diagnostic tool, produced by other cancers like lung, colon. Also non-malignant like cirrhosis, gynecomastia. Beta-HCG-Testicular cancer, choriocarcinoma PSA- Prostate cancer correlates with tumor burden. Tumor Markers NSE- Small cell lung cancer, neuroblastoma BRCA I (5% of breast ca) chr 17- 85% lifetime risk of breast cancer BRCA II chr 13 same risk. Half-lives- CEA 8 days, PSA 18 days, AFP 5 days Oncogenesis Cancer Transformation : inheritable alteration in genome, loss of growth regulation. Latency Period : Dose dependent.Time between exposure and clinical detected tumor. Initiation : carcinogen acts irreversibly with DNA....
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This note was uploaded on 12/27/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Oncology_Review - Oncology Review Vic V Vernenkar D.O Dept...

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