2. 2
Oncology Overview
• Cancer
– Refers to a group of diseases, consisting of
more than 10 different types
– Can originate in almost any body organ
• Most common site for women is the breast
• Most common site for men is the prostate gland
3. 3
Cancer Terms
• Neoplasia
– Development of an abnormal growth of new
cells that is unresponsive to normal growth
control mechanisms
• Neoplasm
– Any abnormal growth of new tissue that
serves no useful purpose
– Neoplasm = tumor
4. 4
Cancer Terms
• Differentiation
– Cells become specialized and differentiated
both physically and functionally
• Cells look and act like the parent cell, or tissue of
origin
• Anaplasia
– Loss of cellular differentiation and reversion to
a more primitive form
• Anaplasia = dedifferentiation
5. 5
Cancer Terms
• Malignant
– Tending to become worse and cause death
• Metastasis
– Process by which malignant cells spread to
other parts of the body
6. 6
Benign versus Malignant Tumors
• Benign
– 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
7. 7
• Malignant
– 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 rapid cell division and
multiplication
Benign versus Malignant Tumors
8. 8
Classification of Neoplasms
• System for naming neoplasms
– Root word to indicate type of body tissue
that gives rise to neoplasm
– Suffix to indicate whether tumor is benign
or malignant
• Benign tumor suffix = oma
• Malignant tumor suffix = carcinoma or sarcoma
9. 9
• Carcinomas
– Solid tumors that originate from epithelial
tissue
• Tissue that covers external and internal body
surfaces, lining of vessels, body cavities, glands,
and organs
• Sarcomas
– Originate from supportive and connective
tissue
• Bone, fat, muscle, and cartilage
Classification of Neoplasms
10. 10
• Grading
– Measures extent to which tumor cells differ
from their parent tissue
– Grade 1 = well-differentiated cells, function
most like the parent tissue
• Least malignant
– Grade 4 = least differentiated cells, not like
the parent tissue
• Most rapidly increasing in number
Grading of Neoplasms
11. 11
• Staging
– Extent of disease and relative size of tumor
– 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
Staging of Neoplasms
13. 13
• Lifetime risk
– Probability that an individual, over the course
of his or her lifetime, will develop cancer or
will die from cancer
• Relative risk
– Measures the strength of the relationship
between risk factors and particular types of
cancer
Risk Factors
14. 14
• Need for immediate follow-up
– C = Change in bowel or bladder habits
– A = A sore that does not heal
– U = Unusual bleeding or discharge
– T = Thickening or lump in breast or
elsewhere
– I = Indigestion or difficulty in swallowing
– O = Obvious change in a wart or mole
– N = Nagging cough or hoarseness
Warning Signs of Cancer
16. 16
• Pronounced
– (BAY-sal sell car-sih-NOH-mah)
• Defined
– Most common malignant tumor of epithelial
tissue, occurring most often on areas of skin
that are exposed to the sun
• Presents as a slightly elevated nodule with a
depression or ulceration in center that becomes
more obvious as the tumor grows
Basal Cell Carcinoma
17. 17
• Pronounced
– (kar-sih-NOH-mah of the breast)
• Defined
– Malignant tumor of the breast tissue
– Most common type, ductal carcinoma,
originates in the mammary ducts
Carcinoma of the Breast:
Breast Cancer
19. 19
Cervical Carcinoma
• Pronounced
– (SER-vih-kal kar-sih-NOH-mah)
• Defined
– Malignant tumor of the cervix
• Most common malignancies of female reproductive
tract
20. 20
Colorectal Cancer
• Pronounced
– (koh-loh-REK-tal CAN-ser)
• Defined
– Presence of a malignant neoplasm in large
intestine
• Most are adenocarcinomas
• At least 50 percent originate in the rectum, causing
bleeding and pain
21. 21
• Pronounced
– (en-doh-MEE-tree-al kar-sih-NOH-mah)
• Defined
– Malignant tumor of inner lining of uterus
– Also known as adenocarcinoma of uterus
• Classic symptom is inappropriate uterine bleeding
• Most common cancer of female reproductive tract
after menopause
Endometrial Carcinoma
22. 22
Lymphoma
• Pronounced
– (LIM-foh-mah)
• Defined
– Lymphoid tissue neoplasm that is typically
malignant
– Painless enlarged lymph node(s)
– Progressing to anemia, weakness, fever, and
weight loss
23. 23
Kaposi’s Sarcoma
• Pronounced
– (KAP-oh-seez sar-KOH-mah)
• Defined
– 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
24. 24
Malignant Melanoma
• Pronounced
– (mah-LIG-nant mel-ah-NOH-mah)
• Defined
– Malignant skin tumor originating from
melanocytes in preexisting nevi, freckles, or
skin with pigment
– Darkly pigmented tumor with irregular
surfaces and borders
– Variable colors
27. 27
Oral Leukoplakia
• Pronounced
– (OR-al loo-koh-PLAY-kee-ah)
• Defined
– Precancerous lesion occurring anywhere in
the mouth
• Elevated gray-white or yellow-white leathery
surfaced lesions have clearly defined borders
28. 28
• Pronounced
– (oh-VAY-ree-an car-sin-OH-mah)
• Defined
– Malignant tumor of the ovaries
– Most commonly occurring in women in their
50s
• Rarely detected in early stage
Ovarian Carcinoma
29. 29
Pancreatic Cancer
• Pronounced
– (pan-kree-AT-ik CAN-sir)
• Defined
– Life-threatening primary malignant neoplasm
typically found in head of pancreas
30. 30
Carcinoma of the Prostate
• Pronounced
– (car-sin-OH-mah of the PROSS-tayt)
• Defined
– Malignant growth within the prostate gland,
creating pressure on upper part of urethra
31. 31
• Symptoms
– Occur in later stages and may include:
• Urinary frequency, especially at night
• Difficulty starting or stopping urine flow
• Inability to urinate
• Weak or interrupted flow or urine when urinating
• Pain or burning when urinating
• Pain or stiffness in lower back, hips, or thighs
• Painful ejaculation
Carcinoma of the Prostate
32. 32
Renal Cell Carcinoma
• Pronounced
– (REE-nal SELL kar-sih-NOH-mah)
• Defined
– Malignant tumor of the kidney, occurring in
adulthood
• Patient is asymptomatic until latter stages of the
disease
33. 33
• Pronounced
– (SKWAY-mus sell car-sih-NOH-mah)
• Defined
– Malignancy of the squamous or scalelike cells
of the epithelial tissue
– Much faster growing than basal cell
carcinoma
– Greater potential for metastasis if not treated
Squamous Cell Carcinoma
34. 34
Squamous Cell Carcinoma
• Frequent sites on sun-exposed areas
– Top of nose
– Forehead
– Margin of external ear
– Back of hands
– Lower lip
35. 35
Carcinoma of the Testes
• Pronounced
– (car-sin-OH-mah of the TESS-teez)
• Defined
– 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
36. 36
Cancer,Thyroid Gland
• Pronounced
– (CAN-sir, THIGH-royd gland)
• Defined
– Malignant tumor of the thyroid gland
– Leads to dysfunction of the gland and thus
inadequate or excessive secretion of the
thyroid hormone
37. 37
Intracranial Tumors
• Pronounced
– (in-trah-KRAY-nee-al TOO-morz)
• Defined
– 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
38. 38
• Pronounced
– (met-ah-STAT-ik in-trah-KRAY-nee-al TOO-
morz)
• Defined
– Tumors occurring as a result of metastasis
from a primary site such as the lung or breast
Metastatic Intracranial Tumors
(Secondary)
39. 39
Primary Intracranial Tumors
• Pronounced
– (PRIGH-mah-ree in-trah-KRAY-nee-al TOO-
morz)
• Defined
– Tumors that arise from gliomas and meninges
• Gliomas = malignant glial cells that are a support
for nerve tissue
40. 40
• Glioblastoma multiforme
– Most rapidly growing of the gliomas
• Astrocytomas
– Tend to invade surrounding structures
• Ependymomas
– Occur more commonly in children and
adolescents
– Usually encapsulated and benign
Primary Intracranial Tumors
41. 41
• Oligodendrogliomas
– Usually slow growing
• Medulloblastomas
– Occur most frequently in children between
5 and 9 years of age
– Rapid growing; poor prognosis
• Meningiomas
– Occur most often in adults
– Slow growing
Primary Intracranial Tumors
42. 42
Wilms’ Tumor
• Pronounced
– (VILMZ TOO-mor)
• Defined
– Malignant tumor of the kidney occurring
predominately in childhood
• Most frequent finding is palpable mass in the
abdomen
44. 44
Treatment
Techniques and Procedures
• Chemotherapy
– Use of cytotoxic drugs and chemicals to
achieve a cure, decrease tumor size, provide
relief of pain, or slow metastasis
45. 45
• 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
Treatment
Techniques and Procedures
46. 46
Treatment
Techniques and Procedures
• Mohs Surgery
– Surgical procedure in which the cancerous
tumor is removed in stages
– Tissue is examined for evidence of cancer
– Additional tissue is removed until negative
boundaries are confirmed
• Advanced treatment procedure for skin cancer
47. 47
• Radiation therapy
– Delivery of ionizing radiation to accomplish
one or more of the following:
• Destruction of tumor cells
• Reduction of tumor size
• Decrease in pain
• Relief of obstruction
• To slow or stop spread of cancer cells
Treatment
Techniques and Procedures
48. 48
• 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)
– May be delivered by brachytherapy (internal)
Treatment
Techniques and Procedures
49. 49
• 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
Treatment
Techniques and Procedures
50. 50
• Common surgical procedures
– Incisional biopsies
• Used to remove a piece of a tumor for examination
and diagnosing
– Excisional biopsies
• Used to remove the tumor and a portion of normal
tissue
– En block resection
• Removal of a tumor and a large area of
surrounding tissue that contains lymph nodes
Treatment
Techniques and Procedures
51. 51
• Common surgical procedures
– Fulguration
• Destruction of tissue with electric sparks
– Electrocauterization
• Destruction of tissue by burning
Treatment
Techniques and Procedures
52. 52
• Common surgical procedures
– Cryosurgery
• Destruction of tissue by freezing the malignant
tissue
– Exenteration
• Wide resection that removes the organ or origin
and surrounding tissue
Treatment
Techniques and Procedures
