STRUCTURE, PREVENTION AND SCREENING, WARNING SIGNS OF CANCER, EPIDEMIOLOGY

1. ONCOLOGY
PRESENTED BY
MRS. C. MARY LALITHA KALA
ASSOCIATE PROFESSOR
AMERICAN NRI COLLEGE OF NURSING
SANGIVALASA, VISAKHAPATNAM

2. 1. ABNORMAL PROLIFERATION
OF THE CELLS AND INVASION
INTO THE NORMAL
SURROUNDING CELLS IS KNOW
AS CANCER
DEFINITIONS

3. 2. “Cancer is a group of diseases involving
abnormal cell growth with the potential to
invade or spread to other parts of the body”.
Not all tumors are cancerous; benign
tumors do not spread to other parts of the
body.
Possible signs and symptoms include a
lump, abnormal bleeding, prolonged cough,
unexplained weight loss and a change in bowel
movements. While these symptoms may indicate
cancer, they may have other causes.

4.  Cancers are a large family of diseases that involve
abnormal cell growth with the potential to invade or
spread to other parts of the body. They form a subset of
neoplasms.
 A neoplasm or tumor is a group of cells that have
undergone unregulated growth and will often form a mass
or lump, but may be distributed diffusely.
 All tumor cells show the six hallmarks of cancer. These
characteristics are required to produce a malignant tumor.
 • Cell growth and division absent the proper signals
 • Continuous growth and division even given contrary
signals
 • Avoidance of programmed cell death
 • Limitless number of cell divisions
 • Promoting blood vessel construction
 • Invasion of tissue and formation of metastases

5. NORMAL vs CANCER CELLS

7. Compare and contrast with regards to… .
Normal cells are uniform and
orderly. Cell size and shape
Cancer cells have large variations
in cell size and shape. Often, they
have a large irregularly shaped
nucleus and a relatively small
cytoplasm.
Normal cells grow, divide and die
in a controlled way and with a
predictable lifespan. Normal cells
destroy themselves if they
become damaged (through a
process called apoptosis).
Cell division and deat h
Cancer cells exhibit uncontrolled
growth as they have lost their
normal control mechanisms. They
grow and divide at a rapid rate
and they outlive their normal
lifespan (i.e. become immortal).
They may also be able to prevent
self-destruction when damaged.
Normal cells become specialised
or ‘mature’. They start out as
immature cells (stem cells) and
acquire specific functions when
they mature.
Specialisation of cells
Cancer cells do not carry on
maturing once they have become
cancerous. In fact, the cancer
cells can become less mature
over time. Cancer cells can lose
specialised functions and become
more and more primitive.
Normal cell growth and healing is
very orderly and precise. The
cells know when there are
enough new cells to mend the
body. They send chemical
messages to each other so that
they stop growing and
reproducing.
Obeying signals
Something in the cancer cells
overrides the normal signalling
system. This may be because the
genes that tell the cell to
reproduce keep on and on
sending signals or because the
genes that normally tell the cell
to stop reproducing have been
damaged or lost.
Cells have a natural ability to
stick together in the right place.
Scientists call this cell adhesion.
Molecules on the surface of the
cell matc h those on its
neighbours.
Cells sticking together
Cancer cells can lose the
molecules on their surface that
keep normal cells in the right
place so they can become
detached from their neighbours.
What is the key difference between normal cells and cancerous cells?
Conclusion
The key difference between normal and cancerous cells is that cancer cells have lost the
restraints on growth that characterise normal cells.

9. *17.3 LAKH NEW CASES OF CANCER IN INDIA.
*8.8 LAKH DEATHS DUE TO CANCER BY 2020 DUE
TO CANCERS OF BREAST, LUNGS AND CERVIX
TOPPING THE LIST
*CANCER OF LUNGS, ORAL CAVITY, LIP, THROAT
AND NECK IN MALES
*CANCER OF BREAST, CERVIX, AND OVARY IN
FEMALES ACCOUNT FOR OVER 50% OF ALL
CANCER DEATHS IN INDIA.
.
EPIDEMIOLOGY

10. TOBACCO-22%
OBESITY, POOR DIET,
ALCOHOL, LACK OF
PHYSICAL ACTIVITY-
10%
INFECTIONS-
HEPB,C,HPV-20%
GENETIC DEFECTS.5-
10%
OTHER CAUSES LIKE
IONIZING
RADIATION,HORMONES
IDIOPATHIC.
CAUSES

11.  Cancers are classified by the type of cell
that the tumor cells resemble and is
therefore presumed to be the origin of the
tumor. These types include:
 • Carcinoma: Cancers derived from
epithelial cells. This group includes many of
the most common cancers and include nearly
all those in the breast, prostate, lung,
pancreas and colon.
1. EPITHELIAL
Glandular epithelium –Adeno carcinoma
Squamous epithelium –squamous cell carcinoma
Classification

12.  • Sarcoma: Cancers arising from connective
tissue (i.e. bone, cartilage, fat, nerve), each
of which develops from cells originating in
mesenchymal cells outside the bone marrow.
1. Connective 0r supporting tissue
Bone – osteo sarcoma
Cartilage – chondrosarcoma
Adipose – liposarcoma
Smooth muscle- leiomyosarcoma
Skeletal muscle – rhabdo sarcoma
Fibrous tissue – fibro sarcoma
Membranes lining body cavities- mesothelioma
Blood vessels – angio sarcoma

13.  Myeloma Lymphoma and leukemia: These
three classes arise from hematopoietic
(blood-forming) cells that leave the marrow
and tend to mature in the plasma cells,
lymphocytes and bone marrow ( WBC, RBC),
respectively.
1. Plasma cells – produce anti bodies
2. Lymphocytes ( cellular)– hodgkin lymphoma,
non hodgkin lymphoma
3. WBC – acute myelogenous luekemia
4. RBC – polycythemia vera
5. Lymphocytes ( blood) – acute lymphocytic
luekemia

14.  • Germ cell tumor: Cancers derived from
pluripotent cells, most often presenting in the
testicle or the ovary (seminoma and
dysgerminoma, respectively).
 • Blastoma: Cancers derived from immature
"precursor" cells or embryonic tissue.

15. INVASIVE DUCTAL
CARCINOMA-
BREAST
COLORECTAL
CARCINOMA
SQUAMOUS CELL
CARCINOMA-
BRONCHI LUNG
DUCTAL
CARCINOMA-
BREAST
EXAMPLES

16. PATHOPHYSIOLOGY

18. LOCAL
• DUE TO TUMOR MASS OR ULCERATION
• EX: BLOCK OF BRONCHUS, DYSPHAGIA,
BLOCKAGE OF BOWELS.
• EX: COUGHING OF BLOOD. RECTAL AND
VAGINAL BLEEDING ETC,.
SYSTEMIC
• UNINTENDED WEIGHT LOSS, EXCESSIVE
FATIGUE, CHANGES TO SKIN, HODGKINS
DISEASE, LEUKEMIA,
• PERSISTENT FEVER IS SEEN IN CANCER
OF LIVER OR KIDNEY.
SYMPTOMS

19. METASTASIS

20. prevention
 Primary prevention
Ex: HPV vaccine to prevent cervical
vaccines
 Secondary prevention
Early identification and treatment
 Tertiary prevention
Prevention of metastasis
Prevention, screening, early
detection, warning signs of
cancer

21. Screening, early detection
and treatment

23. The awareness of early signs and symptoms for
cancer types such as skin, cervical, breast,
colorectal and oral in order to get them
diagnosed and treated at early stage is
important.
WHO
7 Warning Signs of Cancer

24. WARNING SIGNS WHAT TO LOOK FOR
1. Unusual bleeding/discharge • Blood in urine or stool
• Discharge from any parts of your body,
for example nipples, penis, etc
2. A sore which does not heal Sores that:
• don't seem to be getting
better over time
• are getting bigger
• getting more painful
• are starting to bleed
3. Change in bowel or bladder
habits
• Changes in the color,
consistency, size, or shape of stools.
(diarrhea, constipation)
• Blood present in urine or stool

25. 4. Lump in breast or other part of
the body
• Any lump found in the
breast when doing a self
examination.
• Any lump in the scrotum
when doing a self exam.
• Other lumps found on the
body
5. Nagging cough • Change in voice/hoarseness
• Cough that does not go
away
• Sputum with blood
6. Obvious change in moles Use the ABCD RULE
• Asymmetry: Does the mole
look the same in all parts or are
there differences?
• Border: Are the borders
sharp or ragged?
• Colour: What are the
colours seen in the mole?
• Diameter: Is the mole
bigger than a pencil eraser (6mm)?

27. 7. Difficulty in
swallowing
Feeling of pressure in
throat or chest which
makes swallowing
uncomfortable

28. TNM CLASSIFICATION OF
CANCER

29. TUMOR
• THE EXTENT OF THE PRIMARY
TUMOR
NODE
• THE ABSENCE OR PRESENCE AND
EXTENT OF REGIONAL LYMPH NODE
METASTASIS
METAS
TASIS
• THE ABSENCE OR PRESENCE OF
DISTANT METASTASIS

30. THE USE OF NUMERICAL
SUBSETS OF THE TNM
COMPONENTS INDICATES
THE PROGRESSIVE EXTENT
OF THE MALIGNANT
DISEASE

31. PRIMARY TUMOR (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ
T1,T2,T3
,T4
Increasing size and or local extent of the primary tumor
REGIONAL LYMPH NODE
Nx Regional lymph nodes cannot be assessed
N0 No regional lymph metastasis
N1,N2,N3 Increasing involvement of regional lymph nodes
DISTANT METASTASIS
Mx Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis

32.  Most cancers are initially recognized either
because of the appearance of signs or
symptoms or through screening.
 A definitive diagnosis, which requires the
examination of a tissue sample (Biopsy) by a
pathologist.
 People with suspected cancer are investigated
with medical tests. These commonly include
blood tests, X-rays, CT scans and endoscopy.
 People may become extremely anxious and
depressed post-diagnosis. The risk of suicide
in people with cancer is approximately double
the normal risk
Diagnosis

33. TREATMENT MODALITIES will
be continued