Principle of oncology By Dr. Somaya Banaei Resident of General Surgery Herat-Afghanistan

2. Oncology
Is a branch of medicine that deals with the :
• PREVENTION
• DIAGNOSIS
• AND TREATMENT OF CANCER
A Medical Professional Who Practices Oncology Is An Oncologist
The name's etymological origin is the Greek word ὄγκος (ónkos), meaning "tumor",
"volume" or "mass" and the word λόγος (logos), meaning "study"
By: Dr. Somaya Banaei 1

3. Cancer
By: Dr. Somaya Banaei 2

4. By: Dr. Somaya Banaei 3
Epidemiology
EtiologyStaging
Cancer and Surgery

5. Multidisciplinary team
I. Surgeons
II. Medical oncologists
III. Radiation oncologists
IV. Reconstructive Surgeons
V. Pathologist
VI. Radiologist
VII. Primary Care Physicians
By: Dr. Somaya Banaei 4

6. Cancer Epidemiology 2013
Estimated New Cases
Prostate
Lung & bronchus
Colorectum
U. Bladder
Melanoma of the skin
Kidney & Renal pelvis
Non-Hodgkin Lymphoma
Oral Cavity & pharynx
Leukemia
Pancreas
Etc
Breast
Lung & bronchus
Colorectum
Uterine corpus
Thyroid
Non-Hodgkin Lymphoma
Melanoma of the skin
Kidney & Renal pelvis
Pancreas
Ovary
Etc
28%
14%
9 %
6%
5 %
5 %
4 %
3 %
3 %
3 %
100 %
29%
14%
9 %
6%
6 %
4 %
4 %
3 %
3 %
3 %
100 %
By: Dr. Somaya Banaei 5

7. Lung & bronchus
Prostate
Colorectum
Pancreas
Liver & intrahepatic bile duct
Leukemia
Esophagus
U. Bladder
Non-Hodgkin Lymphoma
Kidney & Renal pelvis
Etc
Lung & bronchus
Breast
Colorectum
Pancreas
Ovary
Leukemia
Non-Hodgkin Lymphoma
Uterine corpus
Liver & intrahepatic bile duct
Brain & other nervous system
Etc
26%
14%
9 %
7%
5 %
4 %
3 %
3 %
2 %
2 %
100 %
28%
10%
9 %
6%
5 %
4 %
4 %
4 %
3 %
3 %
100 %
By: Dr. Somaya Banaei 6
Cancer Epidemiology 2013
Estimated Deaths

8. Self Sufficiency In Growth Signals
Insensitivity To Anti-growth Signal
Evading Apoptosis
Sustained Angiogenesis
Tissue Invasion & Metastasis
Limitless Replicative Potential
AcquiredCapabilities
ofCancer
By: Dr. Somaya Banaei 7

9. Tumorigenesis
INITIATION
PROMOTION
PROGRESSION
By: Dr. Somaya Banaei 8

10. Cancer Etiology
By: Dr. Somaya Banaei 9
Cancer
Carcinogens
Genes

11. Oncogene
By: Dr. Somaya Banaei 10

12. Apoptosis
By: Dr. Somaya Banaei 11

13. Three Major Types Of
Carcinogens
Chemical
Mutagens
Their metabolism
Physical
UV radiation
Asbestosis
Chronic
Inflammations
IBS
Infections
H. Pylori
Hepatitis Virus
HPV
Human T-cell
Leukemia Virus
By: Dr. Somaya Banaei 12

14. Three Main Types Of Tumor
Benign: These are not cancerous. They either cannot
spread or grow, or they do so very slowly. If you
remove them, they do not generally return.
Premalignant: In these tumors, the cells are not yet
cancerous, but they have the potential to become
malignant.
Malignant: Malignant tumors are cancerous. The cells
can grow and spread to other parts of the body.
By: Dr. Somaya Banaei 13

15. Three Main Types Of Tumor
Benign
Adenomas
Fibroids
Hemangiomas
Lipomas
Premalignant
Actinic
keratosis
Cervical
dysplasia
Metaplasia of
the lung
Leukoplakia
Malignant
Carcinoma
Sarcoma
Germ cell
tumor
Blastoma
By: Dr. Somaya Banaei 14

16. Invasive cancers cells
By: Dr. Somaya Banaei 15

17. Mean Cancer Cells
By: Dr. Somaya Banaei 16

18. Metastasis
By: Dr. Somaya Banaei 17

19. By: Dr. Somaya Banaei 18
Metastasis

20. By: Dr. Somaya Banaei 19
Epithelial Mesenchymal Transition
i. Tumor immune escape
ii. Stemness
iii. Resistance to therapy

21. Angiogenesis
By: Dr. Somaya Banaei 20

22. Predisposing factors for CA
• Age
• Alcohol
• Obesity
• Less actions
• Diet
• Unsafety Sexual Relation
By: Dr. Somaya Banaei 21
• Infected injections
• Chronic Inflammation
• Radiation
• Sunlight
• Tobacco
• Smoke of Fuel gas at homes
• Air pollution

23. By: Dr. Somaya Banaei 22
Criteria suggest of Hereditary Cancer
 Tumor development at a much younger age than usual
 Presence of bilateral disease
 Presence of multiple primary malignancies
 Presentation of a cancer in the less affected sex (e.g., male breast cancer)
 Clustering of the same cancer type in relatives
 Cancer associated with other conditions such as mental retardation or
pathognomonic skin lesions

24. Tumors and serum markers
A tumor marker is anything present in or produced by cancer cells or other cells of the body in
response to cancer .
Tumor markers have traditionally been proteins or other substances that are made by both
• NORMAL CELLS
• CANCER CELLS
But at HIGHER amounts by cancer cells.
These can be found in the blood, urine, stool, tumors, or other tissues or bodily fluids of some
patients with cancer.
By: Dr. Somaya Banaei 23

25. THERE ARE TWO KINDS
OF SERUM MARKERS
Prognostic Predictive
By: Dr. Somaya Banaei 24

26. By: Dr. Somaya Banaei 25

27. By: Dr. Somaya Banaei 26
 Prevention of Cancer
 Diagnosis of Cancer
 Treatment of Cancer
Roles of Surgery in Cancer

28. By: Dr. Somaya Banaei 27
Goals of Treatment
Primary goal of surgical and
radiation therapy
• Local and regional control
Primary goal of systemic therapies
•Systemic control by treating distant foci of
subclinical disease to prevent recurrence.

29. By: Dr. Somaya Banaei 28
Primary or Definitive Therapy
En bloc resection of tumor with adequate margins of normal tissues
and in some cases regional lymph nodes.
Adjuant Therapy
Refers to radiation therapy and systemic therapies, including
chemotherapy, immunotherapy, hormonal therapy, and
increasingly, biologic therapy
Definitions

30. By: Dr. Somaya Banaei 29
Early Diagnosis and screening
Clinical Staging
Detect cancer in early stages in asymptomatic persons

31. BiopsyExcisional
Biopsy
Incisional
Biopsy
Core
Needle
Biopsy
Fine
Needle
Aspiration
By: Dr. Somaya Banaei 30

32. By: Dr. Somaya Banaei 31
Fine needle Aspiration Biopsy

33. By: Dr. Somaya Banaei 32
Core needle Aspiration Biopsy

34. Incisional vs Excisional Biopsy
By: Dr. Somaya Banaei 33

35. By: Dr. Somaya Banaei 34
Lymphatic Mapping
&
Sentinel Lymph Node Biopsy

36. American Joint Committee on Cancer (AJCC)
Union Internationale Contre Cancer (International
Union Against Cancer, UICC) three components:
I. Primary tumor (T)
II. Nodal metastases (N)
III. Distant metastases (M)
Clinical staging (cTNM or TNM), Pathologic staging (pTNM), re-
treatment (rTNM) or autopsy staging (aTNM)
Cancer Staging
By: Dr. Somaya Banaei 35

37. By: Dr. Somaya Banaei 36
TMN – Pathologic Stages