This document discusses cancer, including its definition, incidence rates by cancer type and gender, mortality rates, risk factors, specialists involved in cancer treatment, diagnostic tests, tumor markers, staging classifications, treatment types (curative vs palliative), and side effects of treatment. It notes that cancer is a continuum of cellular changes over time that results in abnormal cell growth and function. The most common cancers by incidence in men are prostate, lung, and colorectal cancer, while in women they are breast, lung, and colorectal cancer. Lung cancer is the leading cause of cancer death in both men and women. Risk factors include age, smoking, family history, sun exposure, and obesity. Diagnostic tests include imaging,

1. CANCER
Dr. Kamal Kishore
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2. A continuum of discrete
tissue and cellular changes
over time resulting in
aberrant physiologic
processes.
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3. INCIDENCE
♂ ♀
1. Prostrate 27% 1. Breast 29%
2. Lung 14% 2. Lung 13%
3. Colorectal 8% 3. Colorectal 8%
MORTALITY ☠
♂ ♀
1. Lung 28% 1. Lung 26%
2. Prostrate 10% 2. Breast 15%
3. Colorectal 8% 3. Colorectal 9%
2nd leading cause of unnatural death
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4. Progressing age
Smoking
Family history
Excessive sun exposure
Obesity
Carcinogenic chemical
exposure
Risk of developing cancer
♂ ♀
44% 38%
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5. Primary care physician
Medical oncologist
Surgical oncologist
Radiation oncologist
Oncology nurse specialist
Pharmacist
Social workers
Rehabilitation specialist
Alternative medicine specialist
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6. Education of avoidable indentified risk factors
Healthful habits
Physical exercise
Smoking cessation
Diet modification
Maintenance of BMI
Sun avoidance
Naimittaka rasayana
Prophylactic chemoprevention e.g. tamoxifen for breast cancer ,
finasteride for prostrate cancer, NSAID for colon cancer
Vaccination e.g. hep. B , HPV vaccine.
Prophylactic surgical prevention e.g. Mastectomy, hysterectomy,
oophorectomy
Cancer screening ( ? Ethical dilemmas)
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7. Pain
Nausea
Effussions ( Pleural Cavity, Pericardium, Peritoneum)
Decrease in Nutrition (sudden weight loss, Cachexia )
Sudden appearance of lump in body
Unexplained and contrast symptoms e.g. diarrhoea and constipation
Haemorrhage (urine, vagina, mouth)
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8. NON INVASIVE DIAGNOSTICTEST
Lab values of tumor
markers
Imaging e.g. X-ray, CT,
MRI, PET.
INVASIVETISSUE BIOPSY
Histopathological studies
(HPE)
Fine needle aspiration
cytology
Invasive tissue biopsy is the final approach in order
to truly diagnose cancer
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9. MARKER NEOPLASTIC
CONDITION
NON
NEOPLASTIC
CONDITION
Human Chronic
Gonadotropin
(HCG)
Gestation and
Gonadal germ cell
tumor
Pregnancy
Calcitonin Thyroid
α- Fetoprotein Hepatocellular
Carcinoma
Cirrhosis, Hepatitis
Carcino Embryonic
Antigen (CEA)
Adenocarcinoma of
Colon, Pancreas,
Lung, Ovary
Pancreatitis,
Hepatitis, IBD
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10. MARKER NEOPLASTIC
CONDITION
NON
NEOPLASTIC
CONDITION
Prostrate Specific
Antigen (PSA)
Prostrate cancer Benign Prostrate
Hypertrophy
CA-125 Ovarian cancers Pregnancy,
Menstruation
CA-19-9 Colon, Pancreatic,
Breast cancer
Pancreatitis
CD 30 Hodgkin’s diseases
CD 25 Leukemia
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Tumor markers values are also used to assess the
response the treatment.

11. CLINICAL PATHOLOGICAL
Physical examination
Radiographs
CT, MRI, PET
Histopathological
examination of tissue itself
after biopsy or FNAC
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12. TNM STAGING
TUMOR NODES METASTASIS
T1 N1- Present M1 - Present
T2 N0- Absent M0 – Absent
T3 (lymph nodes
irregularities)
(to distant organs
other than primary
organ)
T4
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Based on staging the treatment plan is made and
prognosis is sought.
Tumor
size

13. CURATIVE PALLIATIVE
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Depends upon patient wish and prognosis.

14. CURATIVE
MEDICAL MANAGMENT SURGICAL MANAGMENT
Chemotherapy
Radiotherapy
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Depends upon site and extent of metastasis.

15. SOMATIC PSYCHOLOGICAL
Nausea Depression
Vomiting Dysphoria
Febrile Neutropenia Anhedonia
Anaemia Insomnia
Anorexia/ weight loss Agitation
Jaundice Fear
Systemic infection Anxiety
Immunosuppression Suicidal ideation
Mouth sores Social rejectance
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16. SOMATIC PSYCHOLOGICAL
Appetite reduction Behavioral problems
Fatigue
Deforming surgery
(Disfigurement)
Loss of hair
Sexual dysfunction
Physical loss ( Handicap)
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17. To cure sometimes,
To extend life often,
but
To comfort always.
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18. Referance :- “Harrisonstextbook
of Principlesof Internal
Medicine 19th edition.
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