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Neoplasia part II

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Neoplasia part II By Dr. Mohsen Dashti Clinical Medicine & Pathology 3rd lecture Lecture outline Diagnosis of cancer. Symptoms of cancer. Cancer therapy. – PowerPoint PPT presentation

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Title: Neoplasia part II


1
Neoplasia part II
  • By
  • Dr. Mohsen Dashti
  • Clinical Medicine Pathology
  • 3rd lecture

2
Lecture outline
  • Diagnosis of cancer.
  • Symptoms of cancer.
  • Cancer therapy.

3
Diagnosis of cancer
  • Is visual examination enough for diagnosing
    cancer?
  • Off course not. Final diagnosis of cancer
    requires medical laboratory tests.
  • Laboratory tests can be done in number of
    methods
  • Biopsy.
  • Following a surgical operation the tumor is sent
    to the laboratory to check whether or not the
    lesion is malignant.
  • In some cases, particularly breast cancer, the
    surgeon might ask for a quick report on the
    nature of the lesion while the patient is still
    under the knife so appropriate action can be
    taken.
  • The report bares extreme responsibility since
    surgeons depend heavily on its outcome.

4
Diagnosis of cancer
  • Exfoliative cytology.
  • Casting or shedding cells from the body surface
    since cancer cells tend to lose adhesiveness
    characteristic of normal cells.
  • Although this method is loosely inaccurate, it
    opened doors for early diagnosis.
  • It is routinely used in vaginal testing and
    considered the early method of smear test.
  • Fine needle aspiration cytology.
  • Small cell clumps are aspirated through a long
    needle attached to a syringe to obtained cells
    deeply located organs. Example?
  • Thyroid gland, lymph nodes, or pancreas.

5
Diagnosis of cancer
  • Chemical tests.
  • It is an ultimate dream to come up with some sort
    of chemical tests for the diagnosis of cancer
    without the need for previously mentioned
    methods. Do dreams come true?
  • Some of them do. Example?
  • Some tests may be of clinical value, as in
    carcinoma of the prostate, in which increased
    acid phosphatase levels suggests that diagnosis.
  • The production of alpha-fetoprotein by the
    abnormal cells of the liver can indicate
    cancerous cells and may be detected chemically.
  • CEA or carcinoembryonic antigen can also be
    detected chemically to indicate cancer of the
    large bowel.

6
Diagnosis of cancer
7
Symptoms of cancer
  • How painful is cancer in the early stages?
  • Not painful at all and thats a major problem.
    Why?
  • If it were as painful as toothache, far fewer
    people would die from the disease.
  • So what are the general symptoms of cancer?
  • Weakness, loss of weight, anemia, and pain late
    in the disease. Do they differ in various region
    of the body?
  • Yes. Example?
  • Lip or breast, a lump may be felt.
  • If the affected organ communicates with the
    surface, there may be a discharge or bleeding as
    in cancer of the uterus.
  • Lost of appetite as in cancer of the stomach.
  • Blood in the urine as in cancer of the kidneys.

8
Symptoms of cancer
  • It should be noted that a malignant tumor of some
    size may be discovered incidentally at autopsy
    and may not present any pain.
  • It must be remembered that the symptoms may not
    be due to the primary tumor, which may remain
    latent, but due to metastases. Example?
  • A silent carcinoma of the lung that metastasizes
    to the brain, so that the patient comes to the
    doctor with symptoms of brain tumor, but no
    cough, shortness of breath, pain in the chest, or
    spitting of blood.

9
Symptoms of cancer
10
Symptoms of cancer
  • The previously mentioned symptoms are considered
    clinical effects of cancer due to a local lesion
    or metastases however, there are other symptoms
    known as systemic manifestations.
  • These include various inflammation of the skin,
    vascular effects, hormonal disturbances, and
    neuromuscular symptoms suggesting lesions of the
    nerves and muscles.

11
Cancer therapy
  • What are the common ways in cancer therapy?
  • Surgical removal.
  • Radiotherapy.
  • Chemotherapy.
  • It should be clearly understood that malignant
    cancer can not be cured entirely especially if it
    metastasizes.
  • 1. Surgical removal
  • Innocent tumors (benign) are treated with
    complete success by local removal, that is to
    say, only the tumor itself needs to be removed
    and none of the surrounding tissue. How about
    malignant tumors?
  • With malignant tumors not only the tumor is
    removed, but also as much as is feasible of the
    surrounding tissue as well.

12
Cancer therapy
  • In some cases and depending on the part of the
    body affected, the regional lymph nodes also may
    have to be removed.
  • The removal of the lymph nodes may not be
    necessary in all malignant tumors and depends on
    the regional location.
  • A good example is with breast cancer compared to
    a lip cancer where the latter doesnt require
    lymph nodes removal.
  • Radiotherapy
  • How can radiation differentiate between cancer
    and non cancer cells in radiotherapy?
  • Radiations have a greater destructive action on
    rapidly growing cells than on normal cells,
    therefore they have a selective action on cancer
    cells compared with that on surrounding tissue.

13
Cancer therapy
  • Does radiotherapy require special skills how
    does it work?
  • Yes it does.
  • Either gamma rays or x-rays are used in radiation
    therapy.
  • X-rays may be generated by low voltage (50,000 to
    100,000 volts) or high voltage (220,000 volts).
    The low voltage rays are known as soft, whereas
    the higher voltage rays called hard.
  • Soft rays have light penetration power and mainly
    suitable for surface tumors.
  • Hard rays have higher penetration power and
    suitable for deep-seated tumors.

14
Cancer therapy
  • It should be clearly understood that
    understanding tumor pathology and its associated
    manifestations is extremely important prior to
    any radiotherapy plan.
  • Some tumors are highly radiosensitive, whereas
    others are highly radioresistant.
  • Radiation therapy is employed in the treatment of
    localized neoplastic lesions that are not
    surgically accessible or in situations where
    surgery would be impractical.
  • Chemotherapy
  • It employs a wide variety of powerful metabolic
    inhibitors and other cell-killing chemicals that
    are often used on various combinations for
    treatment of different cancers.
  • They work on cancer cells in a similar way that
    radiations do.

15
Cancer therapy
  • Chemotherapy has been most successful for certain
    types of leukemias and lymphomas.
  • Other treatment options in cancer therapy
    include hormonal therapy used in breast and
    prostate cancers, and protein therapy that kills
    selective cells.

16
Cancer free
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