CID Cancer

What is Cancer?

Abnormal and unregulated proliferation (growth) of cells, arising from cells of a specific organ

•General name for a group of more than 100 diseases

•Although many kinds, they all start because abnormal cells grow (proliferate) uncontrolled Cancer cells have the ability to create their own blood supply, break away from the organ of origin, travel, and spread to other organs of the body

•Morbidity and mortality arise predominantly from organ damage caused by local growth and metastases to distant anatomic areas

Cancer Cell Basics

Normal cells:

•Knows and stays in its place of origin

•Knows when to replicate and when to die

Cancer cells:

•Does not know when to stop growing and proliferating

•Can travel (metastasize) from organ of origin to any place within the body

Major Risk Factors for Cancer

• Genetic predisposition

• Tobacco use and alcohol excess

• Lack of physical activity

• Environment and diet

  • Pollution, chemical exposure, etc.

  • Obesity link to cancer

• Virus

• Sun exposure

5 Classifications of Cancer

• carcinomas

• sarcomas

• leukemia

• lymphomas

• CNS cancers

Carcinomas

begin in the skin or tissues that line the internal organs

Sarcomas

develop in the bone, cartilage, fat, muscle or other connective tissues

Leukemia

begins in the blood and bone marrow

Lymphomas

start in the immune system

Central Nervous System Cancers

develop in the brain and spinal cord

Cancer/Carcinoma (“solid tumors”)

Generally, refers to cancers that arise from epithelial surfaces and cells that line glands:

thyroid, kidney, testis, ovary, adrenals, liver, cervix, skin/epidermis, glands, intestines, bronchus, breast, prostate, pancreas

Major Types of Carcinomas

Adenocarcinoma

• Any gland (breast, prostate, lung, pancreas, ovary, colon...)

Squamous cell carcinoma

• Any surface or lining of mucous membrane (skin, lung, head and neck)

Others

• Urothelial (bladder)

• Islet (pancreas)

Types of Lymphomas

Hodgkin’s Lymphoma

• Characteristic appearance and clinical presentation

• Specific type of cell

• Various types

• Specific response to therapy*

  • Easier to treat because of this

Non-Hodgkin’s Lymphoma

• Wide variety of pathologic subtypes*

• Wide range of presentations and outcomes

• Differing treatments than for Hodgkin’s lymphoma

The Leukemias

Malignant cells arising from cells of the bone
marrow
•   White cells (myeloid cells, lymphoid cells,   monocytes)
•   Red cells (erythroleukemia)
•   Platelets (megakaryocytic leukemias)
•   Plasma cells (myeloma)

How is cancer diagnosed (symptomatic)?

Cough, rectal bleeding, palpation of breast lump, weight loss, skin abnormality, coughing up blood/chest pain, change in bowel habits, abdominal pain, blood in urine, difficulty swallowing, hoarseness.

How is cancer diagnosed (asymptomatic)?

• blood test—PSA, other markers

• screening study—PAP, PSA, colonoscopy, mammogram, total-body CT scan

• asymptomatic pick up on physical exam

• leads to radiographic or surgical biopsy and then to pathology

• pathologist makes actual cancer diagnosis

CAUTION

•Change in bowel or bladder habits

•A sore that does not heal

•Unusual bleeding or discharge

•Thickening or lump in the breast, testicles, or elsewhere

•Indigestion or difficulty swallowing

•Obvious change in the size, color, shape, or thickness of a wart, mole, or mouth sore

•Nagging cough or hoarseness

Other symptoms signaling presence of some types of cancer.

•Persistent headaches

•Unexplained loss of weight or appetite

•Chronic pain in bones or any other areas od the body

•Persistent fatigue, nausea, or vomiting

•Persistent low-grade fever, either constant or intermittent

•Repeated infection

What is staging?

Process of finding out how far the cancer has spread; vital step in determining treatment choices; also gives clear idea of the outlook for recovery

Staging Using TNM and Group Staging

T = Tumor size
N = Node status
M = Presence or absence of metastases
G = Degree of differentiation

(lower the number the less severe the cancer)

Oncology

The branch of medicine dedicated to diagnosing, treating and researching cancer is known as oncology, while a physician who works in the field is called an oncologist. Some oncologists focus solely on particular cancer types or treatments. Depending on the type, stage and location of a cancer, multiple oncology specialists may be involved in a patient’s care. The field of oncology has three main specialties—medical, surgical and radiation—and numerous sub-specialties.

What is a Cancer Cluster?

A greater-than-expected number of cancer cases that occurs within a group of people in a defined geographic area over a specific period of time.

Criteria for a Cancer Cluster

•A greater than expected number:
A greater than expected number is when the observed number of cases is higher than one would typically observe in a similar setting (in a group with similar population, age, race, or gender). This may involve comparison with rates for comparable groups of people over a much larger geographic area – e.g., an entire state.

•Of cancer cases:
All of the cases must involve the same type of cancer, or types of cancer scientifically proven to have the same cause.

•That occurs within a group of people:
The population in which the cancers are occurring is carefully defined by factors such as race/ethnicity, age, and gender, for purposes of calculating cancer rates.

•In a geographic area:
Both the number of cancer cases included in the cluster and calculation of the expected number of cases can depend on how we define the geographic area where the cluster occurred. The boundaries must be defined carefully. It is possible to “create” or “obscure” a cluster by selection of a specific area.

•Over a period of time:
The number of cases included in the cluster – and calculation of the expected number of cases – will depend on how we define the time period over which the cases occurred.

What is a cancer typically not?

Note that the definition of a cancer cluster does not include anything about the cancers all having a common cause.

Interpretation of a Cancer Cluster

Confirmation of a cancer cluster does not necessarily mean that there is any single, external cause or hazard that can be addressed. A confirmed cancer cluster could be the result of any of the following:

• chance

• miscalculation

• known causes

• unknown causes