Cancer Classifications and Treatment Options

Introduction to Cancer Classifications

• Understanding cancer requires knowledge of tumors, their origin, and behavior.

Tumor Identification

• Tumors are identified based on:
• Tissue of origin
• Anatomic site
• Behavior of the tumor

Staging and Grading of Tumors

• Staging:
• Measures tumor size, local invasion, and metastasis.
• The TNM System categorizes cancer as follows:
  • T: Tumor size
  • N: Nodes involvement
  • M: Metastasis presence
• Staging is essential for determining treatment options and prognosis.
• Stages:
  • Stage 0: Carcinoma in situ, localized.
  • Stage 1: Limited to tissue of origin, localized tumor.
  • Stage 2: Limited local spread.
  • Stage 3: Extensive local/regional spread.
  • Stage 4: Metastatic disease, often inoperable.

Grading of Tumors

• Grading examines the appearance and activity of tumor cells relative to normal cells:
• Grade 1: Well-differentiated, similar to origin cells.
• Grade 2: Moderately differentiated, more abnormal.
• Grade 3: Poorly differentiated, very abnormal.
• Grade 4: Undifferentiated, primitive cells.

Treatment Goals

• Understanding the goals of treatment is vital for care:
• Cure: Complete eradication, sustainable health.
  • Duration of disease-free periods vary by cancer type.
• Control: Prolonged survival without cure, containment of growth.
  • Examples: Chronic leukemias, lymphomas.
• Palliation: Symptom relief, maintenance of quality of life.
  • Example: Radiation for bone metastases.

Surgical Therapy

• Oldest cancer treatment approach; uses:
• Diagnostic Surgery: Identify cancer existence.
• Primary Treatment: Remove cancerous tissues.
• Prophylactic Treatment: Remove at-risk organs (e.g., BRCA1-related mastectomies).
• Palliative Surgery: Relieve symptoms or pressure from tumors.
• Three Surgery Goals: Cure, Control, Palliation.

Radiation Therapy

• Aims to kill cancerous cells by damaging DNA using high-energy beams or particles:
• Specific targeting minimizes damage to normal tissues.
• Treatment duration is typically 6-7 weeks (5 days a week).
• Types of Radiation:
  • External Beam: Most common; directed at tumor.
  • Internal Radiation (Brachytherapy): Implants placed close to or within tumor.
  • Radioisotopes: Administered orally or through IV.

Localized Treatment

• Both radiation and surgery target specific areas.

Side Effects of Radiation

• Mostly localized, important to monitor for:
• Fatigue: Metabolic increase, rest required.
• Anorexia: Nutrient management imperative.
• Bone Marrow Suppression: Monitor blood counts regularly.
  • Risk of anemia, leukopenia, thrombocytopenia.
• Skin Reactions: From mild irritation to serious desquamation.
  • Care tips: Keep area dry, avoid irritants.
• Mucosal Reactions: Stomatitis, mucositis, need for gentle oral care.
• GI Complications: Need for dietary adjustments, monitoring for severe reactions.
• Reproductive Effects: May cause temporary or permanent sterility, hormone changes.

Coping with Treatment Effects

• Support for lifestyle changes and emotional stress.

Safety Measures for Healthcare Workers

• Time, Distance, Shielding: Key principles to minimize radiation exposure:
• Limit time spent near radiation sources.
• Increase distance to reduce exposure.
• Use appropriate shielding methods.

Chemotherapy

• Discussed briefly; details would be covered later.