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Causes of Cancer Defective cellular growth

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Presentation on theme: "Causes of Cancer Defective cellular growth"— Presentation transcript:

1 Causes of Cancer Defective cellular growth
Stem cells Generation time Contact Inhibitor Defective cellular differentiation Exposure to carcinogens Moves to less mature form Leads to invasion and metastasis

2 Characteristics of Normal Cells
Limited Cell Division Specific Morphology Small Nuclear-Cytoplasmic Ratio Perform Specific Differentiated Functions Adhere tightly together… Are nonmigratory Grow in an orderly and well differentiated manner Are contact inhibited

3 Characteristics of Early Embryonic Cells
Demonstrate rapid and continuous cell division Show anaplastic morphology Have a large nuclear-cytoplasmic ratio Perform no differentiated functions Adhere loosely together Are able to migrate Are not contact inhibited.

4 Characteristics of Benign Cells
Demonstrate continuous or inappropriate cell growth. Show specific morphology Have a small nuclear-cytoplasmic ratio Perform differentiated functions Adhere tightly together Are nonmigratory Grow in an orderly and well regulated fashion.

5 Characteristics of Malignant Cells
Demonstrate rapid or continuous cellular division. Show anaplastic morphology Have a large nuclear-cytoplasmic ratio Lose some or all differentiated functions Adhere loosely together Are able to migrate Grow by invasion Are not contact-inhibited

6 Definitions Anaplasia Anaplastic Carcinogen Carcinoma

7 Hyperplasia Hypertrophy Metastasis Neoplasia Neoplasm

8 Stages of Carcinogenesis (Oncogenesis)
Initiation Promotion Progression Metastasis

9 Common Steps in Metastasis
Extension into Surrounding Tissues Penetration into Blood Vessels Release of Tumor Cells Invasion of Tissue at the Site of Arrest

10 Immune Response Attempts to destroy abnormal cells Surface Antigens
Used as tracers to indicate success of treatment CEA (carcinoembrionic antigen) - GI tract AFP (alphafetoprotein) - liver CA ovarian PSA – prostate

11 Cancer Grade and Stage Grading; Classifies cellular aspects of a cancer. Staging; Classifies clinical aspects of the cancer.

12 Histologic Class I - Well differentiated II - Moderate differentiation
III - Poor differentiation IV - Immature & Undifferentiated

13 Clinical Staging O - Ca in situ I (A) - Localized growth
II (B) - Limited local growth III (C) - Extensive local and regional growth IV (D) - Metastasis

14 TNM Classification Tis No Mo T4 N3 M1 T - Primary tumor
N - Regional lymph nodes M - Distant metastasis Tis No Mo T4 N3 M1

15 Goal Education and early detection C A U T I O N

16 Surgical Interventions
Biopsy Cure Control - Debulking Palliative Staging Reconstructive Prophylaxis

17 Radiation Destroys cells, causes inflammatory response Side Effects
Goals: Cure Control Palliative Radiation Recall External Implants Isotopes

18 Chemotherapy Cell Cycle Non-specific
Alkylating –Cytoxan, Leukeran, N.Mustard Antitumor antibiotics - Adriamycin Nitrosoureas –Carmustine, Hydrourea Corticosteroids –Prednisone, Decadron Hormones –Estrogen, Provera, Androgen Cell Cycle Specific Antimetabolities –Methotrexate, 5-FU Plant Alkaloids (Miotic Inhibitors) –Vinblastine, Vincristine Cisplatin Tamoxifen

19 Synergistic Effect The total is greater than the individual parts
Each agent has: action against cancer different site of action different organ toxicity or time of toxicity

20 MOPP Protocol Agent Action Toxicity Synergistic Effect
Complete response Agent Action Toxicity 20% Mustargen DNA Marrow – 10 days  10% Oncovin Mitosis Neurotoxic Procarbazine RNA Synthesis Marrow – 21 days  5% Prednisone Cell membrane Immune suppression 80% Synergistic Effect

21 bone marrow suppression
Side Effects Cluster the common ones: bone marrow suppression alopecia nausea and vomiting Adriamycin - Cardiac Cisplatin – Renal

22 Complications Pain Control Bone Marrow Suppression Infarction
Infection - Neutropenia Hemorrhage Anemia Infarction Superior Vena Cava Syndrome Spinal Cord Compression Tumor Lysis Syndrome

23 Common Problems/Complications Associated With Cancer
Tumor Lysis Syndrome (TLS); Destruction of cells (lysis) Release of Purine and Potassium (K+) into Bloodstream Purines converted to uric acid (in liver) K+ into Bloodstream Hyperuricemia Hyperkalemia Obstruction of Kidney Tubules ARF

24 Paraneoplastic Syndromes
Secretion of Insulin Secretion of ACTH Hypercalcemia SIADH

25 SIADH - Syndrome of Inappropriate ADH
ADH release Water Reabsorption into circulation -Renal Tubules Extravascular Fluid Plasma Osmolality Glomerular Filtration Rate Serum Sodium Levels CEREBRAL EDEMA

26 Leukemia AML - Acute Myelogenous ALL - Acute Lymphocytic
Age of Onset (15-39 yrs), usually affects adults Prognosis is generally poor, best with bone marrow transplant Most common type of leukemia Equal incidence in males and females ALL - Acute Lymphocytic Age of Onset (<15 yrs), usually affects children, accounts for approx 10% of adult leukemia's Prognosis is poorer for adults than for children Fever & Bleeding Increased incidence in males

27 Leukemia CML - Chronic Myelogenous CLL - Chronic Lymphocytic
Age of Onset (>50 yrs) Involves liver & spleen Blastic Crisis CLL - Chronic Lymphocytic Older patients – over 50 Lymph node involvement

28 Lymphoma Lymph system Lymphocytes & histiocytes (macrophages) Hodgkins
15-35 and over 50 yrs. Non-Hodgkins Outside of lymph nodes Wide spread before Dx Multiple Myeloma Infiltrates marrow destroys bone

29 Breast Early detection - Education Treatment options Mastectomy care

30 Gynecological Cervical Endometrial Ovarian

31 Genetics and Cancer BRCA

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