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AN INTRODUCTION TO CANCER
Neoplasms:
• The vast majority of cancer happens in people older than 65 and the
greatest peak in data occurs at ages 70 and above
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• There are more effective treatments for quite a number of cancers
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A neoplasm is an abnormal mass of tissue, the growth of which exceeds
and is uncoordinated with that of normal tissue and which persists in the
same excessive manner after cessation of the stimuli, which evoked the
change
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Normal cells on a petri dish will respect each other’s boundaries and will
stop at the edge of the petri dish
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3
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• Supportive stroma made up of connective tissue (collagen), blood
vessels and possibly lymphatic’s
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à The lesion arising from the mucosa is made up of a stalk
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à This is called the polyp – an entophytic growth (grows within the lumen,
because there is enough room for growth
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à This tumour has 3 components: an adenoma, it’s a cystadenoma (has many
cysts) and it’s mucinous (produces mucin)
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à Within the cysts are teeth, bone, hair, mucin and cartilage
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This is an example of a teratoma
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Malignant Tumour Nomenclature:
1
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g
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2
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g
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[Greek
“sarca” = flesh]
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Squamous cell carcinoma in situ with a keratin horn
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Basal cell carcinoma with very prominent blood vessels, often described
as “pearlescent”
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5
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6
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7
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8
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Due to the excess of mucin, it
causes constipated cells as it has taken up all the cytoplasmic space in the
cell, pushing the nucleus to the edge
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9
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It poses a great challenge to the surgeon because it cannot be seen
causing the complete removal of the stomach, as it isn’t localised
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Physical invasion – they invade other tissues and progress
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2
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3
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Loss of “contact inhibition”
5
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Differences between benign and malignant neoplasms:
1
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• In general, all benign tumours are well differentiated
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• A well-differentiated tumour will be a low grade or grade 1 – it will
not be aggressive
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• Anaplasia means “to form backward”
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This is a marker of
malignancy
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• Tripolar mitosis – this is not a normal phase in mitosis, hinting at
a malignant tumour
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Rate of growth:
• Most benign tumours grow slowly over a period of years, whereas
malignant tumours grow rapidly, often at an erratic pace
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3
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• The capsule makes it easy for the surgeon to remove the tumour
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• Next to the development of metastases, invasiveness is the most
reliable feature that distinguishes malignant from benign
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4
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• Metastases are tumour implants discontinuous with the primary
tumour
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• Metastasis unequivocally marks a tumour as malignant because
benign tumours never metastasise
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Direct seeding of body cavities or surfaces
2
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3
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They invade lymphatic vessels and drain into the first lymph
nodes
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4
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