Escolar Documentos
Profissional Documentos
Cultura Documentos
Heri Fadjari
Hematology Medical Oncology Division
Dept. of Internal Medicine
Hasan Sadikin General Hospital
Bandung
What Is Cancer?
Some common
carcinomas:
Lung
Breast (women)
Leukemias:
Bloodstream
Lymphomas:
Lymph nodes
Colon
Bladder
Prostate (men)
Some common
sarcomas:
Fat
Bone
Muscle
Naming Cancers
Cancer Prefixes Point to Location
Prefix
Meaning
adeno-
gland
chondro-
cartilage
erythro-
liver
lipo-
fat
lympho-
lymphocyte
melano-
pigment cell
myelo-
bone marrow
myo-
muscle
osteo-
bone
Cancer
cell division
First
mutation
Second
mutation
Third
Fourth or
mutation later mutation
Uncontrolled growth
Dead cells
shed from
outer surface
Epidermis
Dividing cells
in basal layer
Cell migration
Dermis
Underlying tissue
Tumors (Neoplasms)
Underlying tissue
1
Cancer cells invade
surrounding tissues
and blood vessels
2
Cancer cells are
transported by the
circulatory system
to distant sites
3
Cancer cells
reinvade and grow
at new location
Time
Malignant (cancer)
cells invade
neighboring tissues,
enter blood vessels,
and metastasize to
different sites
Melanoma
cells travel
through
bloodstream
Liver
Melanoma
(initial tumor)
Normal
Pap smear
Abnormal
Pap smear
Biopsy
Pathology
Proteomic profile
Patients
tissue sample or
blood sample
Genomic profile
Hyperplasia
Normal
Hyperplasia
Dysplasia
Normal
Hyperplasia
Mild dysplasia
Carcinoma in Situ
Normal
Hyperplasia
Mild
dysplasia
Carcinoma in
situ (severe
dysplasia)
Cancer
(invasive)
Tumor Grading
100%
Low grade
Patient
Survival
Rate
High grade
3
Years
Tumor Staging
100%
50%
I
II
III
Stage at Time of Initial Diagnosis
Some chemicals
Radiation
Heredity
Diet
Hormones
Population-Based Studies
U.K.:
Lung
cancer
JAPAN:
Stomach
cancer
CHINA:
Liver
cancer
AUSTRALIA:
Skin
cancer
CANADA:
Leukemia
U.S.:
Colon
cancer
BRAZIL:
Cervical
cancer
100
Stomach Cancer
100
70
50
5
0
7
Japan Japanese
families
in U.S.
U.S.
Japan Japanese
families
in U.S.
U.S.
Low-Strength Radiation
High
Dallas
Skin
Cancer
Incidence
Pittsburgh
Detroit
Low
Least
Most
Annual Sunshine
(UV radiation)
High-Strength Radiation
High
Leukemia
Incidence
Low
Least
Most
X-ray Dose
(atomic radiation)
Lag Time
20-Year Lag Time Between
Smoking and Lung Cancer
4000
Cigarettes
Smoked
per Person
per Year
3000
Cigarette
consumption
(men)
Lung
cancer
(men)
150
100
2000
50
1000
1900 1920 1940 1960 1980
Year
Lung Cancer
Deaths (per
100,000 people)
Viruses
Virus inserts
and changes
genes for
cell growth
Cancer-linked virus
Without
disease
HIV infection
Depressed
immune
system
KSHV infection
Kaposis
sarcoma
Patients
tissue sample
H. pylori
Inherited factor(s)
Other factor(s)
Genetic Testing
400
Colon
300
Breast
Number of
Cancer Cases 200
(per 100,000
people)
100
20
40
60
80
Age of Person (in years)
Cancer Tends to
Corrupt Surrounding Environment
Growth factors = proliferation
Invasive
Matrix
Proteases
Fibroblasts,
adipocytes
Blood vessel
Cytokines
Cancer Prevention
Carcinogenic
chemicals
Carcinogenic
radiation
Cancer viruses
or bacteria
Avoid Tobacco
Lung Cancer Risk Increases
with Cigarette Consumption
15x
10x
Lung
Cancer
Risk
5x
Non-smoker
15
Cigarettes Smoked per Day
30
Risk
Increase
30x
20x
10x
Alcoholic Drinks
Consumed per Day
AND
Packs of Cigarettes
Consumed per Day
Number of Cases
(per 100,000
people)
30
20
10
80
100
200
300
High
Cervical
Cancer
Risk
Low
Noninfected
women
Women
infected
with HPV
Industrial Pollution
Incidence of
Most Cancers
1930
1950
1970
Year
1990
Breast implant
Breast augmentation
Augmentation
Complications
Wrinkling
Reoperation
Loss of Nipple Sensation
Capsular Contracture
Implant Remova
Asymmetry
Intense Nipple Sensation
Breast Pain
Leakage/Deflation
Implant Palpability
Infection
Breast Sagging
Scarring Complications
20%
10%
8%
7%
6%
5%
4%
4%
2%
2%
1%
1%
2%
Wrinkling
Capsular contracture