Oncology Pathologies Flashcards
Lung Cancer
Cancer of the lungs
Aetiology:
* 90% due to smoking. Frequently follows COPD.
* More commonly affecting men (3:1)
* Second most common malignancy in men
* Peak incidence of lung cancer is between 6-70 years of age
Main signs and symptoms:
* Dry and persistent cough
* Dyspnoea and chest pain
* Weight loss and voice hoarseness
* Haemoptysis (bloody / raspberry sputum)
* Wasting of muscles in hand (if apical tumour)
* Clubbing of nails
Diagnosis/investigations:
* Sputum culture
* FBC
* Chest X-ray
* CT scan
Allopathic treatment:
* Radio / chemo therapy
* Surgery
Alternative treatment:
* Herbs
* Nutritional supplements – antioxidants
* Plant base diet – alkalizing
* Homeopathy
* Acupuncture
Other notes:
* Five year survival rate of 15%
* 95% arise in bronchi. Diagnosed by x-ray.
* A study found that a diet rich in fruit and vegetables reduces the incidence of lung cancer by 25%
* Most commonly secondary cancers = colorectal, osteosarcoma, prostate
Colorectal Cancer
- Cancer of the colon or rectum
Aetiology:
* Locally invasive but metastatic spread may be evident before growth produces symptoms – metastasizes to the liver, lungs, brain and bone
* More common over 50 years of age
* More common in developed countries
Risk factors:
* Strong link with diet high meat, low fibre, lack of vit. D.
* Polyps, Family history
Main signs and symptoms:
* Initially few symptoms
* Rectal bleeding, blood / mucus in stool
* Obstruction causing colicky abdominal pain
* Anaemia = fatigue, pallor, etc.
* Consistent change in bowel habits (diarrhoea / constipation)
Diagnosis/investigations:
* Colonoscopy and biopsy
* Stool analysis (occult (hidden) blood and M2-PK)
* Blood test (CEA and inflammatory markers)
Allopathic treatment:
* Radio / chemo therapy
* Surgery
* Palliative
Alternative treatment:
* Herbs
* Nutritional – supplements – anti-oxidants
* Plant-based diet – alkalising
* Homeopathy
* Acupuncture
Other notes:
* Screening in developed countries often involves stool analysis and endoscopy (looking for occult blood in stool)
* Five year survival: Stage I = 93%, Stage IV = 3%
* Most colorectal tumours are on the left side, 40% are in the rectum, 25% in the descending colon, the rest in the ascending colon (left sided pain more likely)
Benign Breast Masses
(Fibroadenoma / Fibrocystic)
- Benign mass / swelling in the breast
Aetiology:
* Most prevalent in pre-menstrual women and cysts often shrink following the onset of menses
Main signs and symptoms:
* Fibrocystic breast disease often presents as breast pain / tender masses / nodules
* Typically mobile, smooth and have regular borders (this differs from a malignant mass)
* Hormones are thought to be critical in aetiology
Other notes:
* Most breast lumps are benign – these will generally be cysts of fibroadenomas
* Pain not usually associated w/ breast cancer
Ovarian cancer
- Cancer that affects the ovaries
Aetiology:
* Mostly affects women over 40 yoa
* Generally oestrogen dependant, like breast cancer
Risk factors:
* Family history
* BRCA 1&2
* Long reproductive lifespan- late menopause, early menarche
* Infertility / never given birth
* HRT
* Poor lifestyle; exercise, smokers. Obesity
* Diet rich in animal fats
* Talcum powder used between legs
Main signs and symptoms:
* Early stage symptomatic
* Vague abdominal discomfort and bloating
* Abdominal mass with pelvic pain (through seeding along peritoneum)
* 75% present with advanced disease
* Later – change in bowel habits
Diagnosis/investigations:
* Ultrasound
* CT, MRI
* Bloods: CA-125 tumour marker
Other notes:
* Most lethal gynaecological malignancy
* Prognosis: 38% survival rate
Breast cancer
- Cancer of the breast (either ductal or lobular epithelial cells)
Aetiology:
* The most common female cancer
* Can also affect men (1% of breast cancer cases – associated with alcohol consumption and liver issues)
Risk factors:
Risk Factors:
* Breast cancer cells contain receptors that hormones or other proteins can bind to and promote tumour growth
- These receptors are most commonly for oestrogen (80%)
- The two other receptor sites are for ‘progesterone’ or epidermal growth factor’
- If a tumour contains none of the three-receptor types, the breast cancer is ‘triple negative’. Accounts for 15% cases
* Therefore, most breast cancer is known to be associated with oestrogen. High oestrogen exposure increases risk. The exposure can include endogenous and exogenous oestrogen.
- Risk Factors 1;
- Oestrogen ahs the ability to promote the growth of breast cancer cells (as it does at puberty and in pregnancy). Oestrogen is a hormone that will always promote the growth in the body
- BRCA1 or BRCA2 mutations increase the risk of breast (and ovarian) cancer. However, it is essential to consider the environment these genes are bathed in. These mutations only account for 5% of all breast cancer.
- A longer ‘reproductive life’ (early menarche, late menopause = higher oestrogen exposure), the combined oral contraceptive pill and HRT
- BPA (in plastics) – mimics oestrogen
- Risk factors 2:
- IGF-1 promotes breast cancer in women with high oestrogen levels (IGF-1 high in dairy)
- Breast quadrants and breast cancer; once oestrogen is metabolized, it has to leave the breast via the upper lateral quadrant, where most cancers occur
- Aluminum is found within many antiperspirants, which may be absorbed and cause oestrogen-like hormonal effects
- Parabens in deodorant can also mimic oestrogen (found in breast tumours)
- Upper medial quadrant tumours are becoming more common (mobile phones?)
Endogenous = from within, exogenous = from outside
Main signs and symptoms:
* Asymptomatic usually
* Painless, unilateral fixed lump (benign breast tumours are very common and typically present as mobile lumps)
* Overlying skin changes; i.e. dimpling, ‘orange peel’ appearance
* Asymmetry of breasts, inverted and discharging nipple
* Enlarged axillary lymph nodes
Diagnosis/investigations:
Mammography:
* An X-ray that directs radiation into breasts.
* Mammography looks for the presence of tumours – these tumours would have to reach a certain size before becoming visible on an x-ray (=
* Mammography increases breast cancer risk
Thermography:
* A safer and more effective method of detecting earlier pathological cancerous changes
* As already mentioned, as cancer cells divide they must undergo angiogenesis (increases the local temperature)
Allopathic treatment:
* Radiotherapy, Chemotherapy, Surgery
* Hormonal therapy; if oestrogen positive – ‘Tamoxifen’ (blocks oestrogen receptors). This can cause hot flushes, joint pains, osteoporosis, DVTs and sleep irregularities
Alternative treatment:
* Supporting oestrogen detoxification and elimination – plant based diet, diet high in fruit, vegetables
* Reduce obesity and alcohol, Ozone therapy (O3 rather than O2)
* Herbs – shitake mushrooms, green tea
* Homeopathy and Acupuncture
Complications:
* Metastatic spread via lymphatics
Cervical Cancer
- A cancer that is found anywhere in the cervix
Aetiology:
* Most common cancer I young women – commonly 25-35 years of age
* Persistent HPV infection (strains 16 + 18 cause 70%)
* Sexual behaviour (multiple partners, young age)
* Smoking, COPD
Main signs and symptoms:
* Non specific symptoms
* Abnormal vaginal bleeding (after sexual intercourse, between menstrual periods)
* Vaginal discharge
* White / red patches on cervix
Diagnosis/investigations:
Screening;
* 30% detected by screening
* Smear; detect cancerous & pre-cancerous changes
Diagnosis:
* Biopsy and histological examination
* MRI > CT
Allopathic treatment:
* Surgical – hysterectomy (preferred up to stage 2), Chemo-radiotherapy
Alternative treatment:
* Herbs
* Nutritional supplements – anti-oxidants
* Plant based diet – alkalising
* Homeopathy and acupuncture
Other notes:
* Accounts for 20% of all cancers in women
* 4,500 cases per year
Liver Cancer
- Primary liver cancer forms in the tissues of the liver
- Secondary liver cancer - metastasized from another part of the body
Aetiology:
* More common in men over 60 yeo
* Associated with liver cirrhosis; alcohol, toxins = necrosis > chronic inflammation and cell proliferation
* Hepatitis b/C = viral integration into host genome (host DNA deletions; oncogenes activated)
Necrosis = cell / tissue death, Genome =complete set of genes in a cell
Main signs and symptoms:
* In the advanced stages; Jaundice, ascites, hepatomegaly
* Pruritis (itchy skin), bleeding oesophageal varices (dark stools/vomiting blood -secondary to portal hypertension), weight loss
* Vomiting, loss of appetite, feeling very full after eating, feeling sick, pain or swelling in the abdomen, fatigue and weakness
Hepato = liver, -megaly = enlargemn, ,Aascites = fluid in peritoneum
Allopathic treatment:
* Surgery – transplant, portal vein embolisation
Alternative treatment:
* Herbs
* Nutritional supplements
* Plant based diet rich in nutrients and anti-oxidants
* Alkalising the body
* Homeopathy and Acupuncture
Other notes:
* Usually co-exists with liver-cirrhosis
Gastric Cancer
- Cancer that forms in the tissues lining the stomach (AKA stomach cancer
Gastric = of the stomach
Aetiology:
* Diet rich in salted, pickled and smoked foods (N-nitroso compounds)
* Male, smoking, age (55+)
* H.pylori infection
* Low fruit and vegetables diet
Main signs and symptoms:
* Early stages: Persistent indigestion, frequent burping, heartburn, feeling full quickly when eating, bloated, abdominal discomfort
* Advanced stages: Black blood in stools (black / tarry stool), loss of appetite, weight loss, tiredness, anaemia, jaundice (metastasis to portal vein)
Diagnosis/investigations:
* Blood in stool. Endoscopy, biopsy
* Tumour markers: CEA and CA 19-9
Allopathic treatment:
* Herbs
* Nutritional supplements – anti-oxidants
* Diet is essential for all forms of cancer – plant based diet rich in nutrients & antioxidants, alkalising body
* Homeopathy and acupuncture
Alternative treatment:
* Gastrectomy
* Chemo / Radiotherapy
Other notes:
* 2nd cause of cancer related death in the world (highest rates in Eastern Asia, with the highest rates worldwide being Korea and Japan)
Oesophageal cancer
- Cancer that affects the oesophagus
Aetiology:
* Chronic irritation, alcohol, smoking
* GORD and Barrett’s oesophagus
* Obesity, low fruit and veg diet, age
Main signs and symptoms:
* Few early symptoms, later obstruction may occur
* Dysphagia (Red flag!)
* Anorexia and melaena (due to oesophageal bleeding)
Allopathic treatment:
* Herbs
* Nutritional supplements – antioxidants
* Diet is essential –plant based diet rich in nutrients and antioxidants
* Alkalising the body
Other notes:
* A common aggressive cancer with a poor prognosis
Pancreatic Cancer
- Cancer of the pancreas
Pathophysiology:
* Most arise from exocrine cells
* Less commonly from endocrine Islet cells (pancreatic neuroendocrine tumour)
Aetiology:
* Common in older people, uncommon in people under 40 years – poor prognosis
Cause is unknown, but risks include;
* Age, smoking, family history (germ line defects in 5-10%)
* Other health conditions (diabetes, chronic pancreatitis, H.pylori)
Main signs and symptoms:
* Asymptomatic early
* Epigastric pain radiating to the back
* Unexplained weight loss, anorexia and fatigue
* Jaundice
* Post-prandial nausea
* Glucose intolerance (Neuroendocrine tumours)
Endocrine = hormones
Allopathic treatment:
* Surgery
* Chemo / Radiotherapy (adverse effects)
* Palliative care
Alternative treatment:
* Nutritional supplements and primarily plant based diet rich in nutrients and antioxidants, alkalising the body
* Herbs, homeopathy and acupuncture
Other notes:
* Approx 60% metastatic at diagnosis
* Poor prognosis – average life expectancy from diagnosis is 6 months
Prostate Cancer
- Cancer that forms in the tissues of the prostate
Aetiology:
* Most common cancer in men
* Generally 50+ years
Main signs and symptoms:
* Same urinary symptoms as BPH
* Key symptoms include nocturia and haematuria
* Back pain can indicate bone metastases
* Poor urinary flow
* Stop / start, dribbling
Dysphagia = difficulty swallowing, meaena = black tarry stools)
Diagnosis/investigations:
* Elevated PSA
* Digital rectal examination
* Biopsy
Allopathic treatment:
* Radiotherapy (localized, non invasive), Chemotherapy
* Androgen deprivation therapy
* Surgery (removal)–50% never recover urinary/erectile function
Alternative treatment:
* Obesity is a significant risk factor
* High meat consumption (esp. char-grilled), dairy and saturated fats, refined sugars increase risk
* Fish, fruit, vegetables, soy and a plant based diet show to have protective factors
* Herbs – Boswellia (frankiscence), carotenoids (antioxidants), green tea
Other notes:
* Most common cancer in men – increasing incidence
* 90% of prostate cancer never grows out of the capsule
Bladder Cancer
- Cancer that forms in the tissues of the bladder
Pathophysiology:
* Commonly originates from transitional epithelial cells in the bladder
Aetiology:
* 2 x more common in men and most common between 70-80 yoa
* Smoking (amines / hydrocarbons = carcinogens = pool in the bladder and induce mutations)
* Chronic cystitis, increasing age, catheterisation
Main signs and symptoms:
* Painless haematuria (90%)
* Increased urine frequency, urgency, dysuria
* Bone metastases (with pain e.g. in spine)
Cysto = referring to bladder, -ectomy = removal, dysuria = painful urination
Diagnosis/investigations:
* Transurethral resection or cystectomy
Testicular Cancer
- Cancer that forms in one or both of the testicles
Aetiology:
* Most common cancer in young men (15-35 yrs)
* Higher risk if undescended testis and family history
* Cause not fully known
Main signs and symptoms:
* Hard, painless, unilateral mass (95% present with a lump on testes)
* Dragging sensation and dull ache
* Metastasises to bone, brain, lungs and liver
Allopathic treatment:
* Orchidectomy
Alternative treatment:
Support:
* Regular, monthly self-examination
* Herbs
* Nutritional supplements – antioxidants
* Diet is essential for all forms of cancer – primarily plant based diet rich in nutrients and antioxidants
* Homeopathy and acupuncture
Other notes:
* Excellent prognosis if caught early; Orchidectomy
Skin Cancers
- Cancer that forms in the tissues of the skin
- Skin cancer types differ based on the cells affected
Aetiology:
* Most common in fair skinned people aged 40+
* Cases are on the increase. Strong connection to UV light exposure and the chemicals in sunscreens
Main signs and symptoms:
* Usually arise on head, neck or back (sun-exposed areas most commonly)
- Asymmetry; unsymmetrical halves of lesions / moles may signify be malignancy
- Border; Non-malignant tumours = smooth, regular border. Early melanoma = jagged or uneven
- Colour; One colour = good sign. Melanomas have a variety of colours, particularly shades of black, brown, pink, tan. Also can be blue, red and other colours
- Diameter; non-malignant skin cancers tend to be smaller than ¼ inch in diameter. Melanomas are usually larger
- Evolving; Changes in colour, elevation, size or shape, or if new symptoms arise such as bleeding, itchiness, crusting, it could be dangerous
Other notes:
* Highest rate of reoccurrence
* Visible, generally easily detected and develop slowly = good prognosis
Squamous Cell Carcinoma
(Non melanoma skin cancer)
- Malignant tumour from keratanised epithelial cells
Main signs and symptoms:
* A red, scaling, thickened nodule / patch on sun-exposed skin
* Some are firm hard nodules with central necrosis = ulcer / bleeding
* When not treated, it may develop into a large mass
Other notes:
* Second most common skin cancer
* It is dangerous, but not nearly as dangerous as a melanoma
