A.

9 Warning Signs of Cancer C A U T I O N U S changes in bowel and bladder habits a sore that does not heal Unusual bleeding or discharge Thickening or a lump in the breast or elsewhere Indigestion or difficulty in swallowing Obvious change in wart or mole Nagging cough or hoarseness Unexplained anemia Severe weight loss

B. Difference of Benign and Malignant Neoplasm

Characteristics Cell characteristics

Benign Benign tumors are made of fullydifferentiated cells which is identical to the organ or tissue where it originated

Malignant Malignant tumors usually consists of unspecialized cells which undergo anaplasia and takes an unusual form with little resemblance to its tissue of origin.

Rate of growth

Benign tumors usually grow in a slow but progressive rate. As it grows, it may come to a standstill or regress.

Mode of growth

Metastasis

The rate of growth of malignant tumors varies and depends widely on the level of the cells differentiation. The more the cells are anaplastic, the faster is the rate of growth of the malignant tumor. Benign tumors grow by expanding Malignant tumors, unlike benign themselves. However, they do not tumors, grow by invasion where invade other tissues around them they infiltrate other tissues and and they are usually cells. encapsulated with a fibrous capsule. Benign tumors do not metastasize Malignant tumors metastasize to to other sites. other distant tissues by gaining access to circulatory mechanisms (lymph and blood).

General effects

Tissue destruction

Is usually a localized phenomenon that does not cause generalized effects unless its location interferes with vital functions Does not usually cause tissue damage unless its location interferes with blood flow

Often causes generalized effects, such as anemia, weakness, and weight loss

Ability to cause death

Death not usually cause death unless its location interferes vital function

Often causes extensive tissue damage as the tumor outgrows its blood supply or encroaches on blood flow to the area; may also produce substances that cause cell damage Usually cause death unless growth can be controlled

Benign Local Cohesive Well-defined Borders Pushes other tissues out of the way Slow growth Encapsulated Easily removed Does not recur

Malignant Invasive Noncohesive Does not stop at tissue border Invades and destroys surrounding tissues Rapid growth Metastasizes to distant sites Not always easy to remove Can recur

C. Benign and Malignant Tumors according to tissue type Tissue type Epithelial Surface glandular Connective Fibrous Adipose Cartilage Bone Blood vessels Lymph vessels Lymph tissue Benign tumors Papilloma Adenoma Fibroma Lipoma Chondroma Osteoma Hemangioma Lymphangioma Malignant tumors Squamous cell carcinoma Adenocarcinoma Fibrosarcoma Liposarcoma Chondrosarcoma Osteosarcoma Hamangiosarcoma Lymphangiosarcoma Lymphosarcoma

Muscle Smooth Striated Neural Nerve cell Glial tissue Nerve sheaths Meninges Hematologic Granulocytic Erythrocytic Plasma cells Lymphocytic Monocytic Endothelial Blood vessels Lymph vessels

Leimyoma Rhabdomyoma Neuroma Glioma (benign) Neurilemmoma Meningioma

Leiomyosarcoma Rhabdomyosarcoma Neuroblastoma Glioblastoma, astrocytoma, medulloblastoma, oligodendroglioma Neurilemmal sarcoma Meningeal sarcoma Myelocytic leukemia Erythrocytic leukemia Multiple myeloma Lymphocytic leukemia or lymphoma Monocytic leukemia

Hemangioma Lymphangioma

Hemangiosarcoma Lymphangiosarcoma

D. Screening Test/s and Laboratory Exam for Detection of Cancer Name of Screening Test Clinical breast examination Self-Breast examination CBE SBE Mammogram Fecal occult blood test Flexible Sigmoidoscopy Colonoscopy Doublecontrast barium enema Frequency Age Tumor markers

Every 3 years

20-39

Every Month > 40 Every Year

Breast

Every Year Every 5 Years Every 10 Years Every 5 years

> 50

Colon/Rectum

Prostatespecific antigen and digital rectal examination Papanicolaou (Pap) test

Every Year

> 50 (40-45 if fat high risk)

Prostate

Every year if regular Pap; every 2 years if liquid Pap test Every year

> 21 or within the 3 years after starting to have intercourse

Cervix

Pelvic examination

Tumor Markers Tumor markers are substances that can be detected in higher than normal amounts in the blood, urine, or body tissues of some people with certain types of cancer. Tumor Marker Primary Tumor Site Normal Values Antidiuretic Hormone (ADH) Alpha-feto Protein (AFP) Small cell cancer, adenocarcinoma Liver, germ cell cancer of ovaries of testis Bladder Breast Pancreas colorectal Ovarian Thyroid medullary carcinoma 1-5 pg/mL 0-6.4 I/ mL in men and nonpregnant women or <15ng/mL Not detected <31 U/mL <33 U/mL 0-35 U/mL Basal : < 0.155 ng/mL for men < 0.105 ng/mL for women < 3 ng/ mL in non-

BTA (Bladder Tumor Antigen CA15-3 (carbohydrate antigen 15-3) CA19-9 CA 125 Calcitonin

Carcinoembryonic

Colon

antigen (CEA) Createnin-kinase-CK hCG (human chorionic gonadotropin) Her2neu (cerbB2) Breast, ovary, colon, prostate Trophoblastic disease, Choriocarcinoma Breast

smokers < 5 ng/mL in smokers 40-200 u/L in men 35-150 u/L in women > 31 IU/mL No normal. The test is to determine if the tissue over expresses her2neu 100-210 u/L

Lactic dehydrogenase (LDH) Neuron-specific enolase (NSE) NMP 22 Prostatic acid phosphatase (PAP)

Lymphoma, seminoma, acute leukemia, metastatic carcinoma Neuroblastoma, small cell lung cancer Bladder Metastatic cancer of prostate. Myeloma, lung cancer, osteogenic sarcoma Prostate

< 13 ng/mL <10 0.5-1.9 u/L

Prostate specific antigen (PSA)

< 4 ng/mL

E. How are neoplasm Graded and Staged? Grading system seek to define the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and histologic characteristics of the tissue of origin. Grade I: Cells differ slightly from normal cells (mild dysplasia) and are well differentiated Grade II: Cells are more abnormal (moderate dysplasia) and moderately differentiated Grade III: Cells very abnormal (sever dysplasia) and poorly differentiated Grade IV: Cells are immature and primitive (anaplasia) and undifferentiated Staging determines the size of tumor and existence of metastasis Stage 0: Cancer Situ Stage I: tumor limited to the tissue of origin; localize tumor growth Stage II: limited local spread Stage III: extensive local and regional spread Stage IV: metastasis

TNM classification system Primary Tumor (T) T0 No evidence of primary tumor Tis Carcinoma in situ T1-4 Ascending degrees of increase in tumor size and involvement Tx Tumor cannot be measured or found Regional Lymph Nodes (N) N0 No evidence of disease in lymph nodes N1-4 Ascending degrees of nodal involvement Nx Regional lymph nodes unable to be assessed clinically Distant Metastases (M) M0 No evidence of distant metastases M1-4 Ascending degrees of metastases involvement of the host , including distant nodes Mx Cannot be determined