1. What are the classification of cancer?

Cancer classification is made according to the site of origin of the malignant cells; the
histology, or cell analysis (called grading); and the extent of the disease (called staging).

Site of Cancer Origin

This classification describes the type of tissue in which the cancer cells begin to develop.
Here are some common examples of site of origin classification:

Carcinoma
Carcinoma refers to a malignant neoplasm of epithelial origin or cancer of the internal or
external lining of the body. Carcinomas, malignancies of epithelial tissue, account for 80
to 90 percent of all cancer cases.
Carcinomas are divided into two major subtypes: adenocarcinoma, which develops in an
organ or gland, and squamous cell carcinoma, which originates in the squamous
epithelium.
Adenocarcinomas generally occur in mucus membranes and are first seen as a
thickened plaque-like white mucosa. They often spread easily through the soft tissue
where they occur. Squamous cell carcinomas occur in many areas of the body.
Most carcinomas affect organs or glands capable of secretion, such as the breasts,
which produce milk, or the lungs, which secrete mucus, or colon or prostate or bladder.

Sarcoma
Sarcoma refers to cancer that originates in supportive and connective tissues such as
bones, tendons, cartilage, muscle, and fat. Generally occurring in young adults, the most
common sarcoma often develops as a painful mass on the bone. Sarcoma tumors
usually resemble the tissue in which they grow.
Examples of sarcomas are:

Osteosarcoma or osteogenic sarcoma (bone)

Chondrosarcoma (cartilage)

Leiomyosarcoma (smooth muscle)

Rhabdomyosarcoma (skeletal muscle)

Mesothelial sarcoma or mesothelioma (membranous lining of body cavities)

Fibrosarcoma (fibrous tissue)

Angiosarcoma or hemangioendothelioma (blood vessels)

Liposarcoma (adipose tissue)

Glioma or astrocytoma (neurogenic connective tissue found in the brain)

Myxosarcoma (primitive embryonic connective tissue)

Mesenchymous or mixed mesodermal tumor (mixed connective tissue types)

Myeloma
Myeloma is cancer that originates in the plasma cells of bone marrow. The plasma cells
produce some of the proteins found in blood.

Leukemia
Leukemias ("liquid cancers" or "blood cancers") are cancers of the bone marrow (the site
of blood cell production). The disease is often associated with the overproduction of
immature white blood cells. These immature white blood cells do not perform as well as
they should, therefore the patient is often prone to infection. Leukemia also affects red
blood cells and can cause poor blood clotting and fatigue due to anemia. Examples of
leukemia include:

Myelogenous or granulocytic leukemia (malignancy of the myeloid and

granulocytic white blood cell series)
Lymphatic, lymphocytic, or lymphoblastic leukemia (malignancy of the lymphoid
and lymphocytic blood cell series)
Polycythemia vera or erythremia (malignancy of various blood cell products, but
with red cells predominating)

Lymphoma
Lymphomas develop in the glands or nodes of the lymphatic system, a network of
vessels, nodes, and organs (specifically the spleen, tonsils, and thymus) that purify
bodily fluids and produce infection-fighting white blood cells, or lymphocytes. Unlike the
leukemias which are sometimes called "liquid cancers," lymphomas are "solid cancers."
Lymphomas may also occur in specific organs such as the stomach, breast or brain.
These lymphomas are referred to as extranodal lymphomas. The lymphomas are
subclassified into two categories: Hodgkin lymphoma and Non-Hodgkin lymphoma. The
presence of Reed-Sternberg cells in Hodgkin lymphoma diagnostically distinguishes
Hodgkin lymphoma from Non-Hodgkin lymphoma.

Mixed Types
The type components may be within one category or from different categories. Some
examples are:

adenosquamous carcinoma

mixed mesodermal tumor

carcinosarcoma

teratocarcinoma

Tumor Grading
Grading involves examining tumor cells that have been obtained through biopsy under a
microscope. Theabnormality of the cells determines the grade of the cancer. Increasing
abnormality increases the grade, from 14. Cells that are well differentiated closely resemble
mature, specialized cells. Cells that are undifferentiated are highly abnormal, that is,
immature and primitive.
Grade
Grade
Grade
Grade

1
2
3
4

Cells
Cells
Cells
Cells

slightly abnormal and well differentiated

more abnormal and moderately differentiated
very abnormal and poorly differentiated
immature and undifferentiated

Cancer Staging
Staging is the classification of the extent of the disease. There are several types of
staging methods. Thetumor, node, metastases (TNM) system classifies cancer by tumor
size (T), the degree of regional spread or node involvement (N), and distant metastasis (M).
Tumor (T)

T0 No evidence of
tumor
Tis
T1-4

Carcinoma in situ (limited to

surface cells)
Increasing tumor size and
involvement

Node (N)

N0 No lymph node involvement

N1- Increasing degrees of lymph node
4
involvement
Lymph node involvement cannot be
Nx assessed

Metastases (M)

No evidence of distant
M0 metastases
Evidence of distant
M1 metastases

A numerical system also is used to classify the extent of disease.

Stage
Stage
Stage
Stage
Stage

0
I
II
III
IV

Cancer in situ (limited to surface cells)

Cancer limited to the tissue of origin, evidence of tumor growth
Limited local spread of cancerous cells
Extensive local and regional spread
Distant metastasis

2. Compare benign and malignant tumors

Thetermbenignisusedtodescribebothmedicalconditionsandtumorsandusuallyrefersto
aprocessthat'snotespeciallydangerous.
Thetermmalignantisoftenusedsynonymouslywiththeworddangerousinmedicine.

Somesimilaritiesinclude:

Bothcangrowquitelarge.Sizealonedoesnotmakethedistinctionbetweenthese
typesoftumors.Infact,benignovariantumorsweighingoverahundredpoundshave
beenremoved.

Bothcanbedangerousattimes.Whilebenigntumorstendtobemoreofanuisance,
theycan,insomecases,belifethreatening.Anexampleisbenignbraintumors.
Whenthesetumorsgrowintheenclosedspaceofthebrain,theycanputpressureon,
anddestroyotherbrainstructures,resultinginparalysis,speechproblems,seizures,
andevendeath.Somebenigntumors,suchaspheochromocytomas,secretehormones
thatcancauselifethreateningsymptomsaswell.

Bothcanrecurlocally.Ifcellsareleftoveraftersurgery,bothbenignandmalignant
tumorsmaylaterrecurneartheregionoftheoriginaltumor.

3. What are the common sites of cancer?

Medical professionals frequently refer to cancers based on their histological type.
However, the general public is more familiar with cancer names based on their primary
sites. The most common sites in which cancer develops include:

Skin
There are three primary types of skin cancer: basal cell, squamous cell, and
melanoma. These cancers are derived from the epidermal layers with the same names.
Melanomas are derived from the melanocytes, or pigment cells, in the deepest level of
the epidermis. Basal cell and squamous cell cancers usually occur on parts of the body
exposed to the sun, such as the face, ears, and extremities. These cancers are highly
curable, especially if detected and treated early. Melanomas, which form dark moles that
spread over the surface of the skin, are more lethal because they metastasize very
quickly.

Lung
Lung cancer is very difficult to detect at an early stage because the symptoms often do
not appear until the disease has advanced. The symptoms include persistent cough,
sputum streaked with blood, chest pain, and repeated attacks of pneumonia or
bronchitis.

Female Breast
Women most likely to develop the disease are those over the age of 50; those who have
already had cancer in one breast; those whose mother or sister had breast cancer; those
who never had children; and those who had their first child after the age of 30. Other risk
factors include obesity, a high-fat diet, early menarche (age menstruation begins) and
late menopause (age menstruation ceases).
Monthly breast self-examination is recommended as a way to detect breast cancer early.
Most of the lumps found in the breasts are not cancerous, but women should see their
physicians to find out for sure.

Prostate
Cancer of the prostate is found mainly in older men. As men age, the prostate may
enlarge and block the urethra or bladder. This may cause difficulty in urination or
interference in sexual functions. This condition is called benign prostatic hypertrophy
(BPH). Although BPH is not cancerous, surgery may be needed to correct it. The
symptoms of BPH, or of other problems in the prostate, may be similar to symptoms for
prostate cancer.
Individuals should consult a physician if any of the following symptoms appear: weak or
interrupted flow of urine; urinating often (especially at night); difficulty urinating; pain or
burning sensation during urination; blood in the urine; or nagging pain in the back, hips,
or pelvis. Often there are no symptoms of early cancer of the prostate.

Colon and Rectum

Of the cancers that affect the large intestine, about 70 percent occur in the colon and
about 30 percent in the rectum. These cancers are the third most common cancers

overall. Symptoms include blood in the stool, which can be tested for by a simple fecal
occult blood test, or a change in bowel habits, such as severe constipation or diarrhea.

Uterus (Corpus Uteri)

Cancer of the uterus is the most common gynecologic malignancy. This cancer occurs
infrequently in women under 40 years of age. It occurs most frequently after the age of
60. The presenting symptom is usually abnormal uterine bleeding. An endometrial
biopsy or D&C is often performed to confirm the diagnosis.
Currently, there has been little insight into the exact causes for uterine cancer. However,
10-25 percent of malignancies occur in women who received pelvic radiation five to 25
years earlier for benign bleeding. As in other cancers of its type, risk factors for uterine
cancer include diabetes, hypertension, obesity, and improper estrogen levels.

4. What are the causes of cancer

Smoking/ Tobacco Use
Chemicals in cigarette smoke enter the blood stream and can then affect the entire body.
This is why smoking causes so many diseases, including at least 14 types of cancer, heart
disease and various lung diseases. Smoking is by far the biggest preventable cause of
cancer.

Unhealthy Diet
Many studies have shown that eating lots of red and processed meat can increase the risk
of bowel cancer, and possibly stomach and pancreatic cancer.
Chemicals called nitrates and nitrites are often used to preserve processed meat. In the
bowel nitrites can be converted into cancer-causing chemicals called N-nitroso compounds
(NOCs). The presence of these chemicals may explain why many studies have found that
processed meat increases the risk of cancer to a greater extent than red meat.

Obesity
Extra fat in the body can have harmful effects, like producing hormones and growth factors
that affect the way our cells work. This can raise the risk of several diseases, including
cancer.
Fat cells in the body are active and produce hormones and proteins that are released into
the bloodstream and carried around the body. Because they are spread through the
circulation, these chemical messengers can affect many parts of the body, and increase the
risk of several different types of cancer.

Alcohol Consumption

Alcohol can increase the levels of some hormones, such as oestrogen. Hormones act as
messengers in the body, giving our cells instructions such as when to divide. Unusually high
levels of oestrogen increase the risk of breast cancer.
In our bodies, alcohol (ethanol) is converted into a toxic chemical called acetaldehyde.
Acetaldehyde can cause cancer by damaging DNA and stopping our cells from repairing this
damage. It also causes liver cells to grow faster than normal. These regenerating cells are
more likely to pick up changes in their genes that could lead to cancer.

Exposure to ultraviolet radiation

Overexposure to ultraviolet (UV) radiation from the sun or sunbeds is the main cause of skin
cancer. Too much UV radiation from the sun or sunbeds can damage the genetic material
(the DNA) in your skin cells. If enough DNA damage builds up over time, it can cause cells to
start growing out of control, which can lead to skin cancer.

Viruses

Normally, Human Papillomavirus infections start in the deepest layers of the skin. During an
infection, HPV causes skin cells to divide more than usual. New virus particles are then
made inside these cells. This fast skin growth can cause warts to develop, but often it
doesnt cause any symptoms at all. In some people with persistent high-risk HPV infections,
the virus damages the cells' DNA and causes cells to start dividing and growing out of
control. This can lead to cancer.
Inheritance or Family History
Some faulty genes that increase the risk of cancer can be passed on from parent to child.
These are called inherited cancer genes. This occurs when there is a mistake or a fault in the
genes in an egg or sperm cell. Then the gene fault can be passed on to children.

Carcinogens
Substances and exposures that can lead to cancer are called carcinogens. Some carcinogens do
not affect DNA directly, but lead to cancer in other ways. Substances labeled as carcinogens may
have different levels of cancer-causing potential. Some may cause cancer only after prolonged,
high levels of exposure.

5. Explain cellular/ cell division

Multi cellular organisms, like humans, are made up of billions of cells. These cells need
to divide and copy themselves for a variety of reasons. The most common form of cell
division is called mitosis. It is used for growth and repair. During mitosis, a cell makes
an exact copy of itself and splits into two new cells. Each cell contains an exact copy of
the original cell's chromosomes in their 23 pairs. This is the reason why all the cells in an
organism are genetically identical.
Mitosis is closely controlled by the genes inside every cell. Sometimes this control can
go wrong. If that happens in just a single cell, it can replicate itself to make new cells that
are also out of control. These are cancer cells. They continue to replicate rapidly without
the control systems that normal cells have. Cancer cells will form lumps, or tumours, that
damage the surrounding tissues. Sometimes, cancer cells break off from the original
tumour and spread in the blood to other parts of the body. When a tumour spreads to
another part of the body it is said to have metastasized. They continue to replicate and
make more tumours. These are called secondary tumours.