HUMANITAS HOSPITAL:

Oncology

What’s cancer?

Is the name of a group of diseases in which we observe an

uncontrolled process in the division of the cells in the human

body. This cells make a tissue called neoplasia which is bigger

than other normal tissues and it’s not coordinated with the

rest of the body, it doesn’t have any role and it’s autonomous.

It can be expanded to nearby tissues. In general ,cancer can

kill people if they don’t receive the treatment they need.

Cancer cells

multiply in a

disordered and

uncontrolled way

forming tumors

that invade normal

tissues

The main reason why it is so dangerous is because of its

capacity of expanding to some parts of the body like bones,

tissues and organs through the blood.

The process in which the cancer cells travel to other parts of

the body is called metastasis.

Bladder cancer starts when cells that make up the urinary

bladder start to grow out of control. As more cancer cells

develop, they can form a tumor and go to other parts of the

body.

Metastatic Bladder cancer

Types:Urothelial carcinoma; is the most common type of bladder

cancer, about 90% of all that are diagnosed. It begins in the

urothelial cells found in the urinary tract.

Squamous cell carcinoma; Squamous cells develop in the

bladder lining in response to irritation and inflammation. Over

time, these cells may become cancerous. It is not very

common, but it occupies a 4% of all the bladder cancers.

Adenocarcinoma; only about 1% of bladder cancers are

adenocarcinomas.This type develops from glandular cells and

accounts for about 2% of all bladder cancers and

The first bladder cancers were found in 1854, through the

years, new ways of treating and discovering the cancer were

developed. Now, the technology helps the doctors to detect

cancerous tumors in the bladder that are invisible to the

naked eye.

History:

The majority of the cases are registered in developed

countries, especially in the South of Europe and North

America. It is more common in men. Most of the cases are

found in between 65 and 75 year old people. Maybe it can

appear between the 40 and 45 years.

Epidemiology:

The most common symptoms are urinary problems, blood in

the urine, pain or obstruction of urine.

The cystoscopy is an exam that allows the inspection of the

inside of the bladder and the urethra in order to detect the

presence of the tumor. There are also specific tests like the

Histopathologic exam in which tissue samples are subjected

to an exam in the laboratory to know the characteristics of

the tumor to determine the type of bladder cancer.

Diagnosis and symptoms:

Treatment:

Cystoscopy, transurethral resection (RTU)

Chemotherapy or instalated immunotherapy directly in the

bladder.

If these treatments fail, the extirpation of the bladder

(cistectomia) would be an option.

Prevention:

The best way of preventing the appearance of the bladder

cancer is by not smoking, controlling the occupational risk

(limit the exposition to certain chemical substances at work),

drink a lot of liquids, mainly water and eating lots of fruits and

vegetables. This ways may work or not. Scientist can't prove

these ways will prevent for sure the bladder cancer.

Transmission:

Bladder cancer can't be transmitted, but we can influence in

someone to smoke, which may cause him/her bladder cancer.

Colon cancer

It takes place when colon cells start growing uncontrollably.

Some main types: - Adenocarcinoma: Cancer of the cells that line the inside

surface of the colon- Carcinoid Tumors: Develop in the neuroendocrine cells

that form the lining of the gastrointestinal tract. The tumors grow relatively slow

- Lymphoma: Cancer of the immune system, more commonly starts in the lymph nodes but can start in the colon

Colon cancer

It is one of the cancers with the highest incidences nowadays.

It was in the 18th century when they started developing some treatments.

The risk of suffering from this cancer is slightly low in women, it is more usual to develop this cancer during our 50’s, also if you drink alcohol in excess, if you eat a high-fat/low-fiber diet, if you smoke…

This cancer can also be hereditary.

The most important step to prevent colon cancer is to talk to your doctor about getting screened.

The tests used to screen the diagnosis of colon cancer include: colonoscopy, contrast radiography colon, blood and stool DNA test…..

There are many symptoms of colon cancer, that vary depending on the person:

- Bright red or dark red blood in your faeces.- Feeling like you cannot completely empty your insides.- Abdominal discomfort and muscular pain.

Colon cancer: Prevention, diagnostic and symptoms

Depending on the development of the cancer you can remove it by different ways:

Laparoscopic surgery: With this technique, several viewing scopes are passed into the abdomen while a patient is under anesthesia. The surgeon removes the cancer in that moment, without opening a wound.

Colostomy for rectal cancer: Rectal cancer is less often, the person with rectal cancer may need to have a colostomy. This is a surgical opening through which the colon is connected to the abdominal surface and provides a path for waste to exit the body. This waste is collected in a pouch worn by the patient.

There are lot of other ways, but this two ones are the most common ones.

Colon cancer: Treatments

COLOSTOMY

The prostate is a gland that is found under the bladder of

men and produces fluid for semen. Prostate cancer is

common in older men.

This cancer is an illness where malignant cancerous cells are

form in the tissues of the prostate.

Prostate cancer

CAUSES

● Generic factors

● Hormonals factors

● Ambiental factors

- High fat diet.- The pollution on the air.- The expansion to the smoke of the

exhaust pipe In transports.

● Involuntary loss of urine

● Increased frequency of urination

● Pain and stinging during urination

● Feeling of incomplete emptying of the bladder

● Urinary retention

SYMPTOMS

PREVENTIONS

● The antioxidant

substances present in

tomatoes and

watermelons or the

isoflavones found in

soybeans.

● There is currently no

preventive medication.

● Prostate biopsy

● Digital rectal exam (rectal

examination)

● Urine test

● Blood test

DIAGNOSTIC

TREATMENTS

● Hormonal therapy

● Surgery:

- retropubic prostatectomy :

abdomen incision

- prostatectomy: incision

included between the scrotum

and the anus.

It’s ocasonated when cancerous cells growth without control

and it affect the pancreas tissue developing a tumor.

Pancreatic cancer

Exocrine tumors: Most tumors affecting the exocrine

gland are called adenocarcinomas. This type of

cancer is form in the pancreas ducts.

There are some types of cancerous cells:

Pancreatic cancer

It is not known when the first case of pancreatic cancer

occurred but it is the most deadly cancer, only 5% of

patients survive more than five years after diagnosis

and 75% do not exceed the first year. And the risk of pancreatic cancer increases as the person ages. Almost all patients are over 45 years of age. About two-thirds of patients are at least 65 years of age. The average age at the time of diagnosis is 71 years.

Pancreatic cancer

Epidemiology

The overall incidence of pancreatic cancer is10 of 100,000 inhabitants in our country and occupies the sixth and ninth place of mortality in women and men,respectively. That is to say that they occur between 350 to 400 new cases a year of this type of tumors. 80%of these are acinar adenocarcinomas, most ofcephalic location.

Pancreatic cancer

Factors such as age, gender, race and family history can not be controlled.But if you do not smoke, maintain a healthy weight, limit alcohol consumption and exposures to certain chemicals you can prevent having this cancer.

Prevention

Pancreatic cancer

Symptomsabdomen or back pain, weight loss, lack of appetite, nausea, vomiting and enlargement of the liver.

Causes

the cells stop working for a change in the DNA and cause the formation of tumors.These tumors begin to expand and affect organs near the pancreas such as the gallbladder

Pancreatic cancer

Diagnosticexams that create images of your internal organs (to visualize them), physical exams (such as skin, tongue or eyes) and blood tests (to detect specific proteins that are released from cancer cells in the pancreas).

Treatment

According to the type and stage in which this cancer is, we have surgery, radiotherapy and chemotherapy.

Pancreatic cancer

SURGERY:Potentially curative surgery is used when the results of exams and tests suggest that it’s possible to remove all the cancer.Palliative surgery may be done if tests show that the cancer is too widespread to be removed completely. This surgery is done to relieve symptoms or to prevent certain complications like a blocked bile duct or intestine, but the goal is not to cure the cancer.

Treatment

Bone cancer

Bone cancer are damaging cells found in bones.

There are 3 types: OSTEOSARCOMA (the cancer cells appear

in the new tissue of bones in growth), CHONDROSARCOMA

(takes place in the cartilage) and EWING SARCOMA (it is

developed in the nervous tissue, normally in bone marrow).

This cancer has existed for a really long time. There are some

bone remains from the XIV century that identify the first bone

cancer in America.

Bone cancer

Bone cancer is more common in males, and each type has a

more common age: Osteosarcoma (adolescents),

Chondrosarcoma (50-60 years old) and Ewing Sarcoma

(adolescents).

The symptoms are basically persistent pain or inflammation of

the bone.

Bone cancer

Nowadays bone cancer can’t be prevented, but there are

some factors that increase the possibilities to have it, like for

example having previously received external radiation.

Diagnosis: you can identify it by multiple ways; x-rays,

magnetic resonance, positron emission tomography, blood

tests...

Bone cancer

There are 4 types of treatment, usually doctors use at least 2

of them in each patient:

SURGERY (depending on the part/limbs:amputation),

CHEMOTHERAPY, RADIATION and TARGETED THERAPY.

Bone cancer has no transmission, just a low percentage is

hereditary.

Bone cancer: Experience

He was 12 years old when doctors told him he had an Ewing Sarcoma on his

right part of the pelvis. At first he noticed pain after water-polo trainings. Then

pain started to get bigger, he lost weight and started to limb. Doctors told him

he could have the flu, contractures or the worst he could have was a fracture.

After that he got palid, that’s when doctors looked deeper on him. He went

through chemotherapy and after that, through an experimental

immunotherapy. Because the tumor was on the pelvis, he couldn’t be operated.

His family always lived without making plans for the future, they just enjoyed

the moments they were living.

He passed away 6 months ago. People with cancer really need support.

Is the disease of blood-producing organs characterized by

excessive proliferation of leukocytes or white blood cells in

the blood and bone marrow.

It’s more common in men’s over 65 , but it’s also common in

children.

Leukemia

Types of leukemia

-Acute Myeloid Leukemia (AML)

-Acute Promyelocytic Leukemia (APL)

-Chronic Lymphocytic Leukemia (CLL)

-Chronic Myeloid Leukemia (CML)

-Myeloproliferative Neoplasms (MPN)

-Systemic Mastocytosis

-Hairy Cell Leukemia (HCL).

-Acute Lymphocytic Leukemia (ALL)

History

● First identified as a new disease in 1845.

● After the years more cases were known and register.

● After the years they started to studied it.

Epidemiology

Leukemia accounts for 2.5% of overall cancer incidence and

3.5% of deaths from cancer in the United States. It is the most

common cancer diagnosed in children, and acute

lymphoblastic leukemia (ALL) is about five times more

common than acute myeloid leukemia (AML).

Prevention

There are a number of risk factors for leukemia that can't be

modified, such as your age or your sex.

More cancers can be prevented by changes in lifestyle or diet,

which will reduce the risk factors.

Unfortunately in leukemia there are no known risk factors and

without risk factors it’s difficult to prevent it.

Diagnosis Treatments

Leukemia may be diagnosed

incidentally during a physical exam

or as a result of routine blood testing.

If a person appears pale, has

enlarged lymph nodes, swollen gums,

an enlarged liver or spleen,

significant bruising, bleeding, fever,

persistent infections, fatigue, or a

small pinpoint rash.

The only treatment for leukemia is

chemiotherapy.

Its also used the transfusions of

blood and the bone marrow

transplant.

Causes Symptoms

Scientists do not understand exactly

what the causes of leukemia are.

Apparently, it is generated from a

combination of genetic and

environmental factors , that affect to

leukocytes.

-Fever or chills

-Persistent fatigue, weakness

-Frequent or serious infections

-Weight loss without proposing it -

Swollen lymph nodes, enlarged liver

or spleen

-Tendency to bleeding and bruising

-Recurrent nosebleeds

-Small red spots on the skin

(petechia)

-Excessive sweating, especially at

night

-Pain or sensitivity in the bones

● Carcinoma ductal

infiltrante (CDI):which

begins in the tubes that

carry milk from the breast

to the nipple. 80% of all

breast cancer diagnoses

are CDI.

Breast cancer: Types● Carcinoma lobulillar infiltrante:

Corresponds the 10 to 12% of

cases, it begins in parts of the

breast called lobules, which

produce breast milk.

Breast cancer: Epidemiology

Worldwide, breast cancer is the most common aggressive cancer in

women, it affects about 12% of woman worldwide, for that reason it’s

quiet investigated and has lot of treatments, however there are lot of

types of breast cancer and lot of people that can’t afford the

treatments, that’s why about 500.000 people who were

diagnosticated die every year.

Breast cancer: Diagnosis and treatment.

To diagnose breast cancer doctors usually do medical tests:

mammography, ultrasound, octave pink and more.

Ones the cancer is diagnosed the treatments received are

surgery,chemotherapy,radiotherapy,psychotherapy , etc.

The treatment can be mixed.

When the treatment is completed and there is no tumor there is a

possibility to the cancer to be returned, in that case the cancer goes

into a metastasis and the patient will die.

Breast cancer: Factors & Symptoms● Age over 50

● DNA(Genetics)

● Hormones

● Lifestyle: bad habits

● Inflammation

● Eczema

● Lump in the breast or armpit

● Pain

The incidence and mortality attributed to lung cancer has risen

steadily since the 30s. So since then, there have been more efforts to

improve the understanding of the tumors.

This type of cancer doesn’t differ significantly by region, with 43%

deaths in developed countries and 57% in undeveloped ones.

It was the first cause of death because of cancer between men and

the second between woman in 2002. Although the mortality between

women increases in european and north american countries, where it

surpasses mammarian cancer.

Lungs cancer

Lungs cancerThere are two types of cancer:

SMALL CELL LUNG CANCER which grows quickly so in more than

half of the cases of this type, the cancer has spread beyond the lungs

by the time is diagnosed (to the liver, brain bones & adrenal glands).

Less than 70% survive 5 years and it is produced by a genetic

mutation.

NON-SMALL CELL LUNG CANCER which has three subtypes. About

the 17% survives the first year.

Adenocarcioma: appears in the alveoli.

Squamous cell carcioma: appears in the squamous cells of bronchi.

Large cell carcioma: appears in any other areas which haven’t

mentioned before.

Lungs cancer

Some of the symptoms are; coughing up blood, chest pain,

hoarseness,shortness of breath, weight loss and feeling weak

and infections like bronchitis and pneumonia.

To diagnose the cancer these tests are needed; Imaging test

(X-ray image of our lungs), Sputum cytology (using a

microscope) or a biopsy (taking tissue cells samples).

Although cancer is not contagious, you can inherit an altered

gene which increase the probabilities for you to have cancer

in general.

Lungs cancer

Once your lung cancer has been diagnosed, depending on

your cancer’s stage the doctor will determine which is the

appropriate treatment:

Chemotherapy: to reduce the tumor.

Radiation therapy: uses X-ray & protons to kill cancer cells.

Surgery:to eliminate the tumor with a Wedge resection,

segmental resection, lobectomy or pneumonectomy.

Lungs cancer

There are some risk factors that increase the probability of

having lung cancer like suffering from lung diseases

(tuberculosis, chronic bronchitis…), polluted air exposition

and smoking.

Cigarette smoking is the most dangerous risk ( 90% men and

80& women lung cancer deaths are caused by this)

So, to prevent lung cancer, avoid the risk factors mentioned

before and make sure you visit the doctor if you have had lung

cancer before to make sure it doesn’t reappear.

Lungs cancer

Treatments