Difference between revisions of "Cancer"

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'''Cancer''' is a leading cause of mortality and morbidity.  It keeps pathologists busy.
[[Image:Colon cancer 2.jpg|thumb|300px|[[Gross]] image of a [[colon cancer]].]]
'''Cancer''' is a leading cause of mortality and morbidity.  It is what keeps pathologists busy.


This article deals with general concepts in cancer.  Specific forms of cancer are described by the site from which they arise.  This article discusses ''cancers of unknown primary''.
This article deals with general concepts in cancer.  Specific forms of cancer are dealt with in their own articles (e.g. [[colorectal adenocarcinoma]]) and/or the [[site|anatomical site]] articles.   
 
In addition to be an introduction to cancer, this article also deals with ''cancers of unknown primary''.


==Definition of cancer==
==Definition of cancer==
Robbins definition of cancer:<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref>
The ''Robbins'' definition of cancer:<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref>
*Tumour with the capacity to:
*Tumour with the capacity to:
*#Invade (infiltrate) and destroy adjacent tissue.  
*#Invade (infiltrate) and destroy adjacent tissue.  
*#Spread to other sites (metastasize).
*#Spread to other sites (metastasize).


Notes:
Note:
*Tumour = abnormal mass of tissue.<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref>
*Tumour = abnormal mass of tissue.<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref>
**Neoplasm = literally "new growth"; used interchangeably with ''tumour''.<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref>
**Neoplasm = literally "new growth"; used interchangeably with ''tumour''.<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref>


===Tumours===
===Tumours===
Tumours ''per Robbins''<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref> consist of:  
Tumours per ''Robbins''<ref name=Ref_PCPBoD8_145>{{Ref PCPBoD8|145}}</ref> consist of:  
#Clonal expansions.
#Clonal expansions.
#Stromal components - controlled by the clonal component.
#Stromal components - controlled by the clonal component.
Note:
*''Tumour'' may be used to refer to a non-neoplastic process; one dictionary definition of ''tumour'' is ''abnormal swelling''.<ref>URL: [http://dictionary.reference.com/browse/tumour?s=t http://dictionary.reference.com/browse/tumour?s=t]. Accessed on: 22 May 2012.</ref> Also see note in ''[[definition of cancer]]''.


==Clinical features of cancer==
==Clinical features of cancer==
Line 23: Line 29:
#Direct invasion/destruction of tissue.
#Direct invasion/destruction of tissue.
#Metastases.
#Metastases.
Notes:
*3 may or many not be present. Primary brain cancer rarely metastasizes.


==Theory==
==Theory==
Line 29: Line 38:


==Cancers of unknown primary==
==Cancers of unknown primary==
:''Undifferentiated malignancy'', ''unknown primary tumours'', and ''poorly differentiated malignancy'' redirect here.
===Clinical history===
===Clinical history===
#Past history of cancer, i.e. is it a recurrence?
#Past history of cancer, i.e. is it a recurrence?
#Family history of cancer?
#Family history of cancer?
#Symptoms/presentation.
#Symptoms/presentation.
#Occupation & documented exposures.
#Occupation & documented exposures - esp. [[smoking]], excessive [[alcohol]] use.
#Impression from clinician(s).
#Impression from clinician(s).
===Radiology/gross pathology===
===Radiology/gross pathology===
#Location of lesion(s).
#Where is the largest lesion?
#Location of the other lesions?
#Is the pattern of spread compatible with the suspected primary site?
#Is the tumour at a location of a common (primary) cancer in the individual's demographic group?


===Pathologic features===
===Pathologic features===
#Histomorphologic characteristics - see ''[[Basics]]'' article.
#Histomorphologic characteristics - see ''[[modified general morphologic DDx of malignancy]]''.
#Special [[stains]].
#Special [[stains]].
#[[Immunohistochemistry]].
#[[Immunohistochemistry]].
#[[Molecular pathology]].
#[[Molecular pathology]].
#[[Electron microscopy]].


==Incidence and deaths in Canada==
==Incidence and deaths in Canada==
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*[[Choristoma]].
*[[Choristoma]].
*[[Cancer staging systems]].
*[[Cancer staging systems]].
*[[Angiogenesis]].
*[[Metastasis]].
*[[Collision tumour]].
*[[Viruses and cancer]].


==References==
==References==

Latest revision as of 14:56, 9 December 2021

Gross image of a colon cancer.

Cancer is a leading cause of mortality and morbidity. It is what keeps pathologists busy.

This article deals with general concepts in cancer. Specific forms of cancer are dealt with in their own articles (e.g. colorectal adenocarcinoma) and/or the anatomical site articles.

In addition to be an introduction to cancer, this article also deals with cancers of unknown primary.

Definition of cancer

The Robbins definition of cancer:[1]

  • Tumour with the capacity to:
    1. Invade (infiltrate) and destroy adjacent tissue.
    2. Spread to other sites (metastasize).

Note:

  • Tumour = abnormal mass of tissue.[1]
    • Neoplasm = literally "new growth"; used interchangeably with tumour.[1]

Tumours

Tumours per Robbins[1] consist of:

  1. Clonal expansions.
  2. Stromal components - controlled by the clonal component.

Note:

  • Tumour may be used to refer to a non-neoplastic process; one dictionary definition of tumour is abnormal swelling.[2] Also see note in definition of cancer.

Clinical features of cancer

  1. Uncontrolled growth (compared to normal tissue).
    • Autonomous growth - without external stimulus.
  2. Direct invasion/destruction of tissue.
  3. Metastases.

Notes:

  • 3 may or many not be present. Primary brain cancer rarely metastasizes.

Theory

  • Cancer results from an accumulation of driver mutations.
    • It is thought that approximately seven driver mutations are required.[3]

Cancers of unknown primary

Undifferentiated malignancy, unknown primary tumours, and poorly differentiated malignancy redirect here.

Clinical history

  1. Past history of cancer, i.e. is it a recurrence?
  2. Family history of cancer?
  3. Symptoms/presentation.
  4. Occupation & documented exposures - esp. smoking, excessive alcohol use.
  5. Impression from clinician(s).

Radiology/gross pathology

  1. Where is the largest lesion?
  2. Location of the other lesions?
  3. Is the pattern of spread compatible with the suspected primary site?
  4. Is the tumour at a location of a common (primary) cancer in the individual's demographic group?

Pathologic features

  1. Histomorphologic characteristics - see modified general morphologic DDx of malignancy.
  2. Special stains.
  3. Immunohistochemistry.
  4. Molecular pathology.
  5. Electron microscopy.

Incidence and deaths in Canada

Men

Incidence:[4]

  1. Prostate.
  2. Lung.
  3. Colorectal.
  4. Bladder.
  5. Non-Hodgkin lymphoma.
  6. Kidney.
  7. Melanoma.
  8. Leukemia.
  9. Oral.
  10. Pancreas.
  11. Stomach.
  12. Brain.

Death:[4]

  1. Lung.
  2. Colorectal.
  3. Prostate.
  4. Pancreas.
  5. Non-Hodgkin lymphoma.
  6. Leukemia.
  7. Esophagus.
  8. Bladder.
  9. Stomach.
  10. Kidney.
  11. Brain.

Women

Incidence:[4]

  1. Breast.
  2. Lung.
  3. Colorectal.
  4. Body of uterus.
  5. Thyroid.
  6. Non-Hodgkin lymphoma.
  7. Ovary.
  8. Melanoma.
  9. Pancreas.
  10. Leukemia.
  11. Kidney.
  12. Bladder.
  13. Cervix.

Death:[4]

  1. Lung.
  2. Breast.
  3. Colorectal.
  4. Pancreas.
  5. Ovary.
  6. Non-Hodgkin lymphoma.
  7. Leukemia.
  8. Body of uterus.
  9. Brain.
  10. Stomach.
  11. Multiple myeloma.
  12. Kidney.
  13. Bladder.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 145. ISBN 978-1416054542.
  2. ↑ URL: http://dictionary.reference.com/browse/tumour?s=t. Accessed on: 22 May 2012.
  3. ↑ Nordling C (1953). "A new theory on cancer-inducing mechanism". Br J Cancer 7 (1): 68–72. doi:10.1038/bjc.1953.8. PMC 2007872. PMID 13051507. http://www.carlonordling.se/Cancer.html.
  4. ↑ 4.0 4.1 4.2 4.3 URL: http://www.cancer.ca/Canada-wide/About%20cancer/Cancer%20statistics/~/media/CCS/Canada%20wide/Files%20List/English%20files%20heading/Powerpoint%20-%20Policy%20-%20Canadian%20Cancer%20Statistics%20-%20English%202011/2011%20Figures%201.1-3.2%20E.ashx. Accessed on: 24 September 2011.
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