NCM 118 – RLE (WEEK 1)  In the Philippines, about 80, 000 per

year or 1 out of every 5 Filipinos who

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live to age 74 will get cancer
CELLULAR ABERRATIONS – Ma’am VAB
EPIDEMIOLOGY
Understanding Cancer

CANCER is a complex of diseases which occurs

when normal cells mutate into abnormal cells
that take over normal tissue, eventually
harming and destroying the host.

 Came from the Latin word CANCRI

which means crab.
 It is a disease characterized by
stretching out in many directions like PATHOPHYSIOLOGY
the legs of the crab.

A large group of diseases characterized by:

 Uncontrolled growth and spread of

abnormal cells
 Proliferation (rapid reproduction of a
cell)
 Metastasis (the development of
secondary malignant growths at a
distance from a primary site of cancer)
Classification of Cancer
WHO CAN GET CANCER?
ACCORDING TO BEHAVIOR OF TUMOR
 75% occur after the age 50
 6% occurs in pediatric age group of  Benign - tumors that cannot spread by
0- 14 years invasion or metastasis; hence, they only
grow locally.
  Malignant - tumors that can spread by CHARACTERISTICS OF MALIGNANT CELLS
invasion and metastasis. By definition,
the term “CANCER” applies only to
malignant tumors.

MALIGNANT VERSUS BENIGN TUMORS

 MALIGNANT (cancer) cells invade

neighboring tissues, enter blood
vessels, and metastasize to different
sites
 BENIGN (not cancer) tumor cells grow
only locally and cannot spread by
invasion or metastasis

BENIGN AND MALIGNANT CELLS DIFFERS IN:

 Cellular growth characteristics

 Method of growth
 Rate of growth
 Ability to metastasize or spread
 General effects
 Destruction of tissue
 Ability to cause death
ONCOGENES
MICROSCOPIC APPEARANCE OF CANCER CELLS
 a) Hyperplasia: “increase in the
number of cells in a tissue”;
maybe normal/abnormal
cellular response.
b) Metaplasia: refers to
conversion of 1 type of cell in a
tissue to another type not
normal for that tissue – it
results from an outside stimulus
affecting parent stem cells and
maybe reversible or progress to
dysplasia
c) Dysplasia: refers to change in
size, shape or arrangement of
normal cells into bizarre cells –
may precede an irreversible
neoplastic change.
d) Anaplasia: involves a change in
the structure of cells & their
orientation to one another, Cx
by loss of differentiation
returning to a more primitive
form.
e) Neoplasia: refers to abnormal
cell growth; maybe benign or
malignant.

BENIGN: harmless, not infiltrative

of other tissues

MALIGNANT: always harmful, may

spread or metastasize to tissues
sometimes far removed from the
site of origin.

PROLIFERATIVE PATTERNS OF A NEOPLASM

 Benign & malignant cells display diff.

characteristics of cellular growth,
degree of differentiation (anaplasia)
that determines cells malignant
potential.
HYPERPLASIA in w/c the normal
mechanisms of the
 Tissue growth based on an excessive control of growth
rate of cell division, leading to a larger and proliferation
than usual number of cells; the process Malignant Neoplasm have been altered. It
of hyperplasia is potentially reversible; is invasive, spreading
can be a normal tissue response to an directly to
irritating stimulus. An example is a surrounding tissues
callus as well as to new
sites in the body.
MILD DYSPLASIA Benign Neoplasm A harmless growth
that does not spread
 Bizarre cell growth differing in size,
or invade other
shape and cell arrangement
tissue.
Hypertrophy Increase in cell size.
Hyperplasia Increase in cell
number.
Metaplasia Replacement of one
adult cell type by a
different adult cell
type.
Changes in cell size,
shape and
Dysplasia organization.
Anaplasia Reverse cellular
development with
more primitive or
embryonic cell type.
RISK FACTORS OF CANCER – Ma’am VJ
Metastasis Spread of cancer cells
to distant part of the
body to set up new
tumors.
Oncology The medical specialty
that deals w/ the
diagnosis, treatment,
and study of cancer.
Adenocarcinoma Cancer that arises
from glandular
tissues (breast,
thyroid, colon and
pancreas)
Carcinoma A form of cancer that
DEFINITIONS OF TERMS develops in tissues
Neoplasia Abnormal cellular covering or lining
changes and growth organs of the body
of new tissues. such as skin, uterus,
or breast
Cancer A disease of the cell
 Sarcoma A cancer of 2018. The rate was higher for men (218.6 per
supporting or 100,000) than women (182.6 per 100,000).
connective tissue
- Global cancer data by country | World Cancer Research
such as cartilage,
Fund International [Link] › dietandcancer ›
bones, muscles or global-cancer-dat.
fats.
Carcinogens Factors that cause How many people globally get cancer each
cancer such as year?
radiation, chemicals,
viruses and physical Statistics at a Glance: The Burden of Cancer
agents. Worldwide

In 2018, there were 18.1 million new cases and

CELLULAR ABERRATION 9.5 million cancerrelated deaths worldwide. By
2040, the number of new cancer cases per year
 CANCER - Came from the Latin word is expected to rise to 29.5 million and the
CANCRI which means crab. number of cancerrelated deaths to 16.4 million.
 It is a disease characterized by
- Cancer Statistics - National Cancer Institute
stretching out in many directions like
[Link] › about-cancer › understandin
the legs of the crab. A large group of
disease characterized by uncontrolled A. INTERNAL RISK FACTORS
growth and spread of abnormal cells.
 AGE
WHO CAN GET CANCER?  Older individuals - exposed to
carcinogen longer, altered
 75% occur after the age 50
immune system
 6% occur in pediatric age group of 0-14  Fetuses, infants and children –
years still developing.
 189 of every 100,000 Filipinos are
afflicted with cancer RISK FACTORS
 4 Filipinos die of cancer every hour or
 GENDER
96 cancer patients every day
 Women have a lower cancer
- (University of the Philippines' Institute of
Human Genetics, National Institutes of Health, incidence than men but men
2021) have a higher survival rate.
 Females - breast, colon, lung,
In 2021, there will be an estimated 1.9 million
and uterine cancers.
new cancer cases diagnosed and 608,570
 Males - prostate, lung, GIT and
cancer deaths in the United States.
bladder cancers
- Cancer Facts & Figures 2021 | American Cancer Society  RACE
[Link] › research › cancer-facts-figures...  Blacks – higher cancer
What is the worldwide cancer rate? incidence and mortality due to
economic, social and
The age-standardized rate for all cancers environmental factor
(including non-melanoma skin cancer) for men  Japan - gastric cancer
and women combined was 197.9 per 100,000 in  US - breast cancer
 GENETIC FACTOR
  Certain cancers tend to run in  Herpes simplex virus type 2 - uterine
families. and cervical
 Women who have first degree  Hepatitis B and C – hepatocellular
relatives (mother, sister) with cancer
breast cancer are at greater risk  Helicobacter pylori - gastric cancer
than the general population.
FOODS and PRESERVATIVES
 IMMUNOLOGIC FACTORS
 Immune Surveillance Theory  Colon cancer - low fiber and high in fats
-antigen determine differences diet
between normal and cancerous  Liver tumors - food additives such as
cells may help the body nitrates (bacon, smoked meat)
eliminate malignant cells. Thus,  Aflatoxin - fungus that grows on stored
immunosuppression may grains, nuts and other food stuff
increase susceptibility to  Nitrosamines – rubber baby nipples
cancer.  Food sweetener
 PSYCHOLOGICAL FACTORS  Polycyclic hydrocarbons - charcoal
 Emotional stress may increase broiling
a person's cancer risk by leading
to poor health habits (smoking, TOBACCO USE
alcohol drinking), by depressing
 Lung cancer - leading cause of cancer
the immune system, or by
deaths in both men and women.
leading him to ignore early
Cigarette smoking accounts for about
warning signs
30% of all cancers
B. EXTERNAL RISK FACTORS • Mouth, pharynx, larynx, esophagus,
pancreas, cervix and bladder.
 RURAL vs URBAN Residence • Pipe smoking and chewing tobacco
 CHEMICAL CARCINOGENS - Industrial are linked to oral cancer.
compounds- vinyl chloride, polycyclic
aromatic hydrocarbon, fertilizer, weed ALCOHOL USE
killers, dyes  Heavy beer consumption may increase
the risk of colorectal cancer through an
 RADIATION - Ionizing radiation unknown mechanism
Ex: X-rays and nuclear radiation, UV
rays CHEMOTHERAPEUTIC DRUGS
 Fair-skinned Caucasian have higher risk
 Directly carcinogenic or may enhance
for skin cancer from UV radiation. Skin
neoplastic development by suppressing
cancer develops on exposed
the immune system.
extremities, the amount of exposure.
HORMONES
VIRUSES - infect host DNA
 By altering the body's normal endocrine
 Human Papilloma - cervical cancer
balance, hormones may contribute to
 Epstein Barr - lymphoma and
neoplastic development especially in
nasopharyngeal carcinoma
 endocrine sensitive organs such as  this gene determines whether
breast or prostate. Ex: estrogen, DES cells will live or die after their
DNA is damaged.
 Apoptosis - is the innate cellular
CARCINOGENESIS – Ma’am PL process of programmed cell death.

- The process by which normal, healthy cells During progression, the altered cells exhibit
transform into cancer cells is termed increased malignant behavior. These cells
carcinogenesis or oncogenesis. have a propensity to invade adjacent tissues
and to metastasize. Agents that initiate or
Molecular Process promote cellular transformation are
 Initiation referred to as carcinogens.
 Promotion  Carcinogens  substances that cause
 Progression the formation of cancer
During initiation, initiators (carcinogens), such Examples of Carcinogens
as chemicals, physical factors, and biologic  Radiation that breaks apart
agents, escape normal enzymatic mechanisms cellular DNA
and alter the genetic structure of the cellular  Toxins and poisons, including
DNA. chemotherapeutic drugs
 Viruses
During promotion, repeated exposure to  Lifestyle choices such as the
promoting agents (cocarcinogens) causes the food you eat, alcohol, or
expression of abnormal or mutant genetics smoking
information even after long latency periods.

 Cellular oncogenes are responsible for

the vital cellular functions of growth COMPARISON OF THE CHARACTERISTICS OF
and differentiation. BENIGN AND MALIGNANT NEOPLASM – Ma’am
 Cellular protooncogenes act as an “on EP
switch” for cellular growth. There are two main categories of cancer:
 Protooncogenes are influenced
by multiple growth factors that  Hematologic (blood) cancers
stimulate cell proliferation, such  are cancers of the blood cells,
as epidermal growth factor including leukemia, lymphoma,
(EGF) and transforming growth and multiple myeloma.
factor alpha.  Solid tumor cancers
 k-ras (KRAS2) - another protooncogene  are cancers of any of the other
that plays an important role in cancer body organs or tissues. The
development, located on chromosome most common solid tumors are
12 breast, prostate, lung, and
 p53 (TP53) gene colorectal cancers.
 is a tumor suppressor gene that  These cancers are alike in some ways,
is frequently implicated in many but can be different in the ways they
human cancers. grow, spread, and respond to
treatment. Some cancers grow and
 spread fast. Others grow more slowly. and does out processes
Some are more likely to spread to other not that
parts of the body. Others tend to stay infiltrate infiltrate and
where they started. the destroy the
 Some types of cancer are best treated surroundin surrounding
with surgery; others respond better to g tissues; tissues
usually
drugs such as chemotherapy. Often 2 or
encapsulat
more treatments are used to get the
ed
best results.
Rate of growth Rate of Rate of
What is a tumor? growth is growth is
usually variable and
 A tumor is a lump or growth. Some slow depends on
lumps are cancer, but many are not. level of
 Lumps that are not cancer are differentiatio
called benign n; the more
 Lumps that are cancer are anaplastic
called malignant the tumor,
the
 What makes cancer different is that it
faster its
can spread to other parts of the body
growth
while benign tumors do not.
Metastasis Does not Gains access
 Cancer cells can break away from the spread by to the blood
site where the cancer started. These metastasis and
cells can travel to other parts of the lymphatic
body and end up in the lymph nodes or channels
other body organs causing problems and
with normal functions. metastasizes
to other
Characteristics of Benign and Malignant areas of the
Neoplasms body
General Is usually a Often causes
CHARACTERIST BENIGN MALIGNANT
effects localized generalized
ICS
phenomen effects, such
Cell Well- Cells are
on that as anemia,
Characteristics differentiat undifferentiat
does not weakness,
ed cells ed and often
cause and weight
that bear little
generalized loss
resemble resemblance
effects
normal to the normal
unless its
cells the cells of the
location
tissue from tissue from
interferes
which the which they
with vital
tumor arose
functions
originated
Tissue Does not Often causes
Mode of Tumor Grows at the
destruction usually extensive
growth grows by periphery
cause tissue
expansion and sends
 tissue damage as
damage the tumor
unless its outgrows its
location blood supply
interferes or
with blood encroaches
flow on blood flow
to the area;
may also
produce
substances
that cause
cell damage
Ability to Does not Usually
cause death usually causes death
cause unless
death growth can
unless its be controlled
location
interferes
with vital
functions