Recognized malignant ta tumor, which can be very dangerous to human health, leading up to death. From such a definition and implies its name. This tumor consists of malignant cells. Often, any malignant tumor is mistakenly called cancer, while not every tumor is cancerous, and the concept of a tumor is much broader.
Malignant neoplasm is a disease characterized by uncontrolled cell division. Such breeding cells begin to spread throughout the body, penetrating into the surrounding tissues, and through lymph flow, blood flow or mixed way reach almost any organ. The process of moving such diseased cells is called metastasis, and the cells themselves - metastasis. Usually this disease is associated with the proliferation of tissue cells and their differentiation as a result of genetic disorders.
Until now, the development of drugs that would help cope with malignant tumors, is one of the primary tasks of pharmacology.
A bit of history
The first descriptions of malignant neoplasms, namely cancerwere described in 1600 BC on Egyptian papyrus. It was a story about breast cancer with a note that there is no medicine for this disease. As a result of Hippocrates introducing the term “carcinoma,” which meant a malignant tumor with inflammation, the term cancer began. He also described several types of cancer, and also introduced another concept - “onkos”, which provided the basis for the modern word “oncology". The famous Roman physician Cornelius Celsus, even before our era, suggested that in the early stages he treated cancer by removing the tumor, and in the later stages - not at all.
Symptoms of a malignant tumor depend on its location, as well as on stages development. As a rule, only in the late stages patients begin to feel pain, in the early stages very often the tumor does not manifest itself.
The most common symptoms of malignant tumors:
- Unusual compaction or swelling, inflammation, bleeding at the site of the tumor
- Symptoms of metastasis: enlarged liver, fractures and bone pain, neurological symptoms, swollen lymph nodes, cough, sometimes with blood
- Depletion, loss of weight and appetite, anemia, hyperhidrosisimmunopathological conditions
Malignant neoplasms have the following properties:
- The possibility of penetration into nearby and distant organs as a result of metastasis
- Metastasis formation
- Tendency to uncontrolled rapid growth, which is destructive, damages and squeezes the surrounding organs and tissues
- They have an effect on the entire body due to the synthesis of the excretion of toxins by the tumor, which can suppress the immune system, lead to human intoxication, exhaustion, depression
- Ability to resist the body's immune system, tricking T-killer cells with a special mechanism
- The presence of a considerable number of mutations in malignant tumors, which increase with its growth.
- Low or total cell immaturity. The lower this data is, the more “malignant” the tumor is, the faster it grows and metastasizes, but at the same time it is more sensitive to chemo - and radiotherapy.
- Presence of pronounced cell atypismi.e. cell or tissue abnormality
- A pronounced process of the formation of new blood vessels in the tumor, which leads to frequent hemorrhage
Malignant tumors are the result malignancy - Malignant transformation of normal cells. These cells begin to multiply uncontrollably and not undergo programmed cell death - apoptosis. One or several mutations cause a malignant transformation, these mutations cause the cells to divide an unlimited number of times and remain alive. Such a malignant transformation recognized by the immune system in time can save the body from the onset of a tumor, but if this does not happen, the tumor begins to grow and subsequently metastasize. Absolutely all tissues can form metastases, but the most common places are lungs, liver, bones, brain.
Cancer in childhood
Some tumors most often develop in adolescents, an example of this type of malignant neoplasm can be leukemia, Wilms tumor, Ewing's sarcoma, rhabdomyosarcoma, retinoblastoma etc. During the first five years of life, the likelihood of morbidity is highest.
Types of neoplasms and incidence rate
By the type of cells from which malignant tumors arise, they can be classified as follows:
- Melanoma - of melanocytes
- Carcinoma - from epithelial cells
- Sarcoma - from muscle cells, bones, connective tissue
- Lymphoma - from lymphatic cells
- Leukemia - arises from brain stem cells
- Teratoma - germ cells are involved
- Choriocarcinoma - from the placenta
Among men and women, various forms of cancer have different prevalence. In men, prostate cancer is most common - it is 33% of all forms of malignant tumors, in second place is lung cancer - 31%. Women are usually affected by breast cancer, which accounts for one-third of all cancers, followed by the rectum, uterus, ovaries, etc.
The basis for preventing the occurrence of malignant neoplasms lies in maximizing a person from carcinogens, reducing radiation doses, a healthy lifestyle, chemoprophylaxis and preventive research.
Lung cancer, for example, is in most cases the result of smoking. In combination with poor ecology and poor-quality food, the risk of developing malignant neoplasms increases even more. An epidemiological study has shown that 30% of deaths that are associated with neoplasms were caused by smoking. Thus, the probability of lung cancer in a smoking person is three times higher than that in a non-smoker, while the vocal cords, esophagus and oral cavity are also observed mainly in the smoking population.
In addition to the above risk factors, it is extremely negative hypodynamia - sedentary lifestyle, drinking alcohol, radiation, overweight.
Recent studies have shown that a significant role in oncology is played viruses. Hepatitis B, for example, can lead to liver cancer, human papillomavirus - to cervical cancer.
Malignant neoplasms of different organs are diagnosed differently.
- Diagnosis of breast cancer is made by self-examination every week, also done mammography.
- Diagnosis of malignant tumors of the testicles can also be made independently.
- Cancer of the body, cervix and bottom of the uterus, colon diagnosed with an endoscope. Even though not all the intestines can be examined with an endoscope, such checks improve the prognosis and reduce the incidence.
- Neoplasms on the larynx are detected and investigated by a special laryngeal mirror during a visit to Laura. Biopsy is a mandatory procedure in case of detection of a tumor. Fibrolaryngoscopy is a more accurate method, its essence lies in the inspection of a flexible endoscope. Examination of the larynx under a microscope is performed when the patient is under anesthesia, this method is called direct microlaryngoscopy. The main risk factor in the incidence of laryngeal cancer is smoking, mostly long-term.
- Diagnosis of prostate cancer at an early stage is carried out through the anus by an independent study, an ultrasound can be assigned as a specialist, and screening for the presence of oncomarter. However, this technique has not received wide distribution due to the fact that it can detect very small, safe malignant tumors. Removal of the prostate as a result of a malignant neoplasm can lead to the development of incontinence and impotence.
Some forms of cancer can be identified on the basis of a genetic test that will show whether a person has a propensity for a particular form of cancer.
One of the latest developments in the diagnosis of malignant tumors in the early stages is immunomagnetic enrichment of the sample and the identification of single tumor cells that circulate in the blood. This method is mainly used in stages 3-4 of cancer of the breast, colon and rectum, prostate gland. It allows you to determine the level of cancer cells in the blood.
The final diagnosis of a malignant neoplasm is based on the results of a biopsy — removal of a tissue sample.
Treatment of malignant neoplasms
In many cases, getting rid of a malignant neoplasm is a quite doable task. But there are times when cancer leads to death. The determining factor is the degree of cancer. Some forms, such as skin cancer, are almost 100% curable in the first stage. Tumor removal it is produced in almost all cases, and usually some of the healthy tissues are also captured, since they can also be affected by cancer cells. Removal can be done both with a scalpel and with a laser beam, which is more gentle. Another type of treatment is to suppress the growth of cells that divide rapidly, forming a tumor - chemotherapy. Radiotherapy is to irradiate malignant cells using gamma rays, electrons and neutrons, which penetrate deeper. Hormone therapy It is used in some cases when cells of a neoplasm are able to respond to the effects of various hormones. By itself, it is not able to save a person from a tumor, but is able to halt its growth and prolong human life. Also applies cryotherapy, immunotherapy, folk and non-standard treatment methods.
Education: Graduated from Vitebsk State Medical University with a degree in Surgery. At the university he headed the Council of Student Scientific Society. Further training in 2010 - in the specialty "Oncology" and in 2011 - in the specialty "Mammology, visual forms of oncology."
Experience: Work in the general health care network for 3 years as a surgeon (Vitebsk Emergency Hospital, Liozno Central District Hospital) and part-time district oncologist and traumatologist. Farm work as a representative throughout the year in the company "Rubicon".
He presented 3 rationalization proposals on the topic “Optimization of antibiotic therapy depending on the species composition of the microflora”, 2 works won prizes in the republican competition review of student research papers (categories 1 and 3).
Causes of Malignant Tumor
Modern oncologists believe that the causes of the formation of a malignant tumor are multiple and it is impossible to identify any one factor leading to the formation of a pathological formation. Studies, the results of which were published in the journal Nature, indicate that most often the development of a malignant tumor is influenced by the external environment, rather than heredity. More than 30 cell mutations leading to the development of a tumor were carefully evaluated and analyzed. As a result, the results showed that no more than 30% of these mutations occurred due to internal factors, and about 70-90% directly depended on the impact of harmful factors of the external environment. Among these are: alcohol intake, smoking, a negative impact on the body of ultraviolet and ionizing radiation, some viruses.
So, modern oncologic polyetiological theory identifies the following causes of the development of malignant tumors:
Effects on the body of chemical carcinogens. Moreover, this effect is both locally and on the organism as a whole. For example, a scrotal tumor develops in chimney sweeps, a lung tumor in smokers, people working with asbestos have a pleural tumor, etc.
Effects on the body of physical carcinogens. Two types of radiation are attributed to physical carcinogens: ionizing radiation (X-rays, gamma rays, atomic particles), as well as exposure to ultraviolet rays, which provoke the development of skin carcinoma.
Genetic causes of the development of malignant tumors. One should not completely reject the fact that a small proportion of tumors appear in humans as a result of the presence of a genetic predisposition. Thus, a mammary gland tumor in girls whose mothers suffered a similar disease is more common three times than in the population as a whole. The same applies to colon tumors, endocrine gland tumors. At this point in time, a genetic link with 50 types of tumors has been proven and tracked.
The dependence of the development of malignant tumors on the geographical area of human residence. So far, this phenomenon has not been scientifically explained, but it has been established that geographical factors have a definite influence on the development of oncology among the population living in the same territory. Scientists believe that factors such as: nutrition, climate, environmental conditions, etc.
Effect of oncogenic viruses. Infectious factors that can provoke the development of a malignant tumor should not be excluded. It is proved that hepatitis B can provoke a tumor of the liver, the herpes virus of the second type leads to cervical tumors.
However, scientists point out that one of these factors is not enough for a person to develop a malignant tumor. A combination of several causes is necessary, as well as disturbances in the functioning of the human immune system.
In addition to the polyetiological theory, indicating the causes of the development of malignant tumors, there are other theories of their origin, including:
The immunological concept suggests that even the slightest failure of the immune system can lead to the formation of a tumor. The adherents of this theory believe that if the immunity has not destroyed at least one mutated cell, then a tumor may develop from it.
Viral theory has existed since 1946 and indicates that viruses that have fallen into them lead to the transformation of healthy cells into tumor cells. However, at this time point, only a few viruses are pathogenic.
The concept of germinal germs indicates that tumors develop from dormant cells that remain in the embryo. Under the influence of a number of factors, they begin to grow and develop. However, it has been proven that this theory is applicable exclusively for disembryonic tumors.
The concept of irritation, which was popular in the 19th century, claims that a tumor forms in those parts of the body that are most likely to be traumatized.
Another theory is that the tumor is the result of regenerative processes that arise in order to eliminate the negative effect of carcinogens. This concept is called regenerative-mutational.
However, none of the listed theories can fully provide an explanation for the causes of all malignant tumors. Therefore, the most popular is the etiology concept.
Symptoms of a malignant tumor
If we consider the symptoms of a malignant tumor, then its specific manifestations will depend on where it is located and what tissues are involved in the pathological process. A characteristic feature of all malignant oncological formations is a progressive increase in symptoms. Oncologists have identified common symptoms for all tumors of a malignant nature:
Syndrome of small signs. This syndrome was first described by Savitsky A.I., who in 1947 described the malignant tumor of the stomach. These symptoms were then supplemented and summarized. So, the early manifestations of oncology are intoxication of the body and its depletion. Although it is possible that these signs of a malignant tumor may occur in a later period of the disease.
The patient begins to arrange faster, unmotivated weakness and fatigue develops. In parallel, the appetite suffers. Lack of desire to consume food leads to weight loss. For a stomach tumor, aversion to meat is characteristic. Anemia is progressing, the level of ESR in the blood rises.
Another symptom that should alarm patients is an increase in body temperature, which cannot be explained.
Syndrome "plus-fabric". This syndrome characterizes the emergence of new tissue in the area where it should not be. That is, a tumor appears in the body, which is not characteristic of it. Often it is possible to test it during a standard examination. In some cases, even deep tumors can be palpated, especially if they are located in the abdominal cavity or in the retroperitoneal space. Other diagnostic methods help in their detection.
Atypical discharge syndrome. Always malignant tumors lead to the appearance of secretions that are not characteristic of a healthy organism. It may be bleeding if the tumor damages the blood vessels. Their localization depends on exactly where it is located. Not excluded gastric and uterine bleeding, expectoration of blood, the appearance of blood in the urine or feces, etc.
In addition, the body reacts to the presence of a tumor with inflammation of its surrounding tissues. This will be expressed in the appearance of mucous or purulent discharge. Naturally, the site of inflammation depends on where the tumor is located.
Syndrome of dysfunctional organ disorder
Disorder of the organs depends on the location of the tumor:
The defeat of the intestine provokes its obstruction.
The defeat of the stomach leads to a variety of dyspeptic disorders: belching, vomiting, heartburn, etc.
The defeat of the esophagus complicates the passage of food on it, leads to a violation of swallowing.
Brain damage provokes nausea, headaches, mental disorders.
The defeat of the mammary gland leads to nipple dropping, pain, lymphadenopathy.
The defeat of the uterus leads to disruption of the menstrual cycle, to the impossibility of conception, etc.
The defeat of the ovaries provokes a hormonal imbalance in the body.
Kidney damage provokes problems with urination, hypercalcemia, anemia, edema, etc.
Occurrence of metastasis
Cells that are separated from the malignant tumor that forms them form through different paths into neighboring organs and tissues. Having settled there, they begin the process of their own division, producing new cells and forming daughter tumors. Most often, metastases are similar in structure to the primary tumor, but in rare cases they may be more aggressive.
Metastases can spread in the following ways: lymphogenous (prevails), hematogenous, implantation, cerebrospinal fluid, distribution through the interstitial gaps. In some cases, there is a mixed pathway of metastasis. It has been established that different pathways and the frequency of metastasis are characteristic of different tumors. For example, a laryngeal tumor metastasizes rarely, but the lung tumor most often has already spread throughout the body when it is first detected.
Types of malignant tumor
The following types of malignant tumors are distinguished: carcinoma or cancer, which originate from epithelial cells and sarcoma, which develops from connective tissue and its subspecies. Therefore, to designate malignant tumors, the suffix “- carcinoma” or “- sarcoma” is used, for example, osteosarcoma, angiosarcoma, etc.
So, the types of malignant tumors:
Carcinoma (basis - epithelial cells).
Sarcoma (base - connective tissue).
Leukemia (base - transformed bone marrow cells).
Lymphoma (base - lymphatic tissue).
Teratoma (base - embryo cells).
Glioma (basis - glial cells).
Choriocarcigoma (base - placental tissue).
Stages of development of malignant tumors
Domestic oncologists work with the classification, which includes four stages of development of malignant tumors.
They look like this:
For the first stage is characterized by a clear localization of education, which is located on a limited area and does not grow into the body. At this stage, tumors do not give metastasis.
The tumor of the second stage of development is large, but does not extend beyond the organ. Metastases can be, but they are determined only in nearby lymph nodes.
At the third stage of tumor development, it has large sizes, the processes of disintegration start. Germination is registered in the wall of the organ. Multiple metastases have been launched into adjacent lymph nodes.
At the fourth stage of tumor development, its germination is observed in adjacent tissues. To this stage include any education that give distant metastases.
The patient is exposed to the stage once, and it remains with him until the end of his life. The stage is not changed, even if the disease does not relapse. Do not confuse the stage of tumor development with clinical groups that are assigned to patients. They also exist four, but they can vary depending on the condition of the person. These groups were created for the convenience of registering people with cancer.
Diagnosis of malignant tumors
Diagnosis of malignant tumors lined up on examination of the patient, who presents these or other complaints. If there is a suspicion of an oncological process, the patient is referred for consultation to an oncologist. He, in his work uses the following methods:
Laboratory diagnosis. It includes a blood test, determination of enzymes and special tests.
Immunological diagnosis. Immunological diagnostics includes the identification of monocloidal bodies that produce hybridomas. In addition, immunological diagnostics are carried out with tumor markers, the number of which increases dramatically in the presence of a malignant tumor in the body. Its tumor markers are specific for certain organs, for example, the tumor marker alpha-fetoprotein is used for liver and testicular tumors, the tumor marker carcinoembryonal antigen, etc. is used to determine the breast tumor.
In the arsenal of doctors there are also markers that allow you to determine which tissue metastases consist of, if the maternal tumor focus is not detected.
Instrumental diagnostic techniques. Instrumental examination methods will depend on which particular tumor is suspected in the patient.
This may be such diagnostic procedures as:
Colonoscopy, FGDES, bronchoscopy - endoscopic examination methods.
Contrast or standard X-ray examination.
Oncological diagnosis verification. To confirm a malignant tumor, a cytological examination is carried out, which allows you to specify the diagnosis in 92% of cases. It includes puncture sampling, biopsy, smear imprint and scarification.
Histological examination allows to determine the probability of the presence of a malignant tumor in 99.8% of cases. To conduct a histological examination, a biopsy is performed, that is, a sample of a tissue is taken from a patient for the purpose of its subsequent examination. The tissue can be excised, taken by the puncture method, or perhaps the total removal of the tumor with its subsequent examination.
A biopsy is not performed on melanoblastoma, since any damage to this type of tumor can trigger its accelerated growth.
Conducting a differential diagnosis. A malignant tumor differs from a benign formation by a rapid growth rate, a bumpy surface, an increased density. Most often, these tumors are immobile, have no clear boundaries and are associated with the skin. At the same time, the lymph nodes are enlarged, but remain painless.
Treatment of malignant tumors
Treatment of malignant tumors exclusively operational. Hormonal therapy is possible, but the indication for this is the presence of hormone-dependent tumors.
In addition, the treatment of malignant tumors can be carried out by means of chemotherapy, radiation therapy and immunotherapy. All these methods can be applied both separately and in combination with each other. Chemotherapy and immunotherapy are not able to save the patient from metastasis, as they relate to systemic treatment methods.
So, the options for operations in the presence of a malignant tumor are as follows:
Radical therapy. The tumor is cut out together with the organ that she struck. In addition, adjacent lymph nodes and cells are removed. Operations are not performed when a fourth stage tumor is detected.
Palliative therapy. If the operation cannot be performed, the patient is prolonged and his life is improved with the help of palliative treatment. The tumor is removed, but the lymph nodes are left. They are affected by other methods, such as radiation therapy. It helps to cope with the disease for a while.
Symptomatic surgery. This therapy is aimed at eliminating the main symptom, which is a direct threat to the life of the patient, for example, arising intestinal obstruction. The tumor is not removed from the body.
As for radiation therapy, the source of radiation can be X-rays, gamma rays, alpha and beta rays. Respond well to radiotherapy for lymphosarcoma, cancer of the skin, larynx, bronchus, esophagus, and cervix. The dose and mode of exposure for each patient is selected individually. Possible intracavitary, interstitial and external irradiation. You should know that radiation therapy can not pass for the human body without a trace. It is almost always associated with a number of complications. About this doctors are required to advise each patient.
Chemotherapy is reduced to the medicinal effects on the tumor. This is achieved through the use of various drugs.
It is prescribed for the following indications:
In combination with other treatments,
Before the operation to improve the effectiveness of the upcoming intervention,
As a palliative technique.
To perform chemotherapy, use of drugs such as: cytostatitis (Vinblastine, Embihin, Cyclophosphamide, etc.), anti-tumor antibacterial drugs (Doxorubicin, Mitomycin, Mitoxantrone, etc.), antimetabolites (Mercaptopurin, Pentostatin, etc.), hormonal preparations (see) taking into account the location of the tumor), platinum preparations (Platinum, Cisplatin, etc.), other means.
Immunotherapy also includes several varieties, including: non-specific immunotherapy (the effect will not always be achieved), local application of vaccines, introduction of cells with cytostatic and cytotoxic effect, introduction of proteins (hematopoietic growth factors), specific immunotherapy (administration of anticancer vaccines and serums ).
Answers to popular questions
Is the tumor visible on ultrasound, x-ray and fluorography? All these methods of examination are able to “see” the presence of one or another formation, but it is impossible to assert that this is a malignant tumor according to only ultrasound, radiographic examination or fluorography. Additional diagnostic procedures will be required.
Can a benign tumor go malignant? Yes, it can, and this process occurs quite often and is called malignancy.
Does a cancerous tumor hurt when pressed? Pain when you press a cancerous tumor appear only in the later stages of its development.
Is there a bone marrow tumor? There is no such thing as a bone marrow tumor, but atypical cells can affect the bone marrow. In this case, doctors talk about cancer of the myeloid (hematopoietic) tissue.
Education: He graduated from the residency in the "Russian Scientific Oncological Center named. N. N. Blokhin "and received a diploma in" Oncologist "
5 diets, the effectiveness of which is confirmed by modern science
Causes and risk factors
There are several theories about the causes and mechanisms of development of malignant tumors:
- physico-chemical (Virchow's theory),
- Dysontogenetic (Congame),
- viral genetic (Silber),
- immunological (burnet),
- etiology (Petrova).
Physico-chemical theory explains the development of malignant tumors as a result of the impact on the body of various exogenous and endogenous carcinogens, systematic injury. Aggressive chemicals, ionizing radiation, some products of their own metabolism (tryptophan and tyrosine metabolites), ultraviolet radiation, components of tobacco smoke, aflatoxins, etc., have the greatest carcinogenic activity. The effects of these substances on the cell in certain doses cause damage to its genetic apparatus and malignant degeneration. Perhaps the development of malignant tumors in places of constant friction, habitual trauma.
The disontogenetic model of the development of malignant tumors (the theory of embryonic buds) was first proposed by Yu. F. Kongeim. It implies the emergence of cellular and tissue malformations in the embryonic period, which further leads to the active reproduction of atypical cells that form tumors. According to this theory, during embryogenesis, an excessive amount of cells are formed in some parts of the body, which "are not needed" are in an inactive state. Latent cell formations have a significant growth potential inherent in embryonic tissues, which explains the active malignant growth in the situation of random activation of dormant structures.
Viral-genetic theory plays a dominant role in the development of tumors to the effects of oncogenic viruses, which include, for example, herpes viruses (including Epstein-Barr), human papillomaviruses, hepatitis viruses, human immunodeficiency, T-cell leukemia virus, etc. After being infected with virus Particles inside a normal cell combine their genetic apparatus. The host cell begins to function as a collector of virus components, producing the elements necessary for its vital activity. At this point, malignant degeneration of normal cells of the body often occurs, uncontrolled cell proliferation starts, the presence of the virus ceases to play a decisive role in carcinogenesis, and the process becomes irreversible.
Burnet’s immunological theory as a provocateur for the formation of malignant tumors calls the failure of the immune system (damage to immunological surveillance), in which it loses the ability to recognize and destroy altered atypical cells, which leads to their rapid uncontrolled growth.
A polyetiological approach to explaining the development of malignant tumors involves a combined effect on the normal structures of the body of many provoking factors, which leads to their damage and further degeneration.
As a result of provocative effects, a failure of the natural anticancer protection system develops, the functioning of which is ensured by the following components:
- anticarcinogenic mechanism responsible for the disposal of potentially dangerous agents,
- anti-transformation mechanism that prevents the malignant transformation of normal cells and tissues,
- anti-cellular mechanism, which consists in the timely removal of malignant cells and normal cells of the body that have suffered from malignancy.
As a result of damage to the antitumor protection system or excessive exposure to provoking factors, malignant neoplasms are formed.
Forms of the disease
Depending on the tissue from which the tumor originates, such forms of malignant neoplasms are distinguished:
- epithelial organ-specific (in places atypical localization of epithelial tissue),
- organ-specific epithelial (exo- and endocrine glands, integuments of the body),
- melanin-forming tissue
- the nervous system and the membranes of the brain and spinal cord,
- hematopoietic and lymphatic tissues (hemoblastosis),
- formed from germinal tissues.
Malignant neoplasms have multiple effects on the body - both local and systemic.
Types of tumors in accordance with the types of original cells:
- carcinoma (actually cancer) - epithelial cells,
- melanoma - melanocytes,
- sarcoma - connective tissue cells,
- leukemia - blood-forming cells of the bone marrow,
- lymphoma - lymphatic cells,
- teratoma - gonocytes,
- glioma - neuroglia cells,
- choriocarcinoma - trophoblast cells.
The types of cancer proper (carcinoma) are distinguished depending on the type of epithelial tissue from which it originates and the structural features:
- squamous (without keratinization, with keratinization),
- in situ cancer
- solid (trabecular),
- small cell.
By morphological features:
- differentiated cancer (slowly progressing, metastasis develops slowly),
- undifferentiated (evolves quickly, gives common metastases).
By the number of pathological foci of neoplasm can be uni- and multicentric (one or more primary foci, respectively).
Depending on the characteristics of growth in the lumen of organs, malignant tumors are:
- expansive (exophytic growth), when the tumor grows in the lumen of the body,
- infiltrating (endophytic growth) - in this case, the tumor grows into the wall of the organ or surrounding tissue.
In accordance with the extent of the process, the presence or absence of metastases, and involvement of the lymph nodes, malignant neoplasms are classified according to the TNM system (tumor - “tumor”, nodulus - “nodes”, metastasis - “metastases”).
The degree of development of the main lesion is denoted as T (tumor) with the corresponding index:
- Tis or T0 - the so-called cancer in situ (cancer in place), when the altered cells are located intraepithelially, without germinating into the underlying tissues,
- T1–4 - the degree of development of a malignant tumor, from a minimally pronounced (T1) up to maximum (T4) respectively.
Involvement of regional lymph nodes in the pathological process (local metastasis) is denoted as N (nodulus):
- Nx - examination of nearby lymph nodes was not conducted,
- N0 - during examination of regional lymph nodes, no changes were detected,
- N1 - during the study metastasis to nearby lymph nodes was confirmed.
The presence of metastases - M (metastasis) - indicates the involvement of other organs, damage to nearby tissues and distant lymph nodes:
- Mx - identification of distant metastases was not conducted,
- M0 - distant metastases are not identified,
- M1 - remote metastasis confirmed.
Malignant neoplasms have multiple effects on the body - both local and systemic. Local negative consequences consist in compression of the adjacent tissue structures, vascular and nerve trunks, lymph nodes with a growing tumor. Systemic exposure is manifested by general intoxication with decay products, depletion of body resources, up to cachexia, and violation of all types of metabolism.
Local signs, often indicating the presence of a malignant tumor, are diverse and vary depending on the organ of interest:
- unusual asymmetric swelling, compaction,
- systematic pain
- spontaneous increase in the size and color of moles, birthmarks, etc.
General nonspecific signs:
- severe depression or loss of appetite,
- progressive weight loss with an unchanged eating pattern,
- intolerance of meat food, taste perversion,
- violations of the “sleep - wakefulness” regime (drowsiness during the day, insomnia at night),
- reduced performance
- intolerance to habitual physical activities, etc.
For the diagnosis of malignant tumors and detection of local and distant metastasis, the whole range of research methods is used - depending on the proposed localization of the neoplasm (laboratory tests, X-ray and ultrasound, computer and magnetic resonance imaging, endoscopic methods, etc.).
The final diagnosis is made after a biopsy is taken - a cell is taken or a tissue fragment is taken, followed by a histological or cytological examination of the material obtained. The presence of atypical cells in the sample under study indicates a malignant process.
Every year in the world, malignant neoplasms are diagnosed in more than 10 million people, in the structure of mortality, these diseases are in second place after cardiovascular pathology.
Tactics of treatment of a malignant tumor is determined depending on its location, size, degree of malignancy, the presence of metastases, involvement of other organs and tissues and other criteria.
Conservative therapy methods:
- chemotherapeutic effect (drug suppression of uncontrolled reproduction of malignant cells or their direct destruction, destruction of micrometastases),
- radiotherapy (effect on the tumor by X-rays and γ rays),
- cryotherapy (effect on atypical cells by low temperatures),
- photodynamic therapy,
- experimental methods of influence for which evaluation the sufficient evidential base is not collected.
In some cases, in addition to these methods of exposure, surgical excision of a malignant tumor with nearby tissues, lymph nodes, surgical removal of distant metastases is indicated.
If the patient is at the terminal stage of the disease, the so-called palliative treatment is prescribed - therapy aimed at reducing the suffering of an incurable patient (for example, narcotic analgesics, sleeping pills).
Possible complications and consequences
Complications of malignant tumors can be:
- germination in neighboring organs with their damage,
- uncontrolled rapid progression,
The prognosis for patients who are carriers of malignant tumors depends on many factors:
- localization of the pathological process
- age of the patient
- the presence of metastases,
- structures and forms of tumor growth,
- volume and method of surgical intervention.
In recent decades there has been a clear upward trend in the number of oncological diseases.
Five-year survival for patients with a specific type of disease is purely individual and usually varies from 90 to 10% depending on the listed factors. The most prognostic adverse are lung cancer, stomach cancer, breast cancer, more "prosperous" - cancer in situ. Undifferentiated cancer is more aggressive, prone to active metastasis (compared to differentiated).
Malignant tumors result from the malignant transformation (malignancy) of normal cells, which begin to multiply uncontrollably, losing the ability to apoptosis. Malignant transformation is caused by one or more mutations that cause cells to divide indefinitely and violate the mechanisms of apoptosis. If the body’s immune system does not recognize such a transformation in time, the tumor begins to grow and eventually metastasizes. Metastases can form in all organs and tissues without exception. Most often metastases are formed in the bones, liver, brain and lungs.
Uncontrolled cell division can also lead to a benign tumor. Benign tumors differ in that they do not form metastases, do not invade other tissues and therefore are rarely life-threatening. However, benign tumors often turn into malignant (rebirth tumors).
The final diagnosis of a malignant tumor is made after histological examination of a tissue sample by a pathologist. After the diagnosis, surgical treatment, chemotherapy and radiation therapy are prescribed. As medical science improves, treatment becomes more specific for each type of tumor.
Without treatment, malignant tumors usually progress to death. Most tumors are treatable, although the results of treatment depend on the type of tumor, its location and stage.
Malignant tumors affect people of all ages, but more often occur in old age. This is one of the main causes of death in developed countries.
The study of the etiology of various diseases is an important link in medical science, and in particular, in oncology. Identifying the etiological factors of human tumors is a necessary prerequisite for their prevention. The ancient Roman physician Claudius Galen believed that no single cause could cause a disease without a corresponding susceptibility of the organism. It is known that a number of chemical substances and production processes, ionizing and ultraviolet radiation, smoking, and also separate exogenous viruses, are etiological factors of tumor growth in humans. It is established that malignant neoplasms arise as a result of violations of the DNA of cells that occur under the influence of environmental factors and changes in the organism itself. Cells go out from under the regulatory influence of the organism, infinitely divide, thereby giving rise to malignant growth. In the process of development, malignant tumors have a series of successive stages of the pathological process with their own characteristics, which is reflected in the overall clinical picture of the disease.
According to the virus-genetic theory, in various forms of carcinogenesis, the cause of tumors are viruses, and various physical and chemical carcinogenic factors stimulate the implementation of their oncogenic potency and are pathogenetic, and not etiological factors. Tumor viruses do not differ from viruses that cause infectious diseases and their circulation in nature obeys the laws established for infectious agents. The modern concept of cancer is based on the fact that this is a disease of the genetic apparatus. The virus changes the genetic apparatus of the cell, and it is these changes that become critical for the development of malignant cell transformation. Since the 1970s, genes that stimulate cell growth (oncogenes) and genes that inhibit this growth have been discovered — suppressor genes. Among the suppressor genes, the p53 gene plays an especially important role, which stops cell division from damaged DNA and triggers the repair mechanism. If it is impossible to eliminate the damage, the p53 gene activates the apoptosis program and the cell dies, the threat of a tumor is eliminated. A damaged p53 gene with a loss of ability to inhibit tumor growth contributes to the emergence of such tumors as breast cancer, lung cancer, pancreatic cancer, bladder cancer, etc.
Gene analysis contributed to the identification of new diagnostic and prognostic markers, to find and develop optimal chemotherapeutic methods of treatment, to develop targeted antitumor drugs. The genome of each human cell contains about 30,000 genes and 3.5 billion nucleotides. Malignant transformation develops as a result of numerous DNA changes that are not amenable to correction, which leads to fatal disruption of the structure and functions of cells.
Activation of oncogenes, inactivation of suppressor genes and other genes associated with carcinogenesis, can occur both due to mutations and due to epigenetic changes. These changes play a key role in the occurrence and progression of tumors, are used as biomarkers for early diagnosis of tumors, prognosis and monitoring of the disease, as well as for predicting the resistance or sensitivity of a tumor to chemotherapy and identifying target drug genes.
Neoplasm cells and their metastases, as a rule, retain the structural features of the original tissue. Cancer accounts for about 90% of all malignant neoplasms. Malignant tumors from the connective tissue are sarcomas, from lymphoid lymphoma, pigment cells melanoma. Tumors of the same histological structure arise from cells that are at different stages of development. Such differences relate to the degree of differentiation: high - G1, medium - G2, low - G3, undifferentiated - G4. The lower the degree of cell differentiation, the worse the prognosis.
The study, published in the journal Nature, presents evidence that environmental factors rather than genetic predisposition affect the development of tumors. Researchers evaluated 30 major cellular mutations leading to cancer (colon, lung, bladder, thyroid, etc.). It turned out that only 10–30% of them are caused by internal factors, such as heredity, while 70–90% of mutations are directly related to exposure to harmful environmental factors. The data from this study are important for developing strategies for the prevention of cancer.
Diseases accompanied by abnormal proliferation with an increased incidence of cancer are called precancerous. These diseases are characterized by a long course and individual signs of violation of various functions of the body.Depending on the likelihood of cancer, there are obligate cancers, on the basis of which a malignant tumor and facultative cancers are likely to occur, in which cancer develops relatively rarely, but more often than in healthy people. In 1952, the International Anti-Cancer Union adopted the classification of malignant neoplasms according to the TNM system, developed by P.Denoix. According to the TNM system, tumor spread is assessed twice: before the start of treatment, according to clinical data and examination results, and re-evaluation based on postmortem post-mortem information.
Infection with papillomaviruses (HPV) is quite widespread in the human population — up to 44% of the population is infected with them. More than 100 HPV serotypes are known that can infect the skin and mucous membranes. Primary infection usually leads to the formation of benign lesions, and some can cause the formation of tumors. There are 34 known types of HPV, associated mainly with carcinomas of the anogenital areas (the so-called HPV high-risk HPV-HR viruses). For the anogenital zone, the dominant type is HPV 16 type, to a somewhat lesser extent HPV 18 type, which account for 70-80% of these types of cancers. Among the rest, the most common are HPV types 31. 33. 35, 39, 45 and some others. Cervical cancer is an oncological disease for which the etiological role of the papillomavirus is considered fully proven, as reflected in the WHO Bulletin in 2003.
There are many types of malignant tumors, which are classified according to the organ in which the primary tumor has appeared, the type of cells that undergo a malignant transformation, and the clinical symptoms observed in the patient. The field of medicine that studies and treats malignant tumors is called oncology.
How does cancer develop? The general opinion, which adheres to the majority of modern specialists, is a mutation (transformation) of a normal cell, under the influence of various adverse factors. To study this issue in more detail, let's consider the normal healthy state of the cells.
As we all know, our body consists of a huge number of cells, which in turn form various types of tissue - epithelial, connective, muscular, nervous. All cells are programmed in a specific way, i.e. have their own genetic work and life programs. Moreover, some cells perform one function in the body, and live for one period of time, others - other functions, for example, the erythrocyte lifetime, is 125 days, while the platelet - 4 days, after which they die, and in their place new cells.
The whole process of cell life goes through the following stages: nucleation and division - maturation (future functions are determined) - specialization (the cell acquires the signs of maturity and begins to perform its function in the body) - activity (full functioning under the control of the genetic program) - aging (decay of functioning) - death. Only 6 stages, which the body fully controls.
At this time, various minor disruptions in work that the body controls can occur, and the cells that drop out of their “work program” are destroyed.
When a serious failure occurs under the influence of adverse factors, and the body is weakened at this time or is not able to regulate / normalize the work of the cells, the altered cells are not blocked and continue to involuntarily and randomly multiply in a given place. In connection with the violation of the genetic program, they also do not die off properly.
Rapidly multiplying and not fulfilling its role in a given place, the abnormal cells begin to suffer a malfunction in the work, first the affected organ / tissue, and if not to provide the necessary external intervention, then the whole organism, even death.
What we call a malignant tumor is a collection of unregulated bad cells.
Now that we know how cancer cells are formed, consider the stages of formation of the tumor itself.
Stages of tumor development in the body
1. Hyperplasia. The formation and accumulation of a large number of immature (bad) cells.
2. A benign tumor is formed. However, in some cases this stage may not be present, and hyperplasia will pass into the dysplasia stage, and continue to form a malignant tumor.
3. Dysplasia. Cells are fixed and form a pathological change in tissues. This is also the stage at which the tumor passes from a benign to a malignant form, which is called - malignancy.
4. Pre-cancerous condition. At this stage, the tumor is located in a limited area, has a small shape and is able to absorb by the body.
5. Invasive cancer. A malignant tumor is rapidly developing, inflammatory reactions appear around it, metastases appear, sometimes in distant tissues / organs.
The main causes of cancer
Below is a list of the most frequently identified factors, due to which a person has a malignant tumor (% - percentage of cases):
- Food - 35%
- Smoking - 30%
- Infections (HIV, AIDS, sexually transmitted diseases and others) - 14%
- Ultraviolet, ionizing radiation - 6%
- Carcinogens - 5%
- Low physical activity - 4%
- Alcoholism - 2%
- Polluted air - 1%
Under nutrition you need to understand the use of poor-quality food - the use of high-calorie foods, as well as products that contain carcinogens, nitrates, some food additives (for example - E121, E123, etc.). The lack of fiber in food also affects the body in an unfavorable way. In addition, the wrong diet leads to obesity, which also literally exhausts the body, weakening all the protective and other functions it requires for normal human life.
- Dyes: E-121, E123, E-125
- Preservatives: E-211 (sodium benzoate)
- Acidity Regulators: E-510, E-513, E-527
- Flavor enhancers: E-621 (monosodium glutamate)
Important! E *** - the international designation of food additives. The labels of many products contain the designations of certain additives, if they are present in this product. Always pay attention to exactly which "eshki" used in those products that you intend to purchase.
Smoking and cancer
Smoking and cancer are directly related things. According to some media sources - in addition to the toxic effect, cigarette smoke irradiates the body with a dose of radiation! Yes, yes, you did not hear, dear readers, a smoked pack of cigarettes, according to various sources, irradiates the body with a dose of radiation of as much as 800 micro X-rays! An interesting fact is that such radiation background is present in many parts of the Chernobyl exclusion zone.
Common symptoms of cancer:
- pain, general weakness,
- loss of appetite, weight, depletion of the body (cachexia),
- anemia (anemia),
- hyperhidrosis (increased sweating),
- immunopathological conditions,
- increased body temperature,
- psychological disorders.
Types of cancer by cell type
Glioma (develops from glial cells)
Carcinoma (develops from epithelial cells)
Leukemia (developed from bone marrow stem cells)
Lymphoma (develops from lymphatic tissue)
Myeloma (develops from plasma blood cells and bone marrow)
Melanoma (developed from melanocytes)
Sarcoma (develops from connective tissue, bones and muscles),
Teratoma (developed from gonocytes - embryonic cells),
Choriocarcinoma (developed from placental tissue).
Types of cancer by localization
Uterine cancer (cervix, uterus, uterus)
Cancer classification by TNM system
TNM (abbr. from tumor (tumor), nodus (node) and metastasis (metastases)) - international classification of stages of malignant tumors.
T - primary tumor:
- TX - primary tumor cannot be assessed,
- T0 - no primary tumor data,
- Tis - preinvasive cancer (carcinoma in situ),
- T1-T4 - the degree of prevalence and / or size of the tumor.
N - the presence, absence and prevalence of metastases in the regional lymph nodes:
- NX - regional lymph nodes cannot be assessed,
- N0 - metastases in regional lymph nodes are absent,
- N1-N3 - the degree of involvement of regional lymph nodes.
M - the presence or absence of distant metastases:
- M0 - distant metastases are absent,
- M1 - distant metastases are present.
Subcategory M1 may have clarifications aimed at the location of the tumor:
Peritoneum - PER (C48.1, 2)
Brain - BRA (C71)
Leather - SKI (C44)
Bones - OSS (C40, 41)
Bone Marrow - MAR (C42.1)
Lungs - PUL (C34)
Lymph Nodes - LYM (C77)
Adrenal glands - ADR (C74)
Liver - HEP (C22)
Pleura - PLE (C38.4)
Other organs - OTH
Stage of cancer
Cancer stage 1 (degree). DNA damage occurs, which is why cells change their functioning program and begin to divide uncontrollably. Symptoms are virtually absent. Diagnosis and treatment of cancer at this stage has the most positive prognosis for recovery.
Cancer stage 2 (degree). Foci of altered "Bad" cells are formed, which in turn form tumors. Visible swelling, swelling, a slight increase in body temperature, weakness.
Cancer stage 3 (degree). Atypical cells with the flow of blood and lymph begin to migrate to adjacent and / or distant tissues / organs, metastases appear.
Cancer stage 4 (degree). Metastasis appears uncontrollably in other parts of the body. Inherent pain, fever, neurological and mental abnormalities. In many cases, this stage is fatal.
The main types of cancer treatment
Removal of the tumor by physical means. The method involves the physical removal of a cluster of cancer cells, along with the surrounding tissues. For example, in breast cancer, the entire breast is often removed. Among the instruments, there is a common scalpel, an ultrasound scalpel, a radiofrequency knife, a laser scalpel, and others. Foreign clinics, for example, in Israel and Germany, use exactly modern tumor removal instruments. The rehabilitation period after such a toolkit is easier.
Chemotherapy. The essence of chemotherapy is to use against cancer cells with special drugs that carry different functions - to stop DNA duplication, interfere with cell division, etc. The disadvantage of chemotherapy is severe side effects, since together atypical "bad" cells are damaged and healthy. This cancer treatment is most common.
Radiotherapy. The essence of the method consists in irradiating the body with X-rays and gamma rays. Various particles — photons, neutrons, electrons, protons, etc. — act as a “drug”. An oncologist determines the choice of particles on the basis of a diagnosis. Healthy cells, unlike chemotherapy, are less damaged.
Cryotherapy. The essence of cryotherapy treatment for cancer is the use of extreme cold temperatures against cancer cells. A cancerous tumor is frozen with liquid nitrogen or argon gas, which causes the cell structure to collapse.
Photodynamic therapy. Special preparations are introduced into the tumor area (Alasens, Radachlorin, Photohem), which, under the influence of the light flux, destroy the cells of a malignant tumor.
Immunotherapy. The human immune system, which is the "shield" of the body from various adverse internal and external factors - infections, diseases, etc., is capable of coping with its function without external help. Another thing, when it is weakened or damaged. The essence of the method is to strengthen the immune system, as well as stimulate its work. Thanks to special preparations, the immune system will independently attack the cancer cells, as well as normalize the work of the tissues surrounding the tumor. Some of these tools are “William Coley vaccine”, “Interferon”.
Hormone therapy. It is more a supportive method for the treatment of malignant tumors, therefore it can only be used as an additional means of therapy. The essence of the method consists in the use of hormones of various directions against cancer cells, for example:
- estrogen - in the treatment of prostate cancer,
- glucocorticoids - in the treatment of lymphoma, etc.
Often, oncologists use a combination of the above methods to achieve the best result.
What can you eat with cancer?
Vegetable foods: potatoes, tomatoes, garlic, radish, radishes, eggplants, pumpkin, horseradish, soybeans and their derivatives, beans, peas, white rice, wheat, oats, barley, lentils, nuts, ginger, chili peppers, crackers, toasts, turmeric, olive oil, fruit puree, berries (strawberries, strawberries, raspberries, blueberries, blueberries, currants, lingonberries, cranberries), mushrooms (oyster, shiitake, boletus, chanterelles, fun, champignons), herbs (mint, motherwort, rosemary, basil, thyme), citrus fruits (oranges, tangerines, grapefruit, lemons), melon, apricot, apples, rosehips, honey.
Foods of animal origin: natural dairy products (homemade milk, yogurt, cheese, cottage cheese), eggs,
Drinks: plain water, smoothies, green tea, pomegranate juice
What can not eat with cancer?
White chocolate, alcohol, meat products, white refined sugar, white flour, salt in large quantities, canned food, instant food (fast food), products with hydrogenated fats (margarine) and trans fats.
Important! Some of the above foods come in the category of increased allergenicity, so before you eat them, consult a nutritionist.
- refuse junk food, give preference to products enriched with vitamins, or occasionally take vitamin complexes, especially in spring,
- avoid contact with carcinogens,
- avoid foods that have food additives that can trigger tumor development,
- try to move more, lead an active lifestyle,
- undergo periodic examinations,
- give up bad habits - smoking, drinking alcohol,
- avoid the role of a “passive” smoker,
- watch your weight, do not allow obesity,
- treat illnesses to the end, do not leave them to chance, especially if they are provoked by hepatitis B viruses, human papillomas, etc.,
- watch your mental health, because stresses, depression and other mental disorders weaken the immune system, which actually regulates the process of normal cell activity,
- at the first sign of cancer, contact an oncologist.