Malignant tumors of the skin. Malignant tumor - what is it

Which can be very dangerous for human health, leading up to death. From this definition, its name follows. This tumor is made up 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 reproducing cells begin to spread throughout the body, penetrating into the surrounding tissues, and through, blood flow or mixed way reach almost any organ. This process of moving diseased cells is called metastasis, while the cells themselves are . 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 to cope with malignant neoplasms is one of the primary tasks of pharmacology.

A bit of history

The first descriptions of malignant neoplasms, namely cancer, were described in 1600 BC on an Egyptian papyrus. It was a story about breast cancer with a note that there is no cure for this disease. As a result of the introduction of the term "carcinoma" by Hippocrates, which meant a malignant tumor with inflammation, the term "cancer" arose. He also described several types of cancer, and also introduced another concept - "onkos", which gave the basis for the modern word " oncology". The famous Roman physician Cornelius Celsus even before our era proposed to treat cancer in the early stages by removing the tumor, and in the later stages not to treat it at all.

Symptoms

Symptoms of a malignant tumor depend on its location, as well as on stages development. As a rule, only in the later stages, patients begin to feel pain, but in the early stages, the tumor often does not manifest itself.

The most common symptoms of malignant neoplasms:

  • Unusual hardening or swelling, inflammation, bleeding at the site of the tumor
  • Jaundice
  • Symptoms of metastases: liver enlargement, bone fractures and pain, neurological symptoms, swollen lymph nodes, cough, sometimes with blood
  • Wasting, weight and appetite loss, anemia, immunopathological conditions

Malignant neoplasms have the following properties:

  • The possibility of penetration into nearby and distant organs as a result of metastasis
  • Formation of metastases
  • The tendency to uncontrolled rapid growth, which is destructive, damages and compresses the surrounding organs and tissues
  • They have an effect on the entire body due to the synthesis of the release of toxins by the tumor, which can suppress immunity, lead to human intoxication, exhaustion,
  • The ability to resist the body's immune system, deceiving T-killer cells with a special mechanism
  • The presence of a considerable amount in malignant tumors, which increase with its growth.
  • Low or complete immaturity of cells. The lower this value is, the more “malignant” the tumor is, the faster it grows and metastasizes, but at the same time it is more sensitive to chemotherapy and radiotherapy.
  • The presence of a pronounced cell atypism , i.e. cellular or tissue abnormality
  • Pronounced process of 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 more mutations cause malignant transformation, these mutations cause cells to divide an unlimited number of times and still remain alive. Timely recognized by the immune system, such a malignant transformation can save the body from the onset of a tumor, but if this does not happen, the tumor begins to grow and subsequently metastasize. Metastases can form in absolutely all tissues, 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 is 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

According to the type of cells from which malignant tumors arise, they can be classified as follows:

  • - from
  • Carcinoma - from epithelial cells
  • - from muscle cells, bones, connective tissues
  • Lymphoma - from lymphatic cells
  • - derived from brain stem cells
  • Teratoma - germ cells are involved
  • Choriocarcinoma - from the placenta

Among men and women, different forms of cancer have different prevalence rates. In men, prostate cancer is the most common - it is 33% of all forms of malignant neoplasms, 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, and so on.

Prevention

The basis for the prevention of the occurrence of malignant neoplasms is the maximum protection of a person from carcinogens, the reduction of radiation doses, a healthy lifestyle, chemoprophylaxis and preventive studies.

Lung cancer, for example, in most cases is the result of smoking. In combination with poor ecology and low-quality food, the risk of developing malignant neoplasms increases even more. As an epidemiological study showed, 30% of deaths associated with neoplasms were caused by smoking. Thus, a smoker is three times more likely to develop lung cancer than a non-smoker, while cancer of the vocal cords, esophagus, and oral cavity is also observed mainly in the smoking population.

In addition to the risk factors described above, it has an extremely negative effect - a sedentary lifestyle, drinking alcoholic beverages, exposure,.

Recent studies have shown that a significant role in oncology is played by viruses. Hepatitis B, for example, can lead to liver cancer, cervical cancer.

Early diagnosis

Malignant neoplasms of different organs are diagnosed in different ways.

  • Diagnosis of breast cancer is made by self-examination every week, also done.
  • Diagnosis of malignant neoplasms of the testicles can also be done independently.
  • Cancer of the body, cervix and fundus of the uterus is diagnosed using an endoscope. Even though not all of the bowel can be examined with an endoscope, such examinations improve prognosis and reduce morbidity.
  • Neoplasms on the larynx are detected and examined with a special laryngeal mirror during a visit to the ENT. is a mandatory procedure in case of detection of a tumor. Fibrolaryngoscopy is a more accurate method, its essence lies in the examination with a flexible endoscope. Examination of the larynx under a microscope is performed when the patient is under, 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 examination may be prescribed by a specialist, as well as screening for the presence of oncomarters . However, this technique has not been widely used due to the fact that it can detect very small, harmless malignant neoplasms. Removal of the prostate as a result of the occurrence of a malignant neoplasm can lead to the development of incontinence and.

Some forms of cancer can be detected through a genetic test that will show if a person has a tendency to develop a particular form of cancer.

One of the latest developments in the field of diagnosis of malignant neoplasms in the early stages is sample immunomagnetic enrichment and detection of single tumor cells that circulate in the blood. This method is mainly used in 3-4 stages of breast cancer, colon and rectum, prostate cancer. 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 - the removal of a tissue sample.

Treatment of malignant neoplasms

In many cases, getting rid of a malignant neoplasm is a completely doable task. But there are cases when cancer leads to death. The determining factor is the extent of the cancer. Some forms, such as skin cancer, are almost 100% curable in the first stage. Removal of the tumor It is produced in almost all cases, and part of healthy tissues is usually also captured, since they can also be affected by cancer cells. Removal can be performed 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 are rapidly dividing, forming a tumor - . Radiotherapy is to irradiate malignant cells using gamma rays, electrons and neutrons that penetrate to great depths. hormone therapy used in some cases when neoplasm cells are able to respond to the effects of various hormones. By itself, it is not able to rid a person of a tumor, but it is able to stop its growth and prolong a person's life. Also applies , folk and non-standard methods of treatment.

Ordinary cells, if damaged, undergo apoptosis (A). Cancer cells do not undergo apoptosis and continue to divide (B)

A malignant tumor is a tumor, the properties of which most often (in contrast to the properties of a benign tumor) make it extremely dangerous for the life of the organism, which gave reason to call it "malignant". A malignant tumor is made up of malignant cells. Often, any malignant tumor is incorrectly called cancer (which is only a special case of a malignant tumor). In foreign literature, however, any malignant tumor is really called cancer.

A malignant neoplasm is a disease characterized by the appearance of uncontrollably dividing cells capable of invasion into adjacent tissues and metastasis to distant organs. The disease is associated with impaired cell proliferation and differentiation due to genetic disorders.

The development of drugs and methods for the treatment of malignant tumors is an important and still not fully resolved scientific problem.


General information

Malignant tumors arise as a result of 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 disrupt 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. The most common metastases are in the bones, liver, brain, and lungs.

Uncontrolled cell division can also lead to benign tumors. Benign tumors are distinguished by the fact that they do not form metastases, do not invade other tissues, and therefore are rarely life-threatening. However, benign tumors often turn into malignant (tumor degeneration).

The final diagnosis of a malignant tumor is made after a histological examination of a tissue sample by a pathologist. After diagnosis, surgical treatment, chemotherapy and radiation therapy are prescribed. As medical science improves, treatment becomes more and more specific to each type of tumor.

Without treatment, malignant tumors usually progress to death. Most tumors are treatable, although treatment outcomes depend on the type of tumor, location, and stage.

Malignant tumors affect people of all ages, but are much more common in the elderly. It is one of the leading causes of death in developed countries. The appearance of many tumors is associated with the action of environmental factors such as alcohol, tobacco smoke, ionizing radiation, ultraviolet radiation, and some viruses.

A recent study published in the journal Nature provides evidence that the development of cancer is influenced mainly by environmental factors rather than genetic predisposition. The 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 of this study are important in terms of developing strategies for the prevention of cancer.

There are many types of malignant tumors, which are classified depending on the organ in which the primary tumor appeared, the type of cells that undergo cancerous transformation, as well as the clinical symptoms observed in the patient. The field of medicine that deals with the study and treatment of malignant tumors is called oncology.

History of the study of malignant tumors

Since, apparently, malignant tumors have always been part of the human experience, they have been repeatedly described in written sources since ancient times. The most ancient descriptions of tumors and methods of their treatment include ancient Egyptian papyri from about 1600 BC. e. The papyrus describes several forms of breast cancer, and cauterization of the cancerous tissue was prescribed as a treatment. In addition, the Egyptians are known to have used caustic ointments containing arsenic to treat superficial tumors. There are similar descriptions in the Ramayana: the treatment included the surgical removal of tumors and the use of arsenic ointments.

The name "cancer" comes from the term "carcinoma" introduced by Hippocrates (460-377 BC) (Greek καρκίνος - crab, cancer; ωμα, abbreviated from ὄγκωμα - tumor), denoting a malignant tumor with perifocal inflammation. Hippocrates called the tumor a carcinoma because it looks like a crab due to the presence of outgrowths directed in different directions. He also proposed the term onkos (ὄγκος). Hippocrates described cancers of the breast, stomach, skin, cervix, rectum, and nasopharynx. As a treatment, he proposed the surgical removal of accessible tumors, followed by the treatment of postoperative wounds with ointments containing plant poisons or arsenic, which were supposed to kill the remaining tumor cells. For internal tumors, Hippocrates suggested refusing any treatment, as he believed that the consequences of such a complex operation would kill the patient faster than the tumor itself.

Roman physician Aulus Cornelius Celsus in the 1st century BC. e. proposed to treat cancer at an early stage by removing the tumor, and at later stages - not to treat it in any way. He translated the Greek word καρκίνος into Latin (cancer - crab). Galen used the word "ὄγκος" to describe all tumors, which gave the modern root to the word oncology.

Despite the existence of numerous descriptions of malignant tumors, practically nothing was known about the mechanisms of their occurrence and spread throughout the body until the middle of the 19th century. Of great importance for understanding these processes were the works of the German physician Rudolf Virchow, who showed that tumors, like healthy tissues, are composed of cells and that the spread of tumors throughout the body is associated with the migration of these cells.

Properties of malignant tumors

  • The tendency to rapid uncontrolled growth, which is destructive in nature and leads to compression and damage to surrounding normal tissues.
  • The tendency to penetrate ("invasion", "infiltration", "penetration") into the surrounding tissues, with the formation of local metastases.
  • The tendency to metastasize to other tissues and organs, often very distant from the original tumor, by moving through the lymph and blood vessels, as well as by implantation. Moreover, certain types of tumors show a certain relationship (“tropism”) to certain tissues and organs - they metastasize to certain places (but can metastasize to others).
  • The presence of a pronounced general effect on the body due to the production of toxins by the tumor that suppress antitumor and general immunity, contributing to the development of general poisoning ("intoxication"), physical exhaustion ("asthenia"), depression, emaciation up to the so-called cachexia in patients.
  • The ability to escape from the immunological control of the body with the help of special mechanisms to deceive T-killer cells.
  • The presence of a significant number of mutations in tumor cells, the number of which increases with age and tumor mass; some of these breakdowns are necessary for carcinogenesis itself, some are necessary for evading immunity or for acquiring the ability to metastasize, while others are random and arise due to the reduced resistance of tumor cells to damaging effects.
  • Immaturity ("non-differentiation") or low, compared with benign tumors, the degree of maturity of the cells that make up the tumor. Moreover, the lower the degree of cell maturity, the more malignant the tumor, the faster it grows and metastasizes earlier, but, as a rule, the more sensitive it is to radiation and chemotherapy.
  • The presence of severe tissue and / or cellular abnormality (“atypism”).
  • The predominance of cellular atypia over tissue.
  • Intensive stimulation of the growth of the circulatory system ("angiogenesis") in the tumor, leading to its filling with blood vessels ("vascularization") and often to hemorrhages into the tumor tissue.

Symptoms of malignant tumors

Symptoms vary depending on the location of the tumor. Pain usually occurs only in the later stages. In the early stages, the tumor often does not cause any discomfort. Some common symptoms include:

local symptoms:

  • unusual swelling or hardening (often the earliest symptom);
  • bleeding;
  • inflammation;
  • jaundice;

symptoms of metastases:

  • swollen lymph nodes;
  • cough, possibly with blood;
  • liver enlargement;
  • bone pain, bone fractures;
  • neurological symptoms;

general symptoms:

  • cachexia (weight loss, loss of appetite, exhaustion);
  • immunopathological conditions;
  • hyperhidrosis;
  • anemia;

psychological symptoms.

A change in psychological status can be caused by several factors:

  • the reaction of the body to painkillers;
  • behavioral response to "fear of death" (if the patient is aware of his condition);
  • metastasis to the brain region;
  • a sharp change in hormonal status.

Types of malignant tumors

Malignant tumors differ in the type of cells from which they arise. Types of malignant tumors:

  • carcinoma, or cancer itself - from epithelial cells (for example, cancer of the prostate, lung, breast, rectum);
  • melanoma - from melanocytes;
  • sarcoma - from connective tissue, bones and muscles (mesenchyme);
  • leukemia - from bone marrow stem cells;
  • lymphoma - from lymphatic tissue;
  • teratoma - from germ cells;
  • glioma - from glial cells;
  • choriocarcinoma - from the tissue of the placenta.

Malignant tumors of childhood

There are tumors that especially often affect children and adolescents. The incidence of malignant tumors in children is highest in the first 5 years of life. Leading tumors are leukemias (especially acute lymphoblastic leukemia), tumors of the central nervous system, and neuroblastoma. This is followed by nephroblastoma (Wilms' tumor), lymphomas, rhabdomyosarcoma, retinoblastoma, osteosarcoma, and Ewing's sarcoma.

Epidemiology of malignant tumors

The International Agency for Research on Cancer for 2000 provides the following data: 10 million people fell ill with malignant tumors in the world. According to the same estimates, 8 million people died of cancer in the world in 2000. In terms of the number of both sick and dead, lung cancer ranks first, with which 1.238 million fell ill in 2000, and 1.102 million people died.

The second place in the structure of the incidence of malignant tumors in the world is occupied by breast cancer: the number of cases is 1.050 million people. In the structure of mortality, it occupies the 5th place; in 2000, 372 thousand women died from this disease. Colon cancer ranks third in incidence. In 2000, 943 thousand people fell ill with it, and in terms of the number of deaths (491 thousand), colon cancer ranks 4th. Stomach cancer ranks fourth, although cancer of this localization ranks second in terms of mortality. In 2000, 875 thousand people fell ill with stomach cancer and 646 thousand people died.

The ratio of deaths to cases for breast cancer (0.35) and colon cancer (0.52) is significantly lower than for stomach cancer (0.73), indicating a significantly better prognosis for the first two diseases. In terms of the number of patients with malignant tumors, liver cancer occupies the 5th place, with 563 thousand people falling ill in 2000. In terms of mortality, liver cancer ranks 3rd, the number of deaths is 547 thousand people.

Further in the structure of the incidence of malignant tumors follow: prostate cancer (542 thousand people), cervical cancer (470 thousand), esophageal cancer (411 thousand), bladder cancer (365 thousand), non-Hodgkin's lymphoma (286 thousand people). ), oral cancer (266 thousand), leukemia (256 thousand), pancreatic cancer (215 thousand), ovarian cancer (192 thousand women), and kidney cancer completes the list of 15 most common forms of malignant tumors (188 thousand people).

In the structure of mortality, the ranking numbers of the above forms of malignant tumors are somewhat different. On the 6th place - cancer of the esophagus, from this disease in 2000, 336 thousand people died in the world. This is followed by: cervical cancer (233 thousand women), pancreas (212 thousand people), prostate cancer (204 thousand men), leukemia (194 thousand people), NHL (160 thousand people), bladder cancer (132 thousand people), oral cancer (127 thousand people), ovarian cancer (114 thousand women) and kidney cancer (90 thousand people).

In the United States and other developed countries, malignant tumors are the direct cause of death in 25% of cases. Approximately 0.5% of the population is diagnosed with malignant tumors every year.

The incidence of malignant neoplasms in Russia

According to the P. A. Herzen Moscow Research Institute of Optics, in Russia in 2012, 525,931 cases of malignant neoplasms were initially detected (0.7% more than in 2011), and 480,028 patients were registered in oncological institutions. In total, at the end of 2012, the contingent of patients with malignant neoplasms registered in oncological institutions was 2,995,566 people (2.1% of the country's population); while 51.1% of them were registered for 5 years or more.

Prevention of malignant tumors

The goal of prevention is to reduce the frequency and severity of the appearance of malignant tumors. Its means are: preventing contact with carcinogens, correcting their metabolism, changing diet and lifestyle and / or using appropriate products and drugs (chemoprophylaxis), reducing radiation doses, as well as conducting preventive examinations.

One of the significant modifiable factors affecting the incidence of lung cancer is smoking. Together with malnutrition and environmental influences, smoking is an important risk factor for the development of malignant neoplasms. According to a 2004 epidemiological study, tobacco smoking was the cause of death in one third of cancer-related deaths in many Western countries. A smoker is several times more likely to get lung cancer than a non-smoker. In addition to lung cancer, smoking increases the likelihood of other types of malignant tumors (mouth, esophagus, vocal cords), as well as other diseases, such as emphysema. In addition, smoking increases the likelihood of malignant neoplasms in others (the so-called passive smoking).

Other factors that increase the incidence of malignant tumors include: alcoholic beverages (tumors of the mouth, esophagus, breast and other types of malignant tumors), physical inactivity (colon and breast cancer), overweight (colon, breast, endometrial cancer) ), irradiation.

Viruses play a role in the development of cancer. For example, the hepatitis B virus increases the risk of developing tumors in the liver, and the human papillomavirus plays an important role in the occurrence of cervical cancer.

Early diagnosis

Breast cancer is diagnosed by weekly self-examination and self-palpation of the breast, as well as mammography (best - a combination of these two methods). According to the latest data [what?], the breast self-examination method is not an effective diagnosis, since it allows you to notice formations of only 0.5 mm, which corresponds to stages II-III of cancer, and in these cases, therapy will be ineffective.

Testicular cancer can be diagnosed at an early stage by testicular self-examination, which is why it is recommended for men with a family history of cancer. The American Urological Association recommends monthly self-exams for all young men.

Laryngeal cancer is diagnosed by indirect laryngoscopy (examination with a special laryngeal mirror when visiting an otolaryngologist) followed by a biopsy of suspicious areas of the mucous membrane. More accurate methods are fibrolaryngoscopy (examination with a flexible endoscope) and direct microlaryngoscopy (examination of the larynx with a microscope under anesthesia). The main risk factor for laryngeal cancer is long-term smoking (more than 1 pack per day for 10-20 years). The vast majority of patients with laryngeal cancer are men (95%). Cancer of the vocal cords has a more favorable prognosis than cancer of the vestibular larynx, since the former is manifested by hoarseness even with a small tumor size and can be diagnosed at an early stage. The first symptoms of vestibular cancer of the larynx (which is located above the vocal folds) usually occur in the later stages of tumor growth and are manifested by difficulty in breathing (mainly on inspiration), choking, discomfort when swallowing, coughing, and hemoptysis. It is necessary to remember the general manifestations of malignant tumors. The most important of these is unmotivated weight loss in a short period of time (more than 10 kg in 3-6 months).

Colon cancer, cervical cancer, and cancer of the fundus and body of the uterus are diagnosed with endoscopes. Endoscopic examinations of the intestine both reduce the incidence of cancer (polyps are removed before malignant transformation) and improve the prognosis. However, not all intestines can be checked with an endoscope.

Early diagnosis of prostate cancer is carried out by palpation of the prostate through the rectum, as well as ultrasound of the prostate and screening for cancer markers in the blood. However, this technique for early detection of prostate cancer has not caught on because it often detects small, malignant tumors that are never life-threatening. However, finding them leads to treatment, usually removal of the prostate. Removing the prostate can lead to impotence and urinary incontinence.

For some types of cancer (particularly breast cancer and colon cancer), there is a genetic test that allows you to identify some types of predisposition to them.

A newer research method is the technology of immunomagnetic enrichment of the sample and the determination of single circulating tumor cells in the blood (Veridex CellSearch). It is used to diagnose breast cancer, prostate cancer, rectal and colon cancer in stages 3-4. The technology allows to estimate the number of circulating tumor cells in the blood. The principle of analysis is based on the immunomagnetic enrichment of cells using metal nanoparticles coated with a polymer layer containing antibodies to EpCAM molecules (epithelial cell markers) with further immunofluorescent identification of cells collected in a magnetic field. It is a less expensive, minimally invasive method for assessing the prognosis of survival and evaluating the effectiveness of chemotherapy in breast, prostate, rectal and colon cancer.

Final diagnosis and treatment

For the final diagnosis of malignant tumors, a biopsy is used - taking a tissue sample for analysis.

Main types of treatment

Some malignant tumors are poorly curable and often lead to the death of the patient. However, in many cases a cure is possible. An important factor determining the success of treatment is early diagnosis. The outcome of treatment is largely determined by the degree of development of the tumor process, its stage. In the early stages, the chances are very high, so you should constantly monitor your health using the services of professional doctors. At the same time, you can’t waste time trying to be cured with the help of alternative medicine, ignoring modern methods of treatment, this can only aggravate your condition and complicate subsequent treatment.

The following treatments are currently being used:

  • Removal of the tumor. Since tumor cells can also be found outside the tumor, it is removed with a margin. For example, in breast cancer, the entire breast is usually removed, as well as the axillary and subclavian lymph nodes. If, nevertheless, there are tumor cells outside the removed organ or part of it, the operation does not prevent them from forming metastases. Moreover, after removal of the primary tumor, the growth of metastases is accelerated. However, this method often cures malignant tumors (such as breast cancer) if the operation is done early enough. Surgical removal of the tumor can be carried out both with traditional cold instruments and with the use of new instruments (radio frequency knife, ultrasonic or laser scalpel, etc.). For example, removal of laryngeal cancer (stages 1-2) with a laser with direct laryngoscopy allows the patient to maintain an acceptable voice and avoid tracheostomy, which is far from always possible with traditional open surgeries (not endoscopic). The laser beam, compared to a conventional scalpel, reduces bleeding during surgery, destroys tumor cells in the wound, and provides better wound healing in the postoperative period.
  • Chemotherapy. Drugs are used that target rapidly dividing cells. Drugs can suppress DNA duplication, interfere with the division of the cell membrane into two, etc. However, in addition to tumor cells, many healthy ones, for example, stomach epithelial cells, are intensively and rapidly dividing in the body. They are also damaged by chemotherapy. Therefore, chemotherapy leads to severe side effects. When chemotherapy is stopped, healthy cells regenerate. In the late 1990s, new drugs came on the market that attacked the proteins of tumor cells with little or no damage to normal dividing cells. Currently, these drugs are used only for certain types of malignant tumors.
  • Radiotherapy. Radiation kills malignant cells by damaging their genetic material, while healthy cells suffer less damage. For irradiation, X-rays and gamma radiation are used (short-wavelength photons, they penetrate to any depth), neutrons (have no charge, therefore they penetrate to any depth, but are more effective in relation to photon radiation, the use is semi-experimental), electrons ( charged particles penetrate to a conventionally shallow depth - up to 7 cm using modern medical accelerators; are used to treat malignant tumors of the skin and subcutaneous cells) and heavy charged particles (protons, alpha particles, carbon nuclei, etc., in most cases semi-experimental).
  • Cryotherapy.
  • Photodynamic therapy drugs that can destroy malignant tumor cells under the influence of a light flux of a certain wavelength (Photohem, radachlorin, photosens, alasens, photolon, etc.).
  • hormone therapy. Cells of malignant tumors of some organs react to hormones, which is used. So, for prostate cancer, the female hormone estrogen is used, for breast cancer - drugs that suppress the action of estrogen, glucocorticoids - for lymphomas. Hormone therapy is a palliative treatment: it cannot destroy the tumor on its own, but it can prolong life or improve the chances of a cure when combined with other methods. As a palliative treatment, it is effective: in some types of malignant tumors, it prolongs life by 3-5 years.
  • Immunotherapy. The immune system seeks to destroy the tumor. However, due to a number of reasons, it is often unable to do so. Immunotherapy helps the immune system fight the tumor by making it attack the tumor more effectively or by making the tumor more susceptible. Sometimes interferon is used for this. The William Coley vaccine, as well as a variant of this vaccine, picibanil, are effective in the treatment of some forms of neoplasms.
  • Combined treatment. Each of the methods of treatment separately (except palliative) can destroy a malignant tumor, but not in all cases. To improve the effectiveness of treatment, a combination of two or more methods is often used.
  • To alleviate the suffering of terminal patients, drugs are used (to combat pain) and psychiatric drugs (to combat depression and fear of death).

One of the most terrible diseases in the modern world. When a person hears this word from the lips of a doctor as a diagnosis, he has a lot of negative emotions, and especially fear.

A cancer diagnosis can be stressful for you and your family, but there are many resources available to help you. You owe it to yourself to learn as much as possible about your diagnosis and how your condition can be treated. Knowledge is power and it can help you deal with this disease.

What is cancer?

Cancer is a disease that occurs when cells in the body start dividing faster than the body needs. These rapidly dividing cells develop into a growth known as a tumour. The tumor may be benign(non-cancerous) or malignant(cancerous).

What are the causes of cancer?

Many factors can cause the development of cancer in the body. Some of these factors, such as heredity, cannot be avoided. Others, such as lifestyle, can be controlled.

For example, tobacco use is one of the main causes of cancer, especially lung cancer. Tobacco use, whether in the form of smoking, chewing, or exposure to second-hand smoke (passive smoke), can also cause cancer of the mouth and throat, esophagus, throat, and many other parts of the body.

Other primary causes of cancer include:

  • Diet/diet. A poor diet can increase the risk of cancer, for example, eating a lot of high-fat foods can contribute to colon and prostate cancer. A poor diet can lead to overweight and obesity, which can be a risk factor for various types of cancer, including breast, uterine, ovarian, prostate, and colon cancers.
  • Environment. Cancer can develop if a person is exposed over a period of time to various chemicals present in the environment, including pesticides, asbestos, and radon.
  • Exposure to radiation. Excessive exposure to the sun (ultraviolet radiation) can cause skin cancer. Also, overexposure to x-rays or radiation therapy (as part of cancer treatment) may be a risk factor for developing cancer.
  • hormone therapy. Women who are going through menopause can get a prescription for hormone replacement therapy, either estrogen alone or combined with progesterone. Both of these hormones have been found to increase the risk of developing breast cancer. A woman who still has her uterus and takes only estrogen (no progesterone) has a significantly increased risk of developing endometrial cancer.

What are the symptoms of cancer?

The most pronounced symptoms of cancer are:

  • Non-healing wounds
  • A wart or mole that is changing
  • Unusual growth anywhere on the body
  • Persistent cough and hoarseness
  • Indigestion or trouble swallowing
  • Changes in bowel habits or urination
  • Unusual weight loss
  • Unusual bleeding or discharge from various parts of the body

Please note that these symptoms do not mean you definitely have cancer. However, if any of these symptoms appear, you should contact your doctor right away.

How is cancer diagnosed?

If your doctor thinks you may have cancer, they will test you and may refer you to certain diagnostic procedures, such as:

  • Blood and urine tests.
  • Radiography, computed tomography (CT), magnetic resonance imaging (MRI), radionuclide scanning and ultrasound (ultrasound).
  • A biopsy is a procedure in which a doctor takes a small sample of a tumor and examines it under a microscope.

What is cancer staging?

One of the biggest problems with a cancer diagnosis is the spread of cancer (metastases) to other organs and tissues. To indicate this, the doctor assigns a number (from I to IV) to your diagnosis. The higher the number, the more the cancer spreads throughout the body. This is called "staging". Your doctor needs this information to plan your treatment.

What are the treatments for cancer?

To treat your cancer, the doctor needs to know the location of the tumor, the stage (whether or not it has spread), and whether you are strong enough to treat it.

Cancer treatment can take the following forms:

  • Chemotherapy: This treatment uses powerful drugs that destroy cancer cells. Chemotherapy is given orally or intravenously.
  • Radiation therapy: This is a treatment that kills cancer cells with radiation (high energy rays). Radiation therapy can be either internal (placed inside the body) or external (outside the body). Note: In some cases, doctors give radiation therapy and chemotherapy at the same time.
  • Surgery: the surgeon removes the tumor along with surrounding tissues (in some cases).
  • hormone therapy: Hormones (substances produced by the glands to regulate organ functions) may be given to the patient to block other hormones that can cause cancer.
  • Biological response modifiers: Biological Response Modifier Therapy uses natural or artificial (lab-created) substances to restore the body's natural defenses against disease. Biological therapies include immunotherapy, gene therapy, vaccines, monoclonal antibody therapy, and some targeted therapies. (Monoclonal antibodies are created in a laboratory to work like natural antibodies that are produced by the body's immune system to fight disease.)
  • Immunotherapy: A type of biological therapy that uses substances that affect the immune system to help the body fight cancer, infection, and other diseases. Some types of immunotherapy are designed only for certain cells of the immune system. Others affect the immune system in general. Types of immunotherapy include cytokines, vaccines, bacilli Calmette-Guerin (BCG), and some monoclonal antibodies.
  • : Stem cells (immature cells from which all blood cells develop) are removed from the patient's circulating blood or bone marrow and then returned after chemotherapy.

What are the side effects of cancer treatment?

  • Chemotherapy: side effects include hair loss, fatigue, nausea, vomiting.
  • Radiation therapy: side effects include fatigue, hair loss and skin problems (darkening, dryness, itching).
  • Surgery A: Pain and weakness are possible side effects of surgery.
  • hormone therapy: This therapy can lead to fatigue, water retention, hot flashes, impotence and blood clots.
  • Biological response modifiers and immunotherapy: These treatments can cause flu-like symptoms (fever, chills, muscle pain, etc.), skin rash, swelling, and an increased tendency to bruise or bleed.
  • stem cell transplant Side effects include nausea, vomiting, flu-like symptoms and an increased risk of infections.

You can learn more about the different types of cancer, their symptoms, causes, diagnosis, prevention and treatment in this section below.

A tumor is a formation that results from the uncontrolled growth of similar cells in various organs or tissues of the body. It develops independently, its cells can be very diverse.

The cells of a malignant tumor differ significantly from the normal cells of the organ in which the cancer develops, sometimes so much so that when examining the tumor tissue under a microscope (histological examination), it is impossible to understand from which organ or tissue these cells originate. The degree of difference between tumor cells and normal cells characterizes the degree differentiation tumor cells. They are medium-differentiated, low-differentiated and undifferentiated.

The lower the differentiation, the faster the cells divide and the tumor grows. Its active growth is accompanied sprouting (infiltration of cells) to the surrounding organs. And growth is accordingly called infiltrating.

Malignant neoplasms are characterized by the ability to metastasis. Metastasis is the development of tumor cells of the original tumor in a new place. In the process of tumor growth, single cells can break away from the tumor body, while they enter the blood, lymph, and are transferred to other organs with the blood or lymph flow. Accordingly, allocate lymphogenous(with lymph flow, through the lymphatic vessels to the lymph nodes, first located close to the primary focus, then to more distant ones), hematogenous(with blood flow through the blood vessels to different organs, often far from the site of the primary tumor), and implantation(along the serous membrane, when it enters the serous cavities, for example, in the chest or abdomen) metastasis pathways.

Malignant tumors can recur . Even with complete radical removal of the neoplasm, i.e. the same tumor recurs in the same organ or area.

If the tumor is not completely removed, its growth is considered progression cancer.

Cancer tumors affect the entire body, causing cancer intoxication. Intoxication is due to the fact that for the rapid growth and division of tumor cells, additional nutrients are required, which the growing tumor takes away from other organs and systems. In addition, during the decay of tumor cells, substances enter the body that poison the body. With the death of tumor cells or damage to surrounding tissues, an inflammatory process begins, which is accompanied by an increase in body temperature and additional toxicity.

Some patients (especially those with advanced cancer) report severe pain. This is due to both the germination of tumor cells in the nerves and compression of the surrounding tissues.

Causes of malignant neoplasms

There are many theories about the causes of cancer, but the current view on this issue suggests that a combination of factors influence the occurrence of malignant neoplasms. These include hereditary predisposition, decreased immunity, certain diseases and infections, as well as exposure to environmental factors. Carcinogens (as external factors are often called) can be different for different types of tumors and differ greatly in nature. These include ultraviolet radiation (skin cancer), certain chemicals (exposure to tobacco smoke and smoking), exposure to certain viruses.

Classification of malignant tumors

Tumors are divided depending on the tissue from which the tumor cells originate. Crayfish is a tumor of cells epithelial tissue. With highly differentiated cells, additional types of tissues are isolated, for example, squamous cell carcinoma, adenocarcinoma (glandular epithelium). For poorly differentiated cells, the name may include the shape of these cells: oat cell carcinoma, small cell carcinoma, cricoid cell carcinoma, etc. Sarcoma It is a malignant tumor of the connective tissue. Blood and lymph are also connective tissue, so it is wrong to say blood cancer. It's right to talk about hemoblastosis(a tumor of the hematopoietic tissue spread throughout the circulatory system) or about lymphoma(a tumor of the hematopoietic tissue that has developed in one part of the body). Melanoma It is a tumor of pigment cells.

Cancer can also be subdivided according to the anatomical formation in which this epithelial tissue is located. That is why they say lung cancer, stomach cancer, and so on.

Stages of a malignant neoplasm

When making a diagnosis and determining a treatment plan, it is very important to clarify the prevalence of a neoplasm.

For this, two main classifications are used: the TNM system (classification of the International Anti-Cancer Union, MPRS, UICC) and the clinical classification describing the stages of cancer.

ClassificationTNM

It is international and gives a description of the following parameters:

1. T (tumor, tumor)- describes the size of the tumor, the spread to the departments of the affected organ, the germination of surrounding tissues.

2. N (nodes)- the presence of growth of tumor cells in regional (local) lymph nodes. With the flow of lymph, regional lymph nodes are first affected (collector of the 1st order), after which the lymph goes to a group of more distant lymph nodes (collectors of the 2nd and 3rd orders).

3.M (metastasis, metastases) - the presence of distant metastases.

In some cases, they also use:

4.G (gradus, degree)- the degree of malignancy.

5. P (penetration, penetration)- the degree of germination of the wall of a hollow organ (for tumors of the gastrointestinal tract).

The following indicators are offered:

Tx - no data on tumor size.

T0 - the primary tumor is not determined.

T1, T2, T3, T4 - depends on the increase in the size and / or degree of germination of the primary tumor.

Nx - no data on the defeat of regional lymph nodes.

N0 - regional lymph nodes are not affected.

N1, N2, N3 - reflect the increase in the degree of involvement in the process of regional lymph nodes.

Mx - the presence of distant metastases cannot be assessed.

M0 - no distant metastases.

M1 - distant metastases are determined.

The G indicator is established after an additional study of a piece of the tumor, and it shows the degree of cellular differentiation of the tumor:

Gx - it is impossible to estimate the degree of differentiation.

G1-G4 - reflect the increase in the degree of undifferentiation (malignancy) and the rapidity of cancer development.

Clinical classification

This classification combines different parameters of a malignant neoplasm (the size of the primary tumor, the presence of regional and distant metastases, germination into surrounding organs) and highlights 4 stages of the tumor process.

1 stage: the tumor is small (up to 3 cm), occupies a limited area of ​​​​the organ, does not germinate its wall, there is no damage to the lymph nodes and there are no distant metastases.

2 stage: the tumor is larger than 3 cm, does not spread outside the organ, but a single lesion of the regional lymph nodes is possible.

3 stage: the tumor is large, with decay and germinates the entire wall of the organ or a smaller tumor, but there is multiple damage to the regional lymph nodes.

4 stage: germination of the tumor in the surrounding tissues or any tumor with distant metastases.

The TNM and clinical classifications complement each other and both are indicated when making a diagnosis.

The stage of the cancer determines the outcome of the treatment. The earlier the diagnosis is made, the greater the chance of recovery.

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