What are the Clinical Aspects of Neoplasia?
- Local and hormonal effects
- Cancer cachexia
- Paraneoplastic syndromes
- Grading and staging
Local and Hormonal Effects of neoplasia
- Location as a critical determinant of the clinical effects of both benign and malignant
tumors
- Bleeding and infection if tumor ulcerates through adjacent surfaces
- Impingement on adjacent structures, example: pituitary adenoma can compress and
destroy the surrounding normal gland → hypopituitarism
- Neoplasms in the gut may cause obstruction.
- Pancreatic cancer can obstruct bile ducts → jaundice
Cancer Cachexia
- Progressive loss of body fat and lean body mass,"wasting"
- Profound weakness, anorexia, anemia
- Elevated basal metabolic rate
- Evidence of systemic inflammation
- The mechanisms not fully understood.
- Role of TNF-alpha in cachexia
Paraneoplastic Syndromes
Some signs and symptoms in patients with cancer which cannot be explained by tumor
spread or release of hormones that are indigenous to the tumor "cell of origin".
how often are Paraneoplastic Syndromes seen in people with cancer?
10% of the time
why are Paraneoplastic Syndromes important?
They may be the earliest manifestation of an occult neoplasm.
T/F In affected patients, Paraneoplastic Syndromes can cause significant
clinicalproblems and may even be lethal
True
how can Paraneoplastic Syndromes confound treatment?
They may mimic metastatic disease
what causes Disseminated intravascular coagulation (DIC) and what are the major
underlying cancers that could be the cause?
- Tumor products that activate clotting
- Leukemia, Prostatic carcinoma
what causes Cushing syndrome (endocrinopathies) and what are the major
underlying cancers that could be the cause?
- ACTH or ACTH-like substance
- Small cell carcinoma of lung, pancreatic carcinoma, neural tumors
what causes Paraneoplastic autoimmune multiorgan syndrome (PAMS)
(Paraneoplastic pemphigus) and what are the major underlying cancers that
could be the cause?