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THYROID TUMORSTHYROID TUMORS
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Thyroid GlandThyroid Gland10/2/2010 3
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Thyroid CancerThyroid Cancer
y Cancer that forms in the thyroid gland.
y E stimated new cases and deaths fromthyroid cancer in the United States in2009:
New cases: 37,200Deaths: 1,630
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Risk FactorsRisk Factorsy F amily History
y Agey Gender ( F emale )
y Iodiney Radiation
5
y A lump in the front of the neck
y Hoarseness or voicechanges
y Swollen lymph nodesin the neck
y Trouble swallowing orbreathing
y
Pain in the throat orneck that does not goaway
ManifestationsManifestations
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DiagnosisDiagnosis
y Physical Examy Blood Testy Ultrasoundy Thyroid Scany Biopsyy CXRy CT Scany MRI
6
y Surgeryy Thyroid Hormone
Treatmenty Radioactive Iodine
Therapyy External Radiation
Therapyy Chemotherapy
Treatment & Treatment & ManagementManagement
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B RAIN TUMORSB RAIN TUMORS
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The B rainThe B rain
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3 Major Parts of the B rain3 Major Parts of the B rain10/2/2010 9
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y The growth of abnormal cells inthe tissues of the brain.
y E stimated new cases anddeaths from brain and othernervous system cancers in theUnited States in 2009:
New cases: 22,070Deaths: 12,920
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B rain TumorB rain Tumor
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Types of PrimaryTypes of PrimaryB rain TumorsB rain Tumors
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B rain TumorsB rain Tumors
y
Primary brain tumors are namedaccording to the type of cells or the partof the brain in which they begin
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y ASTROCYTOMAy The tumor arises from star-shaped glial
cells called astrocytes. It can be anygrade. In adults, an astrocytoma mostoften arises in the cerebrum.
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y Meningioma:
The tumor arises in the meninges.y Oligodendroglioma:
The tumor arises from cells that make the fattysubstance that covers and protects nerves.
It usually occurs in the cerebrum. It's mostcommon in middle-aged adults
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y Medulloblastoma:The tumor usually arises in the cerebellum
y E pendymoma:The tumor arises from cells that line theventricles or the central canal of the spinalcord.
y B rain stem glioma:The tumor occurs in the lowest part of the brain
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Risk FactorsRisk Factors
y Ionizing radiation
y F amily History
10/2/2010 1 6
y Headachesy Nausea and vomitingy Changes in speech, vision,
or hearingy Problems balancing orwalkingy Changes in mood,
personality, or ability toconcentrate
y Problems with memoryy Muscle jerking or twitchingy Numbness or tingling in
the arms or legs
ManifestationsManifestations
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DiagnosisDiagnosisy Neurologic Ex amy MRI y Sp inal Ta py B io psy
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TreatmentTreatmenty Surgery
Craniotomy
y Radiation Therapyy Chemotherapy
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Supportive CareSupportive Care
y Swelling of the brain:Steroids
y Seizures : Anti- Seizure Drugsy Fluid buildup in the skull :
the surgeon may place a shuntto drain the fluid.
y Sadness and other feelings :
it helpful to talk about theirfeelingsy Nutrition: High Calorie Diet
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L ung CancerL ung Cancer
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L ungsL ungs10/2/2010 20
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L ung CancerL ung Cancer
y Is a disease of uncontrolled cell growth intissues of the lung. This growth may leadto metastasis.
y Most lung cancers begin in epithelial cellslining the bronchi.
y The leading cause of cancer related deathin men and women.
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2 Main Types2 Main Types
y
Small CellL ung Cancer(SC L C)
y Non-SmallCell L ungCancer(NSC L C).
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Small Cell L ung CarcinomaSmall Cell L ung Carcinoma
y also called "oat cell carcinoma y It tends to arise in the larger airways and
grows rapidly, becoming quite large.y It usually responds better tochemotherapy and radiation
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NonNon- -Small Cell L ungSmall Cell L ungCarcinomaCarcinoma
y is any type of lung cancer other thansmall cell carcinoma (SCLC).
y are relatively insensitive to chemotherapy,compared to small cell carcinoma.
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SC L C vs. NSC L CSC L C vs. NSC L Cy Small-cell lung cancer grows rapidly.y Small-cell lung cancer spreads quickly.y Small-cell lung cancer responds well to
chemotherapy and radiation therapy (y Small-cell lung cancer is frequently
associated with distinct paraneoplasticsyndromes (collection of symptoms that resultfrom substances produced by the tumor,occurring far away from the tumor).
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Risk FactorsRisk Factorsy F amily History
of Lung Cancery Smokingy Radony Asbestosy Chronic Lung
Diseases
y Persistent coughy Sputum streaked
with bloody Chest painy Voice changey Recurrent
pneumonia or
bronchitis
Manifestations:Manifestations:
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DiagnosisDiagnosisy Chest x-rayy Chest CT scany Bronchoscopyy Sputum
cytology
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y Surgeryy Chemotherapyy Radiation Therapy
TreatmentTreatment
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Cancer of theCancer of theDIG E STIV E DIG E STIV E
TRACTTRACT10/2/2010 28
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E SOPHAG E AL CANC E R E SOPHAG E AL CANC E R
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The E sophagusThe E sophagus
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E sophageal CancerE sophageal Cancer
y Cancer that forms in tissueslining the esophagus
y
E stimated new cases anddeaths from esophagealcancer in the United Statesin 2009:
New cases: 16,470Deaths: 14,530
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Risk FactorsRisk Factors
y Age 65 or oldery Being Maley Smokingy
Heavy Drinkingy Diety Obesityy Acid Reflux
y F ood gets stuck in theesophagus, and food maycome back up
y Pain when swallowingy Pain in the chest or backy Weight lossy Heartburny A hoarse voice or cough
that doesn't go away
within 2 weeks
ManifestationsManifestations
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DiagnosisDiagnosis
y BariumSwallow
y Endoscopyy Biopsy
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y Endoscopic UTZy MRIy CT Scany
PET Scany Bone Scany Laparoscopy
StagingStaging
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TreatmentTreatment
y Surgeryy Radiation
Therapyy Chemotherapy
34
Supportive CareSupportive Care
y Cancer Blocks theEsophagus
y
Painy Sadness and Other
F eelingsy Nutrition
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The StomachThe Stomach10/2/2010 3 5
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Gastric CancerGastric Cancery Cancer that forms in tissues lining the
stomach.E stimated new cases and deaths from
stomach cancer in the United States in2009:New cases: 21,130Deaths: 10,620
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Risk FactorsRisk Factors
y Agey Sexy Racey F amily Historyy Diety H. Pyloriy Smokingy Certain Health
Problem
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y Discomfort in thestomach area
y F eeling full or
bloated after asmall mealy Nausea and
vomitingy Weight loss
ManifestationsManifestations
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DiagnosisDiagnosisy Physical Examy Endoscopyy Upper GI
Seriesy Biopsy
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y L ocal therapy:Surgery andradiation.
y Systemic therapy:Chemotherapy issystemic therapy.The drug enters thebloodstream and
destroys or controlscancer throughoutthe body.
TreatmentTreatment
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SurgerySurgery
y Partial (subtotal)gastrectomy : Thesurgeon removes thepart of the stomach withcancer.
y Total gastrectom y: Thedoctor removes theentire stomach, nearbylymph nodes, parts of the esophagus and smallintestine, and other
tissues near the tumor.
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Supportive CareSupportive Care
y Nutrition
y F ollow- up Care
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ColoColo- -Rectal CancerRectal Cancer
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Colorectal cancer is the third most frequently diagnosedColorectal cancer is the third most frequently diagnosedcancer in men and women and the second highest cause of cancer in men and women and the second highest cause of cancer deaths in the U.S. Yet, when found early, it is highlycancer deaths in the U.S. Yet, when found early, it is highlycurablecurable
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The Colon and RectumThe Colon and Rectum
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ColonColon- - Rectal CancerRectal Cancery Colon Cancer is a cancer that forms in the
tissues of the colon.y Rectal Cancer is a cancer that forms in the
tissues of the rectum.
y E stimated new cases and deaths from colonand rectal cancer in the United States in 2009:
New cases: 106,100 (colon); 40,870 (rectal)
Deaths: 49,920 (colon and rectal combined)
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Risk FactorsRisk FactorsUncontrollable:y Age most patients
are older than 50y Polyps or
inflammatory boweldisease
y F amily history of colorectal cancer
y History of ovarian orbreast cancer
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Controllable:y Diet high in red,
processed, orheavily cookedmeats
y Being overweight(excess fat aroundthe waist)
y Exercising too littley Smoking or drinking
alcohol
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SymptomsSymptoms
diarrhea orconstipationbowel does not empty
completelyblood (either brightred or very dark) instool
Stools are narrowerthan usual
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y
Gas pains or cramps,or feeling full orbloated
y Losing weight with noknown reason
y F eeling very tired allthe time
y nausea or vomiting
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DiagnosisDiagnosisy F OBTy Colonoscopyy Sigmoidoscopyy Double- Contrast
Barium Enemay Digital rectal examy Biopsy
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SurgeryRadiation therapy
Chemotherapy
Biological therapy
TreatmentTreatment
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Colonoscopy Sigmoidoscopy
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CO L ONOSCOPY CO L ON CANC E R
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Colon CancerColon Cancer10/2/2010 5 0
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SurgerySurgery
y Colonoscopyy
Laparoscopyy Open Surgery
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Supportive CareSupportive Care
y
Nutritiony Physical Activityy Rehabilitationy F
ollow- up Care
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L iver CancerL iver Cancer
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The L iverThe L iver10/2/2010 5 4
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L iver CancerL iver Cancery Primary liver cancer is cancer that forms
in the tissues of the liver.y
E stimated new cases and deaths fromliver and intrahepatic bile duct cancer inthe United States in 2009:
New cases: 22,620
Deaths: 18,160
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Risk FactorRisk Factory Infection withhepatitis B virus
(HBV) or hepatitis Cvirus (HCV)
y Heavy alcohol usey Aflatoxiny Iron storage Diseasey Cirrhosisy Obesity and Diabetes
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SymptomsSymptomsy Pain in the upper
abdomen on the rightside
y A lump or a feeling of
heaviness in theupper abdomen
y Swollen abdomen(bloating)
y Loss of appetite andfeelings of fullness
y Weight loss
5 7
y Weakness or feelingvery tired
y Nausea andvomiting
y Yellow skin andeyes, pale stools,and dark urine from
jaundicey F ever
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DiagnosisDiagnosis
y Physical Examy Blood Testy
CT Scany MRIy Biopsy
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10/2/2010 5 9
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TreatmentTreatmenty Surgery (including aliver transplant,
Hepatectomy)y Ablationy Embolizationy Targeted therapyy Radiation therapyy Chemotherapy
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Supportive CareSupportive Carey Pain Controly Sadness and Other
F eelingsy Nutritiony F ollow- up Care
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Pancreatic CancerPancreatic Cancer
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The PancreasThe Pancreas10/2/2010 6 3
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In 2008 , the American Cancer Society estimated thatIn 2008 , the American Cancer Society estimated that37 ,6 80 people in the U.S. were diagnosed with37 ,6 80 people in the U.S. were diagnosed withpancreatic cancerpancreatic cancer
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Pancreatic CancerPancreatic Cancery A disease in which malignant (cancer) cells
are found in the tissues of the pancreas. Alsocalled exocrine cancer.
y E stimated new cases and deaths from
pancreatic cancer in the United States in2009:New cases: 42,470Deaths: 35,240
y
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Risk FactorRisk Factory Agey Diabetesy Being Maley African Americany F amily Historyy Chronic Pancreatitis
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SymptomsSymptomsy Pain in the upper abdomen or upper backy Yellow skin and eyes, and dark urine from jaundice
y
Weaknessy Loss of appetitey Nausea and vomitingy Weight loss
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DiagnosisDiagnosisy Physical Examy Lab Testy CT Scany UTZy ERCPy PTCy Biopsy
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TreatmentTreatmenty Surgeryy Radiation Therapyy Chemotherapyy Biological Therapy
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SURG E RYSURG E RY
y Whippleprocedure
y Distal pancreatectomyy Total
pancreatectomy
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Radiation therapy (radiotherapy) uses highRadiation therapy (radiotherapy) uses high- -powered radiation to damage cancer cells andpowered radiation to damage cancer cells andstop them from growing.stop them from growing.
EX TE RNA L RT INT E RNA L RT
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Chemotherapy uses drugs to kill cancer cells andChemotherapy uses drugs to kill cancer cells and
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py gpy gmay be given by mouth or by injection into amay be given by mouth or by injection into amuscle or vein.muscle or vein.
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Supportive CareSupportive Carey Painy Nutritiony F ollow- up
Care
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Gallbladder CancerGallbladder Cancer
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Gallbladder CancerGallbladder Cancer
y Cancer that forms in tissues of thegallbladder.
y It begins in the innermost layer of tissue andspreads through the outer layers as it grows.
y E stimated new cases and deaths fromgallbladder (and other biliary ) cancer in theUnited States in 2009:
New cases: 9,760Deaths: 3,370
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Risk FactorRisk Factor
y Agey Gendery Ethnicityy Industrial and environmental chemicalsy Gallbladder Polypsy Diet and Obesity
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Risk FactorsRisk Factors
y Gallstones and inflammation of thegallbladder
y Porcelain gallbladdery Typhoidy Choledochal cystsy
Cigarette smoke
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Signs & SymptomsSigns & Symptoms
y Abdominal painy Nausea and
Vomitingy Jaundicey Gallbladder
E nlargement
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DiagnosisDiagnosis
y History and PEy CT- Scany MRIy Angiographyy Cholangiographyy ERCPy Laparoscopyy Lab Test Biopsyy UTZ
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SURG E RYSURG E RY
y Pot en t ially cura t ive surgery is used whenimaging s t udies indica t e a high likelih oo d t ha t t he surgeon will be able to remove all
of the cancer known to be present.
y P allia t ive surgery may be perf o rmed to relieve pain o r preven t complications.
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y Cholecystectomy :If the entiregallbladder (butonly thegallbladder) isremoved.
OpenCholecystectomyLaparoscopicCholecystectomy
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TreatmentsTreatmentsy Radiation Therapyy Chemotherapyy Palliative Therapy
Biliary bypassBiliary stent or biliary catheterPalliative radiationPain Medications
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