Tumours can be benign or malignant. Malignant tumours grow rapidly, invade nearby tissue, lose cell differentiation, and can metastasize to other parts of the body. Tumours are diagnosed through history, examination, investigations, and histopathology. Tumour markers in the blood can indicate the presence or type of tumour. Treatment options include surgery, radiation, chemotherapy, hormone therapy, and palliative care to ease symptoms. Prognosis depends on the extent of spread, appearance under the microscope, anatomical location, and patient's general health. Screening tests can detect some cancers early in asymptomatic people.

1. TUMOURS

2. What is a tumour?
Overgrowth of cells

3. Neoplasia
An abnormal mass of tissue, the growth of
which exceeds and is uncoordinated with that
of normal tissues and persists in the same
excessive manner after the cessation of the
stimuli which evoked the change

4. Classification
• Benign
• Malignant
– Primary
– secondary

5. Malignant:
• Rapid increase in size
• Local invasion
• Loss of differentiation of cells
• Anaplasia and dysplasia
• Metastasis

6. Clinical Features
• Malignant tumour may manifest itself in four
ways:
1. Effects of primary tumour
2. Effects of secondary deposits
3. General effects of malignant disease
4. Paraneoplastic syndromes – remote effects of
hormones or other tumour-cell products e.g.
ACTH, PTH in lung cancer

7. Diagnosis
• History
• Examination
• Special investigations
• Histopathology

8. Tumour Markers
• Blood chemicals produced by malignant cells
• Biochemical indicators of the presence of a
tumour
• Cell surface antigens
• Cytoplasmic proteins
• Enzymes
• Hormones

10. Significance:
• Screening
• Diagnosis
• Prognostic indicator
• May indicate malignant change in a benign
condition
• Postoperative monitoring – fall, recurrence

11. Treatment
• Curative
– Ablate the disease completely
– Removal of primary and secondary
• Palliative – measures taken to ease the
symptoms

12. CURATIVE:
• Surgery
• Radiotherapy – seminoma, lymphoma, SCC
• Cytotoxic chemotherapy – lymphoma
• Combination

13. PALLIATIVE:
1. Surgery
2. Radiotherapy
3. Hormone therapy
4. Cytotoxic chemotherapy
5. Drugs
6. Nerve blocks

14. • Surgery
– Curative resection
– Bypass

15. • Radiotherapy
– Indicated for localized irremovable disease
– Localized secondary deposits in bone
– Inoperable lymph node deposits

16. • Hormone therapy
– Breast cancer
– Prostate cancer

17. • Cytotoxic chemotherapy
– Damage dividing cells – normal and abnormal
– Curative
– Adjuvant
– Neoadjuvant
– Palliative

18. • Drugs
– Pain relief – NSAIDS, opiates
– Hypnotics
– Anti-emetics

19. • Nerve blocks
– With phenol or alcohol
– Celiac plexus – pancreatic, gastric, hepatic cancer
– Subcostal – rib metastasis

20. PROGNOSIS
is a medical term for predicting the likely
outcome of one's current standing.

21. Prognosis depends on:
1. Extent of spread
2. Microscopic appearance
3. Anatomical situation
4. General condition of the patient

22. 1. Extent of spread - STAGING
• Clinical examination
• At operation
• Excised specimen
• TNM classification
– Tumour – size, degree of invasion
– Node – regional, distant
– Metastasis – presence or absence

23. 2. Microscopic appearance
• Degree of histologic differentiation
• Well-differentiated – good prognosis
• Un-differentiated – bad prognosis

24. 3. Anatomical situation
• Site may preclude a tumour’s adequate
removal
• E.g.
– Lower esophagus
– Behind aortic arch
– Frontal lobe
– Brain stem

25. 4. General condition
• Poor general health
• Co-morbidities e.g. congestive cardiac failure

26. Screening
Detection of disease in an asymptomatic
population

28. EXAMPLES:
• Mammography
• Pap smear
• PSA level
• Colonoscopy