Principles of Tumors

Leon P. Bignold

• Publisher: Academic Press
• Year: 2015
• ISBN:
  9780128017531
• Topic: Biological Sciences
• Subtopic: Cell Biology
• Index: Biological Sciences

Principles of Tumors covers all of the fundamental aspects of tumors, including their definitions, incidences, causation, pathogenesis, treatments, and prevention. The book provides a unique approach, integrating a wide range of basic bioscience findings with clinico-pathological observations and phenomena encountered in their treatment.

As tumors are studied in fairly separate, broad areas, such as basic biological sciences, pathology, oncology, and epidemiology, this book brings together these perspectives, providing an all-inclusive text that benefits all researchers, while also providing an avenue for translational research.

• Integrates both cell mechanisms and tumor physiopathology
• Brings together research and perspectives from basic biological sciences, pathology, oncology, and epidemiology, providing an all-inclusive text
• Provides a concise tumor reference for the tumor researcher and oncologist
• Includes appendices for foundational material
• Brings out the cell detail of tumors

Chapter 1

Introduction

This chapter is designed for readers who have little or no prior knowledge of tumors. It summarizes in plain English the main, fundamental topics in the other chapters, excluding Chapter 10. The sections of the chapter are in the same order as the chapters in the book. Thus Section 1.1 summarizes Chapters 1–3. Section 1.2 summarizes Chapters 4–7. Section 1.3 summarizes Chapters 8 and 9. Section 1.4 summarizes Chapters 11–13. Section 1.5 summarizes Chapter 14.

Keywords

Tumors; causation; molecular pathology; micro-metastases; clinical features; treatments

Outline

1.1 Essential Aspects of the Nature, Types, and Rates of Incidence of Tumors 2

1.1.1 “Tumors” Used in the Sense of “True” Tumors 2

1.1.2 Classifications and Terminology of the Tumor Types 3

1.1.3 Incidences Especially of Malignant Tumor Types 5

(a) General 5

(b) Influence of Ageing Populations 5

(c) Incidences of Tumor Types According to Kind of Parent Cell 5

(d) Use in Medical Practice 6

1.1.4 Epidemiology of Tumors 7

1.1.5 Uses of Animals in Research into the Aspects of Human Tumors 8

1.2 Basic Aspects of Etiopathogenesis 9

1.2.1 Etiological Factors 9

1.2.2 Pathogenesis: DNA Damage 10

1.2.3 “Cancer Genes” in Pathogenesis 11

(a) When the Genomic Events Occur Entirely in the Somatic Cell (i.e., Without Germ-Line Genomic Alteration) 12

(b) Requiring Germ-Line Alteration as Well as a Somatic Alteration in the Genome 12

(c) Cell Signaling in Normal Growth Control 13

1.3 Abnormalities in Morphology and “Molecular Pathology” 15

1.3.1 Background 15

1.3.2 Grading of Tumors 15

(a) General 15

(b) Grading of Carcinomas of the Lung 16

(c) Grading of Carcinomas of the Breast 16

(d) Grading of Carcinomas of the Large Bowel (Colon and Rectum) 16

(e) Grading of Carcinomas of the Prostate 16

1.3.3 Staging of Cases of Tumor 16

(a) General 16

(b) Staging of Carcinoma of the Lung 17

(c) Staging of Carcinoma of the Breast 17

(d) Staging of Carcinoma of the Large Bowel (Colon and Rectum) 17

(e) Staging of Carcinoma of the Prostate 17

1.3.4 Importance of Micro-Metastases 17

1.3.5 “Molecular Pathology” and Other Nonmorphological Features of Tumor Cells 18

1.4 Fundamental Aspects of Clinical Features and Treatments 18

1.4.1 Principles of Symptoms and Signs of Tumors 18

(a) Skin 19

(b) Respiratory Tract 21

(c) Female Breast 21

(d) Alimentary System 22

(e) Hematopoietic and Lymphoid Systems 22

(f) Female Genital 22

(g) Male Genital 23

(h) Nervous System 23

(i) Urinary System 23

(j) Skeletal System 23

(k) Other Systems: Including Endocrine and Special Senses 23

(l) “Progression” 23

(m) Miscellaneous Clinical Features of Tumors 24

1.4.2 Diagnosing Suspected Cases of Tumor 24

1.4.3 Surgery 24

1.4.4 General Aspects of Nonsurgical Treatments 26

1.4.5 Radiation Therapies 26

1.4.6 Anticancer Drug Therapies 27

1.4.7 Relapses 27

1.4.8 Common Side Effects of Nonsurgical Anticancer Therapies 28

1.4.9 “Lifetime Limits” of Doses of Certain Anticancer Therapies 28

1.5 Prevention 29

References 29

Tumors are autonomously growing accumulations of cells which occur in types characterized by distinct, variable combinations of variable differences from their respective kinds of cell of origin. The natures and causes of most of the types of tumors are not well understood. The types which invade adjacent tissues and metastasize to other parts of the body are liable to cause death if untreated.

This chapter summarizes the fundamental aspects of tumors as a basis for the discussions of topics in the following chapters. Much of the material will be at familiar to medical students, as well as to many bioscience students in disciplines such as molecular biology, cell biology, and genetics.

The general principles of normal histology which are relevant to tumors are outlined in Appendix 1. The general aspects of the human genome are described in Appendix 2.

1.1 Essential Aspects of the Nature, Types, and Rates of Incidence of Tumors

1.1.1 “Tumors” Used in the Sense of “True” Tumors

In its most general sense, a “tumor” is any swelling in the body. The term can be applied to a wide variety of conditions including physiological swellings such as a normal pregnant uterus, as well as to pathological swellings such as inflammations (see Section 11.1). In this book, as in most medical situations, the term “tumor” is used as a synonym for “neoplasm” or “true tumor.”

All tumor cells are irreversibly modified normal cells. As a result, tumor cells have two sorts of hereditary characteristics [1]:

i. Those which are particular features of their parent cell and are retained to greater or lesser extents.

ii. Those which are effects of the genomic event associated with tumor.

Tumor cells usually have the following characteristics:

i. The cells have morphological and behavioral abnormalities in comparison with the parent kind of normal cell. They also have different and variable life spans compared to their parent kinds of cells.

ii. While tumor cells individually are not immortal, the cell population of each case of tumor is immortal, in the sense that the population almost invariably continues to grow without any tendency to regress or heal.

iii. In many cases, with time, tumor cell populations show progressive increases in morphological and other abnormalities. The populations virtually never spontaneously revert to less malignant populations.

The degrees of retention of parental features and the degrees of intensity of the acquired abnormalities are highly variable between different tumors. The variability is seen at three levels: between different types of tumors, between different cases of the same kind of tumor, and between different foci in individual cases of tumor.

While the distinction between tumors and nontumorous lesions is usually easy, pathologists recognize many clinicopathological conditions as “tumor-like.” Examples include benign hyperplasias of the breast and prostate gland.

1.1.2 Classifications and Terminology of the Tumor Types

Tumors comprise a thousand or so different types. How these types are recognized and the differences between them are described in multivolume works such as the Armed Forces Institute of Pathology’s Atlas of Tumor Pathology [2] and the World Health Organization Classification of Tumours [3]. The diversity of the tumor types also applies to their clinical behavior and responses to therapies. This is the basis of the complexities which are apparent in clinical oncology [4–7].

The different types of tumors are classified according to three main criteria:

i....

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Preface and Acknowledgments
• Chapter 1. Introduction
• Chapter 2. Theories and Definitions of Tumors
• Chapter 3. Incidences, Mortality, and Classifications of Tumors
• Chapter 4. Etio-pathogenesis I: Causative Agents of Tumors
• Chapter 5. Etio-Pathogenesis II: Genomic Events and Processes Potentially Caused by Etiological Agents
• Chapter 6. Etio-Pathogenesis III: Growth, Invasion, and Metastasis
• Chapter 7. Etio-Pathogenesis IV: Heredity
• Chapter 8. Morphology, Type Characteristics, and Related Features of Tumors
• Chapter 9. Molecular Abnormalities in Tumors: “Molecular Pathology” and “Biomarkers”
• Chapter 10. Sublethal Injuries and Deaths of Cells and Tissues
• Chapter 11. Therapies I: General Principles
• Chapter 12. Therapies II: Specific Non-surgical Treatments
• Chapter 13. Therapies III: Development of Therapies, Costs, and Ethics
• Chapter 14. Aspects of the Prevention of Tumors
• Appendix 1. Principles of Normal Histology and Related Cell Biology
• Appendix 2. Aspects of the Normal Genome
• Appendix 3. “Pre-Target,” “Target,” and “Post-Target” Factors in the Defense of Cells Against Carcinogens and Cytotoxic Agents
• Index