Some people believe that if cancer has spread
to other parts of the body (called metastatic
cancer), it is the same as advanced cancer. This
is not necessarily true. You can have widespread
cancer, but it can still be treatable and sometimes
curable. Examples of this are testicular cancer and
certain types of leukemia and lymphoma.
Harrison's Internal Medicine Chapter 83. Cancer of the Skin
Melanoma Pigmented lesions are among the most common findings on skin examination. The challenge is to distinguish cutaneous melanomas, which may be lethal, from the remainder, which with rare exceptions are benign. Examples of malignant and benign pigmented lesions are shown in Fig. 83-1.
Atypical and malignant pigmented lesions. The most common melanoma is superficial spreading melanoma (not pictured). A.
Ovarian cancer can no longer be considered one disease entity, but a heterogeneous group
of diseases. Our understanding of its clinical and molecular complexity is improving nota‐
bly over the last decade. This is of utmost importance when it comes to determine the most
adequate treatment strategy for each individual patient. Despite not being the most frequent
tumor, ovarian cancer has the highest mortality rate amongst gynecological cancers.
There are four types of cutaneous melanoma (Table 83-2). In three of these—superficial spreading melanoma, lentigo maligna melanoma, and acral lentiginous melanoma—the lesion has a period of superficial (so-called radial) growth during which it increases in size but does not penetrate deeply. It is during this period that the melanoma is most capable of being cured by surgical excision. The fourth type—nodular melanoma—does not have a recognizable radial growth phase and usually presents as a deeply invasive lesion, capable of early metastasis.
No matter where a cancer may spread, it is always named for the place where it started. For
example, breast cancer that has spread to the liver is still called breast cancer, not liver
cancer. Likewise, prostate cancer that has spread to the bone is metastatic prostate cancer, not
Different types of cancer can behave very differently. For example, lung cancer and breast
cancer are very different diseases. They grow at different rates and respond to different
treatments. That is why people with cancer need treatment that is aimed at their particular
kind of cancer.
When cancer spreads from its original place to
another part of the body, the new tumor has the same
kind of abnormal cells and the same name as the
original tumor. For example, if ovarian cancer spreads
to the liver, the cancer cells in the liver are actually
ovarian cancer cells. The disease is metastatic ovarian
cancer, not liver cancer. For that reason, it is treated as
ovarian cancer, not liver cancer. Doctors call the new
tumor “distant” or metastatic disease.
A. Papules related to Escherichia coli bacteremia in a neutropenic patient with acute lymphocytic leukemia. B. The same lesion the following day.
Candidemia (Chap. 196) is also associated with a variety of skin conditions and commonly presents as a maculopapular rash. Punch biopsy of the skin may be the best method for diagnosis.
Cellulitis, an acute spreading inflammation of the skin, is most often caused by infection with group A Streptococcus or Staphylococcus aureus, virulent organisms normally found on the skin (Chap. 119).
Gastric (Nonlymphoid) Sarcoma Leiomyosarcomas and GISTs make up 1–3% of gastric neoplasms. They most frequently involve the anterior and posterior walls of the gastric fundus and often ulcerate and bleed. Even those lesions that appear benign on histologic examination may behave in a malignant fashion. These tumors rarely invade adjacent viscera and characteristically do not metastasize to lymph nodes, but they may spread to the liver and lungs. The treatment of choice is surgical resection. Combination chemotherapy should be reserved for patients with metastatic disease.
Radiation therapy to the pelvis is recommended for patients with rectal cancer because it reduces the 20–25% probability of regional recurrences following complete surgical resection of stage II or III tumors, especially if they have penetrated through the serosa.
The regional draining lymph nodes for the testis are in the retroperitoneum, and the vascular supply originates from the great vessels (for the right testis) or the renal vessels (for the left testis). As a result, the lymph nodes that are involved first by a right testicular tumor are the interaortocaval lymph nodes just below the renal vessels. For a left testicular tumor, the first involved lymph nodes are lateral to the aorta (para-aortic) and below the left renal vessels. In both cases, further nodal spread is inferior, contralateral, and, less commonly, above the renal hilum.
Cancer can be defined as a disease in which a group of abnormal cells grow uncontrollably by disregarding the normal rules of cell division. Normal cells are constantly subject to signals that dictate whether the cell should divide, differentiate into another cell or die. Cancer cells develop a degree of autonomy from these signals, resulting in uncontrolled growth and proliferation. If this proliferation is allowed to continue and spread, it can be fatal. In fact, almost 90% of cancer-related deaths are due to tumour spreading – a process called metastasis....
Most cancers found in the adrenal gland did not start there and are not adrenal cancers.
Instead, they start in other organs or tissues and then spread (metastasize) through the
bloodstream to the adrenal glands. For example, lung cancers, melanomas, and breast
cancers often spread to the adrenals. Even when other cancers spread to the adrenals;
however, they are still named after the place they started and are treated like other
cancers that start in the same place. They are not considered adrenal cancer. Their
treatment is described in our documents on these cancers. ...
Different types of cancer can behave very differently. For example, lung cancer and
breast cancer are very different diseases. They grow at different rates and respond to
different treatments. That is why people with cancer need treatment that is aimed at their
own kind of cancer.
Not all tumors are cancerous. Tumors that aren't cancer are called benign (be-nine).
Benign tumors can cause problems-- they can grow very large and press on healthy
organs and tissues. But they cannot grow into other tissues.
are there breast cancer cells
in your lymph nodes?
Your doctor will examine your lymph
nodes to see if they contain cancer.
Having cancer cells in the lymph nodes
under your arm is associated with an
increased risk of the cancer spreading.
Lymph nodes are filters along the lymph
fluid channels. Lymph fluid leaves the
breast and eventually goes back into the
bloodstream. The lymph nodes try to
catch and trap cancer cells before they
reach other parts of the body.
When lymph nodes are free, or clear,
of cancer, the test results are called
Being diagnosed with cancer is devastating. But when the cancer cells have to spread
to form secondary colonies, the prognosis for the patient is worse. If meaningful
improvements in survival are to occur, then control of metastasis will be a
foundation. Relatively little is known about the control of the metastatic process at
the molecular level. This volume begins to explore our current knowledge regarding
the underlying molecular and biochemical mechanisms controlling the metastatic
The head and neck is a region of considerable anatomical and functional complexity,
making the accurate staging of a head and neck neoplasm a challenging task. The clinician
often detects pathology, but may not appreciate, based on the physical examination, the
entire submucosal tumor extension, nor the possible regional and distant disease spread.
The introduction of CT and MRI has revolutionized head and neck radiology. Current
radiological modalities provide a reliable visualization of the head and neck structures to
an unprecedented level of detail.
Exchange involves the transfer of ownership -- goods for money or goods for goods. Most
exchange transactions are concluded with the payment of money, although some barter exchange
is practiced among countries having centrally controlled trading agencies.
Many people and agencies are engaged in the exchange of agricultural products. The courts
stand ready to enforce rules of fair dealing. Commercial banks provide credit for the shipment of
products and to finance processing and storage. The futures market is available to help in
spreading the market price risk.
The rise and rapid spread of HIV infection, the resurgence of other serious communicable
diseases such as tuberculosis and hepatitis and the increasing recognition that prisons are
inappropriate receptacles for people with drug or alcohol dependence and mental health
problems have thrust prison health high on the public health agenda. As WHO has emphasized,
any national health strategy must include prison policies that address these serious health
In this book dealing with the lung health, the authors focus on various fields, spreading from pulmonary oncogenesis, to inflammatory and parasitic lung diseases. The first section deals with the fundamental research on lung cancer that is mandatory for the development of novel and early biomarkers for diagnosis of the lung cancer. This development could be enhanced using experimental models despite the species barrier. Mouse models can help us understand the sequence of events involved in human lung neoplasia and their underlying molecular mechanisms....