In theory, cancers
can be cured if entirely removed by surgery, but this is not
always possible. When the cancer has metastasized to other sites
in the body prior to surgery, complete surgical excision is
usually impossible. In the Halstedian model of cancer
progression, tumors grow locally, then spread to the lymph
nodes, then to the rest of the body. This has given rise to the
popularity of local-only treatments such as surgery for small
cancers. Even small localized tumors are increasingly recognized
as possessing metastatic potential.
Examples of surgical procedures for cancer include mastectomy
for breast cancer and prostatectomy for prostate cancer. The
goal of the surgery can be either the removal of only the tumor,
or the entire organ. A single cancer cell is invisible to the
naked eye but can regrow into a new tumor, a process called
recurrence. For this reason, the pathologist will examine the
surgical specimen to determine if a margin of healthy tissue is
present, thus decreasing the chance that microscopic cancer
cells are left in the patient.
In addition to removal of the primary tumor, surgery is often
necessary for staging, e.g. determining the extent of the
disease and whether it has metastasized to regional lymph nodes.
Staging is a major determinant of prognosis and of the need for
adjuvant therapy.
Occasionally, surgery is necessary to control symptoms, such as
spinal cord compression or bowel obstruction. This is referred
to as palliative treatment.
Treatment Radiation
therapy >>
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Cancer
Classification
1. Nomenclature
2. Adult cancers
3. Childhood cancers
Signs and symptoms
Diagnosis
1. Investigation
2. Biopsy
Treatment
1. Surgery
2. Radiation therapy
3. Chemotherapy
4. Targeted therapies
5. Immunotherapy
6. Hormonal therapy
7. Symptom control
8. Complementary and alternative
9. Treatment trials
Prognosis
1. Emotional impact
Causes
1. Chemical carcinogens
2. Ionizing radiation &
Infectious diseases
3. Hormonal imbalances
& Immune system dysfunction
4. Heredity & Other causes
Pathophysiology
1. Epigenetics
2. Oncogenes
3. Tumor suppressor genes
4. Cancer cell biology
4.1 Clonal evolution
4.2 Biological properties of cancer cells
Prevention
1. Modifiable ("lifestyle") risk factors
2. Diet
3. Vitamins
4. Chemoprevention
5. Genetic testing
6. Vaccination
7. Screening
Epidemiology
History
Research |
