Cancer & Mimics

This is a summary page co-ordinating cancer and cancer mimics. 

I use the following classification systems: 

1. Body System

2. Life Cycle

3. Specialty

4. Histology

Pathophysiology

Definition

• Genetic damage to cell's DNA causing damage to cell reproductive cycle and

• Damage to host

Monoclonal vs Polyclonal

All cancers involved a genetic mutation to a cell's DNA. In monoclonal cancers, this single cell multiplies uncontrollably and all subsequent cancer cells are clones. Therefore if a biopsy of the cancer is obtained the results of the genetic and cell analysis will be applicable to all of the cancer cells in the body. 

As a cancer progresses it can become polyclonal. Due the excessive number of replications, further mistakes can be made and new cell lineages emerge. Naturally polyclonal cancers are harder to treat due to the diversity of damaged cells. 

Some cancers are naturally polyclonal. For example the prostate may have many individual monoclonal cancers, which can collectively be thought of as polyclonal. 

Grade and Severity

There are some core severity markers associated with the cell abnormalities and clinical presentation. 

Cell

• Level of differentiation

• Genetic profile- presence of multiple DNA mutations

Clinical presentation

• Short history/ quick doubling speed

• Metastatic spread

• Younger age suggests more abnormal and resistant cancer to natural immune system guards

Cancers classified

Cancer's and their growth's are usually named via their site of damage or site of primary. 

The 12 body systems & specialties involved, excluding oncology, palliative & paediatrics. 

Nervous: (Neurology)

• Brain Cancer

  • Primary: Gliobastoma, Meningioma, Astrocytoma

  • Metastatic Cancer

• Spinal Cord Cancer

• Peripheral nervous cancers: Tuberous Sclerosis, Neurofibromatosis 

Endocrine (Endocrinology)

• Phaeochromocytoma, Thyroid cancer, Multiple endocrine neoplasia, Carcinoid syndrome, Paraneoplastic cancers

Senses

• Ophthalmology: retinoblastoma

• ENT: head & neck cancer

Cardiovascular (Cardiology, cardiothoracic)

• Cardio myxoma

Respiratory (Respiratory, cardiothoracic)

• Lung cancer- small cell and non small cell

• Mesothelioma

GI (Gastroenterology, general surgery)

• Oesphagus, Stomach, Colorectal, Anal cancers

• Pancreas, Liver, Gallbladder

Urinary (Renal, urology)

• Renal & Bladder cancers

Repro female (Gynaecology)

• Breast, ovarian, cervical, vulva cancers

Repro male (Urology)

• Testicular, Prostate, Penile cancers

Haematopoietic (Haematology)

• Lymphoid: ALL, CLL; Lymphoma, myeloma, amyloidosis

• Myeloid

  • AML, CML,

  • Myeloproliferative: Polycythaemia vera, essential thrombocytosis, myelofibrosis, 

  • Myelodysplastic disorders (MDS)

Musculoskeletal (Orthopaedics, rheumatology)

• Sarcoma, Osteoblastoma

Skin (Dermatology)

• Malignant melanoma, Squamous cell carcinoma, Basal cell carcinomas

Life cycles

1. Neonates Retinoblastoma

2. Paediatrics Wilms tumour, ALL

3. Adult Medicine Breast, cervical, testicular, lymphoma, ovarian

4. Medicine of the Elderly Prostate, colorectal, breast, lung

5. Palliative Care Lung, colorectal, breast, ovarian, pancreatic..

By Aetiology

1. Genetic

   • All cancers, retinoblastoma, CRC, breast cancer

2. Environment

   • Chemical Trauma

     • Skin cancer, lung cancers, mesothelioma

   • Infections: bladder cancer

By Histology

• Adenocarcinoma

  • • • Esophageal,  gastric and colorectal cancer

      • Prostate cancer

      • Lung cancer in non smokers

• Squamous cell carcinoma

  • • • Lung cancer (hyper calcaemia)

      • Skin cancer: SCC

      • Cervical cancer

• Small cell: lung cancer

• Grossly differentiated (unknown)

Cancer Complications

Boney Metastasis

Management

1. Analgesia

2. Bisphosphonates

3. External beam radiotherapy

Core Oncology Emergencies

• Tumour Lysis Syndrome 

• SVCO (Superior Vena Cava Obstruction) 

• HyperCalcaemia 

• Neutropenic Sepsis 

• Spinal cord compression

• Raised ICP

• Ascites or pleural effusion

• Hyperviscosity syndrome

Cancer Biomarkers

Biomarker Cancer associated

Ca125 Ovarian cancer

Ca19-9 Biliary & pancreatic cancer

Ca15-9 Breast cancer

CEA Colorectal cancer

AFP Testicular (non-seminoma), hepatocellular cancer, teratomas

HCG Seminomas

References and Resources

Page written in 2024.