1. Cancer development - -steps of cell growth -malignant vs. benign -S/S -staging (TNM) 2. Initiation (Steps of cell growth) - -this is an irreversible event -that can lead to cancer development -this can happen due to the presence of carcinogens (cancer causing agents i.e. cxm., physical agents (barret's epithelium in the esophagus), or viruses (HPV) 3. Promotion (Steps of cell growth) - -refers to the enhanced growth of a cell by substances known as promoters -hormones (especially estrogen), body proteins i.e. insulin -causes the malignant cells to divide more rapidly & become a tumor -the period between initiation & growth into a tumor called the latency period-can range from months to yrs. 4. Progression (Steps of cell growth) - -is the continued change of cancer making it more malignant -after a tumor grows to 1cm-it has at least 1 billion cells -once it begins to build its own blood supply, it becomes a health problem -as tumors grow they contain less and less normal cells 5. Metastasis (steps of cell growth) - development of secondary malignant growth somewhere else other than the primary site 6. Malignant - -indicates cancer -serious leads to death without intervention -cells invade the surrounding tissue. -malignant tumors arise from epithelial cells of the skin, lungs, liver, kidneys, stomach, breast, prostate & thyroid- these tumors are called CARCINOMAS -malignant transformation refers to the process in which regular cells are changed into cancer cells (this occurs through loss of cellular regulation) -so cells become damaged & divide rapidly & in an unorderly fashion -serve no useful function 7. Benign - -harmless, does not usually require intervention -normal cells grow in the wrong place or time, but do not invade surrounding tissue -benign tumor cells (moles, uterine fibroid tumors, skin tags, endometriosis, nasal polyps) -benign tumors continue to produce fibronectin which keeps them tightly adhered to each other. 8. 7 S/S of cancer - C=changes in bowel or bladder habits A=a sore that does not heal U=unusual bleeding or discharge T=thickening or lump in the breast or elsewhere I=indigestion or difficulty swallowing O=obvious change in wart or mole N=nagging cough or hoarseness 9. Staging TNM - T=tumor N=node M=metastasis 10. Staging Tumor - Tx (primary tumor cannot be assessed) To (no evidence of primary tumor) Tis (carcinoma in situ-regional place) T1, T2, T3, T4 (increasing size &/or local extent of the primary tumor