Find out how to avoid missing the early stages of carcinoma

Carcinoma is a malignant neoplasm originating from epithelial tissue. It is carcinoma that is usually meant when talking about cancer.

The treatment of carcinomas has its own specifics. Therefore, they should be treated by an oncologist who specializes in this type of tumor. One of the world's most famous specialists in the treatment of carcinomas is Professor Moshe Inbar. He works at the Israeli clinic Top Ichilov - https://www.topichilov.com/

For the first time, the term “karkinos”, that is, “cancer”, was mentioned in his writings by Hippocrates (ancient Greek καρκίνος - “crab”, -ωμα from ὄγκωμα - “tumor”) due to the external resemblance of a growing malignant neoplasm to an arthropod.

Changes in the color and size of moles are possible signs of carcinoma

Unlike benign neoplasms, carcinoma is characterized by rapid uncontrolled growth with penetration into nearby tissues, metastasis (screening out of atypical cells) both in neighboring structures and organs, and in distant ones.

The annual incidence of cancer exceeds 10 million people: lung cancer ranks first (about 1.3 million people per year), followed by breast cancer (just over 1 million) and colon cancer (more than 900 thousand). In Russia, about 2% of the country's population are diagnosed with cancer.

Every year, more than 8 million people worldwide die from various forms of cancer.

Causes of carcinoma

The reasons for the occurrence of lesions are vague and represent a list of points that are easy to find in any large city. The patient’s lifestyle before the onset of cancer has a significant impact:

• bad habits and sedentary lifestyle;
• unbalanced diet, excess body weight;
• radiation or excess of received ultraviolet rays;
• living in a polluted area or working with hazardous substances.

Hereditary location plays a special role. If your relatives have had malignant tumors, especially of the mammary glands, then you should be very careful about your health and respond to any manifestations of any disease.

Symptoms

The manifestation of the disease is determined by the type of neoplasm. Common symptoms include the following:

• loss of appetite, weight loss;
• development of weakness and anemia;
• temperature changes;
• development of anemia;
• the appearance of dense nodes of a single or multiple nature, some of them can be felt by palpation, but this does not apply to a poorly differentiated tumor;
• the appearance of pain in different parts of the body;
• changes in the skin;
• disruption of the hormonal system;
• enlarged lymph nodes.

As the tumor grows, the signs and symptoms become more distinct and vivid.

Types of carcinoma

Mutating cells affect any organ in the human system; when the formations decay, the body is poisoned with toxic substances. There are enough reasons for this, they are listed above. As it spreads, the disease covers a larger area, disrupting the functioning of body systems, internal organs and the endometrium.

Carcinoma classification:

• Basal cell. The skin is damaged, metastases do not form. However, deep germination damages organs. Location: open areas of the body, often exposed to ultraviolet rays: face, arms, neck. Indirect causes of the disease: weak immune system and long-term use of dosage forms.
• Squamous. Consists of epithelial cells, spreading metastases throughout the body. Most patients with this type of tumor are fair-skinned people. If the epithelium is capable of forming a horny substance, it is a differentiated type of squamous cell carcinoma. If it is impossible to form, the cancer is called non-keratinizing. Microinvasive cervical cancer, formed specifically from squamous cell tissue, is often found.
• Neuroendocrine. A neoplasm from epithelial glandular cells found in the digestive system. Rarely found on the lungs, ovaries or thymus. The most poorly studied type of neuroendocrine carcinoma is considered to be cancer formed from Merkel cells, which are part of human skin. Violation of the composition of these cells leads to a deterioration in the sense of touch and the occurrence of basal cell carcinoma. A rare form of cancer has an aggressive course and rapid spread to the lymph nodes. Forms on the face, neck, head in the form of a bump.
• Clear cell. 85% of this type of tumor disrupts the functioning of an organ such as the kidneys. The rate of development of cancer cells is high, metastases form in any organ. The altered epithelium of the kidney causes renal failure, and pain appears in the lumbar region.

Clear cell carcinoma

• Primary peritoneal. An aggressive form of cancer that affects the lining of the peritoneum. The symptoms are similar to ovarian cancer, which may result in an incorrect diagnosis. 75% of such tumors are discovered when the disease has reached stage 3, the remaining 25% - at stage 4. The neoplasm is divided into clear cell, serous or mucinous adenocarcinoma. Women in the postmenopausal period are especially susceptible to the disease.
• Mucoepidermoid. Disturbs the functioning of the salivary gland without manifestation. Therefore, this cellular form is detected by doctors in the last stages. Outwardly it resembles a node measuring from 5 mm to 12 cm. Despite the size of the tumor, the disease is curable. The presence of affected glands can be checked using cytological analysis.
• Cervical, or cervical cancer. If the lesion is on the neck, squamous cancer is diagnosed. When the cervical canal is damaged, it is called adenocarcinoma. The disease develops inside the organ, i.e. intraepithelial, or invasive - with extension beyond the affected organ.
• Bronchial. Affects the lungs. In 20% of cases of this type, a small cell type of carcinoma is formed with an unfavorable prognosis. This type of disease often occurs in smokers or workers in hazardous industries. However, this form of the disease is also possible for those who live in an environmentally polluted place.
• Papillary. A formation in the thyroid gland that affects people of all ages. The cause of the manifestation is a hormonal imbalance. Amenable to hormone therapy.

In addition to these types, malignant cancer is divided into subtypes based on location, symptoms, and survival prognosis. Much depends on the degree of maturity of the cancer cells. Therefore, an additional classification is distinguished, where glandular carcinoma is:

• highly differentiated;
• moderately differentiated;
• poorly differentiated.

If the structure of the tumor is close to healthy cells, this is a high degree of differentiation. If the difference between a healthy cell and a diseased one is high, we are talking about a low-differentiated degree. The complexity of the low-differentiated degree lies in the maximum diversity or the same set of affected cells. Despite the difficulties, there are mucinous, solid, small cell, fibrous and other forms of low-grade cancer.

Development of a cancerous tumor

Forms of the disease

Types of carcinoma are distinguished taking into account the type of cells in which the malignant process unfolds. Types of carcinoma include the following:

• squamous cell (the basis for it is the epithelium, which can be keratinizing or non-keratinizing);
• adenocarcinoma (its base is glandular structures).

Various types of carcinoma are also distinguished based on the degree of differentiation, in this case the following options are distinguished (the following are listed in order of increasing malignancy and, accordingly, danger):

• well-differentiated cancer (its cells largely resemble those from which they originated);
• moderately differentiated;
• poorly differentiated (these are two intermediate options);
• Finally, the most dangerous carcinoma, the prognosis in this case is the least favorable - the undifferentiated type, in this situation the cancer cells are almost undifferentiated, as a result, doctors cannot determine which specific cancer was underlying, in this case the disease also progresses at the highest speed.

Benign neoplasms

Separately, Fr. This is the name of a benign neoplasm of glandular tissue. When there is a hormonal imbalance, the adenoma develops into a malignant tumor.

Most often, the tumor is localized in the prostate area, but it also forms in other organs. Prostate adenoma – there is no metastatic phase, but it is characterized by a transition to adenocarcinoma.

Adenoma of the stomach and intestines is an acquired disease in people who previously suffered from gastritis, had an unhealthy diet, or have a genetic predisposition. An adenoma of the digestive tract is called a polyp. A single tumor is surgically removed; for multiple polyps, electrocoagulation is used.

Fibrous adenoma of the breast is a mobile formation. Women often discover changes in the breast area on their own. In the stage of rapid development, the tumor is removed. Until this moment, she is simply being watched.

Endometrial adenoma in the uterus is the growth of the endometrium to the formation of a cyst or polyp. Accompanied by bloody discharge between menstruation and cramping pain. This type of adenoma is visible on ultrasound and is removed by curettage of the uterus. Endometrioid adenocarcinoma of the uterus is the scourge of women who have no sex life, have not had childbirth or pregnancy, and also experience hormonal imbalance. As the tumor grows, the woman looks like a pregnant woman, her stomach grows, and lower back pain appears. Foul-smelling vaginal discharge indicates that the tumor is disintegrating.

Examining the adenoma of the lower extremities, it is noticeable that its degeneration resembles rheumatism. For this reason, the patient often ignores the first signs, missing favorable treatment of the disease. As the pain increases, the legs become inactive and swelling occurs. With the last stage of the disease, fractures that become chronic are more common. The lesion affects the feet, legs, heels, hip joints, and cancer of the upper extremities is less common.

Spinal adenoma is rare. Most often, the patient is faced with a cancerous tumor, which manifests itself as pain in the back. A biopsy will determine the nature of the tumor and help determine the correct treatment for the patient.

Degrees

The degree of danger and, accordingly, the prognosis for carcinoma is established through a comprehensive study of the characteristics of the focus (tumor) itself, the lymph nodes involved in the disease and the quality of metastases.

The following stages of carcinoma are distinguished, taking into account the condition of the tumor:

• T0, in this case, the malignant formation is located exclusively within the epithelium itself and nearby tissues are not affected.
• T1-4 - various stages of carcinoma, when it has spread beyond the epithelium in which it originally arose, the first is the least pronounced, and the fourth is the most.

The degree of lymph node involvement and the number of metastases formed are also assessed using special indices.

Symptoms of the disease

General and local symptoms of the tumor are identified. General signs of the disease indicate the patient’s condition as a whole, local signs indicate a symptom of a damaged organ.

Local signs:

• the skin and mucous membranes are modified, ulcers appear, color, structure externally become different from healthy membranes;
• bleeding of the affected organ;
• breathing problems and difficulty swallowing food;
• cough mixed with phlegm and blood;
• pain in the affected area;
• the genitals hurt during sex, intermenstrual bleeding, blood loss after intercourse;
• urinary incontinence, frequent urge to go to the toilet, bowel movements with altered color and structure;
• disturbances in voice timbre, as well as partial loss of vision, smell, and hearing;
• nausea, vomiting, headaches and dizziness.

Common symptoms of illness experienced by patients:

• loss of appetite followed by aversion to food;
• weight loss;
• weakness, fatigue, drowsiness;
• increased temperature, increased sweating at night;
• anemia and jaundice.

Preventive mastectomy

In Western countries (Europe, USA), preventive operations to remove mammary glands and replace them with implants have become widespread when hereditary mutations of the BRCA genes are detected.

Such operations gained great popularity after the famous American actress Angelina Jolie had a preventive mastectomy after learning that she had a BRCA gene mutation.

In our country, in the absence of breast disease, surgery to remove it in a public medical institution is impossible. Preventive considerations are ignored.

The only option to perform a preventive mastectomy for a BRCA gene mutation is to go to a private oncology center.

Treatment of carcinoma

The resulting diagnosis will help establish a complete picture of the course of the disease. The oncologist prescribes a course of treatment for the patient, taking into account the location of the tumor, its stage and the general condition of the patient.

To achieve cure or stable remission, the following types of therapeutic measures are used:

• surgical intervention;
• radiation or chemotherapy;
• embolization of tumor vessels;
• cryodestruction;
• radiotherapy, hormonal therapy;
• experimental treatment.

To achieve better results, doctors prescribe several types of treatment to provide relief.

Surgical operations

This type of treatment is acceptable up to stage 4 cancer. The last stage is not amenable to surgical intervention due to damage to many organs. If surgery is prescribed, then, depending on the complexity, doctors will remove part or all of the damaged organ, including adjacent tissues.

For example, if carcinoma has damaged the breast, the mammary gland is completely removed. Cervical cancer also results in the complete removal of an organ, including the woman's vagina and uterus. Lymph nodes are also operated on to avoid recurrence of the disease.

Chemotherapy

This therapy is aimed at removing damaged areas of cancer that remain in the body after surgery. Cytostatics are often administered intravenously, and there is also a tablet course of treatment. Chemotherapy may also be given before surgery to shrink the area that will be removed later. Taking medications is aimed at destroying the tumor while preserving healthy cells. Unfortunately, chemicals exhibit side effects. Therefore, along with treatment, the patient is supported with immunomodulators and vitamins prescribed by the doctor.

Carrying out a chemotherapy procedure

Chemoembolization of arteries

It is similar to chemotherapy in terms of the method of exposure, but the distinctive feature of the method is the introduction of the drug into the body. The drugs are delivered directly to the main artery that supplies nutrients to the tumor. Loss of nutrition leads to the arrest and destruction of the tumor site. A de-energized neoplasm, not receiving nutrients, dies.

Forecast

The prognosis of the disease is individual and depends on many factors:

• the age and general health of the patient;
• type of cancer;
• location of the tumor;
• degree of tumor differentiation;
• degree of severity of the process (stage);
• presence of metastases;
• response to therapy;
• presence of complications.

The most severe degree of carcinoma is T4N1M1 (the maximum severity of the oncological process with the involvement of lymph nodes and the presence of distant metastases).

The prognosis is favorable for differentiated cancer diagnosed at an early stage. The favorable prognosis worsens with a low- or undifferentiated process, massive damage to the lymph nodes, metastasis, and the multicentric (multiple) nature of the pathology.

Survival times vary for individual forms of cancer.

Complications caused by the disease

Complications that malignancy entails are the main cause of death among people affected by cancer. Consequences include:

• internal bleeding;
• fistulas in hollow organs;
• penetration of affected cells into other organs;
• inflammatory process in the peritoneum;
• swelling of the brain or lungs;
• blood poisoning;
• overlap of bronchi, ureters;
• intestinal obstruction;
• compression of nerve endings and blood vessels;
• disruption of the heart muscle and breathing;
• complete poisoning of the body, exhaustion;
• coma with central nervous system depression.

Repeated relapses and metastases in distant organs increase the destructive effect on the body. The patient weakens, the immune system stops working at full strength. Such processes lead to the death of the patient.

Diagnostics

Oncologists make the diagnosis; in addition to assessing complaints and examining them, they prescribe a number of examinations. These include:

• complete laboratory examination of blood and urine, including analysis for tumor markers;
• endoscopic examination of the respiratory tract and digestive tube;
• radiography of the suspected tumor site to identify damage to surrounding tissues;
• CT and MRI to clarify the size of the tumor and determine metastases;
• biopsy of a suspicious lesion to confirm the type of cancerSource: Screening and early diagnosis of hepatocellular carcinoma. Kirienko V.T., Zaitsev I.A., Grushkevich V.V., Potiy V.V. Current infectology, 2021. p. 70-76.

Prognosis and prevention

Even if the doctor told the patient his life expectancy, do not forget that this is an approximate scenario for the development of the disease. It all depends on the general condition of the patient, his psychological mood, location and existing diseases. Taking into account the components of the anamnesis, a preliminary prognosis is made, indicating the possible development of the disease. The initial stages are easy to treat, but difficult to diagnose. The last stages are incurable, the doctor maintains the stability of the patient’s condition.

Clinical recommendations for preventive measures:

• Be examined by doctors for preventive measures.
• If symptoms arise, seek advice from oncologists. Especially if similar cases have already been recorded in the family.
• Do not self-medicate.
• Change your lifestyle and give up bad habits.
• Engage in physical exercise, establish proper nutrition and be attentive to the body.

Prevention reduces the risk of cancer. And reducing the amount of ultraviolet rays received by human skin reduces the likelihood of healthy cells developing into cancer.

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Carcinoma does not suddenly arise in place of unchanged epithelium; it is constantly preceded by a precancerous change.

Risk factors

One of the main risk factors is mutations of the BRCA1 and BRCA2 genes. They have an innate character. In the general statistics of the incidence of breast cancer, they account for no more than 15%. However, in the presence of such mutations, the probability of developing carcinoma can reach 80%.

In this regard, many women, having discovered gene mutations in themselves, decide to have their mammary glands removed and replaced with implants.

This type of cancer usually occurs in women. Breast carcinoma in men is 100 times less common.

The age factor matters. Ductal tumors usually occur in women at the age of 40, lobular tumors - after 60 years. Breast cancer is much less common at younger ages.

Hormonal factors play a role in the development of malignant tumors of the mammary glands. Therefore, this type of cancer is usually sensitive to hormone therapy.

The general condition of the genital area, the presence of gynecological diseases and disorders (dysmenorrhea, amenorrhea, endometritis, adnexitis, etc.) play a certain role. Lack of children or late pregnancy are also considered such factors.

Exposure to toxic substances, chemical toxins, and carcinogens are classic factors in the development of cancer, and breast cancer is no exception in this case.

Other factors are oral contraceptives, hormonal drugs (for example, for the treatment of menopausal syndrome), nervous stress, trauma to the mammary glands, early onset of menstruation, a family history of the disease, benign breast tumors, excess weight.

Types

Hepatocellular carcinoma has five different types, each of which is a very dangerous and fatal disease that can cause metastases:

• Obstructive, accompanied by jaundice. It is the most dangerous among all types, as it blocks the bile duct and remains hidden for a long time. And only at the thermal stage can it be detected.
• Cirrhosis-like, the least developing type of the disease, in which the liver increases in size. A common symptom is abdominal hydrops, which appears as a result of venous pressure.
• Cystic, developing somewhat faster. It begins with the detection of round-shaped formations during examination. This hepatocellular liver cancer is accompanied by tumor nodes that cause pain in the right hypochondrium and fever.
• Hepatomegalic type. The rapid and uncontrollable growth of the organ can be described by this tumor. When palpated, the organ's tuberosity and compaction are felt. Temperature and pain appear under the ribs, and the whites of the eyes turn yellow.
• The hepatonecrotic type comes from the cystic type and is accompanied by the death of nodes with tumors. The patient develops unbearable pain, high fever and all signs of intoxication of the body.

Also, many experts divide liver cancer by type into primary and secondary. Primary develops from the liver cells themselves and causes hepatoma or hepatocellular cancer. Less commonly, it manifests itself in the form of a tumor of the bile ducts - cholangiocarcinoma, organ vessels - angiosarcoma, glandular tissue of the liver - adenocarcinoma.

Secondary cancer appears against the background of the development of cancerous tumors in other organs, lymph nodes and tissues in the body . In other words, it is a developing metastasis of another malignant tumor. For example, such a disease can cause cancer of the stomach, intestines or kidneys. As a result, the secondary cancer is metastatic.