3. The effects of a tumor on the host
A. LOCAL EFFECTS
i) Compression - e.g. pituitary adenoma may lead to
serious endocrinopathy; a small benign tumour in ampulla of
Vater may lead to biliary obstruction.
ii) Mechanical obstruction - Benign and malignant
tumours in the gut may produce intestinal obstruction.
iii) Tissue destruction Malignant tumours, both
primary and metastatic, infiltrate and destroy the vital
iv) Infarction, ulceration, haemorrhage -
infarction, surface ulceration, haemorrhage , torsion and
produce infarction and haemorrhage.
Clinical manifestations of Cancer
Cachexia – wasting
6. 1. Cancer Cachexia
The causes of cachexia are obscure but cachexia is NOT caused
by the nutritional demands of the neoplasm
results from the action of soluble factors such as cytokines
(TNF-alpha and IL-1) either produced by the tumor or the
Various other causes of cancer cachexia include necrosis,
ulceration, haemorrhage, infection, malabsorption,
anxiety, pain, insomnia, hypermetabolism and pyrexia.
8. 3. TUMOUR LYSIS SYNDROME
caused by extensive destruction of a large number of
rapidly proliferating tumour cells.
lymphomas and leukaemias, chemotherapy,
administration of glucocorticoids or certain hormonal
agents (e.g. tamoxifen).
It is characterized by hyperuricaemia, hyperkalaemia,
hyperphosphataemia and hypocalcaemia, all of which
may result in acidosis and renal failure.
9. Effects of Tumor on Host:
4. Paraneoplastic Syndromes
group of conditions developing in patients with
either by the local or distant spread of the tumor
or by the elaboration of hormones indigenous to
the tissue from which the tumor arose, are known
as PARANEOPLASTIC SYNDROMES
About 10 to 15% of the patients with advanced
cancer develop one or more of the syndromes
included in the PNS
10. Paraneoplastic Syndromes
Paraneoplastic syndromes are important for
1) they may represent the earliest
manifestation of an occult tumor
2) they may represent significant clinical
problems and may even be lethal
3) they may mimic metastatic disease and
therefore confound treatment
14. Paraneoplastic Syndromes
(Nerve and Muscle Syndromes)
Disorders of the
(small cell Ca),
The prognosis of a patient with any type of neoplasm
depends on a number of factors including:
the rate of growth of the tumor,
the size of the tumor,
the tumor site,
the cell type and
degree of differentiation,
the presence of metastasis,
responsiveness to therapy,
and the general health of the patient.