WHAT IS CANCER ? !

Dairion Gatot Divisi Hematology -Onkology Medic Internal Departement of Medical Faculty of North Sumatera University / Haji Adam Malik General Hospital, Medan 2010

Definition
Tumor Neoplasma
Benigna

Maligna

cancer
( = cancer = lobster)

 Group of diseases Progressif and uncontrol (abnormal) development to be enlargement tumor (Neoplasma) Tumor benigna and malignant. Benigna tumor : abnormal development, is not spread. Malignan tumor : abnormal development, spread, metastase. Tumor solid = hard cancer, Tumor non solid = liquid cancer

Mitosis/miosis activity

EUKARIOT CELL (Ex: Human Cell )

computer Program

DNA

Analysis Data

Instruction Program

Printer output

PATOGENSIS OF CANCER ?

Etiology
Radiation

Gen damage

Uncontrol development Miosis/mitosis

Virus Carsinogen chemistry Environment

transformation Cancer cel

Normal cel

DNA

Mutation = change from instruction program

CANCER CHARACTERISTIC ?

Cancer vs Normal
Progressif, uncontrol. Metastatic stadium IV Non infectious Herediter (?) Genetik !

Cancer vs Normal
Cancer : Uncontrol development and proliferation Immortal To presure normal cell

Progresifitas cancer cell

Mitosis cancer cell every 2-6 week
2-6 week

2-6 week

Cancer Cell size : One milyar cancer cell = nail spuit One billion cancer cell =strowberry 230 = 1,073,741,824 = 1 milyar cell

2-6 week

METASTASIS CANCER ?

Stadium / tahap

SIMPTOM AND SIGN

Bowel and urine disorders Ulcus Chronic Bleeding uncontrol Mass or and calsificatie Dysphagia Dyspepsia chronic Hoarness and cough

CANCER TYPE AND LOCATION

Karsinoma (cancer
surface area)

Leukemia Limfoma

Lung
Breast

Colon

bladder Prostat (male)

Sarkoma (musculo skeletal)

CANCER DIAGNOSTIC

CLINIS (STAGING)
CYITOLOGIS / HISTOPHATOLOGY

RADIOGRAFI

ONCOMARKER

IMUNOHISTOCHEMISTY

HEMATOLOGY MALIGNACY

Dr.Dairion Gatot Sp.PD

Maturasi and Stem cell Diferentiation

INTRODUCTION

Malignancy Hematology :
From single cel , bone marrow, thymus or lymphoid perifer system. - Cel , genetic mutation malignant transformation malignant cel. - Excessive mitosis and uncontrol clone malignant cel. And or resisten for Apoptosis

-Progresife mutasi clone malignant cel subclone maligna cel

(Atul Mechta-Victor Hoffbrand, Hematoloogi at a Glance)

Classification :
Characteristic malignancy hematology and lymphoid : 3 Characteristic : Aggressiveness: Acute versus Chronic Lineage: Lymphoid versus Myeloid

Predominant Site of Involvement: Blood and Bone Marrow versus Tissue

De Vita

DIAGNOSTIC OF ACUTE LEUCAEMIA

SIMPTOM Fatigue,Malaise,Dyspnea hematome , Under weight Bone pain,abdominal pain Neurologic symptom SIGNS Anemia,pallor Trombosit Bleeding Petechia,ecchymosis,fundus hemorrhage Fever and infection Adenopathy Hepatosplenomegali Gum hypertrophy Skin infiltration

DIAGNOSTIC OF ACUTE LEUCAEMIA

Blood periferal : Retikulosit Dif-tel manual Bone Marrow Aspirasi Cytomorpholog Cytogenetic (molecular genetic) Immunophenotyping Histologi/Biopsi Blood chemisty: . Elektrolit, creatinin, uric acid, Ca, LDH Serologi Virus APTT, PT, Fibr.,D-Dimer SPEP I n MM atau Bcell malignancy Blood Bank HLA L.P. pd ALL CT Scan (Whole Body/mediastinum)

Clasification FAB ,Akut Leukaemia

Treatment of acute leukemia

Phase 1: INDUCTION
Target complete remission Temporary (reversible) aplasia Maintain remission (Last timemaintenance therapy Intensive consolidation therapy Stem cell transplantation

Phase 2 : POST REMISSION

Criteria for Remission in Acute Myelogenous Leukemia

Less than 5% myeloblasts in the bone marrow

Restoration of normal hematopoieis

Resolution of cytogenetic abnormalities Resolution of any evidence of extramedullary leukemia (granulocytic sarcomas)

EBM
Criteria for Remission in Acute Leukemia Hematologic Complete Response: BM Aspirasi : Normal cellularity dan < 5% Blast dari semua cell berinti Darah Tepi : Tanpa cell lekemia dan Lekosit > 3000/mm3 Granulosit > 1500/mm3 Trombosit > 100.000/mm3 Lain lain : tak ada tanda klinik lekemia LUMC