Tumor Metastasis

The tumor board conference I attended was held on Tuesday March 27, 2018 at 7:00 AM, at Northwest Community Hospital. The pathology for the patient I chose was an atypical carcinoid in her lungs.

Mai is a 66-year-old female diagnosed with IV NSCLC (with multiple large brain metastases) EGFR exon 19 deletion (C34.90). Mai experienced headaches, weight loss, nausea, and vomiting. A very recent CT scan revealed multiple brain metastases, which are large, and throughout the cerebral hemisphere including both of the cerebellums. Mai is being treated with radiation, decradron and high-dose steroids, but still experienced disease progression. The denial states that Mai must try to fail Tarceva, Iressa and Gilotrif, however due to the highly acute, tumor burden brain metastases, with Tagrisso as a front-lien treatment it will actively fight against exon 19 deletion and more importantly, good CNS activity. Given these results of Tagrisso,

Metastases to the spine represent a challenging problem in an oncology practice. Treatment decisions require multidisciplinary review. Radiation therapy remains the primary treatment for metastatic spinal tumor, but advances in radiation therapy, chemotherapy, and surgery have changed the roles of each and lead to improved patient outcomes. Regardless of the treatment, diagnosis and treatment before the development of significant neurologic and functional deficits improve outcomes. Physician awareness and appropriate imaging greatly assist in the early detection of tumor.

Assessing metastatic involvement of the lymph nodes in breast cancer patients is important in planning surgical and adjuvant therapies. A trend toward breast-conserving therapies with the goal of improving quality of life for breast cancer patients has driven the need to accurately assess lymph nodal staging. The concept of a sentinel lymph node (SLN) biopsy is a valuable tool in evaluating metastatic spread of primary breast tumors (Maaskant-Braat et al.,2012; Noushi et al., 2013). Tokin et al. (2012) describe how the process of tumor spread via the lymphatics occurs to the first draining lymph node, then to subsequent nodes within the same basin and beyond. Breast lymphoscintigraphy has emerged as a useful means of identifying the SLN, although many patient factors, choice of radiopharmaceutical, injection technique, and imaging protocol may affect the successful outcome. The ideal exam protocol would combine speed, accuracy, and sensitivity to identifying the SLN with the least amount of burden to the patient and resources involved (Povoski et al., 2006; Sadeghi et al., 2009; Tokin et al., 2012).

Squamous cell carcinoma represents 30% of all lung carcinomas. A carcinomas is cancer that appears in the epithelial tissue. Epithelial tissue is mostly found in the lining of your organs, like the esophagus. Squamous cell carcinoma, or SqCc for short, is known to produce malignant tumours in the brain parenchyma.

Osteosarcoma is also called osteogenic sarcoma in medical term (“Osteosarcoma”, n.d.). This cancer usually develops in growing bones. Although it can occur at any age, it‘s most commonly found in teenagers and young adults and is slightly more common in males than females. Any bone in the body can be affected, but the most common sites are the arms or legs, particularly around the knee joint(“Osteosarcoma: An Introduction.”, 2012). This cancer is caused by benign tumors and other bone diseases, radiation exposure, genetic factors, children, adolescents, males more than females.(“Osteosarcoma: An Introduction.”, 2012)

Malignant bone tumors have a propensity to spread via the bloodstream to various areas of the body, especially to the lungs and other bones. Annually, approximately 2800 new bone sarcomas are diagnosed in the United States. Unlike soft tissue tumors, malignant bone tumors present most commonly with pain. Therefore, these tumors require serious therapy plans that typically involve some combination of surgery, chemotherapy, and bone reconstruction. Specifically, the treatment of a malignant tumor calls for resection of the main tumor as well as the normal tissue surrounding the cancerous area. Bone sarcomas can come in three types: Osteosarcoma, Ewing sarcoma, and Chondrosarcoma.

Osteosarcomas are primary malignant tumors of the bone characterized by the production of osteoid or immature bone by malignant cells. Although uncommon in general, they are the most common primary malignancy of bone in children and adolescents, and the fifth most common malignancy among adolescents and young adults age 15–19 years old. There is a bimodal age distribution of osteosarcoma incidence, with peaks in early adolescence and in adults over the age of 65. In children, the majority of cases are sporadic, while in older adults, about one third of the cases arise in the setting of Paget disease of the bone. Risk factors include prior irradiation or chemotherapy, Paget disease and other benign bone lesions, and inherited conditions. The majority of patients with osteosarcoma present with localized pain over several months’ duration. The pain commonly begins after an injury and may wax and wane over time. The most important finding on physical examination is a soft tissue mass, which may be large and tender to palpation. Osteosarcomas are commonly found in the metaphyseal region of the long bones, most commonly the distal femur and proximal tibia. Laboratory evaluation may find elevations in alkaline phosphatase, lactate dehydrogenase (LDH), and erythrocyte sedimentation rate. Characteristic features found on plain radiographs include destruction of the normal trabecular bone pattern, indistinct margins, and lack of endosteal bone

My last goal is to show my findings in a good and understandable fashion through this paper to help my readers understand more about Osteosarcoma. Audience Since osteosarcoma is a lesser known type of cancer, I want to tell about what it is, some symptoms of it, and why metastasized cancer is bad. By making my peers my specific audience, I will be able to help them better understand what osteosarcoma is and how it forms.

Propelled malignancy is growth that has spread to far off parts of your body. This can incorporate your liver, brain or bones. Treatment relies on upon your general wellbeing and how best in class the growth is. It might be conceivable to hold the tumor under control by surgery or chemotherapy. Radiotherapy and chemotherapy can both help control side effects by contracting a disease with the goal that it doesn't bring about weight and torment and moderates its development. This is called palliative treatment.

In this paper, Osteosarcoma will be taken apart by details. The symptoms, treatment, signs, and other details will be discussed and explained. In a normal bone for most people there are two types of cells; osteoblasts and osteoclasts. Osteoblasts are what build up our bones by forming the bone matrix and therefore gives us the strength in our bones. Osteoclasts on the other hand break down the bone matrix so that we don’t get too much of it and that helps the bones to keep its proper shape. In Osteosarcoma the osteoblasts are what help make up the cancer in the bones. The bones do not have as strong of a bone matrix. This type of cancer is most commonly found in kids and young adults. There are three forms of treatment but not

Another cause of osteomalacia, although very uncommon, is tumor induced, also know as oncogenic osteomalacia (Kaul et al., 2007). The most common tumor form is phosphaturic mesenchymal and this tumor releases excess fibroblast growth factor-23 (FGF23). The release of FGF23 results in hypophosphatemia, or low phosphate levels in the body by decreasing small intestine and renal resorption of phosphate (William et al., 2011). FGF23 also inhibits 1α-hydroxylase which prevents the formation of the active form of vitamin D. In normal conditions, the bones increase the release of FGF23 when phosphate levels are high, so one can imagine how severe osteomalacia can result from the body being told it has too much phosphate when

Matrix metalloproteinase-3 (MMP-3, is one of several matrix metalloproteinases (MMPs) family that has been observed in several malignant tumors, including breast, colon, cervical and lung cancers, where its expression correlates with the invasion and metastasis of these tumors. However, the roles of MMP-3 in osteosarcoma are totally unknown. In this study, we examined the expression of MMP-3 in 15 primary and metastatic osteosarcomas with case-matched adjacent normal tissues by immunohistochemistry and quantitative RT-PCR. MMP-3 expression were expressed in 86.6 % (13/15) of the osteosarcoma tissues and the expression levels of MMP-3 were significantly higher in metastatic tumors than in primary osteosarcoma tumor tissues. Further, we investigated the expression of MMP-3 in osteoblast and osteosarcoma cells and found that MMP-3 was highly expressed in osteosarcoma cells compared to osteoblast cells. Knockdown of MMP-3 by siRNA in osteosarcoma cells significantly inhibited their migration and invasion properties. These findings suggest that MMP-3 expression is deregulated in osteosarcoma tumors, potentially contributing to metastasis and might be a promising marker for the prognosis and therapy of metastatic osteosarcoma.

The uncontrollable spread of cancer is the principal event which leads to the death in individuals with cancer and it is the greatest barrier of developing cures for cancer. Metastasis is the progressive spread of malignant cancer cells from the primary tumour to secondary organ in distant sites and this potential is dependent on the specific microenvironment which support them to complete each step of the metastatic process (Poste & Fidler 1980). To understand the molecular basis of metastasis, investigators have now separated the complex and highly selective metastasis process into series of steps to try and solve the problems cause by

Over the last decade, medicine has acknowledged the psychosocial impact of cancer treatments on patients, to the point that it has become a subject of psycho-medical research. Chemotherapy-induced alopecia (CIA) is a physical condition that can have profound psychosocial consequences, leading to a negative body image, lowered self-esteem, and a reduced sense of well-being. Patients, women who fear alopecia in particular, may sometimes refuse or select another treatment that lower the risk of baldness. In her testimony, Lori, a breast cancer patient, expresses a common feeling for women with cancer: “The worst part of this entire experience [cancer], is losing my hair [….] The chemotherapy would be so much easier if I had my own hair. I appreciate