Tumor Diseases, Cancer and Benign Neoplasms

In the following, “neoplasms” describes diseases that are assigned to this category according to ICD-10 (C00-D48). The ICD-10 is used for the International Statistical Classification of Diseases and Related Health Problems and is recognized worldwide.

Neoplasms

Neoplasms or neoplasms describe uncontrolled cell growths that result from misregulation during cell proliferation (cell growth). These cells are no longer subject to any regulatory mechanism. They divide more frequently and more rapidly, and do so indefinitely. A growth (tumor = swelling, hardening) forms. Neoplasms can affect any type of body tissue. They can be solitary (isolated) or multifocal (occurring in different parts of the organism). According to dignity (biological behavior of tumors), neoplasms are distinguished as follows:

  • Benign (benign) neoplasms
    • Grow displacing but not infiltrating (invading).
    • Do not form metastases (daughter tumors)
  • Malignant (malignant) neoplasms
    • Grow invasive and destructive
    • Metastasis: hematogenous (via the blood pathway), lymphogenous (via the lymph).
    • Are divided into:
      • Low-malignant tumors
      • High-malignant tumors
  • Semimalignant neoplasms
    • Grow invasive and destructive
    • Usually do not form metastases

Benign and semimalignant neoplasms can be identified by their name. The Latin name of the original tissue of the neoplasm is appended “-om”, for example, adenoma (the tumor consists of glandular tissue), chondroma (the tumor consists of cartilage tissue), fibroma (the tumor consists of connective tissue), lipoma (the tumor consists of fatty tissue).Malignant neoplasms have very different names. They are also often named after the tissue of origin and end in -carcinoma (mammary carcinoma; mamma = breast). But other terms are also used. For example, the appearance of the tumor cells may be taken into account in the naming. In German, malignant neoplasms are colloquially referred to as “cancer“. The therapy of neoplasms depends on various factors such as dignity (biological behavior of tumors) or tumor type, size, growth rate, metastases. The following therapeutic measures are available: Surgery, chemotherapy, radiatio (radiation therapy), hormone therapy as well as immune treatment. In addition, complementary measures are often combined to support the effectiveness as well as the tolerability of the therapies. Malignant tumors represent the second most common cause of death after cardiovascular disease.

Malignant (malignant) neoplasms

In malignant neoplasms, solid tumors are distinguished from hematologic tumors:

  • Solid tumors – solid or hard tumors.
    • Carcinomas – make up the majority of tumor cases
      • Arise from epithelial cells, mucosal cells, glandular cells.
    • Sarcomas – arise from:
      • Connective tissue cells → fibrosarcomas
      • Fat cells → liposarcomas
      • Bone cells → osteosarcomas
      • Muscle cells → myosarcomas
  • Hematologic tumors – arise from cellular components of the blood and blood-forming organs, e.g., leukemias (blood cancers).

Typical behavior of malignant neoplasms:

  • Grow rapidly and invasively, so that the healthy tissue is gradually destroyed
  • Poorly distinguishable from healthy tissue
  • It is immature, heterogeneous (diverse) tissue
  • High cell content
  • High mutation rate as well as high cell division rate
  • Metastasis (formation of daughter tumors)
  • Frequently recurrent (recurring)

Malignant neoplasms are classified according to their size, spread and malignancy (malignancy). For this purpose, the internationally valid, so-called TNM system (tumor, node, metastasis) is used:

  • T: stands for tumor size – the scale ranges from T1 (small tumors) to T4 (large tumors).
  • N: lymph node involvement – N1 stands for involvement of lymph nodes in the closest vicinity of the tumor, N2 and N3 for involvement of lymph nodes further away.
  • M: Metastases (daughter tumors) – M0 means that no metastases were found in more distant organs, and M1 means that metastases have formed somewhere in the body

Benign (benign) neoplasms

Benign neoplasms do not damage the surrounding cells. However, they may press on vessels, nerves, or organs due to their space-occupying nature, causing them to become symptomatic and lead to complications. Benign tumors are very common. Typical behavior of benign neoplasms:

  • Grow slowly and displace, but do not infiltrate (invade).
  • Well demarcated from healthy tissue
  • It is well differentiated, homogeneous (uniform) tissue
  • Low cell content
  • Few to no cell changes, low cell division rate
  • No metastasis
  • Low in symptoms
  • Rarely recurrent (recurring)

Some benign tumors can degenerate, that is, become malignant, such as colonadenomas (colon polyps).

In situ neoplasms

Carcinoma in situ neoplasm (in situ = “in place”) refers to the early stage of a tumor that has spread only in its tissue of origin and has not yet grown invasively into surrounding tissue. It grows epithelially, e.g. in the uppermost layer of skin or mucosa. In this case, the individual cells resemble those of an invasively growing malignant neoplasm in their structure and relationship to one another. Metastasis (formation of daughter tumors) does not occur. However, the in situ neoplasm can develop into a locally invasive tumor and thus become malignant. Metastasis (formation of daughter tumors) is then also possible.Examples of in situ neoplasms include the skin diseases actinic keratosis and Bowen’s disease.

Neoplasms of uncertain or unknown behavior

In a neoplasm of uncertain or unknown behavior, a definitive determination of whether the neoplasm is benign or malignant is not possible. Cellular and tissue changes are present, as in a malignant neoplasm, but the characteristic invasive growth of malignant tumors is absent.They are also referred to as borderline tumors.

Common neoplasms

The main risk factors for neoplasms

Behavioral causes

  • Diet
    • High intake of saturated fatty acids of animal origin and of the polyunsaturated fatty acid linoleic acid (omega-6 fatty acid), contained in safflower, sunflower and corn oil
    • Poor in complex carbohydrates and dietary fiber.
    • High consumption of red meat
    • Too little fish consumption
    • Too little fruit and vegetable consumption
    • Diets high in nitrates and nitrites, such as cured or smoked foods.
    • Foods with acrylamide and aflatoxins.
  • Pleasure food consumption
    • Alcohol consumption
    • Caffeine consumption
    • Tobacco (smoking, passive smoking)
  • Lack of exercise
  • Psycho-social situation
    • Stress
    • Night duty, shift work
  • Overweight
  • Increased waist circumference (abdominal girth; apple type).
  • Poor genital hygiene
  • Hormonal factors in women such as early menarche (first menstrual period); late menopause.
  • Late first gravidity (pregnancy)
  • Short lactation
  • Childlessness

Causes related to disease

Medication

  • Hormone replacement therapy
  • Immunosuppression

X-rays

  • Radiation therapy (radiotherapy, radiatio)

Environmental pollution – intoxications (poisonings).

  • Occupational contact with carcinogens
  • UV radiation

Please note that the enumeration is only an extract of the possible risk factors. Other causes can be found under the respective disease.

The most important diagnostic measures for neoplasms

  • HPV test (molecular detection of HPV DNA).
  • Pap test (Pap smear; cell smear from the cervix; Papanicolaou smear).
  • Tumor marker
  • Histopathological examination (fine tissue examination) from the excised area (collection area).
  • Abdominal sonography (ultrasound examination of the abdominal organs).
  • Lymph node sonography (ultrasound examination of the lymph nodes).
  • Mammary sonography (ultrasound examination of the breast; breast ultrasound).
  • Renal sonography (renal ultrasound).
  • Transrectal prostate ultrasonography (TRUS; ultrasound diagnosis of prostate and seminal vesicles) including prostate biopsy (punch biopsy/extraction for the purpose of histological/fine tissue examination).
  • Transvaginal sonography (ultrasound examination of the genital organs).
  • Colposcopy (cervical endoscopy).
  • X-ray of the affected region of the body
  • Mammography (X-ray examination of the breast)
  • Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based evaluation)) of the affected body region.
  • Magnetic resonance imaging of the affected body region (MRI; computer-assisted sectional imaging procedure (using magnetic fields, that is, without X-rays)).
  • Skeletal scintigraphy (nuclear medicine procedure that can represent functional changes in the skeletal system, in which regionally (locally) pathologically (pathologically) increased or decreased bone remodeling processes are present).
  • Positron emission tomography (PET; nuclear medicine procedure that allows the creation of cross-sectional images of living organisms by visualizing the distribution patterns of weak radioactive substances).
  • Bronchoscopy (lung endoscopy) with biopsy (tissue sampling).
  • Colonoscopy (colonoscopy)
  • Laparoscopy (laparoscopy)
  • Rectoscopy (rectoscopy)
  • Cystoscopy (urinary bladder endoscopy)
  • Bone marrow aspiration

Which doctor will help you?

For neoplasms, the first point of contact is the family doctor, who is usually a general practitioner or internist. Depending on the tumor disease, this will refer to the appropriate specialist or oncologist / hematologist.