Stelson Natalia

MANIFESTATION OF CANCER

RECURENCE OF CANCER

Neuromuscular Vascular Hematological Metabolic Involving skeletal, muscular system and skin

2-6% of initial tumors 8-12% during disease 51% squamosous cell carcinoma 22% adenocarcinoma 15% SCLC (small cell lung cancer) Most patients III IV stage or bony mts

Anorexia Nausea Vomiting Constipation Lethargy Polyuria polydipsia Dehydratation

PTHrP (parathyroid hormon related protein) PTH ( parathormone) Calciotriol

Cytockines ( osteoclast activating factors)

70% structure the same as PTH +13 aminoacids on N-terminus Uses the same receptor with PTH Has the same activity as PTH - activating of osteoclastic resorbtion, - increasing Ca++ reabsorption, - decreasing of P reabsorbtion - stimulation renal 1-alpha-hydroxilase, resulting of production of 1,25-(OH)2-D3 then increasing of Ca++ reabsorbtion. PTHrP cancer cell surviving factor
-

80% SCLC and squamous cell carcinoma

IL-1, IL-6, transforming growth factor (TGF alpha), tumor necrosis factor (TNF), granulocytes colony stimular factor (G-CSF)

TGF alpha + TNF = increase osteoclastic activity

TGF alpha + TNF +IL-1+IL-6 = enhancing PTHrP

30-70% of all tumors, but most cases without significant symptoms 10% of SCLC product ADH Symptoms decrease Na+ and osmolarity od blood, increase Na+ in urine

ACTH is produced by 50% of tumors 30% of SCLC But clinically rare Pulmonary carcinoids produce ACTH in 35-95% SCLC with Cushing syndrome often resistant to the chemotherapy

Anemia (38%) (IL-1, IL-6, IFN-gamma inhibit erytropoesis) Leucocytosis (15%) ( G-CSF production by tumor) Thrombocytosis (16-32%) bad prognosis Eosinophilia (rare) bad prognosis

 Trousseaus

syndrome ( superficial thrombophlebitis)

Deep

venous trombosis

Tissue factor production Normal agent that initiates clotting in case of damage of tissue (often NSCLC)

Cancer procoagulant is a hypothesised protein, most likely a cysteine protease enzyme, that occurs only in fetal and malignant cells. Its activity appears to be the activation of factor X

Digital clubbing Hypertrophic pulmonary osteoarthropathy (HPO) -12% adenocarcinoma Dermato- and polymyositis associate 40% SCLC

0,01% ; exclusively SCLC; almost all caused by antibodies to the neural tissue Lambert-Eaton myastenic syndrome (LEMS) antibodies to the voltage gated Ca++ channels Limbic encephalitis (encephalopathy) antibodies the RNA-binding proteins Polyneuropathy Neuromyothonia - antibodies to the voltage gated K + channels Autoimmune autonomic gangliopathy antibodies to neuronal Ach receptors

Palmo-plantar hyperceratosis (tylosis) can precede of diagnosis of cancer for months or years. Poor prognosis Akantosis nigricans ( some cases associate with lung cancer) Acquired hypertrichosis languinosa Erythema gyratum repens Erythema multiforme Erythroderma Exfoliative dermatitis Sweet syndrome Pruritus and urticaria

part of the general adaptation of the body often seen in trauma, inflammation, infection, and cancer. proinflammatory cytokines - (TNF)-alpha,(IL)-1, IL-6, interferon (IFN)-gamma, and ciliary neutropic factor (CNTF) have been implicated in cachexia mediators - proteolysis-inducing factor (PIF)and lipid mobilizing factor (LMF) anorexia and metabolic alterations. Cancer patients frequently exhibit a relative glucose intolerance and insulin resistance