In general, patients with a carcinoma have fatigue, tiredness, anemia and weight loss. The weight loss can be quite pronounced and rapid. The specific symptoms of a carcinoma depend on where it is located; for instance, a skin cancer, may present the darkening of skin, itching or minor bleeding. A carcinoma of the pancreas may present with abdominal or back pain, nausea and jaundice.

• Pathologist

  Treatments Once the diagnosis is confirmed by the pathologist, complete excision under frozen section control or Moh’s Technique will be recommended. [eyecancer.com]

  Upon further review and consultation with an outside pathologist, a diagnosis of low-grade papillary Schneiderian carcinoma was made. [ncbi.nlm.nih.gov]

  Hes (pathologist, Pilzen, Czech Republic) for two sections of this document: Histological diagnosis and Other renal tumours. 1.4.Available publications A quick reference document (Pocket Guidelines) is available, both in print and as an app for iOS and [uroweb.org]

• Fishing

  Picture of Squamous Cell Carcinoma 1 Squamous cell carcinoma: Cancer that begins in squamous cells -- thin, flat cells that look under the microscope like fish scales. [medicinenet.com]

  Diagnosis The diagnosis of NUT carcinoma requires specific and sensitive immunohistochemistry (IHC) testing, performance of fluorescence in situ hybridization (FISH), or genetic sequencing that can identify the NUT fusion. [dana-farber.org]

  You have 10 fish; 5 drowned, 3 came back to life. How many fish do you have? ? Hmmm…hold on a minute… Stop counting smart one. Fish can’t drown! [breast-cancer.ca]

  If levels are reduced or deficient they may wish to consider taking supplementary vitamin D3, 10-25 micrograms per day, and increasing their intake of foods high in Vitamin D such as oily fish, eggs, meat, fortified margarines and cereals. [britishskinfoundation.org.uk]

• Swelling

  We hereby report a case of PDTC in a 42-year-old female presenting with neck swelling, pain, and dysphagia for 10 months. She was diagnosed as colloid goiter on fine-needle aspiration cytology. [ncbi.nlm.nih.gov]

  The following are possible signs of breast cancer and should immediately be reported to your physician for further evaluation: Lump in the breast Thickening of the breast skin Rash or redness of the breast Swelling in one breast New pain in one particular [hopkinsmedicine.org]

  SCC can appear as skin changes that include pink discoloration, peeling, swelling, ulceration, bleeding, thickening, or crusting. These signs/symptoms can mimic benign skin conditions such as eczema or acne. [tuftsmedicalcenter.org]

  We presented a 56year-old man who reported to his physician because of upper lip swelling. A physical checkup of the patients also showed a lesion on the… CONTINUE READING Figures and Topics from this paper. Citations Publications citing this paper. [semanticscholar.org]

• Malaise

  Among these are: colic, constipation, diarrhea, influenza-like symptoms, malaise, multiple organ failure AND GI neoplasm benign, GI neoplasm malignant. The last two items are relationships to neoplasms. [doi.org]

  Other signs and symptoms include the following: Weight loss Fever Hypertension Hypercalcemia Night sweats Malaise A varicocele, usually left sided, due to obstruction of the testicular vein See Clinical Presentation for more detail. [emedicine.medscape.com]

• Aspiration

  Because of this low rate, fine needle aspiration is generally not recommended, and these lesions are most often treated with radioactive iodine, medication, or surgery. [ncbi.nlm.nih.gov]

  Carcinoma is diagnosed using biopsy, such as fine-needle aspiration, core biopsy or subtotal removal of a single node. [healio.com]

• Diarrhea

  Symptoms Symptoms of neuroendocrine carcinoma can include: Hyperglycemia (too much sugar in the blood) Hypoglycemia (too little sugar in the blood) Diarrhea Persistent pain in a specific area Loss of appetite/weight loss Persistent cough or hoarseness [upmc.com]

  These problems may continue even after stopping treatment with Erivedge The most common side effects of Erivedge are: Muscle spasms Hair loss Change in how things taste or loss of taste Weight loss Tiredness Nausea Diarrhea Decreased appetite Constipation [erivedge.com]

  The most common AEs, which were mostly grade 1/2, were fatigue (23.9%), infusion-related reaction (17%), diarrhea (9.1%), nausea (9.1%), asthenia (8%), rash (6.8%), decreased appetite (5.7%), and maculopapular rash (5.7%). [onclive.com]

  As with other checkpoint inhibitors, PD-1 can lead to common side effects such as fatigue, rash and diarrhea. [curetoday.com]

  Among these are: colic, constipation, diarrhea, influenza-like symptoms, malaise, multiple organ failure AND GI neoplasm benign, GI neoplasm malignant. The last two items are relationships to neoplasms. [doi.org]

• Skin Disease

  diseases Books about the skin Dermatology Made Easy book Advertisement Skin cancer App to facilitate skin self-examination and early detection. [dermnetnz.org]

• Skin Plaque

  Slow-growing ulcer or reddish skin plaque. Bleeding may occur from the tumour. SCC may give rise to local metastases or spread to local lymph nodes [ 1 ]. [patient.info]

• Nipple Discharge

  […] or on the breast skin Nipple pain or the nipple turning inward Nipple discharge Lumps in the underarm area Changes in the appearance of the nipple or breast that are different from the normal monthly changes a woman experiences How is invasive ductal [hopkinsmedicine.org]

  Other symptoms may include: Thickening of the breast skin Rash or redness of the breast Swelling in one breast New pain in one breast Dimpling around the nipple or on breast skin Nipple pain, nipple turning inward, or nipple discharge Lumps in underarm [webmd.com]

  A small number of women are diagnosed with DCIS after finding a lump or experiencing nipple discharge or, occasionally, a change in the nipple itself. [cancernz.org.nz]

• Breast Mass

  There were no other palpable breast masses, no palpable axillary, supra-clavicular, or infra-clavicular lymph nodes. A diagnostic mammogram and ultrasound were performed to evaluate the right breast mass. [academic.oup.com]

  LESSONS: PH should be considered in the differential diagnosis of a slowly growing breast mass that is bluish, cystic, and solid and abuts the dermis. [ncbi.nlm.nih.gov]

  Unlike the more common variants of invasive lobular carcinoma (ILC), the pleomorphic variant can present as a palpable breast mass, with a minority found on screening mammography. [breast-cancer.ca]

• Irritability

  Side effects of 5-FU include irritation at the site, such as stinging, burning, pain, redness, swelling and ulceration or infection. Use of an emollient such as petroleum jelly or a steroid ointment can help soothe the irritation. [tuftsmedicalcenter.org]

  Squamous cell carcinoma of the tongue may also result from any chronic irritation, such as dental caries, overuse of mouthwash, chewing tobacco, or the use of betel quid. [merckmanuals.com]

  Shiny bump or nodule Open sore that does not heal Reddish, irritated or crusty patch that may itch or hurt White, yellow or waxy scars While BCCs rarely spread beyond the original tumor site, if allowed to grow, these lesions can be disfiguring and dangerous [skincancer.org]

  As the cancer continues to develop, it can begin to show some symptoms, such as: Breast pain Dimpling Lump in the underarms Nipple discharge Nipple pain Nipple turning inward Redness Scaliness Skin irritation Thickening of the nipple/breast skin Breast [docdoc.com.sg]

• Meningism

  Invasive lobular carcinoma (ILC) tends to metastasize later than invasive duct carcinoma (IDC); this type of cancer can spread to sites such as the gastro-intestinal tract and meninges. 50% of invasive lobular breast carcinoma (ILC) contain E-cadherin [breast-cancer.ca]

In general, when a cancer is suspected, the following work up is necessary.

• Complete blood count
• Electrolyte levels
• Renal and liver function
• Urine analysis
• Coagulation profile
• Biopsy of the lesion

Only a few carcinomas have specific tumor makers [5] which include:

• Ovary (CA 125)
• Pancreas (CA 19.9)
• Liver (alpha fetoprotein)
• Colon cancer (CEA)
• Lung cancer (EGFR)
• Prostate cancer (PSA)

Other tests depend on where the cancer is located. A CT scan and/or MRI is usually obtained to determine the extent and location of the cancer.

Once a cancer has been biopsied, its grade is determined by the pathologist. All patients who have a cancer are staged according to tumor size location, regional and distant lymph nodes involvement and other areas where the tumor may have spread. No treatment should be started until the staging is confirmed.

TNM staging

The TNM system is a universal method to stage cancers. This staging system is accepted by the American Joint Committee on Cancer and the Union for International Cancer Control (UICC). The TNM system is based on the size and extent of the primary cancer (t), the number of lymph nodes involved (N) and the presence of metastases (M). A number is added to each letter to indicate the extent and size of primary cancer and the extent of spread.

Primary tumor (T)

• TX: Primary tumor cannot be determined
• T0: No evidence of primary tumor
• Tis: Carcinoma in situ (CIS; abnormal cells are present but have not spread to neighboring tissue; although not cancer, CIS may become cancer and is sometimes called preinvasive cancer)
• T1, T2, T3, T4: Size and/or extent of the primary tumor

Regional lymph nodes (N)

• NX: Regional lymph nodes cannot be evaluated
• N0: No regional lymph node involvement
• N1, N2, N3: Degree of regional lymph node involvement (number and location of lymph nodes)

Distant metastasis (M)

• MX: Distant metastasis cannot be evaluated
• M0: No distant metastasis
• M1: Distant metastasis is present

For example, lung cancer classified as T3 N2 M0 refers to a large tumor that has spread outside the lung to nearby hilar lymph nodes but not to other parts of the body. Colon cancer T2 N0 M0 means that the tumor is located only in the colon and has not spread to the lymph nodes or any other part of the body.

• Lymphocytic Infiltrate

  This group of tumors has a relatively good prognosis, possibly due to the associated lymphocyte infiltrate and their presence in patients with BRCA1 germ-line mutations. [breast-cancer.ca]

  This infiltrate is composed largely of plasma cells and small lymphocytes, however the occasional neutrophil and eosinophil can also be found [59]. [hindawi.com]

The treatment of a cancer depends on the type, stage and patient status. The classical treatments for cancer include surgical resection, chemotherapy, radiation, hormonal therapy, immunotherapy and use of biological agents. In the last decade, the development of biological agents that targer the immune system rather than cancer cells seems to have had a small impact on disease free survival [6]. There are also plan to use certain vaccines to prevent cancer [7].

The prognosis depends on the type of cancer, the location as well as the stage and grade of the cancer. Other factors that affect prognosis include age of patient, physical status of the individual and how the cancer cells respond to treatment. The higher the stage, the worse the prognosis. It is important to note that just because patient's have advanced cancer does not mean that they do not require treatment. Many of these patients benefit from palliative care and pain control.

Different types of carcinomas have their own etiological factors. In general, it is estimated that nearly one third of cancers globally are due to potentially modifiable risk factors which include the use of tobacco, alcohol consumption and a diet that is low in vegetables and fruits. One very common cause of skin cancers is sunlight. Solar radiation has been linked to actinic keratosis, squamous cell and basal cell cancers [1]. In addition, being obese and having acquired a sexually transmitted infection (eg. Human papillomavirus (HPV) infection) also appear to be risk factors for cancers (eg. cervical cancer) [2].

Hence, many countries are now trying to introduce steps to help the public reverse these modifiable risk factors. Vaccination against hepatitis B and HPV is now commonly performed in most countries to prevent liver and cervical cancers [3]. Finally, obesity has been linked to several cancers such as lung, colon, breast, kidney and uterus. it is believed that foods high in glycemic index may promote cancers [4].

Cancer is the second leading cause of death in many western countries, lagging just behind heart disease. The cancer with the highest mortality is that of the lungs. The most common cancer occurring in men is prostate whereas in women, breast cancer is most common. In children, leukemia appears to be the most common malignancy. Cancer is a major public health problem globally and carries a high burden on society. Even when the patients of cancer survive, there is a high risk of developing recurrence.

The exact molecular mechanism that explains cancer development is not known; however, the most widely held theory is that there are one or more mutations of genes leading to damage to the DNA. The genetic mutations transform normal cells into a cancer cell; which multiply repeatedly and unchecked. The genetic mutations may also include activation of oncogenes and inactivation of tumor suppressor genes. There are some individuals who have a genetic predisposition to cancer due of inheritance of mutated genes. While models of carcinogenesis are simplistic in nature, carcinogenesis in reality is a complex phenomenon which requires a constellation of steps that take place over a long period of time.

The subtypes of carcinoma include the following:

• Carcinoma-in-situ is the earliest form of cancer that does not penetrate beyond the epithelium of the organ and has hence not spread either locally or systemically.
• Adenocarcinoma is a type of carcinoma that evolves in glandular tissue.
• Squamous cell is a type of carcinoma originating from squamous cells which form the superficial external layers of skin or the epidermis. These flat cells make keratin that is a major component of hair, skin and nails.
• Adenosquamous cell carcinoma is a type of carcinoma with features of both a squamous cell and adenocarcinoma.
• Anaplastic or undifferentiated carcinoma is a type of cancer containing cells that are primitive or lacking in distinct cytological features. A common example is anaplastic thyroid carcinoma.
• Basal cell carcinoma is a type of skin cancer that starts in the basal cells of the skin that normally function to replace old skin cells.
• Carcinosarcoma is a combination of a sarcoma and a carcinoma. These cancers may occur in connective tissue.
• Clear cell carcinoma is one in which cancer cells are clear. A classic example is renal cell cancer.
• Invasive carcinoma or infiltrating carcinoma is a cancer that has spread to adjacent organs.
• Large cell carcinoma is a carcinoma with large cells that are often polygonal in shape. A classic example is a large cell cancer of the lung that primarily involves the bronchioles.
• Non-invasive carcinoma is one which has not invaded any adjacent tissue and is localized at the site of occurrence.
• Pleomorphic carcinoma is one with spindle or giant cell features. It may also have features of squamous cell and adenocarcinoma combined. Pleomorphic carcinoma occurs in the parotid gland.
• Small cell carcinoma is a carcinoma with small cells and scanty cytoplasm. A classic example is small cell lung cancer, which is very aggressive and usually spread at the time of diagnosis.
• Spindle cell carcinoma is one with cells that are slender at both ends and mimic cancers of connective tissues. Spindle cell cancers occur in muscle, gastrointestinal tract and connective tissue.

One should discontinue smoking, maintain a healthy weight, eat ample fruits and vegetables, exercise regularly and avoid excess alcohol to prevent most types of cancer [8]. It is vital to encourage patients to avoid weight gain as this is also a significant risk factor for some cancers. Safe sex, avoid sharing needles and use of sunscreens are some preventive measures that can be undertaken to avoid cancers.

The majority of cancers that develop in humans are carcinomas. Carcinoma is any cancer that develops from the outer or inner epithelium of an organ. All organs that have an epithelial lining have the potential to develop a carcinoma; for instance, a squamous cell cancer may occur on the surface of the skin. Besides skin, epithelial lining is present in almost all internal organs and passageways like the respiratory tract, gastrointestinal tract and the urinary tract.

Carcinomas are divided into two major groups; namely, adenocarcinomas, which occur in a gland or an organ; and squamous cell carcinoma, that arise from the squamous epithelial lining.

Adenocarcinomas generally occur in endocrine and mucus secreting organs like the pancreas, colon, prostate, breast, lung, liver, kidney, etc. These cancers often present as thickened white plaque and because of the surrounding soft tissue, they are often very invasive locally. This propensity to invade locally often prevents them from being cured by surgical resection. Similarly squamous cell cancer can occur in many organs besides the skin like the bladder, oral cavity, vagina, and anal canal.

Carcinoma is a form of cancer that derives from epithelial cells. People should be educated that some cancers are preventable. In order to prevent cancer, one must change the lifestyle and eat a healthy diet, exercise regularly, discontinue or avoid smoking and drink alcohol in moderation. The diet should consist of plenty of vegetables and fruits, limited amount of fat, and plenty of fiber. It is important to avoid weight gain because obesity has been linked to cancers of the breast, colon, lung, prostate and kidney. One should try and walk at least 1 hour a day 5-6 times a week. To protect from the sun, one should avoid the midday sun, wear appropriate garments, avoid tanning salons and use sunscreens liberally when going out. It is important to get vaccinated against hepatitis B and human papilloma virus as this has been shown to prevent liver and cervical cancers. Finally, one should avoid risky behavior (like sharing needles that may transmit HIV) and practice safe sex.

1. Perera E, Gnaneswaran N, Staines C, Win AK, Sinclair R. Incidence and prevalence of non-melanoma skin cancer in Australia: A systematic review. Australas J Dermatol. 2015 Feb 25
2. Bishop JA, Lewis JS Jr, Rocco JW, Faquin WC. HPV-related squamous cell carcinoma of the head and neck: An update on testing in routine pathology practice. Semin Diagn Pathol. 2015 Feb 4. pii: S0740-2570(15)00014-3.
3. Yang X, Gao JY, Wang J, Cheng J. The impact of anti-HBV treatment on the occurrence and Recurrence of hepatocellular carcinoma: focus on Asian studies. Discov Med. 2015 Feb;19(103):89-99.
4. Turati F, Galeone C, Gandini S, Augustin LS, Jenkins DJ, Pelucchi C, La Vecchia C. High glycemic index and glycemic load are associated with moderately increased cancer risk. Mol Nutr Food Res. 2015 Feb 18.
5. Ellinger J, Müller SC, Dietrich D. Epigenetic biomarkers in the blood of patients with urological malignancies. Expert Rev Mol Diagn. 2015 Feb 26:1-12.
6. Shekarian T, Valsesia-Wittmann S, Caux C, Marabelle A. Paradigm shift in oncology: targeting the immune system rather than cancer cells. Mutagenesis. 2015 Mar;30(2):205-211.
7. Cohen JI. Epstein-barr virus vaccines. Clin Transl Immunology. 2015 Jan 23;4(1):e32.
8. Young J, Cund A, Renshaw M, Quigley A, Snowden A. Improving the care of cancer patients: holistic needs assessment. Br J Nurs. 2015 Feb;24(Sup4):S17-S20.