Liwanag, Amabel V.

BS-Psych II-A

The Case of the Aging Surfer

1) Define the bold terms in the text.

Ulcer - a break in skin or mucous membrane with loss of surface tissue, disintegration and
necrosis of epithelial tissue, and often pus.
Tumor - an abnormal benign or malignant new growth of tissue that possesses no physiological
function and arises from uncontrolled usually rapid cellular proliferation called also neoplasm.
Carcinoma - a malignant and invasive epithelial tumor that spreads by metastasis and often
recurs after excision; cancer.
Benign - of a mild type or character that does not threaten health or life; especially : not
becoming cancerous.
Metastasizes - The spread of cancer cells from the place where they first formed to another part
of the body.
Chemotherapy- the treatment of disease by means of chemicals that have a specific toxic effect
upon the disease-producing microorganisms or that selectively destroy cancerous tissue.

2) How are benign and malignant tumors similar and different from each other?
Benign tumors arent cancerous. They can often be removed, and, in most cases, they do not
come back. Cells in benign tumors do not spread to other parts of the body.
Malignant tumors are cancerous and are made up of cells that grow out of control. Cells in these
tumours can invade nearby tissues and spread to other parts of the body. Sometimes cells move
away from the original (primary) cancer site and spread to other organs and bones where they
can continue to grow and form another tumour at that site. This is known as metastasis or
secondary cancer. Metastases keep the name of the original cancer location. e.g. pancreatic
cancer that has spread to the liver is still called pancreatic cancer.

Some similarities include:

Both can grow quite large. Size alone does not make the distinction between these types of
tumors. In fact, benign ovarian tumors weighing over a hundred pounds have been removed.
Both can be dangerous at times. While benign tumors tend to be more of a nuisance, they can,
in some cases, be life-threatening. An example is benign brain tumors. When these tumors grow
in the enclosed space of the brain, they can put pressure on, and destroy other brain structures,
resulting in paralysis, speech problems, seizures, and even death. Some benign tumors, such as
pheochromocytomas, secrete hormones that can cause life-threatening symptoms as well.
Both can recur locally. If cells are left over after surgery, both benign and malignant tumors may
later recur near the region of the original tumor.

Differences Between Benign and Malignant Tumors

Rate of growth - In general, malignant tumors grow much more rapidly than benign tumors, but
there are exceptions. Some malignant (cancerous) tumors grow very slowly, while some benign
tumors grow rapidly.
Ability to metastasize - Benign tumors expand locally, whereas malignant tumors can spread
 (metastasize) to other parts of the body by way of the bloodstream and lymphatic channels.
Site of recurrence - While benign tumors may recur locally that is, near the site of the original
tumor malignant tumors may recur at distant sites, such as the brain, lungs, bones and liver,
depending on the type of cancer.

Stickiness" - The cells in benign tumors manufacture chemicals (adhesion molecules) that
cause them to stick together. Malignant tumor cells do not produce these molecules and can
break off and float away to other regions of the body.

Tissue invasion - In general, malignant tumors tend to invade nearby tissues, whereas benign
tumors do not (though they may grow large and cause damage to nearby organs by creating
pressure on them). A very simplistic way of thinking about this is to envision a benign tumor as
having a wall or boundary (literally, a fibrous sheath surrounding the tumor). This boundary
allows the tumor to expand and push (displace) nearby tissues aside but does not allow the
tumor to penetrate nearby tissues. In contrast, envision cancer as having fingers or tentacles
that can reach into nearby tissues. In fact, the Latin word cancer derives from the word crab,
used to describe the crablike, or fingerlike, projections of cancerous tumors.

Cellular appearance - Under a microscope, cells that are benign often look much different from
those that are malignant. One of these differences is that the cell nucleus of cancer cells is often
larger and appears darker due to an abundance of DNA.

Effective treatments - Benign tumors can usually be removed with surgery alone, while
cancerous (malignant) tumors will often require chemotherapy, radiation therapy, targeted
therapies, or immunotherapy medications. These additional treatments are needed to attempt
to reach cancer cells that have spread beyond the region of the tumor or are left after surgery
for a tumor.

Likelihood of recurrence - Benign tumors seldom recur after surgery, whereas malignant tumors
recur much more commonly. Surgery to remove a malignant tumor is more difficult than surgery
for a benign tumor. Using the fingerlike analogy above, it is much easier to remove a tumor that
has a clear fibrous boundary than a tumor that has penetrated nearby tissues with these
fingerlike projections. If cells are left over from these fingers, the tumor is more likely to come
back.

3) Describe the anatomy of the skin and the relationship of these layers to the type of cancer
that Seth presents with.

4) What are oncogenes and how are they believed to be related to cancer?
Oncogenes are mutant forms of normal human genes which, if not regulated, can trigger a cell
to grow and divide uncontrollably. The formation of tumors, and the cancer that results, usually
require multiple mutations. Some will be oncogenes, which activate growth processes in the cell
5) Identify both primary risk factors that Seth presents with and other risk factors that may or
may not be related to Seths case

6) How do chemotherapy and radiation act as treatment for cancer?

Chemotherapy is the use of one or more anticancer (cytotoxic) drugs to damage cancer cells so
they cant grow and reproduce. Chemotherapy is most effective on cells that are actively
growing and dividing. Because many cancer cells tend to grow and divide quickly, they are
sensitive to the effects of chemotherapy.
Radiation works by damaging the genes (DNA) in cells. Genes control how cells grow and divide.
When radiation damages the genes of cancer cells, they cant grow and divide any more. Over
time, the cells die. This means radiation can be used to kill cancer cells and shrink tumors.

7) Why does chemotherapy cause the side effect of hair loss and nausea?
Chemotherapy drugs are powerful medications that attack rapidly growing cancer cells. These
drugs also attack other rapidly growing cells in your body including those in your hair roots.
Hair follicles, the structures in the skin filled with tiny blood vessels that make hair, are some of
the fastest-growing cells in the body. The most important cause of chemotherapy-induced
nausea and vomiting is the activation of the chemoreceptor trigger zone (CTZ) by the
chemotherapy agents circulating in the blood. But the other pathways are also involved. The
sight and smell of chemotherapy are the main causes of anticipatory nausea and vomiting,
that occurs before chemotherapy is delivered in those who have had bad spells of vomiting with
chemotherapy in prior cycles.