Solid Tumor Oncology

A tumor is an abnormal mass of tissue that can be either benign (noncancerous) or malignant (cancerous). A solid tumor refers to a tumor that does not contain cysts or liquid areas. The term solid tumor is used to distinguish between a localized mass of tissue and leukemia (cancers of the blood), which typically do not form solid tumors. Different types of solid tumors are named for the type of cells of which they are composed. Examples of solid tumors are:

• Sarcomas - Cancer arising from connective or supporting tissues such as bone or muscle.
• Carcinomas - Cancer arising from glandular cells and epithelial cells which line body tissues.
• Lymphomas - Cancer involving the cells of the immune system, called lymphocytes. These cells occur in almost all tissues of the body, so lymphomas can develop in a wide variety of organs.

Hematologic Malignancies

Hematologic malignancies are a group of neoplasms (abnormal growth of cells) that arise from cancerous transformation of cells derived from bone marrow. These types of cancers affect blood, bone marrow, and lymph nodes, which are all closely connected through the immune system. A disease affecting one of these will therefore affect the other two. Hematologic malignancies include leukemia, lymphoma, and multiple myeloma.

Leukemia

Leukemia is cancer of the blood-forming tissues of the body, including the bone marrow and lymphatic system. It is characterized by an abnormal proliferation of blood cells, usually white blood cells (leukocytes).

White blood cells are strong infection-fighters which normally grow and divide in an orderly way as the body needs them. In leukemia, the bone marrow produces a large number of abnormal white blood cells which do not function properly.

Over time, leukemia cells can crowd out the normal blood cells. This can lead to serious complications such as anemia, bleeding, and infections. Leukemia cells can also spread to the lymph nodes or other organs and cause swelling or pain.

Lymphoma

Lymphoma is cancer of the lymphatic system, which is part of the immune system. The lymphatic system is a network of nodes connected by vessels which drain fluid and waste products from all the organs and structures of the body. It is also involved in producing a type of white blood cell called lymphocytes that help protect against infections.

Lymphoma occurs when the lymph node cells or lymphocytes begin to multiply uncontrollably, producing malignant (cancerous) cells. Lymphoma can start almost anywhere in the body and can spread beyond the lymphatic system to other tissues and organs. Over time, lymphoma cells may replace the normal cells in the bone marrow. This can result in the inability to produce red blood cells that carry oxygen, white blood cells that fight infection, and platelets that stop bleeding.

The two main types of lymphoma are Hodgkin's lymphoma (also called Hodgkin's disease) and non-Hodgkin's lymphoma. Non-Hodgkin's lymphoma is about 8 times more common.

Myelodysplastic Syndrome

Myelodysplastic syndromes are diseases of the blood and bone marrow in which not enough healthy blood cells are produced. The bone marrow normally produces immature blood cells known as stem cells, which eventually develop into mature red blood cells, white blood cells or platelets. 

In myelodysplastic syndromes, the stem cells never develop into healthy cells and instead die in the bone marrow or blood, taking up space normally used by developing blood cells and platelets. The lack of healthy blood cells can lead to complications such as anemia, infection or bleeding.

These diseases usually occur for no apparent reason, but certain factors may make a person more likely to develop a myelodysplastic syndrome. These risk factors include:

• Over the age of 60
• Male
• Previous cancer treatment with chemotherapy or radiation
• Smoking

The symptoms of myelodysplastic syndromes can include fatigue, shortness of breath, paleness, easy bruising or bleeding and weight loss. However, symptoms may differ depending on the type of disease.

Patients with symptoms of myelodysplastic syndromes are often given a blood test to check the number and type of blood cells in the body. A bone marrow test can confirm indications from the blood test. After a disease is diagnosed, its symptoms can be treated in several ways depending on the type and severity. Transfusion therapy and drug therapy are common forms of supportive therapy used to manage symptoms. Chemotherapy and stem cell transplant may also be recommended for some patients.

Myelodysplastic syndromes cannot be cured. But persistent treatment and a healthy lifestyle can help to reduce symptoms, fight off infections and slow the progression of the disease. Talk to your doctor for more information.

Anemia

Anemia is a condition that occurs when the red blood cell count or hemoglobin is lower than normal. The hemoglobin may be low due to a decrease in production of red blood cells or a loss of blood.

There are several different types of anemia, characterized by the cause of the low blood cell counts. These causes can include:

Anemia is much more common in women, especially pregnant women. It also occurs frequently in older people, people with poor diets and those with diseases that can cause anemia.

The main symptom of anemia is fatigue. Other common symptoms include weakness, paleness, fast or irregular heartbeat, shortness of breath, dizziness or headache. Symptoms may start out mild but worsen as the condition progresses.

A physical exam and series of blood tests, including a complete blood count, can confirm anemia. Treatment depends on the cause of the condition, but can include iron and vitamin supplements, blood transfusions, bone marrow transplants or chemotherapy for more serious cases. While anemia can be a serious condition, it is often treatable with proper care. Your doctor can recommend the best treatment option for you.

Leucopenia

Leucopenia, or a low white blood cell count, is a symptom of many conditions, such as cancers, infections, congenital disorders and use of some medications. White blood cells are used to fight infection. A low count causes an increased risk of infection, and can also occur as a result of infection. 

There are several different types of white blood cells. Leucopenia refers to a decrease in the total number. Most people with leukopenia only have a decrease in one type of white blood cell though. Tests can be done to determine the levels of each type.

Leucopenia frequently occurs as a result of chemotherapy. Chemotherapy destroys cancerous cells, but also destroys those that produce rapidly, which includes white blood cells. Patients undergoing chemotherapy may be given a white blood cell booster to strengthen the body’s immune system during the complicated treatment.

Leucopenia is prone to cause more infections, so it is important to be alert for symptoms such as fever and other cold and flu characteristics. Gastrointestinal, skin and sinus infections can all occur as a result of a low white blood cell count. Since it can be caused by so many factors, there is no real way to prevent leucopenia. Therefore, it is important to have regular blood tests and maintain a healthy lifestyle to avoid infection.

Thrombocytopenia

Thrombocytopenia is a condition in which the blood has low levels of platelets.  Platelets, also known as thrombocytes, are colorless blood cells that help in blood clotting. They clump together to prevent blood loss in blood vessel holes. Thrombocytopenia often occurs as a result of another medical condition or as a side effect of medication.

A low platelet count can be a result of reduced production, which is often caused by leukemia or other bone marrow conditions. Viral infections and chemotherapy can also decrease production. Low counts can also result from a rapid breakdown of platelets, which only live for 10 days. Certain conditions such as pregnancy, blood poisoning and autoimmune diseases can increase the breakdown of platelets. Less commonly, platelets can become trapped in the spleen, causing a lower number circulating through the body.

Thrombocytopenia can cause several symptoms including:

• Easy or excessive bleeding
• Bleeding into the skin that appears as a rash
• Prolonged or spontaneous bleeding
• Blood in urine
• Unusually heavy menstrual cycles

A platelet count test can diagnose thrombocytopenia. Treatment for the condition usually focuses on the underlying cause, which will often fix the low platelet count as well.  Mild forms of thrombocytopenia may not need to be treated at all.

Blood Coagulation

Coagulation is the process that allows blood to clot and prevent blood loss from a pierced or broken vein or artery. The process of coagulation involves proteins, protein cofactors, platelets and enzymes all found within the flood that react to damaged tissue in the vessels.

When a blood vessel is damaged, these factors combine together to form a protective net over the cut to prevent red blood cells from leaking out. When the net hardens, it forms a protective seal over the cut.

Coagulation is an extremely important natural body process. Without the ability to clot, even the smallest cut would continue to bleed and bleed and quickly lead to death. The most common coagulation disorder is thrombosis, in which blood clots form and block normal blood vessels, preventing blood flow. Other coagulation disorders include hemophilia, an inherited disease that involves a deficiency in an essential blood clotting factor, and thrombocytopenia, or a low platelet count which can result in an inability to clot blood.

Thrombotic Disorders

Hemostasis is a natural body process that allows the blood to form clots (or thrombi) when there is damage to a blood vessel, but not to produce clots that block normal vessels. Abnormalities can result in the inability to form clots or excessive forming of clots, both of which can cause serious damage and may even be fatal.  Some of these disorders include:

• Atrial Fibrillation – An abnormal heart rhythm causes clots to form on the walls of the heart
• Heart Attack – Heart muscle tissue damaged from a heart attack may cause clots within the heart
• Acute Ischemic Stroke – A clot that forms somewhere in the body travels to the brain and causes a loss of blood supply
• Deep Vein Thrombosis – A deep vein in the thigh, leg or pelvic muscle that forms a clot
• Pulmonary Embolism – A clot that breaks off from a deep vein and travels to the arteries of the lungs