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Lung cancer is the leading cause of cancer‐related deaths worldwide. Non‐small cell lung cancer (NSCLC) accounts for nearly 85% of all lung cancer and includes adenocarcinoma, squamous cell carcinoma and large cell carcinoma histology. Treatment of NSCLC is based on stage at the time of diagnosis, histological subtype, molecular status and performance status of the patient. Treatments for early‐stage...
Internationally, breast cancer is the most common cancer among women. Approximately 1% of breast cancers are diagnosed in men. Treatment involves a tailored approach to combine surgery, radiation, hormone, biological and chemotherapies in an attempt to optimize survival while minimizing morbidity, and to avoid over‐treatment. Prognostication based on pathological factors and genetic expression provides...
This chapter discusses the pathology, incidence, presentation, diagnosis, and treatment of liver cancer. In the majority of patients, it develops in fibrotic/cirrhotic livers, and cirrhosis represents the strongest predisposing factor for liver cancer. Most patients with liver cancer have two competing causes of death cirrhosis and cancer. The complexity of liver cancer patients leads to the need...
Extrahepatic cholangiocarcinoma encompasses both hilar and distal cholangiocarcinoma. The incidence is varied worldwide but has been associated with various infectious and inflammatory conditions, such as primary sclerosing cholangitis (PSC) and liver fluke infection, as well as other predisposing factors, such as biliary adenoma and choledochal cyst. Surgical resection offers the only chance of cure,...
Pancreatic adenocarcinoma is a highly aggressive pancreatic exocrine malignancy. Only a small proportion of patients have localized disease at presentation that is amenable to surgical resection and that can prolong survival. Work‐up includes high quality cross‐sectional imaging to assess for distant metastasis and to determine locoregional anatomical resectability. For those with biliary obstruction,...
Oesophageal cancer is the eighth most common cancer worldwide, and the sixth most common cause of death from cancer. Huge differences exist in aetiology, epidemiology, biological characteristics, presentation, and prognosis between squamous cell carcinoma and adenocarcinoma of the oesophagus. Management strategies depend on tumour staging as well as performance status of patients. Generally speaking,...
Gastric cancer is the second most common cause of cancer death, though its age‐standardized incidence has been decreasing worldwide. Localized gastric cancer is treated with gastrectomy and adequate lymphadenectomy. Adjuvant or neoadjuvant chemo‐ or chemoradio‐therapy is considered in most cases except for Stage I disease. The optimal combination of various surgical approaches and adjuvant or neoadjuvant...
Assessment of the patient with prostate cancer includes histological diagnosis and grading using the Gleason score, serum PSA and staging to assign a TNM category. Treatment of localized disease may be with surgery, radiotherapy or by active surveillance. Radiotherapy may be combined with a course of androgen deprivation therapy (ADT). First‐line treatment of advanced disease is with long‐term ADT...
Colorectal cancer (CRC) is a disease predominantly of the developed world, which remains a major public health problem despite screening and preventive strategies. Surgery remains the mainstay of CRC treatment and cure, which is complicated by the location (a narrow bony pelvis) and proximity to the sphincter mechanism, increasing the difficulty of surgical access and risk of a permanent colostomy...
The anal canal has a complex anatomical structure, with a variety of histological components. Squamous cell carcinoma of the anus (SCCA) is a rare cancer, which is strongly associated with human papilloma virus (HPV) infection. Human immunodeficiency virus (HIV)‐infected men who have sex with men appear to be at particular risk. Tobacco smoking and the use of immunosuppressants such as long‐term corticosteroids...
Bladder cancer is a common disease, although its epidemiology differs around the world. Environmental and behavioural factors are important in its aetiology. Significant differences in the biology of different types of non‐muscle‐invasive bladder urothelial cancer, or differences between upper and lower tract cancers, have now been recognized. Management involves multidisciplinary engagement in terms...
Renal cell carcinoma is the third most common urological malignancy (behind prostate and bladder). Its clinical course is highly variable and difficult to predict. Generally, however, tumours confined to the kidney are highly curable through surgical removal, while metastatic tumours have a high mortality rate due in part to their resistance to traditional cytotoxic chemotherapy. However, recent identification...
Testicular germ cell tumours (GCT) represent the most common solid malignancy of young men aged between 15 and 40 years. Histopathologically, testicular GCT are divided into two major groups: pure seminoma and non‐seminoma. The pathogenesis of GCT still remains largely unknown. In cases of GCT suspicion, a surgical exploration for histopathology, in most cases orchiectomy, is obligatory. After completion...
Cancer of the penis is an uncommon malignancy with an incidence in the developed world of about 1 per 100,000 men. There is considerable geographical variation in incidence. Established risk factors include oncogenic HPV types 16 and 18, tobacco consumption, phimosis and increasing age. It most commonly occurs on the glans and foreskin and in early stages is highly curable by local management. Penile...
Hodgkin lymphoma is the classical type, with a small proportion of nodular lymphocyte‐predominant histology, and usually presents at a localized stage. Non‐Hodgkin lymphoma has many subtypes, but most are of B‐cell origin, and can broadly be divided between aggressive and indolent histologies for treatment purposes. There is large geographical variation between the individual subtypes of non‐Hodgkin...
Multiple myeloma is a monoclonal gammopathy characterized by bone marrow infiltration by plasma cells or a biopsy‐proven plasmacytoma, monoclonal protein in serum and/or urine, and evidence of end‐organ damage (CRAB): hypercalcaemia, Renal impairment, Anaemia or Bone lesions. It accounts for 1% of all cancers and 10% of all haematological malignancies. Although recent therapeutic advances have increased...
Leukaemia, although not a common malignancy, poses a major challenge both in diagnosis and treatment. In recent years, a dramatic advance has been made in our understanding of the heterogeneous biology of this disease owing to innovative techniques such as whole‐genome sequencing. This has led to improved classification and genetic risk stratification and hence, to a refined risk‐adapted therapy....
Cervical cancer, a preventable disease with a clearly defined natural history and caused by infection with high‐risk types of the human papillomavirus (HPV), remains the third commonest cancer affecting women globally. Over 85% of cases are diagnosed in developing countries where the case‐to‐fatality rate ranges between 75% and 80%. Secondary prevention of cervical cancer in low income countries has...
Uterine cancers comprise endometrial carcinomas (90%), endometrioid endometrial carcinoma (80%), serous carcinomas (5–7%), clear cell carcinomas (3%), mucinous carcinomas (2%), mixed carcinomas (5%) and uterine sarcomas (5%). This chapter focuses on endometrial carcinomas. Based on clinical and pathological data, two types of endometrial carcinoma (type I, associated with oestrogen, with a favourable...
Ovarian cancer describes a heterogeneous group of tumours which account for more than 140,000 deaths annually. Symptoms are non‐specific and as such, the disease is often diagnosed at an advanced stage. Currently, there is no acceptable screening test for epithelial ovarian cancer. Standard treatment involves primary debulking surgery followed by platinum‐based chemotherapy. Where this is not feasible,...
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