Tumor or Cancer? And Issues Regarding Treatment
The tumor is a group of abnormal cells that form the result of excessive cell division process and uncoordinated. In medical language, a tumor known as neoplasia. Neo means new, plasia means growth / division, so neoplasia refers to the growth of new cells, which differ from the growth of cells in surrounding normal. To note, the general body cells have two main tasks of carrying out its functional activity and reproduce by dividing.However, in tumor cells that occur are almost all the energy cells use to proliferate activity alone. Reproductive function is regulated by the cell nucleus (nucleus), resulting in tumor cells found that cell nuclei are enlarged due to increased work demands.
From the above definition of tumor, tumor divided form the two major groups namely benign tumors (benign) and malignant tumors (malignant) or popular as cancer. There are significant differences in properties between these two tumor types and indeed distinguish a requirement mandatory for medical practitioners. The main difference among them is that malignant tumors are more dangerous and fatal according to the word 'vicious' itself.This picture, although the tumor was malignant or cancerous tissue in the foot, it is in advanced stages can lead to death. Benign tumors can only cause death directly related to the growth of dangerous locations such as tumors in the neck that can suppress the respiratory tract. There are several properties which distinguish between benign and malignant tumors;
1. Its growth.
Malignant tumors grow relatively more quickly because it is more active and aggressive, consequently if the surface of the body will appear to the tumor enlarges rapidly and is often at its peak is accompanied by injury or decay that do not heal. These chronic wounds caused by the supply of nutrients to the tumor cells no longer able to compensate for tumor cells than doubled the number of very fast, resulting in cells that are not getting the nutrients and the threshold of death. So be careful if you have a dirty wound and do not heal with treatment even expanded.
2. Its expansion.
Benign tumors grow expansively or urgent, but not damaging surrounding normal tissue structures. This is because benign tumors have a limiting capsule between the tumor cells are abnormal with normal cells. In contrast to the malignant tumor was not encapsulated, infiltrative tumor growth or infiltrate while damaging surrounding tissue. Such growth was first discovered by Hippocrates - the father of medical science - and he was named as the cancer (the Latin of the crab) because he thinks infiltrative process such as crab claw-like shape. Due to the infiltrative process, the tissue surrounding the malignant tumor is often broken, and if it be a network that infiltrated the tumor blood vessels of this type can cause symptoms of bleeding. For example, in one of the symptoms of lung cancer is coughing up blood.
3. Metastasis.
Metastasis is the spread of children, it means the ability of a tumor tissue to be separated from its mother and stick and be able to live and develop further in other body tissues located far from the parent tumor tissue. For example, breast cancer can metastasize to the lungs and cause respiratory process. Metastatic pathway could be through the bloodstream, lymph flow and process regardless / fall directly attached to a particular place. Metastasis occurs only in malignant tumors. Benign tumors never metastasize.Because metastasis is the malignant tumor of the foot for example may be fatal to the sufferer.
4. Cellular picture.
Malignant tumors under the microscope will appear a set of cells that often do not resemble normal tissue should be, even malignant cells can give an idea that did not resemble any cell in the human body (not differentiate / anaplasi). While the differentiation of benign tumors is generally good, that picture of the cells are similar to normal cells of origin but aktvitas pembelahannya are more active. So it can be concluded that the more anaplastic / undifferentiated a tumor is getting worse then it must have been increasingly malignant tumor.
5. Of recurrence.
Benign tumors are generally rare with appropriate surgery for recurrence. Malignant tumors have higher recurrence due process of the operation, it is difficult to actually complete it due to the abnormal tissue is not encapsulated making it difficult to be distinguished and separated from surrounding normal tissues that have been infiltrated.Besides the advanced stage malignant tumors generally have a wider spread of bermetasasis much so that even surgery is no longer possible cure for malignant cells already exist in almost every part of the body.
What the heck is causing a person may have a tumor? These are the questions most frequently expressed a patient to a medical practitioner about the tumor. And the real question this simple fact alone raises anxiety for the medically whenever asked. Why? Not because we do not know the answer, but the medical world and the research does not yet know the exact cause of the answers will surely someone could have a tumor.
But it is generally believed that the process of tumor formation associated with the three main genetic factors (heredity), carcinogenic (oncogenes) and co-carcinogens (co-oncogenes). Genetic or hereditary factors mentioned that some people carry a talent (in the form of the gene) for certain tumors. Of course, talent alone will not be transformed into tumors at a later date if no other triggering factors. Other trigger factors that are co-carcinogens and carcinogens. Which includes among other chemical carcinogens (such as asbestos, preservatives and food coloring), physical factors (such as excessive x-ray radiation, excessive sunlight), hormonal (such as the role of estrogen in breast cancer, testosterone in prostate cancer), and viruses (such as viruses HPV as the main culprit of cervical cancer). While co-carcinogens are a certain age (generally tumor incidence with age), the wrong lifestyle, smoking, alcohol, eating less fiber, an irritation repeatedly.
Given the discussion above it can be concluded that there was a tumor that is multifactorial and complex process. As a result of neoplasia in the world, prevention of one type of disease is often difficult because the exact cause is unknown. There are some malignancies that already has a suggestion that has been generally accepted prevention include avoiding smoking (to prevent cervical cancer, lung, mouth), avoid too early age of sexual relations and mutually sexually and HPV immunization (to prevent cervical cancer),Avoid alcohol (to prevent stomach cancer, esophagus, liver) and others.
But it is quite important for tumor types other than prevention of disease is early detection or screening tests. The study will test screening and early detection methods is growing into a promising direction. There are several ways to recognize the tumor. Also there is a gradual procedures performed by doctors to diagnose these diseases. Subjective complaints of patients are often not given much help because it is generally non-specific symptoms.
But there are some symptoms that your doctor has directed thought to the possibility of certain tumors, for example:
- Frequent bleeding on the genitals after sexual intercourse without any apparent cause.Usually should be suspected in the direction of cervical cancer.
- Hard lump in breast nipple interested in, to consider breast cancer.
- Coughing up blood in heavy smokers aged> 50 years of often-related lung cancer.
- Changes in the feces into small pieces as well as the presence of blood in it can be suspected colon cancer.
Of these complaints will be made to clinical physical examination of the relevant body.Often required in such digital rectal examination (inserting a finger into the hole butt) or plug in the vagina. But sometimes all this new procedure results in a presumptive diagnosis or suspected in most cases, so that the necessary investigations.
Investigations are needed can be as simple and relatively cheap to supermahal and sophisticated. The principle is the more strange and difficult a tumor will require more sophisticated inspection and expensive. Among other penujang examination is carried out x-ray images, CT scans, MRI, ultrasound, biopsy (part or all of the suspected tissue is taken and examined under a microscope), bronchoscopy (insert camera tube into the airway), endoscopy (inserting a hose into the camera the gastrointestinal tract, can be through the mouth or anus), blood tests, stool examination, Pap's smear and mammography (for breast x-ray images).
Among all types of investigations, the examination can confirm the type of tumor and the degree of ferocity is a biopsy. As alluded to earlier, in terms of known tumor disease screening examination, which means early detection of the presence of the tumor so that management can provide more optimal results. Early detection is paramount in the management of tumors, especially cancer. In fact there are several ways to do early detection of patients themselves, for example, examine your own breasts every month after menses (BSE Breast Self-Check) to detect the presence of tumor in the breast.
But unfortunately not all types of tumors have a way of screening appropriate. A variety of malignant cancers such as lung cancer, pancreatic, stomach, ovaries are often missing from clinical examination of symptoms and complaints that come-come already in advanced stages are difficult to handle anymore. Fortunately, the two most common types of cancer in women, namely breast and cervical cancer, have a fairly accurate early detection. Pap's smear still be an effective screening for cervical cancer or endometrial cancer (uterine lining), while the BSE and mammography combined with ultrasound is used as an effective breast cancer screening.
So do not waste this advantage for women, consult with your doctor regularly and do the screening. In addition to knowing the tumor type, specific to malignant tumors or cancer, is also important to note the classification or derajadnya. In general, the smaller the degree of cancer can be addressed and then the prognosis (cure and life expectancy) is much greater.
There are two systems of classification of tumor grading and staging. In grading, tumor classification based on a microscope picture of the network, ie from biopsy results (picture histopatologik). Here the assessed level of anaplastic or differentiation of cancer cells, the more chaotic picture of the cell (the more anaplastic) the higher the rank and means the cancer is malignant.
While the staging obtained from clinical examination, investigation, and is generally assessed based on the size of a large degree the parent tumor, had spread to lymph nodes or metastasize or not and have not yet. More meaningful in therapy is a classification based on this staging. The higher the staging, for example, who had metastatic cancer, then treatment will find a dead end and reduced life expectancy.
There are a variety of tumor treatment, is generally a combination of surgery, radiation and chemicals (chemotherapy). Benign tumors if the interrupt and allow normally operated on and removed. And subsequent relapses are rare. Benign tumors do not require radiation therapy and chemotherapy. In contrast to benign tumors, only a very early stage cancer that can be treated with surgery alone, the rest is usually treated with combination therapy among the three types above.
With the staging of cancer is generally low with a good appointment and surgery followed by radiation to the possibility of remaining cells in the vicinity of the operation, then it can cure people. In the cancer has metastasize, in the form of additional chemotherapy drugs are injected into blood vessels intended to pursue and kill cancer cells that have been wandering around the body via the blood or lymph vessels. And usually in advanced stages, cancer therapy intended only palliative, which means aiming mempanjang age and relieve the symptoms that make patients suffer. Palliative therapy is not intended to cure, because it is relatively difficult to cure cancer at an advanced stage.
When required by the sensitivity of radiation among other types of cancer cells to radiation. There are some cancer cells are very sensitive irradiated and gives good results such as cancer of the embryonic cells (eg testis), or blood cells and lymph (eg, lymphoma).But there are some cancer cells that are resistant to irradiation. Sometimes radiation performed before surgery in order to shrink the cancer so slightly easier surgery with fewer side effects. Cancer treatment is a complex problem, not as easy as written above.
Although theoretically the radiation and chemotherapy can kill cancer and surgery can get rid of cancer, there are real limits to these efforts. This is because cancer is caused by a unique agent, which is the body's own cells lose control and coordination rebel against the provider. Surely this is different from most other diseases caused by foreign agents such as viruses, bacteria. As a result of cancer treatment such as radiation and chemotherapy are clinically would kill normal cells are affected as well. Therefore, although the medical world has found that radiation doses can be lethal doses of radiation cancer but it is impossible to do because it means damaging the normal tissue around it as well. Imagine if the cancer is in your heart and with radiation means that the liver is damaged, too, it will also bring death at a later date.
Similarly, chemotherapy is the greatest toxic chemicals to the cell, not just cancer cells but also normal body cells that absorb it. Consequently they are undergoing chemotherapy and will radiaoterapi laden with side effects such as nausea, vomiting, body lean, dry skin and rot, eyebrow hair loss, weakness, headaches and more.
Treatment of cancer is still a big challenge for modern medicine. And hopefully one day be found a potent drug that can eliminate cancer from the body without excessive side effects
Tumor atau Kanker? Dan Permasalahan Seputar Terapinya
Tumor merupakan sekelompok sel-sel abnormal yang terbentuk hasil proses pembelahan sel yang berlebihan dan tak terkoordinasi. Dalam bahasa medisnya, tumor dikenal sebagai neoplasia. Neo berarti baru, plasia berarti pertumbuhan/pembelahan, jadi neoplasia mengacu pada pertumbuhan sel yang baru, yang berbeda dari pertumbuhan sel-sel di sekitarnya yang normal. Yang perlu diketahui, sel tubuh secara umum memiliki 2 tugas utama yaitu melaksanakan aktivitas fungsional nya serta berkembang biak dengan membelah diri. Namun pada sel tumor yang terjadi adalah hampir semua energi sel digunakan untuk aktivitas berkembang biak semata. Fungsi perkembangbiakan ini diatur oleh inti sel (nucleus), akibatnya pada sel tumor dijumpai inti sel yang membesar karena tuntutan kerja yang meningkat.The tumor is a group of abnormal cells that form the result of excessive cell division process and uncoordinated. In medical language, a tumor known as neoplasia. Neo means new, plasia means growth / division, so neoplasia refers to the growth of new cells, which differ from the growth of cells in surrounding normal. To note, the general body cells have two main tasks of carrying out its functional activity and reproduce by dividing.However, in tumor cells that occur are almost all the energy cells use to proliferate activity alone. Reproductive function is regulated by the cell nucleus (nucleus), resulting in tumor cells found that cell nuclei are enlarged due to increased work demands.
From the above definition of tumor, tumor divided form the two major groups namely benign tumors (benign) and malignant tumors (malignant) or popular as cancer. There are significant differences in properties between these two tumor types and indeed distinguish a requirement mandatory for medical practitioners. The main difference among them is that malignant tumors are more dangerous and fatal according to the word 'vicious' itself.This picture, although the tumor was malignant or cancerous tissue in the foot, it is in advanced stages can lead to death. Benign tumors can only cause death directly related to the growth of dangerous locations such as tumors in the neck that can suppress the respiratory tract. There are several properties which distinguish between benign and malignant tumors;
1. Its growth.
Malignant tumors grow relatively more quickly because it is more active and aggressive, consequently if the surface of the body will appear to the tumor enlarges rapidly and is often at its peak is accompanied by injury or decay that do not heal. These chronic wounds caused by the supply of nutrients to the tumor cells no longer able to compensate for tumor cells than doubled the number of very fast, resulting in cells that are not getting the nutrients and the threshold of death. So be careful if you have a dirty wound and do not heal with treatment even expanded.
2. Its expansion.
Benign tumors grow expansively or urgent, but not damaging surrounding normal tissue structures. This is because benign tumors have a limiting capsule between the tumor cells are abnormal with normal cells. In contrast to the malignant tumor was not encapsulated, infiltrative tumor growth or infiltrate while damaging surrounding tissue. Such growth was first discovered by Hippocrates - the father of medical science - and he was named as the cancer (the Latin of the crab) because he thinks infiltrative process such as crab claw-like shape. Due to the infiltrative process, the tissue surrounding the malignant tumor is often broken, and if it be a network that infiltrated the tumor blood vessels of this type can cause symptoms of bleeding. For example, in one of the symptoms of lung cancer is coughing up blood.
3. Metastasis.
Metastasis is the spread of children, it means the ability of a tumor tissue to be separated from its mother and stick and be able to live and develop further in other body tissues located far from the parent tumor tissue. For example, breast cancer can metastasize to the lungs and cause respiratory process. Metastatic pathway could be through the bloodstream, lymph flow and process regardless / fall directly attached to a particular place. Metastasis occurs only in malignant tumors. Benign tumors never metastasize.Because metastasis is the malignant tumor of the foot for example may be fatal to the sufferer.
4. Cellular picture.
Malignant tumors under the microscope will appear a set of cells that often do not resemble normal tissue should be, even malignant cells can give an idea that did not resemble any cell in the human body (not differentiate / anaplasi). While the differentiation of benign tumors is generally good, that picture of the cells are similar to normal cells of origin but aktvitas pembelahannya are more active. So it can be concluded that the more anaplastic / undifferentiated a tumor is getting worse then it must have been increasingly malignant tumor.
5. Of recurrence.
Benign tumors are generally rare with appropriate surgery for recurrence. Malignant tumors have higher recurrence due process of the operation, it is difficult to actually complete it due to the abnormal tissue is not encapsulated making it difficult to be distinguished and separated from surrounding normal tissues that have been infiltrated.Besides the advanced stage malignant tumors generally have a wider spread of bermetasasis much so that even surgery is no longer possible cure for malignant cells already exist in almost every part of the body.
What the heck is causing a person may have a tumor? These are the questions most frequently expressed a patient to a medical practitioner about the tumor. And the real question this simple fact alone raises anxiety for the medically whenever asked. Why? Not because we do not know the answer, but the medical world and the research does not yet know the exact cause of the answers will surely someone could have a tumor.
But it is generally believed that the process of tumor formation associated with the three main genetic factors (heredity), carcinogenic (oncogenes) and co-carcinogens (co-oncogenes). Genetic or hereditary factors mentioned that some people carry a talent (in the form of the gene) for certain tumors. Of course, talent alone will not be transformed into tumors at a later date if no other triggering factors. Other trigger factors that are co-carcinogens and carcinogens. Which includes among other chemical carcinogens (such as asbestos, preservatives and food coloring), physical factors (such as excessive x-ray radiation, excessive sunlight), hormonal (such as the role of estrogen in breast cancer, testosterone in prostate cancer), and viruses (such as viruses HPV as the main culprit of cervical cancer). While co-carcinogens are a certain age (generally tumor incidence with age), the wrong lifestyle, smoking, alcohol, eating less fiber, an irritation repeatedly.
Given the discussion above it can be concluded that there was a tumor that is multifactorial and complex process. As a result of neoplasia in the world, prevention of one type of disease is often difficult because the exact cause is unknown. There are some malignancies that already has a suggestion that has been generally accepted prevention include avoiding smoking (to prevent cervical cancer, lung, mouth), avoid too early age of sexual relations and mutually sexually and HPV immunization (to prevent cervical cancer),Avoid alcohol (to prevent stomach cancer, esophagus, liver) and others.
But it is quite important for tumor types other than prevention of disease is early detection or screening tests. The study will test screening and early detection methods is growing into a promising direction. There are several ways to recognize the tumor. Also there is a gradual procedures performed by doctors to diagnose these diseases. Subjective complaints of patients are often not given much help because it is generally non-specific symptoms.
But there are some symptoms that your doctor has directed thought to the possibility of certain tumors, for example:
- Frequent bleeding on the genitals after sexual intercourse without any apparent cause.Usually should be suspected in the direction of cervical cancer.
- Hard lump in breast nipple interested in, to consider breast cancer.
- Coughing up blood in heavy smokers aged> 50 years of often-related lung cancer.
- Changes in the feces into small pieces as well as the presence of blood in it can be suspected colon cancer.
Of these complaints will be made to clinical physical examination of the relevant body.Often required in such digital rectal examination (inserting a finger into the hole butt) or plug in the vagina. But sometimes all this new procedure results in a presumptive diagnosis or suspected in most cases, so that the necessary investigations.
Investigations are needed can be as simple and relatively cheap to supermahal and sophisticated. The principle is the more strange and difficult a tumor will require more sophisticated inspection and expensive. Among other penujang examination is carried out x-ray images, CT scans, MRI, ultrasound, biopsy (part or all of the suspected tissue is taken and examined under a microscope), bronchoscopy (insert camera tube into the airway), endoscopy (inserting a hose into the camera the gastrointestinal tract, can be through the mouth or anus), blood tests, stool examination, Pap's smear and mammography (for breast x-ray images).
Among all types of investigations, the examination can confirm the type of tumor and the degree of ferocity is a biopsy. As alluded to earlier, in terms of known tumor disease screening examination, which means early detection of the presence of the tumor so that management can provide more optimal results. Early detection is paramount in the management of tumors, especially cancer. In fact there are several ways to do early detection of patients themselves, for example, examine your own breasts every month after menses (BSE Breast Self-Check) to detect the presence of tumor in the breast.
But unfortunately not all types of tumors have a way of screening appropriate. A variety of malignant cancers such as lung cancer, pancreatic, stomach, ovaries are often missing from clinical examination of symptoms and complaints that come-come already in advanced stages are difficult to handle anymore. Fortunately, the two most common types of cancer in women, namely breast and cervical cancer, have a fairly accurate early detection. Pap's smear still be an effective screening for cervical cancer or endometrial cancer (uterine lining), while the BSE and mammography combined with ultrasound is used as an effective breast cancer screening.
So do not waste this advantage for women, consult with your doctor regularly and do the screening. In addition to knowing the tumor type, specific to malignant tumors or cancer, is also important to note the classification or derajadnya. In general, the smaller the degree of cancer can be addressed and then the prognosis (cure and life expectancy) is much greater.
There are two systems of classification of tumor grading and staging. In grading, tumor classification based on a microscope picture of the network, ie from biopsy results (picture histopatologik). Here the assessed level of anaplastic or differentiation of cancer cells, the more chaotic picture of the cell (the more anaplastic) the higher the rank and means the cancer is malignant.
While the staging obtained from clinical examination, investigation, and is generally assessed based on the size of a large degree the parent tumor, had spread to lymph nodes or metastasize or not and have not yet. More meaningful in therapy is a classification based on this staging. The higher the staging, for example, who had metastatic cancer, then treatment will find a dead end and reduced life expectancy.
There are a variety of tumor treatment, is generally a combination of surgery, radiation and chemicals (chemotherapy). Benign tumors if the interrupt and allow normally operated on and removed. And subsequent relapses are rare. Benign tumors do not require radiation therapy and chemotherapy. In contrast to benign tumors, only a very early stage cancer that can be treated with surgery alone, the rest is usually treated with combination therapy among the three types above.
With the staging of cancer is generally low with a good appointment and surgery followed by radiation to the possibility of remaining cells in the vicinity of the operation, then it can cure people. In the cancer has metastasize, in the form of additional chemotherapy drugs are injected into blood vessels intended to pursue and kill cancer cells that have been wandering around the body via the blood or lymph vessels. And usually in advanced stages, cancer therapy intended only palliative, which means aiming mempanjang age and relieve the symptoms that make patients suffer. Palliative therapy is not intended to cure, because it is relatively difficult to cure cancer at an advanced stage.
When required by the sensitivity of radiation among other types of cancer cells to radiation. There are some cancer cells are very sensitive irradiated and gives good results such as cancer of the embryonic cells (eg testis), or blood cells and lymph (eg, lymphoma).But there are some cancer cells that are resistant to irradiation. Sometimes radiation performed before surgery in order to shrink the cancer so slightly easier surgery with fewer side effects. Cancer treatment is a complex problem, not as easy as written above.
Although theoretically the radiation and chemotherapy can kill cancer and surgery can get rid of cancer, there are real limits to these efforts. This is because cancer is caused by a unique agent, which is the body's own cells lose control and coordination rebel against the provider. Surely this is different from most other diseases caused by foreign agents such as viruses, bacteria. As a result of cancer treatment such as radiation and chemotherapy are clinically would kill normal cells are affected as well. Therefore, although the medical world has found that radiation doses can be lethal doses of radiation cancer but it is impossible to do because it means damaging the normal tissue around it as well. Imagine if the cancer is in your heart and with radiation means that the liver is damaged, too, it will also bring death at a later date.
Similarly, chemotherapy is the greatest toxic chemicals to the cell, not just cancer cells but also normal body cells that absorb it. Consequently they are undergoing chemotherapy and will radiaoterapi laden with side effects such as nausea, vomiting, body lean, dry skin and rot, eyebrow hair loss, weakness, headaches and more.
Treatment of cancer is still a big challenge for modern medicine. And hopefully one day be found a potent drug that can eliminate cancer from the body without excessive side effects
Tumor atau Kanker? Dan Permasalahan Seputar Terapinya
Dari pengertian tumor diatas, tumor dibagi mejadi 2 golongan besar yaitu tumor jinak (benign) dan tumor ganas ( malignant) atau yang popular dengan sebutan kanker. Terdapat perbedaan sifat yang nyata diantara dua jenis tumor ini dan memang membedakannya merupakan tuntutan wajib bagi praktisi medis. Perbedaan utama di antara keduanya adalah bahwa tumor ganas lebih berbahaya dan fatal sesuai dengan kata ‘ganas’ itu sendiri. Gambarannya begini, walaupun tumor ganas atau kanker itu berada pada jaringan di kaki, hal itu dalam tahap lanjut dapat mengakibatkan kematian. Tumor jinak hanya dapat menimbulkan kematian secara langsung terkait dengan lokasi tumbuhnya yang membahayakan misalnya tumor di leher yang dapat menekan saluran napas. Terdapat beberapa sifat yang membedakan antara tumor jinak dan ganas ;
1. Pertumbuhannya.
Tumor ganas tumbuhnya relative lebih cepat karena memang lebih aktif dan agresif, akibatnya jika di permukaan tubuh akan tampak tumor membesar dengan cepat dan seringkali di puncaknya disertai dengan luka atau pembusukan yang tidak kunjung sembuh. Luka menahun ini diakibatkan suplai nutrisi kepada sel-sel tumor tidak mampu mengimbangi lagi sel-sel tumor yang jumlah sangat cepat berlipat ganda, akibatnya sel-sel yang berada diujung tidak mendapat nutrisi dan mati. Jadi hati-hati jika memiliki luka yang kotor dan tidak kunjung sembuh dengan pengobatan bahkan bertambah luas.
2. Perluasannya.
Tumor jinak tumbuh secara ekspansif atau mendesak, tetapi tidak merusak struktur jaringan sekitarnya yang normal. Hal ini dikarenakan tumor jinak memiliki kapsul yang membatasi antara bagian sel-sel tumor yang abnormal dengan sel-sel normal. Sebaliknya pada tumor ganas yang memang tak berkapsul, tumor ini tumbuhnya infiltratif atau menyusup sembari merusak jaringan disekitarnya. Pertumbuhan semacam ini pertama kali ditemukan oleh Hippocrates – bapak ilmu kedokteran – dan beliau menamakan sebagai cancer (bahasa latin dari kepiting) karena menurutnya proses infiltratif seperti demikian menyerupai bentuk capit kepiting. Akibat proses infiltratif tersebut, maka jaringan disekitar tumor ganas seringkali rusak, dan jika jaringan yang diinfiltrasi itu berupa pembuluh darah maka tumor jenis ini dapat menimbulkan gejala perdarahan. Contohnya, pada kanker paru salah satu gejalanya adalah batuk darah.
3. Metastasis.
Metastasis merupakan anak sebar, artinya kemampuan suatu jaringan tumor untuk lepas dari induknya dan menempel serta mampu hidup dan berkembang lebih lanjut pada jaringan tubuh lain yang letaknya jauh dari jaringan tumor induk. Misalnya kanker payudara dapat bermetastasis hingga ke paru-paru dan menyebabkan gangguan proses pernapasan. Jalur metastasis bisa melalui aliran darah, aliran limfe maupun proses terlepas/terjatuh langsung menempel pada tempat tertentu. Metastasis hanya terjadi pada tumor ganas. Tumor jinak tidak pernah bermetastasis. Oleh karena metastasis inilah maka tumor ganas pada kaki misalnya dapat berakibat fatal terhadap penderitanya.
4. Gambaran selular.
Tumor ganas di bawah mikroskop akan tampak sekumpulan sel-sel yang seringkali tidak menyerupai jaringan normal semestinya, bahkan sel-sel ganas bisa memberi gambaran yang sama sekali tidak menyerupai sel apapun dalam tubuh manusia (tidak berdiferensiasi/anaplasi). Sedangkan tumor jinak umumnya diferensiasinya baik, artinya gambaran sel-selnya masih serupa sel-sel normal asalnya namun aktvitas pembelahannya saja yang lebih aktif. Jadi dapat disimpulkan bahwa semakin anaplastik / berdiferensiasi semakin buruk suatu tumor maka tumor itu pastilah semakin ganas.
5. Kekambuhan.
Tumor jinak umumnya dengan dioperasi secara tepat jarang untuk kambuh lagi. Tumor ganas memiliki kekambuhan lebih tinggi dikarenakan proses pembedahannya sulit untuk benar-benar tuntas dikarenakan memang jaringan abnormal ini tidak berkapsul sehingga sulit untuk dibedakan dan dipisahkan dari jaringan normal sekitarnya yang sudah diinfiltrasi. Selain itu tumor ganas tahap lanjut umumnya penyebaran sudah lebih luas bahkan sudah bermetasasis jauh sehingga operasi adalah tidak mungkin menyembuhkan lagi karena sel-sel ganas sudah ada hampir di setiap bagian tubuh.
Apa sih yang menyebabkan seseorang dapat menderita tumor? Ini adalah pertanyaan yang paling sering diutarakan seorang pasien kepada praktisi medis tentang tumor. Dan pertanyaan yang sebenarnya simpel ini sebenarnya menimbulkan kegelisahan sendiri bagi kaum medis setiap kali ditanyakan. Mengapa? Bukan karena kami tidak tahu jawabannya, tetapi dunia kedokteran dan penelitian memang belum tahu jawaban pasti akan penyebab pasti seseorang dapat menderita tumor.
Tapi secara umum dipercaya bahwa proses terbentuknya tumor berkaitan dengan 3 faktor utama yaitu genetik (keturunan), karsinogenik (onkogen) dan co-karsinogen (co-onkogen). Faktor genetik atau keturunan menyebutkan bahwa beberapa orang membawa bakat (berupa gen) untuk tumor tertentu. Tentunya bakat saja tidak akan menjelma menjadi tumor di kemudian hari jika tidak ada faktor pemicu lainnya. Faktor pemicu lainnya itu adalah karsinogen dan co-karsinogen. Yang termasuk karsinogen antara lain senyawa kimia (seperti asbes, pengawet dan pewarna makanan), faktor fisika (seperti radiasi roentgen berlebih, sinar matahari berlebih), hormonal (seperti peranan estrogen pada kanker payudara, testosterone pada kanker prostate), dan virus (seperti virus HPV sebagai biang keladi utama kanker leher rahim ). Sedangkan co-karsinogen adalah usia tertentu (umumnya kejadian tumor seiring dengan pertambahan usia), pola hidup yang salah, merokok, alkohol, pola makan kurang serat, adanya iritasi berulang-ulang.
Menilik pada bahasan di atas dapat disimpulkan bahwa terjadi suatu tumor itu adalah multifaktorial dan prosesnya rumit. Akibatnya dalam dunia neoplasia, pencegahan terhadap jenis penyakit satu ini seringkali sulit karena memang penyebab pastinya belum diketahui. Terdapat beberapa keganasan yang sudah memiliki anjuran pencegahan yang sudah diterima umum antara lain menghindari merokok (untuk mencegah kanker leher rahim, paru, mulut), hindari hubungan seksual usia terlalu dini dan gonta-ganti seksual serta imunisasi HPV (untuk mencegah kanker leher rahim), hindari alcohol (untuk mencegah kanker lambung, kerongkongan, hati) dan lainnya.
Tetapi yang cukup penting bagi jenis penyakit tumor selain pencegahan adalah deteksi dini atau tes skrining. Penelitian akan tes skrining serta cara-cara deteksi dini semakin berkembang ke arah yang cukup menjanjikan. Terdapat beberapa cara dalam mengenali tumor. Juga terdapat prosedur-prosedur yang bertahap dilakukan oleh dokter guna mendiagnosa penyakit ini. Keluhan subjektif yang disampaikan pasien seringkali tidak banyak menolong karena memang umumnya gejala tidak spesifik.
Namun memang ada beberapa gejala yang sudah mengarahkan pikiran dokter ke kemungkinan tumor tertentu, misalnya :
- Sering keluar darah pada kemaluan setelah berhubungan seksual tanpa sebab jelas. Biasanya perlu dicurigai ke arah kanker leher rahim.
- Benjolan payudara yang keras dengan putting susu yang tertarik ke dalam, perlu dipertimbangkan kanker payudara.
- Batuk darah pada perokok berat yang berusia > 50 tahun seringnya terkait kanker paru.
- Perubahan feses menjadi kecil-kecil serta terdapatnya darah di dalamnya dapat dicurigai kanker usus besar.
Dari berbagai keluhan ini maka akan dilakukan pemeriksaan fisik klinis terhadap tubuh terkait. Seringkali diperlukan pemeriksaan dalam seperti colok dubur (memasukkan jari ke dalam lubang pantat) atau colok vagina. Tetapi seringkali semua prosedur ini baru menghasilkan suatu diagnosa presumptive atau dugaan pada sebagian besar kasus, sehingga pemeriksaan penunjang diperlukan.
Pemeriksaan penunjang yang dibutuhkan dapat yang sederhana dan relative murah sampai yang supermahal dan canggih. Prinsipnya semakin aneh dan sulit suatu tumor maka diperlukan pemeriksaan yang lebih canggih dan mahal. Antara lain pemeriksaan penujang yang dilakukan adalah foto roentgen , CT-scan, MRI, USG, biopsy (sebagian atau seluruh jaringan yang dicurigai diambil dan diperiksa dibawah mikroskop) , bronkoskopi (memasukkan selang berkamera ke dalam saluran napas), endoscopy (memasukkan selang berkamera ke dalam saluran cerna, bisa lewat mulut atau dubur), pemeriksaan darah, pemeriksaan feses, Pap’s smear dan mammografi (foto roentgen khusus untuk payudara).
Di antara semua jenis pemeriksaan penunjang ini, pemeriksaan yang dapat memastikan jenis tumor dan derajad keganasannya adalah biopsy. Seperti yang disinggung sebelumnya, dalam hal penyakit tumor dikenal pemeriksaan skrining yang artinya deteksi dini akan kehadiran tumor tersebut sehingga penatalaksanaan dapat memberikan hasil lebih optimal. Deteksi dini adalah hal terpenting dalam penatalaksanaan tumor, khususnya kanker. Bahkan ada beberapa cara deteksi dini yang dapat dilakukan pasien sendiri, contohnya memeriksa payudara sendiri tiap bulan sehabis mens (SADARI-Periksa Payudara Sendiri) untuk mendeteksi adanya tumor pada payudara.
Namun sayangnya tidak semua jenis tumor memiliki cara skrining yang tepat. Berbagai kanker ganas seperti kanker paru, pancreas, lambung, ovarium seringkali terluput dari gejala keluhan maupun pemeriksaan klinis sehingga datang-datang sudah dalam tahap lanjut yang sulit ditangani lagi. Beruntungnya, dua jenis kanker tersering pada kaum wanita, yaitu kanker payudara dan leher rahim, memiliki deteksi dini yang cukup akurat. Pap’s smear masih menjadi skrining efektif bagi kanker leher rahim maupun kanker endometrium (dinding rahim), sedangkan mammografi dikombinasi dengan SADARI dan USG efektif digunakan sebagai skrining kanker payudara.
Jadi jangan sia-siakan keuntungan ini bagi kaum wanita, berkonsultasilah dengan dokter dan lakukan skrining dengan teratur. Selain mengetahui jenis tumornya, khusus untuk tumor ganas atau kanker, penting pula diketahui klasifikasi atau derajadnya. Secara umum, semakin kecil derajat kanker maka semakin dapat ditanggulangi dan prognosis (harapan kesembuhan dan hidup) jauh lebih besar.
Ada 2 sistem klasifikasi tumor yaitu grading dan staging. Dalam grading, klasifikasi tumor berdasarkan gambaran jaringan pada mikroskop, yaitu dari hasil biopsy (gambaran histopatologik). Di sini dinilai tingkat anaplastik atau differensiasi sel-sel kanker, semakin kacau gambaran sel (semakin anaplastik) semakin tinggi derajatnya dan berarti semakin ganas kanker tersebut.
Sedangkan staging didapatkan dari pemeriksaan klinis-penunjang, dan umumnya derajatnya dinilai berdasarkan ukuran besar tumor induk, sudah menyebar ke kelenjar limfe atau belum serta sudah bermetastasis atau belum. Yang lebih bermakna dalam terapi adalah klasifikasi berdasarkan staging ini. Semakin tinggi staging, misalnya kanker yang sudah bermetastasis, maka pengobatan akan menemukan jalan buntu dan harapan hidup berkurang.
Pengobatan tumor ada berbagai macam, secara umum merupakan kombinasi antara operasi, radiasi dan kimia (kemoterapi). Tumor jinak jika mengganggu dan memungkinkan biasanya dioperasi dan diangkat. Dan selanjutnya kekambuhan jarang terjadi. Tumor jinak tidak memerlukan terapi radiasi maupun kemoterapi. Berbeda dengan tumor jinak, hanya kanker stadium sangat awal saja yang dapat diterapi dengan operasi semata, selebihnya biasanya diterapi kombinasi antar ketiga macam jenis terapi di atas.
Kanker dengan staging rendah umumnya dengan dioperasi pengangkatan yang baik dan dilanjutkan dengan radiasi terhadap kemungkinan adanya sel-sel yang tertinggal di sekitar daerah yang dioperasi, maka dapat menyembuhkan penderita. Pada kanker yang sudah bermetastasis, tambahan kemoterapi yang berupa obat yang disuntikkan ke pembuluh darah dimaksudkan untuk mengejar dan membunuh sel-sel kanker yang sudah berkeliaran ke seluruh tubuh melalui pembuluh darah atau limfe. Dan biasanya dalam tahap lanjut, terapi kanker hanya ditujukan paliatif yang berarti bertujuan mempanjang usia dan meringankan gejala yang membuat pasien menderita. Terapi paliatif tidak bertujuan menyembuhkan, karena memang kanker sudah relative sulit disembuhkan pada stadium lanjut.
Kapan diperlukan radiasi antara lain berdasarkan sensitivitas jenis sel kanker terhadap radiasi. Ada beberapa sel kanker yang memang sangat peka diradiasi dan memberikan hasil baik seperti kanker dari sel-sel embrional (contoh testis), atau sel-sel darah dan limfe (contoh limfoma). Tetapi ada beberapa sel kanker yang memang kebal terhadap penyinaran. Terkadang radiasi dilakukan sebelum operasi dengan tujuan kanker sedikit mengecil sehingga operasi lebih mudah dengan lebih sedikit efek samping. Permasalahan pengobatan kanker adalah kompleks, tidak semudah yang dituliskan diatas.
Walaupun secara teoritis radiasi dan kemoterapi dapat membunuh kanker dan operasi dapat membuang kanker, terdapat batasan nyata terhadap upaya-upaya ini. Hal ini dikarenakan penyakit kanker disebabkan oleh agen yang unik, yaitu sel tubuh sendiri yang kehilangan kontrol dan membangkang terhadap koordinasi selular. Tentunya ini berbeda dengan penyakit lain pada umumnya yang disebabkan oleh agen asing seperti virus, bakteri. Akibatnya pengobatan terhadap kanker seperti radiasi dan kemoterapi secara klinis akan membunuh sel-sel normal yang terkena juga. Oleh karena itu walaupun dunia kedokteran sudah menemukan dosis radiasi yang dapat mematikan kanker tetapi penyinaran sebesar dosis itu mustahil dilakukan karena itu berarti merusak jaringan normal yang ada disekitarnya juga. Bayangkan jika kanker berada di hati dan dengan radiasi berarti hati pun ikut rusak, hal itu akan mendatangkan kematian pula di kemudian hari.
Demikian pula dengan kemoterapi yang merupakan zat kimia racun terhebat bagi sel, bukan semata sel kanker, tetapi juga sel tubuh normal yang menyerapnya. Akibatnya mereka yang menjalani radiaoterapi maupun kemoterapi akan sarat dengan efek samping seperti, mual-muntah, badan kurus, kulit kering dan membusuk, rambut-alis rontok, badan lemah, sakit kepala dan banyak lagi.
Pengobatan terhadap kanker saat ini masih merupakan tantangan yang besar bagi dunia kedokteran modern. Dan semoga kelak dapat ditemukan obat ampuh yang dapat mengeliminasi kanker dari tubuh tanpa efek samping yang berlebih.
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