patobiologi_kanker

7/17/2019 Patobiologi_kanker

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Patobiologi kanker



Patobiologi kanker

Kanker adalah petumbuhan selyang abnormal tak terkendali danterus menerus serta dapat

merusak jaringan setempat sertadapat menjalar ke tempat yang

jauh dari asalnya

Dapat tumbuh/berasal dari setiap jenis sel di tubuh manusia



Loss of contact inhibitionIncrease in growth factor secretion

Increase in oncogene expression

Loss of tumor suppressor genes

Neovascularization

Oncogene expression is rare

Intermittent or coordinated

growth factor secretion

Presence of tumor suppressor

genes

Banyak

mitosis

Nukleus

Blood vessel

Abnormal

heterogeneous cells

sel

normal

sedikit

mitosis

Perbedaan sel kanker dan normal

Sel Kanker Sel normal



Tumorigenesis

Kastan MB Cancer: Principles & Practice of Oncology. !th ed "##$%"&"'"()

Initial

genetic change

(eg, loss of function of pRbor overexpression of c-myc

!ecrease

in apoptosic

cell death

"ubse#uent

genetic change

Normal

cell

Increase in

cell proliferation

and apoptosiccell death

"econdary

genetic change

(eg, dysfunction of p$%or overexpression of bcl-&

'urther alterations

in phenotype

(eg, invasivenessand metastasis



Neoplasiaarcinogens)process of carcinogenesishemical carcinogenesis*he multistep process involves

" Initiation

& Promotion

*hese concepts have arisen from classical experiments performed on mouse

skin+

•. *he researchers have shown that initiation results from the exposure of cells toa certain doze of

a carcinogen +initiator, -n initiated cell is altered ma.ing it more li.el/ to give

rise to a tumour

+if exposed to another agent% group & and ( in figure (, Initiation alone is not

sufficient for

tumour formation +group ", Initiation cause permanent 0N- damage+Mutations, *hus it is

rapid irreversible and inheritable +group (, In this group tumours were produced

even if the

application of the promoting agent was dela/ed for a long period of time after a

single application of the initiator Initiators can themselves bind and change

0N-+direct acting, or procarcinogens1 which re2uire metabolic conversion in

'igure %



*able arcinogenic agents and occupational cancer

Agent Occupation Cancer Site

Ionizing radiations radon certain underground miners bronchus

X-rays, radium radiologists, radiographers skin

Radium luminous dial painters bone

Ultraviolet radiation farmers, sailors, etc. skinPolycyclic hydrocarbons in soot chimney seepers,oil orkers scrotum, skin, bronchus

!-"aphthylamine# $-naph-thylamine rubber orkers bladder

%enzidine# &-aminobiphenyl chemical orkers bladder

'sbestos shipyard and insulation orkers (esothelioma lung

'rsenic sheep dip manufacturers, gold miners skin and bronchus

%enzene orkers ith glues, varnishes, etc. marro )leukemia

*inyl chloride P*+ manufacturers liver )angio-sarcoma

'flatoin %$ ood storage. /ue to groth of 'spergillus flavus)fungi

0iver

%enzo)apyrene 1mokers 0ung

Neoplasia.tiology environmental

!on/t for et the role of viruses and bacteria in ancer



neoplasia

4a/a hidup

olah raga tida. teratur

diet rendah serat

tinggi lema.

obesitas

al.ohol

ro.o.



prevention

Olah raga teratur

Menghindar.an berat badan berlebih

Menghindar.an al.ohol 5 ro.o.

Konsumsi sa/uran dan buah secara teratur 0iet tinggi serat 1 rendah lema. dan .arbohidrat

secu.upn/a

I.an 1 .acang 5 legumes



Pertumbuhan tumor

" cm& cm

6 cm(&cm

"sel

&# x membelah

(7 x

(

&

() x

meninggal

xx

x

x

x



Gambaran klinis kanker 898K LOK-L

IN9IL*:-;I <-:IN4-N ;8KI*-:N=- 1 >L;8:-;I 1 IN98K;I 1 B8:0-:-?

898K M8*-;*-;I;

' paru

' liver

' ota.

' tulang

8fe. paraneoplasti. s/ndrom +4angguan endo.rin 1 neurologi1 darah 1 .ulit 1 gin@al1 mata 1 muscle rigidit/1 paru,

' tumor memeprodu.si zat /ang langsung A td. langsung men/ebab.an ge@ala sistemi.

' respon tubuh terhadap tumor

' penurunan substansi normal

8fe. :9 + defresi1 sa.it 1 gangguan tidur 1 menopouse ,

' energ/ balance

' respon stress

' neuroendo.rin

ancer cachecia + inta.e .urang 1 gangguan metabolisme,

' perbai.an status nutrisi1 anti inflamasi untu. terapi dan .ualitas hidup

+ ?=P8:K-LO:I (7 C (! . cal A .g bb 1 B-- "7 C "! gr Ahari + leucine , 1 8P- & C ( gr Ahari ,



Patogenesis cachexia syndrom

.an.er

Kemoterapi anorexia fa.tor pro'cachexia

inta.e ma.anan +', proteol/sis1l/polisis

Malabsorpsi lean bod/ mass1 fat mass+', BB

cachexia



Program NCCN 2!" 8PI08MIOLO4I K-NK8: K8;--*>-N BIOLO4I K-NK8:

P:80IK;I1 P8N84-?-N

08*8K;I 0INI

BIOIN9O:M-;I

KLINIK-L *:I-L *8:P-0>

M8N=-*>K-N P8:B80--N *8N*-N4 K-NK8:



Complementary alternative medicine#$olkloric%holistik%traditional%non&'estern%unproven(

Kualitas hidup buru. 1efe. samping berat1.ompli.asi perioperatip

Menghambat efe. .emoterapidan radiasi

:esi.o perdarahan

?epatoto.si.

ontoh D Maita.e'saita.e ?oxse/ formula

Laetrile ;har. cartilage Mistletoe 4erson formula

Ban/a. diguna.an untu. supportive +cachexia1nause1 .onstipasi ,

Prevention + l/copene1 selenium1 teh hi@au1 vitamin -118 ,



)erapi

Operasi

:adiasi

.emoterapi

?ormonal *argeting

;emuan/a mempengaruhi

' biologi. + gangguan fungsi 1 .osmeti. 1 anatomis 1 ganguan @antung 1 second

malignansi1 infertil ,

' phisi.ologis + fatigue 1 ta.ut .ambuh1 ganguan be.er@a Amalu ,

' sosial e.onomi + .ontrol teratur 1 bia/a terapi /ang mahal ,



*adiasi

:adiasi fibrosis s/ndrom

' a.ut + selama atau setelah radiasi ,

' earl/ dela/ + ' ( bulan ,

' late dela/ +E ( bulan ,

4e@ala /ang timbul

tergantung dari daerah /ang disinar 1 bisa merusa. .ulit1 otot 1 ligament1

tendon 1 s/araf 1 viscera 1 tulang 1 mu.osa



Kemoterapi

0iare dan .onstipasi

Nause dan muntah

?ilang rambut

ardiac toxicit/

Pulmonar/ toxicit/ ;tomatitis 1 xerostomia

*rombosis



+eberapa komponen penting

8du.asi + .eluarga1 pasien1 donatur .esehatan ,

;urveillance + .e.ambuhan lo.al 1 @auh 1 second cancer1 ps/cososial1 sosial

e.onomi

Intervensi + pencegahan 1 dete.si dini1 terapi,

ommunication +antara do.ter 1 pasien 1 dan donatur ,

:esearch

Patient advocac/ + pe.er@aan 1 insuran 1 .etida. mampuan ,

patobiologi_kanker

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