D. Crowther

Human Tumour Immunobiology

Tumour cells in man must be immunologically “different” from normal cells and the human immune system must be able to “recognize” this difference. It has been demonstrated that: 1. Human tumour cells possess tumour-associated antigens (TAA) not present in normal tissues. 2. Mononuclear cells from patients bearing tumours are capable of destroying autologous tumour cells in in vitro experiments. 3. Plasma or serum from the tumour-bearing patient blocks the ability of that patient’s mononuclear cells to destroy autologous tumour cells.

Complications of the Disease and Their Treatment

These may be classified as follows: Complications as direct manifestations of invasive tumour growth Complications as indirect manifestations of the neoplastic disease Complications unrelated to the neoplastic disease Complications due to treatment of the disease

Hormone Treatment of Tumours

The administration of hormones or the suppression or antagonism of endogenous hormones may significantly inhibit the growth of certain malignant neoplasms (e.g. prostate, male and female breast and endometrium). Growth of tumours of the ovary, kidney and thyroid appear to be to some degree subject to hormonal influences; leukaemia and malignant lymphomas may also be influenced by corticosteroids.

Urogenital Tumours I: Kidney, Renal Pelvis, Ureter, Bladder

Male incidence rates are around 6/100000 per year, female rates are 50%–65% of those in males. The parenchyma/pelvis ratio is fairly constant around 5. Higher incidence in Sweden and Iceland, lower in United Kingdom, Eastern Europe, Africa, Asia.

General Characteristics of Paediatric Tumours

Incidence of cancer in childhood (i. e. number of children newly diagnosed with a cancer per number at risk in the population within a given time period) is given by registries established either in Europe or in United States (USA Third National Survey). Data from Manchester Children’s Tumour Registry give an average annual incidence of 100 new cases per year out of a total population of 5 million. Whereas 20% of this population is less than 15 years of age, malignant tumours form less than 1% of the cancers of the total population.

Education and Psychological Support of the Patient

Implied meaning that the patient attaches to the word “cancer”: 1. Pain 2. Mutilation 3. Hospitalization 4. Debts, inability to care for his own family 5. Loss of sexual attractiveness 6. Possible death

Urogenital Tumours II: Prostate, Testis

Death rates ranging from 10 to 20 per 100000 population, higher incidence in blacks. The incidence of prostatic cancer is increasing in the industrialized countries. More than 10% found at autopsy.

Basic Concepts in Cancer Chemotherapy

Chemotherapy is planned on the basis of observed differences between normal and tumour cells in response to antitumour agents used both singly and in combination. Part of the difference between normal and neoplastic cells can be explained by consideration of proliferative characteristics; however, it must be emphasized that cell kinetics cannot explain all the consequences of tumour cell exposure to a drug, since these are also dependent upon pharmacokinetics, biochemistry and tumour biology.

Head and Neck Tumours

Cancers of the head and neck region represent approximately 5% of the total new cases in the USA.

Tumours of the Endocrine Organs and Apudomas

Cancer of the thyroid in the general population accounts for approximately 1% of the total cancer incidence.