Tumors: Types, Diagnosis, Treatment, Long Term Planning and Outlook


An abnormal mass of tissue that may be solid or fluid filled is known as tumor. It is also known as a neoplasm which is a kind of lump or swelling and does not necessarily have health threat.

August 10, 2018

Tumors: Types, Diagnosis, Treatment, Long Term Planning and Outlook

An abnormal mass of tissue that may be solid or fluid filled is known as tumor.
It is also known as a neoplasm which is a kind of lump or swelling and does not necessarily have health threat. It is not the same as a cancer, although some can develop into cancers.
Tumor sizes may vary enormously. They may be referred to as masses which are larger, or nodules, which refer to smaller lumps. Almost any type of cell or tissue can develop into a type of tumor.

Types of Tumors:

There are many different types of tumors depending on their shape, the origin of the cell, and the type of tissue they appear in. A soft fibroma of the eyelid is just one type of tumor.
In general, tumors are divided into three groups:

  • Benign: These are not cancerous and cannot spread. A benign tumor will remain in its current form. They do not generally return after being removed.
  • Premalignant: A premalignant tumor is not yet cancerous but appears to be developing the properties of cancer.
  • Malignant: Malignant tumors are cancerous. They can grow, spread, and can worse your health condition.

Sometimes it can be difficult to categorized between cancerous, precancerous and non-cancerous tumors, especially if the tumor is in the middle of the spectrum or changing rapidly. Some benign tumors can eventually become premalignant, and then malignant.

Benign Tumors:

Most benign tumors are not harmful to human health as they are not cancerous.
However, some may press against nerves or blood vessels causing pain or other negative effects. Benign tumors of endocrine tissues may result in the excessive production of some hormones.
Examples of benign tumors include:

Adenomas:

Adenomas are tumors that arise from glandular epithelial tissue, which is a thin membrane that covers glands, organs, and other structures in the body.
A polyp in the colon is a type of adenoma. Other examples include:

  • parathyroid adenoma
  • eosinophilic adenoma
  • chromophobe adenoma
  • basophilic adenoma
  • bile duct adenoma
  • fibroadenoma
  • hepatic adenoma

Adenomas do not start as cancers. However, they can change and become cancerous, taking the form of adenocarcinomas.

Fibroids or fibromas:

Fibroids are benign tumors that can grow on the fibrous or connective tissue of any organ. The most common example of fibroid is Uterine fibroids that can cause vaginal bleeding, pelvic pain or discomfort, and urinary incontinence. They can be either soft or hard depending on the proportion of fibers to cells. Different types of fibroma include angiofibroma, dermatofibroma, and ossifying and non-ossifying fibroma. Some fibromas can cause symptoms and may require surgical removal. Fibroids can also become cancerous and are called fibrosarcomas in very rare case.

Hemangiomas:

Hemangiomas are benign tumors that consist of excessive blood cells.
They can sometimes be seen on the surface of the skin and are known as strawberry marks. Most of the hemangiomas appear at the time of birth and gradually go away after some months or years.
Usually Hemangiomas do not require any treatment. However, corticosteroids can be used if the ability of an individual to eat, hear, or see is affected by the tumor.
They are more commonly removed using laser surgery if the patient is over 10 years of age.

Lipomas:

Lipomas are the most common form of soft tissue tumor which consist of fat cells. Most of them are very small, painless, soft to the touch, and generally movable. They are more common among people aged over 40 years. Examples include:

  • angiolipoma
  • myelolipoma
  • fibrolipoma
  • hibernoma
  • spindle cell lipoma
  • atypical lipoma

Premalignant Tumors:

This type of tumor requires close monitoring as they can rapidly become cancerous.
Examples of premalignant growths include:

Actinic keratosis:

This is a premalignant growth consisting of patches of skin that turn crusty, scaly, and thick. It is also called as senile keratosis or solar keratosis. Fair skinned people are at a higher risk of developing these types of growths, especially those who are overexposed to sunlight.
Usually treating them is highly recommended because of the possibility of progress them to squamous cell carcinoma. Continuous exposure to the sun increases the risk of malignancy.

Cervical dysplasia:

This is a change in the normal cells lining the cervix. The growth can be premalignant and is at a risk of developing into cervical cancer. It is most common in women aged 25 to 35 years. Cervical dysplasia can be diagnosed with a PAP smear and may be removed with freezing techniques or by removing the cone of tissue from the cervix.

Metaplasia of the lung:

These growths occur in the tubes that carry air from the windpipe into the lung, or the bronchi. The bronchi are lined with glandular cells, which can change and become squamous cells. The most common cause of Metaplasia of the lung is smoking.

Leukoplakia:

These are thick, white patches that can develop on the gums, the bottom of the mouth, the insides of the cheeks, and, less commonly, on the tongue. They cannot be scraped off easily. The main cause of this type of tumor is smoking or chewing tobacco. Although Leukoplakia is rarely dangerous, a small percentage can eventually become cancerous. Many mouth cancers occur near areas of leukoplakia. Quitting both alcohol and tobacco together usually clears up the condition. The patches can be removed using a laser, a scalpel, or a cold probe that freezes the cancer cells.

Malignant Tumors:

Malignant tumors are cancerous tumors that can potentially cause death. It can grow quickly, and can spread to new location in a process known as metastasis. The abnormal cells that form a malignant tumor multiply at a faster rate. The cancer cells that metastasize are similar to original ones. If a lung cancer spreads to the liver, the cancer cells now growing in the liver are still called as lung cancer cells. However, they have acquired the ability to invade other organs too.
Different types of malignant tumor are made up of specific types of cancer cells, including:

Carcinoma:

These tumors are formed from epithelial cells. Carcinomas can occur in the stomach, prostate, pancreas, lung, liver, colon, or breast. Many of the most common tumors are carcinomas, especially among older adults.

Sarcoma:

These tumors originate in the cells outside the bone marrow. They start in connective tissue, such as cartilage, bones, fat, and nerves. The majority of sarcomas are malignant.

Germ cell tumor:

These are tumors are made from the cells that give life, such as sperm and egg cells. These tumors most commonly occur in the ovaries or testicles. Most of the testicular tumors start from germ cells. Germ cell tumors may also appear in the brain, abdomen or chest which are very rare.

Blastoma:

Tumors formed from embryonic tissue or developing cells are known as blastomas. These are more common in children compared to adults. Examples include medulloblastoma and glioblastoma, types of brain tumor, retinoblastoma, a tumor in the retina of the eye, osteoblastoma, a type of bone tumor, and neuroblastoma, a tumor of the nervous system found in children.

Diagnosis of type of Tumors:

A biopsy can be done to diagnose a tumor and decide whether a tumor is malignant or not. The different types of biopsy are:

Excisional biopsy:

This involves the surgical removal of the entire lump or suspicious area.

Incisional or core biopsy:

In this type of biopsy, a sample is surgically removed from the tumor.

Needle aspiration biopsy:

Fluid or a sample of tissue is removed with a needle.

Samples are often taken from different parts of the tumor for the most accurate results.

Treatment Option :

Making a decision about a treatment option can be difficult as many a times it could be confusing. It is better to work together with your medical team to determine the best course of treatment for you. You should discuss the benefits and side effects for each option before choosing one.
Treatment for any kind of tumors is based on many factors, such as:

  • Your age, overall health, and medical history
  • The type, location, and size of the tumor
  • How likely the tumor is to spread or recur
  • Your tolerance for specific medications, procedures, or therapies
Treatment for these symptoms may include:
  • Antiseizure/Antiepileptic Drugs (AEDs)Steroids
  • Surgery

Usually, low-grade tumors which are either in stage I and II are not aggressive, and are treated with watchful monitoring or surgery alone. Though all tumors are monitored with repeat scans, tumors that are in stage II are watched more closely after surgery and over time to make sure there is no recurrence.
Higher grade tumors which are in stage III and IV, are malignant and can grow quickly. These are more difficult to remove and require additional treatments beyond surgery, such as radiation, chemotherapy, or a clinical trial if one is available. Microscopic tumor cells can remain after surgery and will eventually grow back. All treatments, therefore, are intended to prolong and improve life for as long as possible.
Additional treatment options for high grade tumors include:

  • Radiation therapy: X-rays and other forms of radiation can destroy tumor cells or delay tumor growth.
  • Chemotherapy: The use of drugs to kill rapidly dividing cells. It can be taken orally or intravenously.
  • Targeted therapy: The focus on a specific element of a cell, such as molecules or pathways required for cell growth, in order to use them as a target.
  • Tumor Treating Fields: A wearable device locally or regionally delivered treatment that produces electric fields to disrupt the rapid cell division exhibited by cancer cells. This can be achieved by creating alternating, wave like electric fields that travel across their region of usage in different directions. The cells interact with these electric fields as the structures within dividing cells have an electric charge.
  • It may be beneficial to consider a second opinion if you feel uncertain about your initial diagnosis, recurrence, or response to treatment.

Long Term Planning:

For recovery and long term management, tumor patients can develop a plan with their treatment team such as continuous follow-up care, rehabilitation and supportive care or Palliative care.
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used along with aggressive treatments, such as surgery, chemotherapy and radiation therapy.
People with cancer may feel better and live longer when palliative care is used along with other appropriate treatments . This can be used soon after diagnosing the disease.
Hospice care is often recommended if a person is unlikely to live longer than six months. The care may be given at home, in a nursing home, or at a hospice facility. It involves the care of all aspects of a patient and requirement of a family.
Usually multiple care providers are involved in this. Hospice providers work together to support the caregiver, meet the requirement of a patient and family, and significantly reduce suffering for everyone.

Outlook:

The outlook will depend entirely on the type of tumor. A benign tumor may not create any health problems at all, where as a malignant tumor can be fatal and difficult to treat.
The severity of a malignant tumor also depends on the location of the tumor and how quickly it can metastasize. The earlier a tumor can be identified, the quicker it can be treated if required. Therefore it is advisable to see a doctor if you find a lump on your body that you suspect could be a tumor and get it checked.