What Is Cancer?

Cancer is a group of diseases. More than 100 different types of cancer are known. They all have one thing in common: cells become abnormal. These abnormal cells grow and destroy body tissue and can spread to other parts of the body.

Healthy cells that make up the body's tissues grow, divide, and replace themselves in an orderly way. This process keeps the body in good repair. If cells lose the ability to control their destiny and/or growth, they replicate too rapidly and without any order. They form too much tissue. The mass of extra tissue is called a tumor, or neoplasm. Tumors can be benign, malignant, or borderline.

Benign tumors are not cancer. They do not spread to other parts of the body and are seldom a threat to life. Benign tumors can usually be removed. Although benign bone tumors sometimes return (recur), they usually can be removed with additional surgery.

Malignant tumors are cancer. They can invade and destroy nearby healthy tissues and organs. Cancer cells can also break away from the primary tumor site and enter the bloodstream or the lymphatic system. That is how cancers can spread to other parts of the body. This spread is called metastasis. Cancers are named according to their site of origin. Thus, lung cancer which has spread to bone is called metastatic lung cancer, not bone cancer.

Borderline tumors are tumors in a state of transition between benign and malignant in the tumor spectrum. Similar to many aspects of life, borderline neoplasms are gray. They are neither malignant (black) nor benign (white). Their behavior is typically locally aggressive.

In the USA, there are estimated to be 1. 4 million new cases of cancer occurring each year excluding common skin cancers.

There are three major types of cancer:

1. Carcinomas are most common and comprise 85-90% of the total annual number of newly diagnosed cancers. Common carcinoma originate in the lung, breast, prostate, and kidney, among other organs and sites. Carcinomas may metastasize to the skeleton, as well as other areas. Fractures may result, which require surgical fixation.
2. Hematopoietic neoplasms arise in cells produced in the bone marrow and lymph nodes. Examples include leukemia, multiple myeloma, and lymphoma. They constitute between 7% and 10% of the annual total of newly diagnosed cancers in the US. These tumors are typically treated with chemotherapy and/or radiation. Surgery seldom is necessary.
3. Sarcoma is a malignancy primary to the musculoskeletal system, and can arise in either bone or soft tissue. Cancer that starts in bone is called a skeletal sarcoma, and examples include osteosarcoma, Ewing_s sarcoma, or chondrosarcoma. Soft tissue sarcomas are cancers that begin in muscles, fat, nerves, blood vessels, and other types of connective or supporting tissues in the body. Examples include MFH (malignant fibrous histiocytoma), liposarcoma or synovial sarcoma. Sarcomas are rare, constituting 0. 5% of the total annual number of new cancers, and are 200 times less common than carcinomas. The rarity of sarcoma occurrences means most doctors seldom see one. Their infrequency and propensity to occur on extremities explains why patients are often referred to tertiary care hospitals, where specialized doctors practicing musculoskeletal oncology are located. Experienced surgeons using advanced techniques and a multidisciplined treatment approach utilize limb-sparing (no amputation) surgery.

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Vanderbilt Orthopaedic Oncology
Vanderbilt Orthopaedic Institute
Medical Center East, South Tower, Suite 4200
Nashville, TN 37232-8774

615-343-8612
615-343-1028 (Fax)
marla.johnson@vanderbilt.edu