Neoplasm

A neoplasm is an abnormal growth of tissue that forms when cells in your body grow and divide faster than they should, creating a mass that can be noncancerous or cancerous.

Table of contents

• What is a neoplasm?
• Types of neoplasms
• Causes and risk factors
• Symptoms of neoplasms
• How neoplasms are diagnosed
• Treatment options
• Living with a neoplasm

What is a neoplasm?

A neoplasm is an abnormal growth of tissue that forms in your body. The word comes from ancient Greek, meaning “new formation.” Another common word for neoplasm is tumor, which refers to a solid mass of tissue^[1]. A neoplasm forms when cells grow and divide more than they should, creating an overgrowth or mass^[1].

tumor, tumour

Your body constantly makes new cells to replace old or damaged ones that die off. Normally, this process works without any problems. However, sometimes things don’t go as planned. Instead of dying off as expected, damaged cells may start dividing rapidly and pass along abnormal copies of themselves, over and over again. Eventually, this forms a mass that can be either harmless or dangerous^[6].

The growth of a neoplasm is uncoordinated with that of normal surrounding tissue, and it persists in growing abnormally even if the original trigger is removed^[4]. Neoplasms can develop almost anywhere in your body, including your bones, skin, tissue, organs and glands. They can be big or small, and you can have a single tumor or more than one^[5].

Types of neoplasms

Neoplasms are classified into three main categories based on their behavior and potential to cause harm. Understanding these types is important because they require different approaches to treatment and care.

Benign neoplasms

Benign neoplasms are noncancerous growths that typically grow slowly and remain in one place. They are circumscribed and localized, and do not transform into cancer^[4]. These tumors don’t usually invade nearby tissues or spread to other parts of your body^[6].

While benign neoplasms are rarely life-threatening, they can still cause health problems if they press on nearby organs or structures^[6]. For example, a benign brain tumor, although not cancerous, can be life-threatening if not removed because of the pressure it creates^[6]. Many noncancerous tumors don’t need treatment, but some do require medical care^[5].

Common examples of benign neoplasms include uterine fibroids, which are muscle growths in the uterus, and lipomas, which are fatty tumors under the skin^[4]. Benign tumors generally do not grow back after removal^[6].

Malignant neoplasms

Malignant neoplasms are cancerous tumors that grow more aggressively. These tumors can invade nearby tissues, destroy normal structures, and spread to distant organs through the bloodstream or lymphatic system—a process called metastasis^[4]. If untreated or unresponsive to treatment, malignant neoplasms will generally prove fatal^[4].

When malignant cells begin invading neighboring cells, they multiply and divide at a very fast and out-of-control rate. Each time they copy themselves, they pass along their defects, and cells become more and more abnormal as time passes and they spread further^[6]. Malignant tumors usually grow rapidly and invade other parts of your body^[1].

There are five main types of malignant neoplasms^[1]:

• Carcinomas: Making up about 90% of all cancer cases, carcinomas originate in your epithelial tissue—the tissue that covers body surfaces, such as the skin or linings of your organs. Common carcinomas include cancers of the skin, breast, prostate, bladder, cervix, lung, colon and rectum.
• Sarcomas: This type of cancer begins in your connective tissues, like your bones, cartilage, muscle, tendons and fat. Unlike many other types of cancer, sarcomas are more common in young adults.
• Myelomas: Also called multiple myeloma, this type of cancer forms in the plasma cells (immune cells) of your bone marrow.
• Leukemias: Also called blood cancers, leukemias are cancers of bone marrow. This disease is often associated with the overproduction of immature blood cells, which leads to anemia, fatigue and blood clotting problems.
• Lymphomas: This type of cancer develops in the glands or nodes of your lymphatic system. Lymphomas can occur anywhere in your body, but they’re most commonly felt as lumps in your neck, underarm or groin areas.

Malignant neoplasms are most likely to affect people who are over the age of 65, but this disease can occur in people of all ages^[1].

Precancerous neoplasms

Precancerous or potentially malignant neoplasms are abnormal cell growths that are not yet cancer but have the potential to become malignant over time^[7]. These tumors are localized and do not invade and destroy, but in time, may transform into cancer^[4].

Healthcare providers sometimes describe the cells in a precancerous neoplasm with words like “hyperplasia,” which means the cells are dividing rapidly, or “dysplasia,” which means cells are abnormal and dividing fast^[5]. Examples include colon polyps and cervical dysplasia, which can evolve into colorectal or cervical cancer if left untreated^[7].

Providers monitor these growths closely and provide treatment as needed. Detecting and treating precancerous lesions early can prevent the development of cancer^[7].

Causes and risk factors

Neoplasms form when abnormal cells pile up, creating an overgrowth or mass. Your body constantly makes new cells to replace old or damaged ones that die off. For a neoplasm to form, the cells don’t die off as expected, or new cells grow and multiply faster than they should. The cells accumulate, causing the tumor to grow^[5].

The development of a neoplasm often begins with changes—mutations—in the DNA of cells that regulate growth, division, and death^[7]. Experts don’t fully understand why this happens, but several factors can increase your risk:

Genetic factors

Gene mutations (changes) can cause cells to multiply uncontrollably. These mutations may affect tumor suppressor genes, which normally stop cell division, or oncogenes, which promote it^[7]. Some people inherit conditions that significantly increase their risk. For example, mutations in BRCA genes increase the risk of developing certain cancers, including breast and ovarian cancer^[5]. Inherited conditions such as Lynch syndrome also raise cancer risk^[5].

Environmental exposures

Environmental factors are a leading cause of DNA damage. Tobacco smoke, radiation, air pollutants, and exposure to industrial chemicals can all initiate or promote tumor growth over time^[7].

Infections

Infectious agents contribute to several cancer types. Human papillomavirus (HPV) is strongly linked to cervical and throat cancers, hepatitis B and C viruses are linked to liver cancer, and Helicobacter pylori infection is associated with stomach cancer^[7].

Lifestyle factors

A poor diet, alcohol consumption, obesity, and lack of physical activity also influence cancer development, often by interacting with other risk factors to accelerate cellular changes^[7].

Other factors

Hormonal imbalances and chronic inflammation—such as in inflammatory bowel disease—can create an environment that promotes abnormal cell growth and increases cancer risk^[7].

Neoplasms can affect anyone. The specific factors that increase your chances of developing a neoplasm vary based on the type^[5].

Symptoms of neoplasms

The symptoms of a neoplasm can vary greatly depending on where the tumor is located, its size, and whether it is benign or malignant^[7]. Tumor symptoms vary depending on where it develops, how big it is and whether it’s cancerous^[5].

You may be able to feel the mass, as with a breast lump. You may be able to see a bump or a raised, abnormal area of skin if the neoplasm is close to your skin’s surface. But you can’t always tell if you have a tumor just by looking or feeling for one^[5].

In some cases, a person may feel a lump or swelling—for example, in the breast, under the skin, or in the abdomen^[7]. The tumors that you can detect through touch often feel like a new bump or lump. Cancerous tumors are more likely to feel firm to the touch than benign lumps or cysts. They may also feel less movable^[5].

Sometimes, the neoplasm causes symptoms that depend on its location. For example, someone with a malignant neoplasm of their breast may notice breast pain or abnormal nipple discharge. People with a malignant neoplasm of their colon might have abdominal pain or notice changes in their stool. Those with a malignant neoplasm of the skin may develop sores or lesions on their skin^[1].

There are also general symptoms that people with tumors may experience^[1][5]:

• Fatigue
• Fever or chills
• Night sweats
• Loss of appetite or unexplained weight loss
• Shortness of breath
• Anemia
• Diarrhea
• Drenching night sweats
• Abnormal lumps or bumps
• Painful lump (but not all tumors cause pain)

The only way to know for sure whether a lump is a tumor or a cyst—malignant or benign—is to have a healthcare provider check it^[5].

How neoplasms are diagnosed

Tumors are sometimes detected during a screening test such as a mammogram or during imaging tests^[6]. Tumors grow in solid tissues such as organs, joints, and bones. Sometimes, you may be able to feel a tumor. Other times they are only detectable with imaging tests such as an MRI, CT scan, PET scan, endoscopy, or ultrasound^[6].

In either case, a biopsy is often needed so that tissue can be evaluated under a microscope to determine if it is a benign, precancerous, or malignant tumor^[6]. A biopsy helps your doctor diagnose a medical condition by removing a tissue sample for testing and evaluation in a laboratory by a pathologist. Tissue samples help confirm a diagnosis, identify the type of cancer and determine the stage of the cancer^[1].

When the pathologist evaluates a biopsy of the tissue under a microscope, cells in benign tumors look normal and are well-arranged, unlike malignant cells^[6].

Treatment options

Cancer treatment includes surgery, radiation, medicines and other therapies. The goal of cancer treatment is to cure or shrink a cancer or stop it from spreading^[10]. Many cancer treatments exist. You may receive one treatment or a combination of treatments^[10].

Your cancer treatment plan may be based on your type of cancer and your situation^[10]. Treatment options for malignant neoplasms may include surgery, chemotherapy or radiation therapy. Early detection is key, so be sure to attend all recommended cancer screenings^[1].

Surgery

Surgery is used in several ways to help people with cancer. It provides the best chance to stop many types of cancer, and it also plays a part in diagnosing, staging, and supporting cancer treatment^[16]. The goal of tumor surgery is to remove all the cancer or as much of the cancer as possible^[16].

Cancer surgeries include:

• Curative surgery: Removes the cancerous tumor or growth from the body. Surgeons use curative surgery when the cancerous tumor is limited to a specific area of the body.
• Preventive surgery: Removes tissue that does not contain cancerous cells, but may develop into a malignant tumor.
• Diagnostic surgery: Helps to determine whether cells are cancerous by removing a tissue sample for testing.
• Staging surgery: Determines the extent of cancer in the body.
• Debulking surgery: Removes a portion of a cancerous tumor when removing an entire tumor may cause damage to an organ or the body^[16].

Benign tumors may be removed for three reasons: to confirm they are actually benign, to ensure they don’t have a chance to become cancerous, or to relieve symptoms if the tumor is in a place that causes problems or pressure. Benign tumors generally do not grow back^[6].

Other treatment approaches

Treatment types include^[11]:

• Chemotherapy: Works by killing or stopping the growth of cancer and other fast-growing cells.
• Radiation therapy: Uses high doses of radiation to kill cancer cells and shrink tumors.
• Immunotherapy: Helps your immune system fight cancer.
• Hormone therapy: Slows or stops the growth of breast and prostate cancers that use hormones to grow.
• Targeted therapy: Targets the changes in cancer cells that help them grow, divide, and spread.
• Stem cell transplant: Restores blood-forming stem cells in people who have had theirs destroyed by high doses of chemotherapy or radiation therapy.

Living with a neoplasm

During treatment

When you have cancer, there’s plenty you can do every day to not only survive cancer, but to feel better and live as well as you can^[20]. Whether you’re still in treatment or have completed it, here are tips for taking care of yourself:

• Choose a well-balanced diet that includes lots of fruits and vegetables, whole grains, low-fat dairy, and lean poultry and fish^[20].
• Be active every day if you can. Try to get 30 minutes of aerobic activity every day and work up to 2 days of strength training each week^[20].
• Keep a healthy weight. Use a combination of eating well, exercise, and healthy habits to reach that goal^[20].
• Connect with friends and family. It’s important to have a support system you can turn to when you need it^[20].
• Do things you love. Now is the perfect time to decide what’s really important to you^[20].
• Wash your hands often to lower your risk of infection, especially if you’re receiving chemotherapy^[21].
• Stay up to date with immunizations and take any medications your doctor gives you^[21].

After treatment

People who have completed treatment often say that although they were relieved when it ended, they struggled with the transition to a new way of life after cancer treatment^[22]. Getting used to life after cancer treatment takes time. Some people feel a little lost, not knowing what to do next^[22].

One of the hardest things after treatment is not knowing what happens next. Those who have gone through cancer treatment describe the first few months as a time of change. Some think of this as getting used to a “new normal.” It’s not so much “getting back to normal” as it is finding out what’s normal for you now^[22].

Your new normal may include different plans or goals, changes in the way you eat, new sources of support, having a hard time doing things that used to be easier for you, new routines, emotional scars from going through so much, concerns about your body image or sexuality, and permanent scars on your body^[22].

Probably the most common fear after treatment is that the cancer will come back—a cancer recurrence. This fear is a big source of distress for many people who have had cancer treatment. Fear of recurrence is normal and often lessens over time^[22].

Let your health care team know your concerns. Be honest about the fears of your cancer coming back so they can address your worries. The risk of recurrence differs in each patient. Your care team can give you the facts about your type of cancer and the chances of recurrence^[22].