Malignancy

When malignant cells form, symptoms do not typically appear until there has been a significant growth of the mass. Once signs and symptoms do arise, they are dependent on the location, size and type of malignancy. Usually, it is quite general and can be associated with other illnesses or diseases and thus, can be difficult to diagnose or can be misdiagnosed. Signs include observable or measurable aspects such as weight loss (without trying), a fever or unusual bleeding. On the other hand, symptoms are felt internally by the individual such as fatigue or changes in appetite. A general list of common signs and symptoms includes pain (headaches or bone aches), skin changes (new moles or bumps), coughing and unusual bleeding. There are also signs and symptoms specific to females including belly pain and bloating or breast changes i.e., the formation of a lump. Signs and symptoms specific to males include pain or growths in the scrotum or difficulty urinating. ==Causes==

Malignant cells often evolve due to a combination of reasons rather than one definitive reason. Reasons which can explain their development include genetics and family history, triggers such as infectious diseases, and exposure to risk factors. Triggers Infectious diseases play a role in the development of malignancy, with agents of infectious disease being able to produce a multitude of malignant cells. These include bacterial causes, fungal and parasitic causes, and viral causes. The main purpose of inflammation is to repair tissue, defend the body against pathogens and regenerate cells. Post-transplant malignancy Individuals who undergo organ transplant surgery have an increased risk of developing malignancy in comparison to the general population. This is linked to recipients being at a higher risk when exposed to traditional risk factors as well as, the type and intensity of the operation, the duration of their immunosuppression post-operation, and the risk of developing oncogenic viral infections. ==Management==

There are various treatment forms available to help manage malignancy. Common treatments include chemotherapy, radiation, and surgical procedures. Photoradiation and hyperthermia are also used as treatment forms to kill or reduce malignant cells. A large portion of patients are at risk of death when diagnosed with malignancy as the disease has usually progressed for a number of years before detection. Surgery Surgery can help manage or treat malignancy by either removing the tumour, localising it and/or determining whether there has been a spread to other organs. When undertaking surgery for malignancy, there are six major objectives which are considered. It is commonly used to identify and localise cancers as when it is under activation of blue light the red fluorescence of the malignant tumour (due to the HPD) can be observed easily. The combination of HPD with red light (photoradiation) has been used on various malignant tumours including malignant melanomas and carcinomas on a range of different organs including the breast and colon. The singlet oxygen is a cytotoxic agent The treatment process also utilises HPD's capability of accumulating at higher levels in malignant tissues compared to most other tissues. The use of this treatment type largely depends on the fact that malignant and normal cells have differing responses to the energy source used. It can be administered through "injection, intra-arterial (IA), intraperitoneal (IP), intrathecal (IT), intravenous (IV), topical or oral". It targets the cellular mechanisms which allow the development of malignancy throughout the body. There are no specific areas which are targeted and so, there is a lack of differentiation between normal and malignant cells, resulting in a range of side effects. This includes bone marrow suppression, gastrointestinal problems, and alopecia. Some side effects are specific to the anticancer drug used, the most common being bone marrow suppression as bone marrow has the ability to divide rapidly due to high growth fraction. This is because anticancer drugs have the highest activity in high growth fraction tissues. Alkylating agents are used in chemotherapy as these are chemically reactive drugs which form covalent bonds when reacting with DNA. This results in breaks within DNA strands causing either inter-strand or intra-strand DNA cross-linking. The sub-classes of alkylating agents are "nitrogen mustards, oxazaphosphorines, alkyl alkane, sulfonates, nitrosoureas, tetrazines, and aziridines." ==Epidemiology==

Malignancy has been a constant global health concern for a number of years, resulting in significant social and economic impacts on individuals with malignancy and their families. The risk of developing malignancy is 20.2%. In 2018, 18 million patients were diagnosed with a malignant tumour with lung, breast and prostate being the most common form. The number of smokers in China is rapidly increasing with tobacco killing approximately 3000 people each day. In the 15–49-year-old age bracket the most common form of malignancy is breast cancer with liver and lung cancer following. Finally, those aged 60 and over mainly develop lung, colorectal, stomach, and liver malignancy. Uses of "malignant" in oncology include: • Malignancy, malignant neoplasm and malignant tumor are synonymous with cancer • Malignant ascites • Malignant transformation Non-oncologic disorders referred to as "malignant" include: • Malignant hypertension • Malignant hyperthermia • Malignant otitis externa • Malignant tertian malaria (malaria caused specifically by Plasmodium falciparum) • Neuroleptic malignant syndrome ==See also==