**11.1 TNM staging systems**

It is the cancer staging system that is widely used and varies for each specific form of cancer. Its general principles are:


## *Neoplasia DOI: http://dx.doi.org/10.5772/intechopen.109512*


TNM staging system is widely used. TNM staging.


Grading of tumor depends on the degree of differentiation.

Prognosis of tumor depends on:

1.Histological type.

2.Grade.

3. Stage.

#### **11.2 Prognosis**

The prognosis of malignant tumors varies and is determined partly by the characteristics of the tumor cells (e.g. grower pale invasiveness) and partly by the effectiveness of therapy [30–32].

### **12. Paraneoplastic syndromes**

Malignant tumors invade local tissue, produce metastasis, and can produce a variety of products that can stimulate hormonal, hematologic, dermatologic, and neurologic responses**.**

Definition: Paraneoplastic syndromes are symptom complexes in cancer patients that are not directly related to mass effects or invasion or metastasis or by the secretion of hormones indigenous to the tissue of origin.

Frequency: Though they occur in 10–15% of patients, it is important because:

1.Maybe the first manifestation of an occult neoplasm.

2.Maybe mistaken for metastatic disease leading to inappropriate treatment.

3.May present clinical problems, which may be fatal.


#### **Table 11.** *Selected tumor markers.*

4.Certain tumor products causing paraneoplastic syndromes may be useful in monitoring recurrence in patients who had surgical resections or are undergoing chemotherapy or radiation therapy.

Some paraneoplastic syndromes, their mechanism, and the common cancers causing them are listed in **Table 11** [30–32].
