local health wherever it happens to be so you can see that ah... that all of the above is where the real exclamation point um... and crime cancers can also secrete excess hormone just like the nine and the crime so any of those things that are listed up here you can see now there is there a couple of other things uh... unless i want to go understandably said a conceptual level that uh... malignant neoplasms may be associated with some very very significant systemic changes and uh... one of them that you may be familiar with from for milliliter answer or friends of friends of friends these are the buff twinkly cancer patients will answer phase of disease where they lose their appetites we begin to lose weight the weight comes highly awesome and they get weaker and weaker and weaker and just do windows and very often so we could their beds have some in the final event in their lives is nemo near which overtakes typically will only take a belfast patient like that we refer to their way sort of wasting syndrome as cake x_-ers there's the spelling for it as a general term but here we're talking about cancer coq xy and other words are talking about a patient becoming a nation and wasted because of the cancer being there when i was a kid in pathologies that teach that this is simply a caloric matter we had a rapidly growing tumor which isn't enough calories competing with the host the host lost appetite along the way and that was that we just lost weight on behalf of the jury we now know that that's the only a small part of the story how this is a rather complex business related and i would lead to a cytochrome site a kind secretion on the part of the as a gross but be aware that very often in patients with cancer you see this as syndrome of cake axia there are also in this is an important general concept that i want to get lost in the specifics but there are other symptom complex is that is a syndromes in patients with cancer that you cannot explain uh... by local effects mechanical effects that you can't that they're not explainable on the basis of a predictable and the crying secretion in other words it's not that this is a cancer that's we know is making insulin and therefore beginning insulin sometimes it's not that uh... we find some very weird syndromes affecting a variety of organ systems that are june should be presence of the cancer's not mechanically but the president cancer in the body and these are referred to is para neil plastic syndromes and i want you to to get an idea that concept not the details of the various syndromes they're important because first of all they may be a greater problem to the patient than the mechanical aspect of the tumor itself and another thing is that the patient may present the manifestations of a particular perinatal plastic syndrome at the time the cancer is still are cold behooves you to be able to recognize that all my goodness this mixture symptoms may mean getty just a couple of examples along with the rest of your skimming reading don't try to memorize any of this stuff but one economist uh... para neoplastic syndromes is hyper cal senior elevation in blood calcium you might think if you think he mechanically think well cancer spreading to the bone will destroy both liberate calcium that happens that's not apparently plastics into lesson mechanical thanks but some tumors will secreted parathyroid like hormone in other words are not related to parathyroid glands of tumor of this error that but it's a create something that has a paris i read hormone like activity in a race is the serum calcium that's not at all uncommon uh... other examples of parent neoplastic syndromes are from what we call ext topic hormone production where particular tumor is producing a hormone that has no business coming from there we see for instance 