bios e-162b fall 2010 cancer review session carlos o. mendivil-anaya, md
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Bios E-162b FALL 2010
Cancer review session
Carlos O. Mendivil-Anaya, MD
Neoplasia
Tumor
Cancer, carcinoma
Sarcoma
Lymphoma
Leukemia
New growth: Includes benign disease
Swelling: Includes benign disease
Malignancy of epithelial origin
Malignancy of mesothelial origin
Malignancy of lymphoid organs
Malignancy of blood cells (usually WBC)
Jargon
Lethality
Cancers with potential for screening
Breast
Cervical
Prostate
Colorectal
Mammography
Cervical smear cytology (Pap smear)
Serum PSA
Flexible sigmoidoscopyFecal occult blood test
Stages of cancer
Stages of cancer
The cell cycle
Genetic origin of cancer
(proto)Oncogenes Tumor suppressor
genes
Chemotherapy agents target the cell cycle
Genetic Predisposition (familiar mutations)
Chemical Carcinogenesis
Excessive hormonal stimulus
Ionizing Radiation
Light (Ultraviolet Radiation)
Repeated localized trauma
Tumor Viruses (Oncogenic viruses)
- HIV/Epstein-Barr virus
- Human Papilloma Virus
- Hepatitis B Virus
Etiology of cancer
Carcinogenic mechanism of retroviruses
The key role of angiogenesis
Some cancers are hormone-sensitive
And some others are driven by environmental factors
Metastases prefer some organs
Chemotherapy can be highly toxic
Testicular cancer
Rare
Happens early in life (average age=30)
Main risk factor: Undescended testis (Cryptorchidism)
However, most common cancer in young adult males
Testicular cancer
Prostate cancer
Most common cancer in men
Lifetime risk of developing it is about 17% !
Increased urinary frequency and urgency
Prostate gland grows normally during life in response to androgens
Strong genetic/ethnicity influence
Overweight high IGF-1 levels increased risk
Treated with surgery / radiation / androgen deprivation
Breast cancerMost common cancer in women
Much more prevalent in industrialized countries
Breast cancer
Can be detected early by breast self-exam
http://medicalimages.allrefer.com/
Breast cancer
Can be detected early by breast self-exam
http://medicalimages.allrefer.com/
All women 40 and older should get a mammogram
Breast cancer
http://commons.wikimedia.org/wiki/File:Mammogram.jpgwww.hastingsimagingcenter.com
Breast cancer
Incidence increases with age
Premenopausal and posmenopausal have different risk factors
Risk proportional to estrogen exposure
Old hormonal contraceptives increase risk, New hormonal contraceptives decrease it
Estrogen-like substances in food or environment increase risk
Pregnancy and lactation are protective
BRCA1 and BRCA2 genes mutated in about 10% of cases