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