5
10
15
20
25
30
35
40%
of
tota
l M
ort
ali
ty
25 30 35 40 45 50 55 60 65 70 75 80 85
Age
Cancer and heart disease relative mortality in 2002 (USA)
Heart disease
Cancer
Male cancer statistics
Adapted from Greenlee RT, et al. CA Cancer J Clin. 2000;51:18, 15-36.
Estimated incidenceEstimated incidence Estimated deathsEstimated deaths
Melanoma of skin
Oral cavity & pharynx
Lung & bronchus
Pancreas
Kidney
Colon & rectum
Prostate
Urinary bladder
Leukemia
Non-Hodgkin’s lymphoma
All others
5%
3%
14%
2%
3%
10%
31%
6%
3%
5%
18%
Esophagus
Lung & bronchus
Pancreas
Liver
Kidney
Colon & rectum
Prostate
Urinary bladder
Leukemia
Non-Hodgkin’s lymphoma
All others
3%
31%
5%
3%
3%
10%
11%
3%
4%
5%
22%
13
Female cancer statistics
Adapted from Greenlee RT, et al. CA Cancer J Clin. 2001;51:18, 15-36.
2%
15%
25%
6%
2%
11%
5%
2%
5%
4%
23%
Melanoma of skin
Thyroid
Breast
Lung & bronchus
Pancreas
Colon & rectum
Ovary
Uterine corpus
Urinary bladder
Non-Hodgkin’s lymphoma
All others
4%
2%
31%
13%
2%
11%
4%
6%
2%
4%
21%
Brain
Breast
Lung & bronchus
Pancreas
Stomach
Colon & rectum
Ovary
Uterine corpus
Non-Hodgkin’s lymphoma
Leukemia
All others
Estimated incidenceEstimated incidence Estimated deathsEstimated deaths
14
What is cancer?
What are the etiological causes of cancer?
Why it appears ?
How it appears?
How to treat cancer?
Environmental factors
Occupational exposureLyfestyle factors
Biologic agents
Pharmacologic factorsGenetic factors
Environmental factors
Occupational exposureLyfestyle factors
Biologic agents
Pharmacologic factorsGenetic factors
Folic acid
Dihydro-folate (DHF)
Tertra-hydro-folate (THF)
N5N10 methylene THFdTDP
dTTPDNA
dUMP
dTMP
Thymidilate synthase
CACTACA
CACUACAdUDP
dUTP
CAC UACA
DNA brake
Major causeMajor cause• Lung• Larynx• Oral cavity• Esophagus
Contributory factorContributory factor• Pancreas• Bladder• Kidney• Stomach• Uterine cervix
Smoking-related cancers
Cole P, Rodu B. Cancer: Principles & Practice of Oncology. 6th ed. 2001;241-252.
• Cancer of the esophagus
• Head and neck cancer
• Liver cancer
• Breast cancer
Alcohol-related cancers
Cole P, Rodu B. Cancer: Principles & Practice of Oncology. 6th ed. 2001;241-252.Winer E, et al. Cancer: Principles & Practice of Oncology. 6th ed. 2001;1651-1717.
Environmental factors
Occupational exposureLyfestyle factors
Biologic agents
Pharmacologic factorsGenetic factors
Selected Industries Associated with Exposure to CarcinogensSelected Industries Associated with Exposure to Carcinogens
IndustryIndustry CarcinogenCarcinogen CancerCancer
Shipbuilding, demolition, insulation Asbestos Lung, pleura, skin
Varnish, glue Benzene Leukemia
Pesticides, smelting Arsenic Lung, skin, liver
Mineral refining and manufacturing Nickel, chromiumLung, nasal passages
Furniture manufacturing Wood dusts Nasal passages
Petroleum products Polycyclic hydrocarbons Lung
Rubber manufacturing Aromatic amines Bladder
Vinyl chloride Vinyl chloride Liver
Radium Radium Lung, bone
Outdoor occupations Ultraviolet light Skin
Occupational-related cancers
Costanza ME, et al. American Cancer Society Textbook of Clinical Oncology. 3rd ed. 2001;55-74.
Environmental factors
Occupational exposureLyfestyle factors
Biologic agents
Pharmacologic factorsGenetic factors
Colon cancer genetics
33
Hereditary colon cancers Mutated gene
Hereditary non polyposis colorectal cancer MSH2, MLH1,PMS1,PMS2, etc.
FAP Familial adenomatous polyposis APC
Turcot syndrome (+ medulloblastomas)
APC
Gardner syndrome (osteomas, desmoid tumors, epidermoid cysts, polyposis)
APC
Supernumerary and unerupted teeth
Environmental factors
Occupational exposureLyfestyle factors
Biologic agents
Pharmacologic factorsGenetic factors
AgentsAgents
• Hepatitis B
• Hepatitis C
• HIV-1
• HTLV-1
• HPV
• Epstein-Barr
Virus-related cancers
Site of CancerSite of Cancer
Liver
Liver
Kaposi’s sarcoma
Adult T-cell lymphoma
Uterine cervix
Burkitt’s lymphoma, nasopharynx,Hodgkin’s disease
Cole P, Rodu B. Cancer: Principles & Practice of Oncology. 6th ed. 2001;241-252.39
AgentsAgents
Helicobacter pylori
Schistosoma haematobium
Opisthorchis viverrini
Bacterial-related cancersSite of CancerSite of Cancer
Stomach
Urinary bladder
Liver
Cole P, Rodu B. Cancer: Principles & Practice of Oncology. 6th ed. 2001;241-252.40
Environmental factors
Occupational exposureLyfestyle factors
Biologic agents
Pharmacologic factorsGenetic factors
PharmaceuticalsPharmaceuticals
AgentsAgents Site of CancerSite of Cancer
Cancer chemotherapeutic drugs Bone marrow
Immunosuppressive drugs Reticuloendothelial system
Exogenous hormones
Nonsteroidal estrogens Vagina, breast, testis
Steroidal estrogens Endometrium
Oral contraceptives Liver, endometrium
Tamoxifen Endometrium
Phenacetin analgesics Kidney, pelvis, bladder
Adapted from Cole P, Rodu B. Cancer: Principles & Practice of Oncology. 6th ed. 2001;241-252.
Environmental factors
Occupational exposureLyfestyle factors
Biologic agents
Pharmacologic factorsGenetic factors
Ullrich RL, et al. Cancer: Principles & Practice of Oncology. 6th ed. 2001;195-206.
AgentAgent
Ionizing radiation
Type of CancerType of Cancer
Breast cancer
Leukemia
Skin cancer
Thyroid cancer
Lung cancer
44
Ultraviolet light
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