Aula cancro
Upcoming SlideShare
Loading in...5
×
 

Aula cancro

on

  • 536 views

 

Statistics

Views

Total Views
536
Slideshare-icon Views on SlideShare
530
Embed Views
6

Actions

Likes
0
Downloads
1
Comments
0

1 Embed 6

http://hugomls.no.sapo.pt 6

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Cancer is a renegade system of growth that originates within a patient ’s biosystem, more commonly known as the human body. There are many different types of cancers, but all share one hallmark characteristic: unchecked growth that progresses toward limitless expansion. It is difficult to imagine anyone who has not heard of this illness. Most people have been affected because either they or their loved ones or friends are cancer survivors. Because cancer is so prevalent, people have many questions about its biology, detection, diagnosis, possible causes, and strategies for prevention.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Cancer can originate almost anywhere in the body. Carcinomas , the most common types of cancer, arise from the cells that cover external and internal body surfaces. Lung, breast, and colon are the most frequent cancers of this type in the United States. Sarcomas are cancers arising from cells found in the supporting tissues of the body such as bone, cartilage, fat, connective tissue, and muscle. Lymphomas are cancers that arise in the lymph nodes and tissues of the body ’s immune system. Leukemias are cancers of the immature blood cells that grow in the bone marrow and tend to accumulate in large numbers in the bloodstream.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Scientists use a variety of technical names to distinguish the many different types of carcinomas, sarcomas, lymphomas, and leukemias. In general, these names are created by using different Latin prefixes that stand for the location where the cancer began its unchecked growth. For example, the prefix “osteo” means bone, so a cancer arising in bone is called an osteosarcoma. Similarly, the prefix “adeno” means gland, so a cancer of gland cells is called adenocarcinoma--for example, a breast adenocarcinoma.
  • Figure 1 indicates the most common cancers expected to occur in men and women in 2005. Among men, cancers of the prostate, lung and bronchus, and colon and rectum account for more than 56% of all newly diagnosed cancers. Prostate cancer alone accounts for approximately 33% (232,090) of incident cases in men. Based on cases diagnosed between 1995 and 2000, about 90% of these estimated new cases of prostate cancer are expected to be diagnosed at local or regional stages, for which 5-year relative survival approaches 100%.
  • This is a BEAUTIFUL chart! Another way of understanding the development of malignancy in a logical way!
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer and the Environment NCI Web site: http://cancer.gov/cancertopics/understandingcancer Cancer screening tests help detect cancer at an early stage, which allows treatment to occur before the cancer spreads. Get screened regularly for these cancers:   Colon/rectum : Tests include the fecal occult blood test, sigmoidoscopy, and colonoscopy.   Breast : The standard screening test is a mammogram, or X-ray of the breast tissue.   Cervix : The standard screening test is the Pap smear. Guidelines for when testing should begin and how often it should occur may be different for each person, so talk with your doctor about what ’s right for you. Also talk with your health care provider about exposures at work and at home, and discuss whether your family or personal history may put you at risk for certain types of cancer. Your doctor may recommend other cancer screening tests as well.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer A screening technique called the Pap test (or Pap smear) allows early detection of cancer of the cervix, the narrow portion of the uterus that extends down into the upper part of the vagina. In this procedure, a doctor uses a small brush or wooden scraper to remove a sample of cells from the cervix and upper vagina. The cells are placed on a slide and sent to a laboratory, where a microscope is used to check for abnormalities. Since the 1930s, early detection using the Pap test has helped lower the death rate from cervical cancer more than 75 percent. Should abnormalities be found, an additional test may be necessary. There are now 13 high-risk types of human papillomaviruses (HPV) recognized as the major causes of cervical cancer. The U.S. Food and Drug Administration has approved an HPV test that can identify their presence in a tissue sample. This test can detect the viruses even before there are any conclusive visible changes to the cervical cells.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Breast cancer can sometimes be detected in its early stages using a mammogram, an X-ray of the breast. Mammography is most beneficial for women as they age and undergo menopause. Mammography is a screening tool that can detect the possible presence of an abnormal tissue mass. By itself, it is not accurate enough to provide definitive proof of either the presence or the absence of breast cancer. If a mammogram indicates the presence of an abnormality, further tests must be done to determine whether breast cancer actually is present.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer The U.S. Food and Drug Administration has approved the PSA test along with a digital rectal exam to help detect prostate cancer in men age 50 and older. Doctors often use the PSA test and DRE as prostate cancer screening tests; together, these tests can help doctors detect prostate cancer in men who have no symptoms of the disease. Most men with an elevated PSA test, though, turn out not to have cancer; only 25 to 30 percent of men who have a biopsy due to elevated PSA levels actually have prostate cancer, so researchers are working hard to find new clues. Experts are trying to develop better blood tests that might alert people to malignancies while the cancers are still in their early stages. For example, several new blood tests for ovarian or prostate cancer are under development.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer A procedure called a fecal occult blood test (FOBT) detects invisible amounts of blood in the feces, a possible sign of several disorders, including colon cancer. The test is painless and can be done at home or in the doctor ’s office along with a rectal exam. With an application stick, a dab of a stool specimen is smeared on a chemically treated card, which is tested in a laboratory for evidence of blood. If blood is confirmed in the stool, more elaborate tests may be performed to find the source of the bleeding. Some other options include sigmoidoscopy and colonoscopy. The former exam uses a lighted instrument called a sigmoidoscope to find precancerous or cancerous growths in the rectum and lower colon. The latter exam uses a lighted instrument called a colonoscope to find precancerous or cancerous growths throughout the colon, including the upper part.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Since exposure to carcinogens (cancer-causing agents) is responsible for triggering most human cancers, people can reduce their cancer risk by taking steps to avoid such agents. Hence the first step in cancer prevention is to identify the behaviors or exposures to particular kinds of carcinogens and viruses that represent the greatest cancer hazards.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Since exposure to carcinogens (cancer-causing agents) is responsible for triggering most human cancers, people can reduce their cancer risk by taking steps to avoid such agents. Hence the first step in cancer prevention is to identify the behaviors or exposures to particular kinds of carcinogens and viruses that represent the greatest cancer hazards.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Since exposure to carcinogens (cancer-causing agents) is responsible for triggering most human cancers, people can reduce their cancer risk by taking steps to avoid such agents. Hence the first step in cancer prevention is to identify the behaviors or exposures to particular kinds of carcinogens and viruses that represent the greatest cancer hazards.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Since exposure to carcinogens (cancer-causing agents) is responsible for triggering most human cancers, people can reduce their cancer risk by taking steps to avoid such agents. Hence the first step in cancer prevention is to identify the behaviors or exposures to particular kinds of carcinogens and viruses that represent the greatest cancer hazards.
  • National Cancer Institute Understanding Cancer and Related Topics Understanding Cancer NCI Web site: http://cancer.gov/cancertopics/understandingcancer Since exposure to carcinogens (cancer-causing agents) is responsible for triggering most human cancers, people can reduce their cancer risk by taking steps to avoid such agents. Hence the first step in cancer prevention is to identify the behaviors or exposures to particular kinds of carcinogens and viruses that represent the greatest cancer hazards.

Aula cancro Aula cancro Presentation Transcript

  • + NÚCLEO REGIONAL DO NORTE CANCRO… uma abordagem geral Hugo Sousa BScH Microbiology| MSc Oncology | PhD Biomedical Sciences MD Student @ FMUP hugomls@gmail.com_________________________________________Serviço Virologia – Lab Biologia MolecularGrupo Oncologia Molecular
  • + Verdade ou Mentira…  O Cancro é uma doença GENETICA  O Cancro é uma doença INFECCIOSA  O Cancro é uma doença ADQUIRIDA  O Cancro é uma doença SEXUALMENTE TRANSMITIDA  O Cancro é uma doença PREVENÍVEL  O Cancro é uma doença HEREDITÀRIA
  • + Cancro… Breve introdução
  • + Cancro...
  • + Cancro…
  • + Cancro… Leukemias: Common carcinomas: Bloodstream Lung Lymphomas: Lymph nodes Breast (women) Colon Common Bladder sarcomas: Prostate (men) Fat Bone Muscle
  • + Cancro… Prefix Meaning adeno- gland chondro- cartilage erythro- red blood cell hemangio- blood vessels hepato- liver lipo- fat lympho- lymphocyte melano- pigment cell myelo- bone marrow myo- muscle osteo- bone
  • + Cancro… Epidemiologia
  • + Cancro... Grave problema de saúde pública…
  • + Cancro…
  • + Cancro… Homem
  • + Cancro… Mulher
  • + Cancro… Epidemiologia
  • + Cancro… EpidemiologiaU.K.:Lung cancer JAPAN: CANADA: Stomach Leukemia cancer U.S.: Colon cancer CHINA: Liver cancer BRAZIL: AUSTRALIA: Cervical cancer Skin cancer
  • + Cancro… Etiologia
  • + Cancro... Etiologia Kidney Cancer in Family Kidney Cancer: A Sporadic Case Cancer Does cells your cancer share similar mutations? Gene Gene mutations mutations Cancer Cancer genome genome
  • + Cancro... Etiologia
  • + Cancro... Etiologia hereditária All Breast Cancer Patients Inherited factor(s) Other factor(s) ~15% Hereditário
  • + Cancro... Etiologia multifactorial Agentes Biológicos - Vírus - Bactérias Exposição Ambiental Agentes Químicos Agentes Físicos - Radiações Carga Hospedeiro Genética Ambiente Hábitos Interacção The role of these factors has been demonstrated consistently in modern populations, but the epidemiology of cancer has changed over human history as the environmental conditions and the genetic characteristics of human populations have changed (Vogelstein B and Kinzler KW 2001; Capasso LL 2005)
  • + Cancro... Etiologia multifactorial Age Age Age Hormones Alcohol Alcohol Diet Diet Diet Obesity Smoking Smoking Carcinogens Viruses Weak immune system Cancer Cancer Time
  • + Cancro… Exposição Ambiental = cancer
  • + Cancro… Exposição Ambiental
  • + Cancro… Exposição Ambiental
  • + Cancro… Exposição Ambiental Metal Cancers Present in Human Carcinogen? Arsenic Skin, lung, bladder, Wood preservatives, Yes kidney, liver glass, pesticides Beryllium Lung Nuclear weapons, Yes rocket fuel, ceramics, glass, plastic, fiberoptic products Cadmium Lung Metal coatings, Yes plastic products, batteries, fungicides Chromium Lung Automotive parts, Yes floor covering, paper, cement, asphalt roofing; anti-corrosive metal plating Lead Kidney, brain Cotton dyes, metal Probable carcinogen coating, drier in paints, varnishes and pigment inks, certain plastics, specialty glass Nickel Nasal cavity, lung Steel, dental fillings, Nickel metal: copper and brass, Probable carcinogen permanent magnets, storage batteries, Nickel compounds: glazes Yes
  • + Cancro… Tabaco aminostilbene arsenic benz[a]anthracene benz[a]pyrene benzene benzo[b]fluoranthene benzo[c]phenanthrene benzo[f]fluoranthene cadmium chrysene dibenz[a c]anthracene dibenzo[a e]fluoranthene dibenz[a h]acridine dibenz[a j]acridine dibenzo[c g]carbazone N-dibutylnitrosamine 2,3-dimethylchrysene indeno[1,2,3-c d]pyrene S-methylchrysene S-methylfluoranthene alpha-naphthylamine nickel compounds N-nitrosodimethylamine N-nitrosomethylethylamine N-nitrosodiethylamine N-nitrosonornicotine N-nitrosoanabasine N-nitrosopiperidine polonium-210 15x Lung Cancer Risk 10x 5x 0 15 30 Non-smoker Cigarettes Smoked per Day
  • + Cancro... Vírus  1908 – Leucemia Aviária (Agente transmissível um Vírus);  1911 – Chicken Sarcoma (Rous Sarcoma Virus – RSV);  1964 – Linfoma de Burkitt (Epstein-Barr Virus – EBV);  1980 – Leucemia Células T (Human T-cell Leukemia Virus – HTLV-1) Nos anos 90 a OMS reconheceu a associação entre Vírus e Cancro  HPV e Cancro do Colo do Útero  HBV e Hepatocarcinoma  EBV e Linfoma de Burkitt
  • Representam cerca de 15% de + todos os casos de cancro Vírus Cancro...
  • + Cancro... Etiologia Proportion of Cancer Deaths Linked to Avoidable Risk Factors Tobacco 29–31 percent Diet 20–50 percent Infections: bacteria, viruses 10–20 percent Ionizing and UV light 5–7 percent Occupation 2–4 percent Pollution: air, water, food 1–5 percent Source: Doll R. (UK data) Recent Results in Cancer Research 1998; 154:3-21.
  • + Cancro... Interacção hospedeiro-ambiente
  • + Cancro... Interacção hospedeiro-ambiente Cancer patient Mutated susceptibility genes Weak immune system Mutated detox enzymes Mutated repair genes Change in hormone levels
  • + Cancro... Interacção hospedeiro-ambienteHyperactive detox Slow proteins detox proteins Carcinogen Carcinogen Water-soluble Water-soluble carcinogen carcinogen
  • + Cancro… Carcinogénese
  • + Cancro... Carcinogénese Normal lung cell Normal islet cell Many years later Lung cancer cell Diabetic islet cell
  • +CancroDesregulação•Proliferação aumentada•Morte celular diminuída
  • + Cancro... Carcinogénese Normal cell division Cell Suicide or Apoptosis Químicos Físicos Vírus
  • + Cancro... Carcinogénese  Iniciação  Alterações genéticas  Promoção  Adopção de novo fenótipo  Transformação  Re-organização das células  Progressão  Selecção clonal das células e proliferação  Metastização  Disseminação à distância
  • + Cancro... Carcinogénese G1 (cell growth) M (mitosis) Oncogenes Normal cell First Tumor mutation G2 suppressor genes DNA repair genes Second mutation S (synthesis) Third mutation Malignant cells Fourth or later mutation
  • +CancroDesregulação•Proliferação aumentada•Morte celular diminuída
  • +CancroDesregulação•Proliferação aumentada•Morte celular diminuída
  • +
  • + Cancro... Carcinogénese Benign (not cancer) tumor Malignant (cancer) cells cells grow only locally and invade neighboring tissues, cannot spread by invasion enter blood vessels, and or metastasis metastasize to different sitesTime
  • + Cancro... Carcinogénese Benign (not cancer) tumor Malignant (cancer) cells cells grow only locally and invade neighboring tissues, cannot spread by invasion enter blood vessels, and or metastasis metastasize to different sitesTimeMutation inactivates Cell Mutations inactivate Proto-oncogenes More mutations, moresuppressor gene proliferataion DNA repair genes mutate to oncogenes genetic instability, metastatic disease
  • + Cancro... Carcinogénese
  • + Cancro... Carcinogénese
  • + Cancro... Carcinogénese Invasive Matrix Proteases Fibroblasts, adipocytes Cytokines Blood vessel Cytokines, proteases = migration & invasion Growth factors = proliferation
  • + Cancro... Carcinogénese
  • + Cancro... Carcinogénese Brain Melanoma cells travel through bloodstream Liver Melanoma (initial tumor)
  • + Cancro... Carcinogénese
  • + Cancro… Carcinogénese - exemplos
  • + Cancer Multistep & multifactorial disease Pre neoplastic Abolishment Pre neoplastic Susceptibilit y to Viral lesion of Immune lesion Normal Infection Grade I Response Grade II infection iniciation transformation progression invasion Ca In Situ Invasive Ca Abolishment Pre neoplastic Activation of Abolishment of Cell Cycle lesion of Apoptosis Invasion regulation Grade III Pathways
  • + Cancer Multistep & multifactorial disease
  • + Cancer Multistep & multifactorial disease
  • + Cancer Multistep & multifactorial disease
  • + Cancro… Rastreio e Diagnóstico Precoce
  • Cancer Screening for Early Detection Normal Pap smear Abnormal Pap smear
  • + Cancro… Cervical Cancer Screening Normal Pap smear Abnormal Pap smear
  • + Cancro… Breast Cancer Screening
  • + Cancro… Prostate and Ovarian Cancer Screening
  • + Cancro Colon Cancer Screening
  • + Cancro… Rastreios vs Guidelines…
  • + Cancro… Estadiamento
  • + Cancro… Estadiamento Grade 1 (of 4) Renal Carcinoma Grade 3 (of 4) Renal Carcinoma
  • + Cancro… Estadiamento  Sistema desenvolvido para ajudar os clínicos  Forma uniforme de falar dos casos e de agrupar se acordo com tipos de tratamento e prognóstico  TNM  T = Tumor (tamanho, extensão…)  N = Nodes (gânglios linfáticos locais/distantes)  M = Metastasis (metastização)  Estadio  Integração dos dados do TNM
  • + Cancro… Estadiamento TNM  T refers to the extent of the primary tumor  Tx - cannot assess  T0 indicates no evidence of primary tumor  Tis is carcinoma in situ  T1, T2, T3 and T4
  • + Cancro… Estadiamento TNM  N to the extent of regional lymph node metastases  Nx - cannot assess  N0 - no regional node metastases  N1, N2, N3 indicate increasing involvement of regional lymph nodes  Examples…  Breast  1 of 15 axillary LNs + (breast) = N1  Cervix  1 + pelvic node = N1
  • + Cancro… Estadiamento TNM  M to absence or presence of distant metastases...  Mx - cannot assess  M0 is no distant metastases  M1 indicates distant metastases
  • + Cancro… Estadiamento TNM  Referência global (varia de acordo com o tumor)  Tis = Stage 0  Stage I  Stage II  Stage III Group Stage Examples (Breast)  Stage IV Stage 0 Tis N0 M0 Stage I T1 N0 M0 Stage IIA T0 N1 M0 ~~~~~ ~~~~~ ~~~~ ~~~ Stage IIIB T4 N0 M0 Stage IIIC Any T N3 M0 Stage IV Any T Any N M1
  • + Cancro… Estadiamento TNM  Referência global (varia de acordo com o tumor)  Tis = Stage 0  Stage I  Stage II  Stage III Group Stage Examples (Cervix)  Stage IV Stage 0 Tis N0 M0 Stage I T1 N0 M0 Stage IIA T2a N0 M0 ~~~~~ ~~~~~ ~~~~ ~~~ Stage IIIB T1 N1 M0 T2 N1 M0 Stage IV Any T Any N M1
  • + Cancro… Estadiamento TNM Five-Year Survival Rates for Patients with Melanoma (by stage) 100% 50% I II III Stage at Time of Initial Diagnosis
  • + Cancro… Prevenção
  • + Cancro… Prevenção Carcinogenic chemicals Carcinogenic radiation Cancer viruses or bacteria
  • + Cancro… Prevenção
  • + Cancro… Prevenção Combination of Alcohol and Cigarettes Increases Risk Lung Cancer Risk Increases with for Cancer of the Esophagus 40x Cigarette Consumption 15x Risk Increase 30x Lung Cancer Risk 20x 10x 10x 5x Alcoholic Drinks Consumed per Day 0 15 30 AND Non-smoker Cigarettes Smoked per Day Packs of Cigarettes Consumed per Day
  • + Cancro… PrevençãoCorrelation Between Meat Consumption and Colon Cancer Rates in Different CountriesNumber of Cases (per 100,000 people) 40 30 20 10 0 80 100 200 300 Grams (per person per day)
  • + Cancro… Prevenção HPV Infection Increases Risk for Cervical Cancer High Cervical Cancer Risk Low Noninfected Women women infected with HPV
  • + NÚCLEO REGIONAL DO NORTE CANCRO… uma abordagem geral Hugo Sousa BScH Microbiology| MSc Oncology | PhD Biomedical Sciences MD Student @ FMUP hugomls@gmail.com_________________________________________Serviço Virologia – Lab Biologia MolecularGrupo Oncologia Molecular