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Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
Human Bio Iii Oncology I
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Human Bio Iii Oncology I

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  • 1. Human Biology III Oncology I Ken Bauer [email_address]
  • 2. Objectives <ul><li>Following the lecture the student should be able to: </li></ul><ul><li>1. Differentiate between the characteristics of benign and malignant tumors. </li></ul><ul><li>2. List the 5 broad categories of cancer etiology </li></ul><ul><li>3. Describe the effect cigarette smoking has had on cancer incidence and death rates from 1930 to present. </li></ul>
  • 3. Objectives <ul><li>4. Explain the roles of oncogenes proro-oncogenes, and tumor suppressor genes in the malignant transformation . </li></ul><ul><li>5. List the 3 most common tumor types in men and women by gender </li></ul>
  • 4. Cancer Terminology <ul><li>Cancer is a disorder that occurs at a cellular level </li></ul><ul><li>Cancer occurs when genetic alterations result in the unregulated proliferation of cells </li></ul>
  • 5. Cancer Terminology <ul><li>Cancer - A group of diseases </li></ul><ul><li>Anaplasia - Lack of differentiation </li></ul><ul><li>Dysplasia - Abnormal size, shape </li></ul><ul><li>Hyperplasia - Increase in number of cells </li></ul>
  • 6. Benign Tumor <ul><li>Characteristics typical of tissue of origin </li></ul><ul><li>Slow rate of growth </li></ul><ul><li>Slowly progressive; Not fatal if untreated </li></ul><ul><li>Encapsulated growth </li></ul><ul><li>No tissue destruction </li></ul><ul><li>Rare recurrence </li></ul><ul><li>Poor prognosis only if unable to remove </li></ul>
  • 7. Malignant Tumor <ul><li>Characteristics atypical of tissue of origin </li></ul><ul><li>Slow or rapid rate of growth </li></ul><ul><li>Usually progressive; Fatal if untreated </li></ul><ul><li>Growth by infiltration or metastasis </li></ul><ul><li>Tissue destruction is common </li></ul><ul><li>Recurrence is common </li></ul><ul><li>Fatal prognosis if uncontrolled </li></ul>
  • 8. 2000 Estimated Cancer Statistics <ul><li>1,220,100 : Estimated number of new cancer cases. </li></ul><ul><ul><li>Over 100 types of cancer most common -> </li></ul></ul><ul><ul><li>Women: Breast, Lung, Colon </li></ul></ul><ul><ul><li>Men: Prostate, Lung , Colon </li></ul></ul><ul><li>552,200 : Estimated number of cancer deaths. </li></ul><ul><ul><li>Lung cancer is leading cause of cancer deaths. </li></ul></ul><ul><ul><ul><ul><ul><li>Source: American Cancer Society, www.cancer.org </li></ul></ul></ul></ul></ul>
  • 9. Cancer Statistics <ul><li>From 1930 until 1989 there was a steady overall rise in the age-adjusted death rate due to cancer </li></ul><ul><li>Since 1989 the mortality trend is downward </li></ul><ul><li>Major cause of increase over 60 years was increasing tobacco use and lung cancer </li></ul><ul><li>The current trend down is due at least in part to decreased tobacco use </li></ul>
  • 10. Leading Sites of New Cancer Cases and Deaths—2000 Estimates
  • 11. Age-Adjusted Cancer Death Rates,* Females by Site, US, 1930-1996
  • 12. Age-Adjusted Cancer Death Rates,* Males by Site, US, 1930-1996
  • 13. Etiology of Cancer <ul><li>The most common way of treating cancer today is to treat after detection </li></ul><ul><li>Ideal strategy is prevention: </li></ul><ul><ul><li>eliminate/reduce controllable risk factors </li></ul></ul><ul><ul><ul><li>smoking, diet, alcohol </li></ul></ul></ul><ul><ul><li>chemoprevention </li></ul></ul><ul><ul><ul><li>tamoxifen {breast} </li></ul></ul></ul><ul><ul><ul><li>finasteride {prostate} -investigational </li></ul></ul></ul><ul><ul><ul><li>retinoids {head and neck} -investigational </li></ul></ul></ul>
  • 14. Etiology of Cancer <ul><li>Environmental factors </li></ul><ul><li>Viruses </li></ul><ul><li>Lifestyle factors </li></ul><ul><li>Medical - Drugs and Hormones </li></ul><ul><li>Hereditary </li></ul>
  • 15. Environmental Factors <ul><li>Industrial/Occupational </li></ul><ul><ul><li>Coal miners, factory workers, asbestos </li></ul></ul><ul><li>Ultraviolet Light </li></ul><ul><ul><li> risk of skin cancers </li></ul></ul><ul><li>Ionizing Radiation (Lifestyle Factor?) </li></ul><ul><ul><li>X-rays, nuclear weapons or accidents </li></ul></ul><ul><ul><ul><li>evidence from Japan & Chernobyl </li></ul></ul></ul><ul><ul><ul><ul><li> risk of breast cancer and leukemias </li></ul></ul></ul></ul><ul><ul><ul><li>Thyroid irradiation (for hyperthyroid) </li></ul></ul></ul><ul><ul><ul><ul><li> risk thyroid cancer </li></ul></ul></ul></ul>
  • 16. Viruses <ul><li>Epstein-Barr virus - Hodgkin’s lymphoma </li></ul><ul><li>Human Immuno-deficiency virus - NHL and Kaposi’s sarcoma </li></ul><ul><li>Human Papilloma virus - Cervical cancer </li></ul><ul><li>Hepatitis A, B - Hepatocellular cancer </li></ul><ul><li>HTLV-1 - T-cell leukemia </li></ul>
  • 17. Lifestyle Factors <ul><li>Tobacco - Cigarette Smoking </li></ul><ul><ul><li>lung, oropharygeal, and bladder cancers </li></ul></ul><ul><ul><li>“If cigarettes did not exist lung cancer would be an rarity” </li></ul></ul><ul><li>Radon </li></ul><ul><ul><li>lung cancer </li></ul></ul><ul><li>Electromagnetic fields </li></ul><ul><ul><li>cell phones and high tension power lines </li></ul></ul><ul><ul><li>causal relationship ? </li></ul></ul>
  • 18. Lifestyle Factors <ul><li>Alcohol </li></ul><ul><ul><li>associated with several cancers including esophogeal, liver, oropharynx, breast and larynx </li></ul></ul><ul><ul><li>usually associated with another carcinogen </li></ul></ul><ul><li>Diet </li></ul><ul><ul><li>implicated in colorectal cancer </li></ul></ul><ul><ul><li>Decrease Fat, Increase Fruits and Vegetables </li></ul></ul>
  • 19. Drugs and Hormones <ul><li>Alkylating Agents </li></ul><ul><ul><li>Cyclophosphamide - bladder </li></ul></ul><ul><ul><li>melphalan - leukemia </li></ul></ul><ul><li>Antimetabolites </li></ul><ul><ul><li>Azathioprine - NHL, skin </li></ul></ul><ul><li>Corticosteroids </li></ul><ul><ul><li>Prednisone - NHL </li></ul></ul>
  • 20. Drugs and Hormones <ul><li>Estrogens </li></ul><ul><ul><li>Diethylstilbestrol - vaginal Ca in offspring </li></ul></ul><ul><li>Combined Modalities </li></ul><ul><ul><li>Chemo + Radiation - leukemia </li></ul></ul><ul><li>Others </li></ul><ul><ul><li>Phenacetin - renal </li></ul></ul><ul><ul><li>Phenytoin - liver (rats) </li></ul></ul><ul><ul><li>Chloramphenicol - leukemia </li></ul></ul>
  • 21. Hereditary/Genetic <ul><li>Cancer as Primary Manifestation </li></ul><ul><ul><li>Retinoblastoma, neuroblastoma, pheochromocytoma </li></ul></ul><ul><li>Inherited Condition </li></ul><ul><ul><li>Familial polyposis, Fanconi’s anemia, xeroderma pigmentosum </li></ul></ul><ul><li>Inherited Disease of Immune System </li></ul><ul><ul><li>Wiskott-Aldrich Syndrome </li></ul></ul><ul><li>Chromosomal Aberrations </li></ul><ul><ul><li>Down’s Syndrome, Fanconi’s anemia </li></ul></ul>
  • 22. Hereditary/Genetic <ul><li>Breast cancer </li></ul><ul><ul><li>If first degree relative has(d) breast cancer greatly increases the risk </li></ul></ul><ul><ul><li>BRCA1 mutation </li></ul></ul><ul><li>Retinoblastoma </li></ul><ul><ul><li>Rb </li></ul></ul>
  • 23. Genetic Regulation <ul><li>Oncogenes/Proto-Oncogenes </li></ul><ul><ul><li>normal exons which when mutated promote oncogenesis </li></ul></ul><ul><ul><ul><li>wt = proto-oncogene (no tumor promoting effect) </li></ul></ul></ul><ul><ul><ul><li>mutant = oncogene </li></ul></ul></ul><ul><li>Tumor Suppressor Genes </li></ul><ul><ul><li>Genes which regulate cell proliferation and prevent cell from dividing ‘out of control’ </li></ul></ul><ul><ul><ul><li>wt = ‘prevent’ cell from becoming a tumor </li></ul></ul></ul><ul><ul><ul><li>mutant = unable to prevent tumor-genesis </li></ul></ul></ul>
  • 24. Proto-Oncogenes and Malignant Transformation <ul><li>N-myc {transcription factor} </li></ul><ul><ul><li>Neuroblastoma </li></ul></ul><ul><li>Erb-B(her2neu) {cell surface receptor} </li></ul><ul><ul><li>Breast cancer </li></ul></ul><ul><li>RAS {intracellular messenger} </li></ul><ul><ul><li>Acute Myeloid Leukemia </li></ul></ul><ul><li>BCL {transcription factor/apoptosis} </li></ul><ul><ul><li>Chronic Myeloid Leukemia </li></ul></ul>
  • 25. Tumor Supressor Genes <ul><li>Rb (cell cycle) </li></ul><ul><ul><li>retinoblastoma, osteosarcoma </li></ul></ul><ul><li>p53 (growth arrest/apoptosis) </li></ul><ul><ul><li>sarcomas, breast, and brain tumors </li></ul></ul><ul><li>BRCA1 and BRCA2 (DNA repair) </li></ul><ul><ul><li>breast and ovarian tumors </li></ul></ul><ul><li>E-Cadherin (cell adhesion regulator) </li></ul><ul><ul><li>breast, colon, skin, and lung </li></ul></ul>
  • 26. Cell Cycle Entry to Death: Regulation Growth Factor Receptor Activation Intracellular Kinase Cascade Early Nuclear Proteins (myc, fos, jun etc.) Cell Cycle Activators (cyclins) Regulators (Rb) Genome Checkers (p53) Apoptosis: Cell Cycle Balancers (bcl-2 family)
  • 27. Malignant Transformation <ul><li>Genetic alterations transform normal cells into malignant cells </li></ul><ul><li>Two (multiple) hit hypothesis </li></ul><ul><ul><li>predisposition + external factor </li></ul></ul><ul><ul><li>multiple external factors </li></ul></ul>
  • 28. Questions?

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