This document discusses hormones and their relationship to cancer development. It defines cancer and different types of tumors, and notes that over half of cancers in the US could be prevented through lifestyle changes. Tables show the most common cancers among men and women. The document discusses how hormones like estrogen can promote the growth of hormone-sensitive tumors through various mechanisms, including stimulating cell proliferation and producing genotoxic metabolites. It also discusses how hormones like insulin may increase cancer risk by influencing cell signaling pathways and metabolism.

1. MJ Rasaee
TMU 2022
Hormones &
Cancer

2. Definition of cancer : A Progressive,
purposeless, pathologic proliferation of cells
characterized by loss of control over cell
division.
Tumor: a mass of tissue that serves no purpose
and grows more rapidly than surrounding
tissue.
Malignant tumor: cancerous tumor; can invade
surrounding tissues. Some cancers don’t
produce a tissue mass, such as leukemia
(cancer of the blood), but are considered
cancer because they are characterized by rapid,
uncontrolled growth of abnormal cells.
Benign tumor: noncancerous tumor; mass of
cells usually enclosed in a membrane that
prevents their penetration of other tissues.
Cancer causes more than 550,000 deaths in the
U.S. annually. While scientists struggle finding
cures for various cancers, evidence indicates
that more than half the cancers in the U.S.
could be prevented by changes in lifestyle
behaviors.
Men
20500
12000
10600
3700
3400
2800
2300
2300
2100
1800
0 5000 10000 15000 20000 25000
Prostate
Lung
Colorectal
Bladder
NHL
Kidney
Melanoma
Leukemia
Oral
Stomach
Women
21600
10200
9000
3900
3000
2400
2400
2000
1750
1700
0 5000 10000 15000 20000 25000
Breast
Lung
Colorectal
Uterus
NHL
Thyroid
Ovary
Melanoma
Pancreas
Leukemia
New cases in Canada

3. Loss of Normal Growth Control
Cancer cell division
Fourth or
later mutation
Third
mutation
Second
mutation
First
mutation
Uncontrolled growth
Cell Suicide or Apoptosis
Cell damage—no repair
Normal cell division
Metastasis:Definition:
the spreading of cancer
cells, occurs because
cancer cells do not stick
to each other as strongly
as normal cells. Cells
break away from
primary tumor and
invade surrounding
tissues or travel through
the blood and lymphatic
system. Secondary
tumor or metastases
Secondary Messenger
or Secondary Signal
Cellular
Trafficking
Enzymes
Activated Inhibited
Nucleus DNA Synthesis
RNA Synthesis
Protein
Synthesis
Membrane
Effects
Receptor
Effector
Plasma
Membrane
Hormone

5. Types:
Benign
• slow growing
• capsulated
• non-invasive
• do not metastasize
• well differentiated
Malignant
• fast growing
• non capsulated
• invasive
• metastasize
• poorly differentiated

6. Meningioma Hepatic Adenoma
Male Female
most common (by
occurrence)
most common (by
mortality)
most common (by
occurrence)
most common (by
mortality)
prostate cancer (33%) lung cancer (31%) breast cancer (32%) lung cancer (27%)
lung cancer (13%) prostate cancer (10%) lung cancer (12%) breast cancer (15%)
colorectal cancer (10%) colorectal cancer (10%) colorectal cancer (11%) colorectal cancer (10%)
bladder cancer (7%) pancreatic cancer (5%) endometrial cancer (6%) ovarian cancer (6%)
Cutaneous melanoma (5%) leukemia (4%) non-Hodgkin lymphoma (4%) pancreatic cancer (6%)

7. ‫سينه‬ ‫سرطان‬ ‫فاكتورهاي‬ ‫ريسك‬
Breast cancer cells may contain receptors, or binding sites, for the
hormones estrogen and progesterone. Cells containing these binding sites
are known as hormone receptor-positive cells.
About 75% of breast cancers are estrogen receptor-positive (ER-positive, or
ER+).
Hormone receptor-positive cancer is also called "hormone sensitive"
because it responds to hormone therapy such as tamoxifen or aromatase
inhibitors.
Women have a better prognosis if their tumors are hormone receptor-
positive because these cells grow more slowly than receptor-negative cells.
In addition, women with hormone receptor-positive cancer have more
treatment options. (Hormone receptor-negative tumors can be treated
only with chemotherapy.) Recent declines in breast cancer mortality rates
have been most significant among women with estrogen receptor-positive
tumors, due in part to the widespread use of post-surgical hormone drug
therapy.
Two hypotheses have been proposed to explain why this causes
tumorigenesis ,and the available evidence suggests that both mechanisms
contribute:
Firstly, binding of estrogen to the ER stimulates proliferation of mammary
cells ,with the resulting increase in cell division and DNA replication leading
to mutations .
Secondly, estrogen metabolism produces genotoxic waste .
The result of both processes is disruption of cell cycle ,apoptosis and DNA
repair and therefore tumour formation.
ERα is certainly associated with more differentiated tumours, while
evidence that ERβ is involved is controversial.

8. 1. High fat diet
2. Induced abortions
3. Breast implants
4. Environmental chemical exposure (e.g. pesticides)
5. Tobacco smoke
6. Night shift work
7. Human mammary tumor virus ?
1.Oral contraceptives - remains controversial
2.Hormone replacement therapy - >5 years of
therapy with combined estrogen and
progesterone may increase risk
3.Not breast feeding
4. Obesity, lack of physical activity
5. Alcohol - 2-5 drinks/day can increase risk x
1.5 over non-drinkers.
Factors with uncertain, controversial or unproven effects on risk of developing breast cancer

9. Cancer Etiology
1. Genetic Predisposition &
Oncogens
2. Chemical Carcinogenesis
3.Hormone:Some are
effective in the
development of cancer by
promoting cell
proliferation. Hormones
are important agents in
sex-related cancers such
as cancer of the breast,
endometrium, prostate,
ovary, and testis, and also
of thyroid cancer and
bone cancer
4. Physical Carcinogenesis
5. Viral carcinogeneis
6.Traum, Inflammation
7. Parasites
1. Estrogens Promotes the G1 to S and G0 to Mitosis phase
2. Progestron and Estrogen are synergistic in DNA replication
3. Testostrone reduced the cell cycle time and DNA synthesis
4. Glucocorticoids Delayed G1, inhibit S phase and DNA synthesis
5. Prolactin increased the DNA synthesis conform with insulin
6. Insulin effect on bottom of G1 phase also.
7. Glucagon increased the DNA synthesis in S phase
8. Thyroids hormones decreased all phases except S and are
Mitogenic
Effects of Hormones on Cell Cycle
-The role of hormones as a marker in Cancers:
Β-HCG in Testis cancer, ovarian cancer and as a tumor marker is in gestational trophoblastic disease and
germ cell tumors.
Calcitonin in Medullary Thyroid Cancer.
Glucagon and insulin in pancreatic tumors.
POMC & ACTH in some of carcinomas
Catecholamines by pheochromocytoma
Prolactin in Pituitary Adenoma
PTHRP in several tumors which resulted malignant hypocalcaemia
Ectopic production of PTH in Pituitary adenoma and Pancreas, Pheochromocytoma and Medullary
Thyroid ,17-alfa-hydroxy-progesterone; deoxycorticosterone, DHEAS and Cortisol in Adernocortical
Carcinoma. ACTH and ADH by lung cancers
insulin production by islet cell tumor, calcitonin by medullary thyroid carcinoma, and catecholamines by
pheochromocytoma

10. 1) its role in stimulating breast cell division
2) its activity during the critical periods of breast growth
and development
3) its effect on other hormones that stimulate breast cell
division
4) its support of the growth of estrogen-responsive
tumors
About 1/3 to 2/3 of all breast tumours have estrogen
receptors and depend on estrogen for growth
1.DNA error causes uncontrolled proliferation of breast
cells upon binding of estrogen to its receptor
2.Estrogen turns into reactive metabolite (estradiol 4-
OH) and binds to DNA, causing depurination mutation
Estrogen role in breast cancer Role of ER and estrogen metabolites in breast cancer

11.  Mass or pain
in the axilla
 Palpable mass
 Thickening
 Pain
 Nipple discharge
 Nipple retraction
 Edema or erythema
of the skin
BREAST CANCER Signs and symptoms at presentation
Self and Physical Examination
Manual breast examination
Mammograms
X-ray photograph of breast
Biopsy
If breast cancer suspected
Sample tissue examines

12. Diabetes is cause of following cancers:
Pancreatic Cancer
Colorectal Cancer
Breast Cancer
Prostate Cancer
Liver Cancer
Endometrial Cancer
Bladder Cancer
Renal Cancer
Germline mutations in relevant tumor-suppressor genes
accelerate the transformation to the malignant phenotype

13. ‫بدن‬ ‫وزن‬ ‫افزايش‬

‫و‬ ‫انسولين‬ ‫افزايش‬
IGF-1

‫سنتز‬ ‫كاهش‬
SHBG
‫كبد‬ ‫توسط‬
‫بين‬
BMI
‫و‬
SHBG
‫دارد‬ ‫وجود‬ ‫زنان‬ ‫در‬ ‫معكوس‬ ‫رابطه‬ ‫انسولين‬ ‫و‬
.
‫توليد‬ ‫يائسگي‬ ‫از‬ ‫بعد‬
E2
‫مي‬ ‫متوقف‬ ‫تخمدان‬ ‫در‬
‫تبديل‬ ‫و‬ ‫شود‬
Δ4-A
‫به‬
E1
‫و‬
E1
‫به‬
E2
‫توليد‬ ‫اصلي‬ ‫مسير‬
E2
‫است‬ ‫چربي‬ ‫بافت‬ ‫در‬ ‫بدن‬ ‫در‬
.
‫اندومتريوم‬ ‫سرطان‬ ‫و‬ ‫انسولين‬ ‫به‬ ‫مقاومت‬ ‫و‬ ‫متابوليك‬ ‫تغييرات‬
:
‫ا‬
‫فزايش‬
‫خون‬ ‫چرب‬ ‫اسيدهاي‬
‫اسيدهاي‬ ‫برداشت‬ ‫افزايش‬، ‫سازي‬ ‫كتون‬ ‫افزايش‬
‫ب‬ ‫اين‬ ‫توسط‬ ‫گلوكز‬ ‫به‬ ‫نياز‬ ‫كاهش‬ ‫عدم‬، ‫عضالت‬ ‫و‬ ‫كبد‬ ‫توسط‬ ‫چرب‬
‫افت‬
‫ها‬
‫نتيجه‬ ‫در‬ ،‫شود‬ ‫مي‬ ‫انسولين‬ ‫ترشح‬ ‫افزايش‬ ‫باعث‬ ‫تغييرات‬ ‫اين‬
:
‫سنتز‬ ‫كاهش‬
IGFBP-1
‫ترشح‬ ‫افزايش‬، ‫كبد‬ ‫در‬
IGF-1
‫كبد‬ ‫در‬
‫ابتال‬ ‫خطر‬ ‫انسولين‬ ‫به‬ ‫غيروابسته‬ ‫هاي‬ ‫ديابتي‬ ‫در‬
‫از‬ ‫بعد‬ ‫و‬ ‫قبل‬ ‫ديابت‬ ‫به‬
‫رود‬ ‫مي‬ ‫باال‬ ‫يائسگي‬
.
‫اس‬ ‫اندومتريومي‬ ‫سرطان‬ ‫فاكتورهاي‬ ‫ريسك‬ ‫از‬ ‫يكي‬ ‫هايپرانسولينما‬
‫ت‬
.
‫با‬ ‫مشابه‬ ‫انسولين‬
IGF-1
‫دارد‬ ‫رشدي‬ ‫فاكتور‬ ‫نقش‬
.
‫پپتيد‬ ‫سطح‬
C
‫باال‬
4
‫برد‬ ‫مي‬ ‫باال‬ ‫را‬ ‫سرطان‬ ‫اين‬ ‫به‬ ‫ابتال‬ ‫خطر‬ ‫برابر‬
.
‫و‬ ‫انسولين‬ ‫بين‬
IGFBP-1
‫دارد‬ ‫وجود‬ ‫معكوس‬ ‫رابطه‬
.
‫فعاليت‬ ‫انسولين‬
IGF-1
‫برد‬ ‫مي‬ ‫باال‬ ‫اندومتريوم‬ ‫در‬ ‫را‬
.
‫هاست‬ ‫آندروژن‬ ‫سنتز‬ ‫هاي‬ ‫كننده‬ ‫تنظيم‬ ‫مهمترين‬ ‫از‬ ‫يكي‬ ‫انسولين‬
.
‫اندومتريوم‬ ‫سرطان‬ ‫با‬ ‫بدن‬ ‫وزن‬ ‫ارتباط‬

14. Growth Hormone is anti-apoptic and mitogenic agent in the body
Osteosarcoma , Leukemia & Colorectal Cancer may be promoted by growth
hormones in children treated with this hormones
 In Acromegaly patients, Hyperansulinemia has occurred, and insulin is
mitogenis. In these patients the risk of Breast Cancer development is increased
hyperthyroidism increases risk of certain solid tumors and that spontaneous
 hypothyroidism may delay onset or reduce aggressiveness of cancers.
•
GH/IGF-I
‫شوند‬ ‫مي‬ ‫بدخيمي‬ ‫بروز‬ ‫موجب‬ ‫آپوپتوتيك‬ ‫آنتي‬ ‫محيط‬ ‫ايجاد‬ ‫با‬
.
•
IGF-I
‫درماني‬ ‫شيمي‬ ‫عوامل‬ ‫به‬ ‫مقاومت‬ ‫و‬ ‫آنژيوژنز‬ ،‫متاساتاز‬ ،‫سلول‬ ‫تكثير‬ ‫در‬ ‫دخيل‬
•
IGF-I
‫مسير‬ ‫تحريك‬ ‫با‬
MAPK
‫شود‬ ‫مي‬ ‫سلولي‬ ‫تكثير‬ ‫تحريك‬ ‫موجب‬
.
•
IGF-I
‫مسير‬ ‫طريق‬ ‫از‬
PI3
‫شود‬ ‫مي‬ ‫آپوپتوتيك‬ ‫آنتي‬ ‫اثرات‬ ‫موجب‬ ‫كيناز‬
.
•
‫كلي‬ ‫اثرات‬
IGF-I
:
‫بقاء‬ ‫نيروهاي‬ ‫نفع‬ ‫به‬ ‫باالنس‬ ‫تغيير‬ ‫و‬ ‫آن‬ ‫تكثير‬ ‫افزايش‬ ،‫سلولي‬ ‫مرگ‬ ‫كاهش‬
‫سلولي‬
•
‫خود‬ ‫واسطه‬ ‫طريق‬ ‫از‬ ‫رشد‬ ‫هورمون‬
IGF-1
‫نمايد‬ ‫كنترل‬ ‫را‬ ‫سلولي‬ ‫رشد‬ ‫است‬ ‫قادر‬
.
•
‫وضعيت‬
GH
‫و‬
IGF-I
‫باشد‬ ‫داشته‬ ‫نقش‬ ‫ها‬ ‫نئوپالستي‬ ‫بروز‬ ‫در‬ ‫تواند‬ ‫مي‬
.
•
‫كولوركتال‬ ‫سرطان‬ ‫به‬ ‫ابتالء‬ ‫براي‬ ‫بيشتري‬ ‫خطر‬ ‫داراي‬ ‫هستند‬ ‫مبتال‬ ‫آكرومگالي‬ ‫به‬ ‫كه‬ ‫افرادي‬
‫باشند‬ ‫مي‬
.
•
‫ترشح‬ ‫كمبود‬ ‫دليل‬ ‫به‬ ‫كه‬ ‫كودكاني‬ ‫در‬
GH
‫كولوركتال‬ ‫سرطان‬ ‫به‬ ‫ابتالء‬ ‫خطر‬ ‫اند‬ ‫شده‬ ‫تراپي‬ ‫هورمون‬
‫است‬ ‫يافته‬ ‫افزايش‬
.

15. ‫سرطاني‬ ‫هاي‬ ‫سلول‬ ‫انوع‬ ‫رشد‬ ‫تحريك‬ ‫در‬ ‫بمبزين‬ ‫نقش‬
‫پپتيد‬ ‫يك‬ ‫بمبزين‬
14
‫آمينه‬ ‫اسيد‬
‫اي‬
‫سبب‬ ‫که‬
.1
‫رهايي‬
‫مثل‬ ‫نوروترانسميترها‬ ‫از‬ ‫برخي‬
CCK
‫مهاري‬ ‫پپتيد‬ ،‫گاسترين‬ ،
‫پانكراسي‬ ‫گلوكاگن‬ ،‫اي‬ ‫روده‬ ‫گلوكاگن‬ ،‫پانكراسي‬
.2
‫پانكراس‬ ‫اگزوكرين‬ ‫ترشح‬ ‫تحريك‬
.3
‫گوارشي‬ ‫دستگاه‬ ‫صاف‬ ‫هاي‬ ‫ماهيچه‬ ‫انقباض‬
.4
‫پانكراسي‬ ‫هاي‬ ‫سلول‬ ‫رشد‬ ‫افزايش‬
‫هاي‬ ‫گيرنده‬ ‫طريق‬ ‫از‬ ‫را‬ ‫خود‬ ‫اثرات‬ ‫بمبزين‬
EGF
‫نمايد‬ ‫مي‬ ‫اعمال‬
.
‫است‬ ‫ميتوژني‬ ‫اثرات‬ ‫داراي‬ ‫بمبزين‬
.
‫يك‬ ‫سازي‬ ‫فعال‬ ‫با‬ ‫بمبزين‬
PTK
(
‫كيناز‬ ‫پروتئين‬ ‫تيروزين‬
)
‫تحر‬ ‫افزايش‬ ‫موجب‬
‫ك‬
‫سلولي‬
‫شود‬ ‫مي‬
.
‫پانكراس‬ ‫سرطان‬ ‫در‬ ‫بمبزين‬ ‫نقش‬

16. ‫پانكراس‬ ‫رشد‬ ‫در‬ ‫طبيعي‬ ‫تروفيك‬ ‫عامل‬ ‫يك‬
‫مدت‬ ‫طوالني‬ ‫و‬ ‫مزمن‬ ‫افزايش‬
CCK
‫پانكراس‬ ‫سرطان‬ ‫بروز‬ ‫ساز‬ ‫زمينه‬
‫ترشح‬ ‫مهار‬ ‫موجب‬ ‫تريپسين‬
CCK
‫شود‬ ‫مي‬
.
‫خام‬ ‫سوياي‬ ‫زياد‬ ‫مصرف‬ ‫صورت‬ ‫در‬
(
‫تريپسين‬ ‫كننده‬ ‫مهار‬ ‫حاوي‬
)
‫هايپرترو‬
‫في‬
‫شود‬ ‫مي‬ ‫مشاهده‬ ‫پانكراس‬
.
CCK
‫شود‬ ‫مي‬ ‫پانكراسي‬ ‫هاي‬ ‫سلول‬ ‫روي‬ ‫آزاسرين‬ ‫اثرات‬ ‫تقويت‬ ‫موجب‬
.
‫اثرات‬
CCK
‫رسپتور‬ ‫طريق‬ ‫از‬ ‫بافت‬ ‫رشد‬ ‫روي‬
CCK-A
‫گيرد‬ ‫مي‬ ‫صورت‬
.
‫سيگنالينگ‬CCK CCK
‫پانكراس‬ ‫سرطان‬ ‫و‬

17. ‫نقش‬
CCK
‫پانكراسي‬ ‫هاي‬ ‫سلول‬ ‫رشد‬ ‫تحريك‬ ‫در‬
‫سلول‬ ‫در‬ ‫رشد‬ ‫افزايش‬ ‫سبب‬ ‫گاسترين‬
PNCA-1
‫پانكراسي‬
‫شود‬ ‫مي‬ ‫انسان‬
.
‫گيرنده‬ ‫طريق‬ ‫از‬ ‫را‬ ‫خود‬ ‫اثرات‬ ‫اين‬ ‫گاسترين‬
CCK-B
‫اعمال‬
‫نمايد‬ ‫مي‬
.
‫پانكراس‬ ‫سرطان‬ ‫و‬ ‫گاسترين‬

18. Reduces the amount of hormone circulating in the body .Blocks the hormone receptors on cancer cell membrane .Drugs and/or
removal of organs that secrete hormones
• Aromatase inhibitors are an important class of drugs used for the treatment of breast cancer in postmenopausal women. Letrozole
and anastrozole are aromatase inhibitors
• Aminoglutethimide inhibits both aromatase and other enzymes critical for steroid hormone synthesis in the adrenal glands. It was
formerly used for breast cancer treatment, but has since been replaced by more selective aromatase inhibitors. It can also be used
for the treatment of hyperadrenocortical syndromes, such as Cushing's syndrome and hyperaldosteronism in adrenocortical
carcinoma
• Analogs of gonadotropin-releasing hormone (GnRH) like Leuprolide and goserelin are used primarily for the treatment of hormone-
responsive prostate cancer.
• Hormone Receptor Antagonists bind to the normal receptor for a given hormone and prevent its activation. Antiandrogens are a class of
drug which bind and inhibit the androgen receptor, blocking the growth- and survival-promoting effects of testosterone on certain
prostate cancers: Flutamide and bicalutamide .
• Progestagens: in advanced breast cancer, endometrial cancer, and prostate cancer.
• Androgens: Fluoxymesterone is occasionally used for the treatment of advanced breast cancer.
• The estrogen agonist: Diethylstilbestrol (DES) is occasionally used to treat prostate cancer through suppression of testosterone
production.
• Somatostatin analogs: Octreotide is an analog of the peptide hormone somatostatin, which inhibits the production of the growth
hormone as well as numerous peptide hormones of the gastrointestinal system, including insulin, glucagon, pancreatic polypeptide,
gastic inhibitory polypeptide, and gastrin. Octreotide is used for suppression of the hormonal syndromes which accompany several
pancreatic islet cell tumors, including the Zollinger-Ellison syndrome of gastrinoma and the chronic hypoglycemia of insulinoma.
Hormonal therapy is used for several types of cancers derived from hormonally
responsive tissues, including the breast, prostate, endometrium, and adrenal cortex.

19. Anti cancer property of Melatonin (MT) :Is secreted from pineal
gland which is polymer of Trp is produced after 90min after one falls
asleep and darkness and inhibited when light on.It inhibits the
release of Estrogen and suppresses the development of breast
cancer .Melatonin increase the cytotoxicity of natural killer cells
,suppressed prolactin , EGF and increase the anti-tumor activity of
vitamin D..
 Adrenocorticosteroid Are frequently used in combination
regimen for the treatment of lymphocytic leukemia and
lymphoma.
 They function by binding to glucocorticoid-specific receptors
present in lymphoid cells and initiate programmed cell
death
 They most commonly used agent are prednisone,
methylprednisone,dexamethosone
‫پروستات‬ ‫سرطان‬ ‫به‬ ‫ابتالئ‬ ‫ريسك‬
50
-
30
‫در‬ ‫بيشتر‬ ‫برابر‬
‫نمايند‬ ‫مي‬ ‫زندگي‬ ‫غرب‬ ‫در‬ ‫كه‬ ‫مردان‬
.
‫غربي‬ ‫مردان‬ ‫در‬ ‫سرطان‬ ‫اثر‬ ‫در‬ ‫مرگ‬ ‫عامل‬ ‫دومين‬
‫و‬ ‫ها‬ ‫آن‬ ‫سازهاي‬ ‫پيش‬ ،‫جنسي‬ ‫هورمون‬ ‫افزايش‬ ‫بر‬ ‫دال‬ ‫مدركي‬
‫ندارد‬ ‫وجود‬ ‫پروستات‬ ‫سرطان‬ ‫با‬ ‫ها‬ ‫آن‬ ‫حامل‬ ‫هاي‬ ‫پروتئين‬ ‫يا‬
.