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Disease mgmt


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Disease mgmt

  1. 1. G I TRACK: CANCER Sumit Mohite 11 Vishal Mangukiya 12 Jitendra Mourya 13 Prasad Bhandlikar 14 Sanjeev Kumar 15
  2. 2. Cancer: General Etiology and Pathogenesis
  3. 3. What is cancer?  Abnormal cell growth (neoplasia)  Malignant as opposed to benign  Benign: slow growth, non-invasive, no metastasis  Malignant: rapid growth, invasive, potential for metastasis
  4. 4. What causes the mutations that lead to cancer?  Viruses: HPV --> cervical cancer  Bacteria: H. pylori --> gastric cancer  Chemicals --> B[a]P --> lung cancer  UV and ionizing radiation --> skin cancer  What do these agents have in common?
  5. 5. Mutagens  Viruses: insertional mutagenesis  Chemicals: DNA adducts  UV and ionizing radiation: single and double strand DNA breaks
  6. 6. What types of genes get mutated in cancer?  Oncogenes are activated  Normal function: cell growth, gene transcription  Tumor suppressor genes are inactivated  Normal function: DNA repair, cell cycle control, cell death
  7. 7. Phenotype of a cancer cell  The Six Hallmarks of Cancer  Self-sufficient growth signals  Constitutively activated growth factor signalling  Resistance to anti-growth signals  Inactivated cell cycle checkpoint  Immortality  Inactivated cell death pathway
  8. 8. Phenotype of a cancer cell (cont'd)  The Six Hallmarks of Cancer  Resistance to cell death  Activated anti- cell death signalling  Sustained angiogenesis  Activated VEGF signalling  Invasion and metastasis  Loss of cell-to-cell interactions, etc.
  9. 9. p53—a classic tumor suppressor  “The guardian of the genome”  Senses genomic damage  Halts the cell cycle and initiates DNA repair  If the DNA is irreparable, p53 will initiate the cell death process
  10. 10. Esophageal cancer :- Esophageal cancer usually develops in the inner layer cells and grows outward.
  11. 11.  Treatment :-  Endoscopic treatments such as photodynamic therapy  Radiofrequency ablation Sign & Symptoms :- chronic irritation and inflammation resulting from a backwash of acidic stomach. Painful or difficult swallowing. Weight loss. Pain behind the breastbone. Hoarseness and cough. Indigestion and heartburn.
  12. 12. Stomach Cancer
  13. 13. What is Stomach Cancer?  Stomach Cancer (Gastric cancer)-malignant tumor arising from the lining of the stomach.  Stomach cancers are classified according to the type of tissue where they originate.  Most common type of stomach cancer- Adenocarcinoma(Starts in the glandular tissue of the stomach)  Accounts-90% to 95% of all stomach cancers.  Other forms of stomach cancer-lymphomas, which involve the lymphatic system, and sarcomas, which involve the connective tissue (such as muscle, fat, or blood vessels).
  14. 14. Who Does it Effect?  Males over the age of 55.  A diet low in fruits and vegetables.  A diet high in salted, smoked, or preserved foods.  Chronic gastritis.  Pernicious anemia.  Family history of gastric cancer.  Smokers  People who use tobacco or drink alcoholic beverages regularly.  Workers in certain industries-the coal mining, nickel refining, and rubber and timber processing industries.
  15. 15. Causes  Gender - men have more than double the risk of getting stomach cancer than women.  Genetics - genetic abnormalities and some inherited cancer syndromes may increase your risk.  Advanced age -stomach cancer occurs more often around ages 70 and 74 in men and women, respectively.  Family history of gastric cancer can double or triple the risk of stomach cancer.  Lifestyle factors such as smoking, drinking alcohol, and eating a diet low in fruits and vegetables or high in salted, smoked, or nitrate-preserved foods may increase your risk  Helicobacter pylori (H. pylori) infection of the stomach. H. pylori is a bacterium that infects the lining of the stomach and causes chronic inflammation and ulcers.
  16. 16. Signs and Symptoms  In the early stages of stomach cancer,  Indigestion and stomach discomfort  A bloated feeling after eating  Mild nausea  Loss of appetite  Heartburn
  17. 17. Cont…  In more advanced cancer,  Discomfort in the upper or middle part of the abdomen.  Blood in the stool (which appears as black, tarry stools).  Vomiting or vomiting blood.  Weight loss.  Pain or bloating in the stomach after eating.  Weakness or fatigue associated with mild anemia (a deficiency in red blood cells).
  18. 18. Stomach Cancer Diagnosis  By physical examination-enlarged lymph nodes, an enlarged liver, increased fluid in the abdomen (ascites), or abdominal lumps felt during a rectal exam.  Test such as  Upper GI series  Gastroscopy and biopsy  CT scans, PET scans, bone scans, laparoscopy and endoscopic ultrasound.( to check if cancer is spread)
  19. 19. How Is Stomach Cancer Treated? Stomach cancer may be treated with the following, in combination, or alone:  Surgery, called gastrectomy, to remove all or part of the stomach, as well as some of the tissue surrounding the stomach.  Chemotherapy.  Radiation therapy.
  20. 20. Prognosis/ Survival Rate Prognosis depends on the stage of the disease. Stomach cancer metastasizes in as many as 80% of cases, resulting in a very poor prognosis. In Japan, where stomach cancer often is diagnosed early, the 5-year survival rate is about 50%. In the United States and most of the Western world, the 5-year survival rate ranges from 5–15%.
  21. 21. Management Follow-up care is necessary for stomach cancer patients.  Regular physical examination and tests (e.g., CT scan, MRI scan) are used to detect recurrent or advanced disease.  In addition, patient’s dietary intake must be monitored regularly to promote health.
  22. 22. Liver cancer :- •Starts somewhere else and spreads to the liver. •Reason viral hepatitis 4 main types :- 1) Angiosarcoma, A rare type of cancer that starts in the blood vessels of the liver. 2) Hepatoblastoma, Another rare type of liver cancer occurring chiefly in young children. 3) Cholangiocarcinoma, Which starts in the bile ducts 4) Hepatocellular carcinoma, Also known as Hepatoma. The most common liver cancer is hepatocellular carcinoma which accounts for approximately 84% of liver cancers. As is the case with stomach cancer, liver cancer is hard to diagnose.
  23. 23. Treatment :- •Chemotherapy •Radiofrequency Ablation •Gene Therapy •Magnetic-Chemotherapy
  24. 24. Colorectal cancers :- • Colorectal cancers are common, and occur more frequently in people over the age of 50. • Colorectal cancers are highly treatable when detected early, but the symptoms are often not obvious in early stages.
  25. 25. Sign & Symptoms :- •Blood (either bright red or very dark) in the stool. •Diarrhea & constipation. •Stools that are narrower than usual. •Frequent gas pains, bloating, fullness, or cramps. •Weight loss for no known reason. •Feeling very tired. •Vomiting.
  26. 26. Treatment :- •Surgery (most often a colectomy) to remove cancer cells •Chemotherapy to kill cancer cells Chemotherapy drugs are :- capecitabine, fluorouracil, irinotecan, leucovorin, oxaliplatin •Radiation therapy to destroy cancerous tissue
  27. 27. Management of Cancer Keep to a normal weight Avoid alcohol Take regular exercise Avoid smoking Add Garlic to everything you Eat Eat plenty of Fruits and Vegetables Limit Fats and oily food Avoid unnecessary Scans