Biology, etiology, epidemiology and diagnosis of cancer. Various phases of clinical trials, prevention and early detection of cancer, and treatment options of cancer

1. INTRODUCTION TO ONCOLOGY
DR ALLWIN GEORGE

2. SUMMARY
• BIOLOGY OF CANCER
• ETIOLOGY OF CANCER
• EPIDEMIOLOGY OF CANCER
• DIAGNOSIS OF CANCER
• CLINICAL TRIALS
• PREVENTION AND EARLY DETECTION
• CANCER THERAPEAUTICS

3. BIOLOGY OF CANCER
• Losing control of genome because of mutation.
• Loss of function mutation of tumor suppressor
gene
• Gain in function mutation of proto-oncogenes

4. BIOLOGY OF
CANCER
• Uncontrolled
proliferation of cells
with the following
characteristics

5. ETIOLOGY
OF CANCER
Tobacco
• 72 measurable carcinogens in cigarette smoke
• N-nitrosamines, benzene, 1,3-butadiene, aromatic amines, and
cadmium often rank highly
• carcinogen–DNA adducts, which then cause mutations
Oncogenic viruses
• HPV, Hep B, Hep C, EBV, Kaposi sarcoma virus, Merkel cell polyoma
virus, HTLV, BK Virus
Inflammation
• Eg: Chronic infection ( S. hematobium- Ca U. Bladder)
Chemical factors
• Aldehyde, Alfatoxin, Asbestos, Benzene
Physical factors
• Ionizing radiation
Dietary factors
• Red meat and colon cancer
Obesity and physical inactivity

6. EPIDEMIOLOGY OF CANCER – GLOBOCAN 2020

7. DIAGNOSIS
OF CANCER
• CA125, CEA, AFP, PSA
Biomarkers
Biopsy – HPE
Assay of large scale gene and chromosome
- FISH
• NGS ( massive parallel sequencing)
Treatment target and molecular analysis
• IHC – ER/ PR/ HER2
• ALK, ROS
• MMR, PD1, PDL1
Clinical testing of predictive biomarkers

8. Cancer imaging
Anatomical imaging
•X RAY
•USG
•CT
•MRI
Functional Imaging
•PET

9. CLINICAL TRIALS
• Phase 1
• Phase 2
• Phase 3
• Phase 4

10. PREVENTION
AND EARLY
DETECTION
Screening
• Breast, Cervix
Life style modification
• Smoking cessation
Prophylactic surgeries
Vaccines
• HPV, Hep B
Chemoprevention
• Metformin
• Aspirin

11. VARIOUS
TREATMENT
MODALITIES
OF CANCER
SURGERY
RADIATION
CHEMOTHERAPY
IMMUNOTHERAPY
HORMONAL THERAPY