This document provides an overview of an oncology course for medical students. It discusses that cancer is curable in almost 2/3 of patients but is a catastrophic event for the patient and their family. It changes a person's self-image and how they are viewed by others. The document also covers cancer statistics worldwide, common causes, screening and diagnosis, staging, treatment intent and aggressiveness based on stage and performance status, and supportive care including management of symptoms like pain, depression, and nausea.
This document discusses cancer epidemiology and statistics globally, nationally, and locally. It provides data on the most common types of cancer worldwide, in the United States, and in Colombia in terms of incidence and mortality. It also discusses trends in cancer rates and risk factors for cancer such as obesity, tobacco use, diet, physical activity, and more. Graphics show cancer statistics for specific countries and populations.
Controversias actuales en el manejo de cáncer colorrectal metastàsicoMauricio Lema
This document summarizes recent controversies in the management of metastatic colorectal cancer through an interactive session with fellows. It reviews the current standards of care for first-line systemic therapy including FOLFOX, FOLFIRI, and FOLFOXIRI combinations with or without biologics like bevacizumab. It also discusses predictive biomarkers for anti-EGFR monoclonal antibodies like RAS and BRAF mutations which determine response to these agents. Clinical trials are summarized that establish various chemotherapy regimens and combinations with biologics as effective first-line options for metastatic colorectal cancer.
Integración de cetuximab en cáncer de cabeza y cuelloMauricio Lema
This document discusses several topics related to integrating cetuximab in the treatment of head and neck cancer:
1) It discusses the use of cetuximab combined with radiation therapy based on evidence from clinical trials showing improved outcomes compared to radiation therapy alone.
2) It examines induction chemotherapy in the cetuximab era, noting several clinical trials that have combined induction chemotherapy with cetuximab and radiation therapy.
3) It considers when cisplatin should be avoided for locally advanced head and neck cancer, noting clinical recommendations for defining patient populations unsuitable for platinum-based chemotherapy including factors like renal dysfunction, hearing loss, and cardiovascular disease.
85% of gastric cancers are adenocarcinomas which can be diffuse or intestinal type. Diffuse cancers have worse prognosis and lack cell cohesion. Risk factors include dried foods, nitrates, H. pylori infection, and pernicious anemia. Symptoms include abdominal pain, weight loss, and anemia. Treatment involves surgery with D1 or D2 lymph node dissection and chemotherapy or chemoradiation for advanced or high risk cancers.
The document discusses cancer staging using the TNM system, which evaluates the size and spread of the primary tumor (T), whether the cancer has reached nearby lymph nodes (N), and whether the cancer has metastasized to other parts of the body (M). It then provides details on specific TNM classifications for various cancers like colon, breast, and lung cancer. It also discusses common diagnostic tests and biomarkers used to evaluate different cancer types.
CES202101 - Clase 6 - Tamización contra el cáncer (parte 1/2)Mauricio Lema
The document discusses cancer screening and its goals, challenges, and effectiveness. It provides recommendations for cancer screening in Colombia based on age and cancer type. While screening aims to find cancers early and lower cancer mortality, its effectiveness varies by cancer. For example, mammography increases early breast cancer detection but has not reduced breast cancer mortality. Prostate cancer screening detects more early cancers but has not reduced mortality. Overall screening's benefits depend on the cancer, and it can lead to overdiagnosis and unnecessary treatment.
Tratamiento inicial de cáncer de mama HR+/Her2- metastásico en postmenopáusicasMauricio Lema
Versión inicial (con errores): Presentado en junta de la Clínica VIDA, 11.11.2016. Invitado por Jairo Estrada. La versión corregida está en: http://www.slideshare.net/MauricioLema/tratamiento-inicial-de-pacientes-posmenopusicas-con-cncer-de-mama-hrher2-metastsico-una-visin-panormica
This document discusses cancer epidemiology and statistics globally, nationally, and locally. It provides data on the most common types of cancer worldwide, in the United States, and in Colombia in terms of incidence and mortality. It also discusses trends in cancer rates and risk factors for cancer such as obesity, tobacco use, diet, physical activity, and more. Graphics show cancer statistics for specific countries and populations.
Controversias actuales en el manejo de cáncer colorrectal metastàsicoMauricio Lema
This document summarizes recent controversies in the management of metastatic colorectal cancer through an interactive session with fellows. It reviews the current standards of care for first-line systemic therapy including FOLFOX, FOLFIRI, and FOLFOXIRI combinations with or without biologics like bevacizumab. It also discusses predictive biomarkers for anti-EGFR monoclonal antibodies like RAS and BRAF mutations which determine response to these agents. Clinical trials are summarized that establish various chemotherapy regimens and combinations with biologics as effective first-line options for metastatic colorectal cancer.
Integración de cetuximab en cáncer de cabeza y cuelloMauricio Lema
This document discusses several topics related to integrating cetuximab in the treatment of head and neck cancer:
1) It discusses the use of cetuximab combined with radiation therapy based on evidence from clinical trials showing improved outcomes compared to radiation therapy alone.
2) It examines induction chemotherapy in the cetuximab era, noting several clinical trials that have combined induction chemotherapy with cetuximab and radiation therapy.
3) It considers when cisplatin should be avoided for locally advanced head and neck cancer, noting clinical recommendations for defining patient populations unsuitable for platinum-based chemotherapy including factors like renal dysfunction, hearing loss, and cardiovascular disease.
85% of gastric cancers are adenocarcinomas which can be diffuse or intestinal type. Diffuse cancers have worse prognosis and lack cell cohesion. Risk factors include dried foods, nitrates, H. pylori infection, and pernicious anemia. Symptoms include abdominal pain, weight loss, and anemia. Treatment involves surgery with D1 or D2 lymph node dissection and chemotherapy or chemoradiation for advanced or high risk cancers.
The document discusses cancer staging using the TNM system, which evaluates the size and spread of the primary tumor (T), whether the cancer has reached nearby lymph nodes (N), and whether the cancer has metastasized to other parts of the body (M). It then provides details on specific TNM classifications for various cancers like colon, breast, and lung cancer. It also discusses common diagnostic tests and biomarkers used to evaluate different cancer types.
CES202101 - Clase 6 - Tamización contra el cáncer (parte 1/2)Mauricio Lema
The document discusses cancer screening and its goals, challenges, and effectiveness. It provides recommendations for cancer screening in Colombia based on age and cancer type. While screening aims to find cancers early and lower cancer mortality, its effectiveness varies by cancer. For example, mammography increases early breast cancer detection but has not reduced breast cancer mortality. Prostate cancer screening detects more early cancers but has not reduced mortality. Overall screening's benefits depend on the cancer, and it can lead to overdiagnosis and unnecessary treatment.
Tratamiento inicial de cáncer de mama HR+/Her2- metastásico en postmenopáusicasMauricio Lema
Versión inicial (con errores): Presentado en junta de la Clínica VIDA, 11.11.2016. Invitado por Jairo Estrada. La versión corregida está en: http://www.slideshare.net/MauricioLema/tratamiento-inicial-de-pacientes-posmenopusicas-con-cncer-de-mama-hrher2-metastsico-una-visin-panormica
Dr. Dustin Deming led us through a discussion on the latest research and treatments for colorectal cancer patients presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.
A few of the topics covered include research on immunotherapy and trials studying:
– MSI-H (review of the Anti-PD-1 trial)
– HER2 amplification
– BRAF mutations
For more updates on colorectal cancer research, visit our blog: http://fightcolorectalcancer.org/category/research-treatment/
This document discusses a case of a 55-year-old non-smoking woman presenting with left hip and shoulder pain for 9 months. Imaging showed metastatic lesions and biopsy revealed adenocarcinoma positive for TTF1 and Napsin A. Genotyping found an EGFR L858R mutation but no ALK mutation. She began treatment with afatinib and experienced disease control for 8 months before progressing. Osimertinib was then initiated but also resulted in progression after 9 months, at which time crizotinib was added for a MET amplification, maintaining disease control for over 20 months. The document also reviews data on outcomes from trials of first-line afatinib versus chemotherapy in EGFR
The document discusses staging of lung cancer, including the TNM system for describing the size and extent of the primary tumor (T stage), involvement of lymph nodes (N stage), and presence of distant metastasis (M stage). It provides details on lymph node stations evaluated in lung cancer and proposals to further subclassify N1 and N2 stages based on number and location of involved lymph nodes. Accurate staging is important for prognosis and determining appropriate treatment options for patients with lung cancer.
CES202002 - 09 - Cáncer de esófago y estómagoMauricio Lema
This document provides an overview of esophageal and gastric cancer management. It discusses the epidemiology, risk factors, workup, staging, and treatment approaches for squamous cell carcinoma of the esophagus and adenocarcinoma of the esophagus and stomach. Treatment options include endoscopic resection for very early stages, surgery with or without chemotherapy/radiotherapy for early-mid stages, and definitive chemotherapy/radiotherapy or palliative chemotherapy for advanced stages. The document aims to provide a general understanding of the usual management of patients with these cancers.
1. Colon cancer is the second and third most common cancer in males and females respectively and accounts for 9% of cancer deaths.
2. Screening and lifestyle changes have led to improved outcomes, with a 55% reduction in late-stage colon cancer cases over 3 decades from screening.
3. Adjuvant chemotherapy regimens including FOLFOX, CAPOX and XELOX have improved disease-free and overall survival rates compared to 5-FU/LV alone, particularly for stage III disease.
4. Ongoing research focuses on shortening treatment duration, identifying high-risk patients who may benefit from more intensive regimens, and incorporating molecular markers to optimize adjuvant therapy
The document discusses hypercalcemia associated with malignancy and neoplastic spinal cord compression. It provides information on:
1) Types of cancer that commonly cause hypercalcemia, including symptoms of hypercalcemia.
2) Mechanisms, epidemiology, locations, and causes of neoplastic spinal cord compression.
3) Clinical presentation of neoplastic spinal cord compression including back pain, weakness, sensory deficits, and autonomic dysfunction.
CES2021 - Clase 13 - Cáncer de pulmón (2/2)Mauricio Lema
The document discusses lung cancer treatment and biomarkers. It begins by covering small sample handling and immunohistochemistry markers like p63 and TTF1 that can help classify lung cancer subtypes. It then discusses genomic testing for drivers like EGFR, ALK, ROS1, and BRAF and associated targeted therapies. The TNM staging system and its impact on treatment options like surgery, chemotherapy, and immunotherapy are reviewed. About 35% of advanced non-small cell lung cancer patients have a targetable driver mutation that can be treated with approved targeted therapies to achieve longer survival compared to conventional chemotherapy.
CES2019-02: Cáncer de mama - visión del oncólogoMauricio Lema
This document discusses breast cancer management from diagnosis through treatment and follow-up. It covers breast cancer subtypes, staging, guidelines for workup and determining estrogen receptor, progesterone receptor and HER2 status. Treatment options are discussed for early, locally advanced and metastatic breast cancer including surgery, radiation, chemotherapy regimens and targeted therapies. Main toxicities of common breast cancer drugs are also summarized. The goal is to provide an overview of the usual management of breast cancer patients.
This document summarizes the optimal treatment of ovarian cancer. It presents two case studies, the first involving a 59-year-old woman with stage III ovarian cancer, and the second involving a 62-year-old woman with recurrent ovarian cancer. For the first case, the document suggests that paclitaxel plus carboplatin is the optimal initial treatment. For the recurrent case, it discusses whether debulking surgery is appropriate and different chemotherapy options. The document then outlines milestones in ovarian cancer treatment and strategies for improving outcomes, including increasing optimal debulking rates, adding new drugs, dose-dense therapy, targeted therapies like bevacizumab, and intraperitoneal chemotherapy.
Colorectal Cancer Research & Treatment News - recap from the May 2014 ASCO co...Fight Colorectal Cancer
This document summarizes key findings from the PRIME trial evaluating the addition of panitumumab to FOLFOX4 as first-line treatment for metastatic colorectal cancer. Biomarker analysis found that KRAS exon 2 wild-type tumors derived greater benefit from the addition of panitumumab, with a progression-free survival advantage compared to FOLFOX4 alone. Further biomarker testing found mutations in other RAS isoforms or BRAF reduced likelihood of benefit from panitumumab. The results support use of RAS/BRAF mutation testing to select patients for first-line anti-EGFR therapy in combination with chemotherapy.
Each January, the best and brightest minds in colorectal cancer research meet at the Gastrointestinal Cancers Symposium. Fight Colorectal Cancer and the Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the 2013 symposium.
Join us to learn more about these topics:
- Can aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) keep cancer from returning?
- The relationship of body mass index (BMI) and exercise in colorectal cancer
- What scientists are learning about how your immune system can fight cancer
- The latest on what biomarkers can tell us about your cancer
- Rectal cancer treatment that is based on your biological make-up
The webinar will be led by Dr. Richard Goldberg, an internationally renowned gastrointestinal oncologist who specializes in colorectal cancer. He is a tenured professor in the Department of Internal Medicine at The Ohio State University and serves as physician-in-chief at Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
1) Non-operative management or 'watch and wait' involves avoiding surgery for rectal cancer patients who achieve a complete clinical response after chemoradiation therapy.
2) The goal is to avoid the morbidities associated with surgery if the clinical response indicates the cancer has been eradicated.
3) Patients undergo regular examinations and imaging to monitor for tumor regrowth, with the first year involving examinations every 6-8 weeks and subsequent years every 3-6 months.
This document provides an introduction and overview for a webinar on molecular and genetic tumor testing for colorectal cancer. It discusses the importance of tumor testing to help determine treatment for stages II-IV colorectal cancer and highlights several key biomarkers such as KRAS, NRAS, BRAF and MSI status that can help predict response to targeted therapies like EGFR inhibitors and determine optimal treatment strategies. The webinar aims to explain how molecular profiling of tumors can personalized treatment decisions and improve outcomes for colorectal cancer patients.
1. Ovarian cancer is the second most common gynecologic malignancy in the US, with most cases presenting at advanced stages.
2. Recurrent disease is common, even after initial treatment, and targeting angiogenesis through VEGF inhibition has shown promising results both as single agent therapy and in combination with chemotherapy.
3. Bevacizumab has been approved as front-line treatment combined with chemotherapy based on improved progression-free survival seen in clinical trials, though no overall survival benefit has been proven.
This class covers what all physicians need to know about colorectal cancer (except prevention and screening, dealt with elsewhere). It is exceedingly simple, but accurate to the best of my knowledge. It is based on Harrison's 19th, Edition.
§ This study evaluated nivolumab in patients with metastatic squamous cell carcinoma of the anal canal (SCCA) who had progressed on at least one prior therapy.
§ Of the initial 12 patients treated with nivolumab, 9 patients (24.3%) had an objective response, meeting the threshold for expansion to additional patients.
§ The trial was then expanded to enroll 37 total patients. The overall response rate was 26.5% among evaluable patients, with 2 complete responses and 7 partial responses observed.
§ Nivolumab demonstrated promising antitumor activity in this heavily pretreated patient population with metastatic SCCA.
HTAi 2015 - Cost-effectiveness analysis of bevacizumab and cetuximab in advan...REBRATSoficial
This document summarizes a cost-effectiveness analysis of treatment strategies for metastatic colorectal cancer in Brazil. It finds that adding monoclonal antibodies like bevacizumab and cetuximab to chemotherapy improves survival but that the strategies are not cost-effective in Brazil's public health system as the cost per life year gained is over the hypothetical threshold of 3 times GDP per capita. The analysis uses a Markov model to compare costs and outcomes of 3 treatment sequences over a lifetime, finding that chemotherapy alone without antibodies has the best cost-effectiveness profile.
This document summarizes information on biomarkers for ovarian cancer, including CA-125, HE4, and risk algorithms like ROMA and OVA1. It discusses several studies on the diagnostic performance of these biomarkers alone and in combination for detecting ovarian cancer, especially early-stage disease. The document also reviews recommendations and guidelines for the use of CA-125 testing in different clinical contexts. Finally, it presents findings from a study showing that hormone receptor expression levels have prognostic value for survival in certain ovarian cancer histological subtypes.
This patient presented with rectal bleeding and weight loss and was found to have stage III adenocarcinoma. Given his family history of colorectal cancer in a first-degree relative at a young age, he is at high risk for hereditary non-polyposis colorectal cancer (HNPCC). HNPCC accounts for 5-7% of colorectal cancers and results from a mutation in DNA mismatch repair genes. Individuals with HNPCC have an increased lifetime risk of colorectal and other cancers. The patient was counseled on genetic testing and increased screening for relatives is recommended.
Este documento presenta información sobre el cáncer de próstata, incluyendo su epidemiología, factores de riesgo, métodos de detección, clasificación patológica, estadificación, pronóstico y opciones de tratamiento. Discute los beneficios y riesgos del tamizaje de PSA, así como las recomendaciones de varias organizaciones. También cubre temas como la biología molecular del cáncer de próstata, técnicas de diagnóstico y valoración pronóstica.
Telomeres are repetitive DNA sequences that cap the ends of chromosomes. They shorten with each cell division due to the end replication problem. When telomeres become critically short, cells enter a state of replicative senescence. Cancer cells express telomerase to maintain telomere length, avoiding replicative senescence and achieving immortality.
Dr. Dustin Deming led us through a discussion on the latest research and treatments for colorectal cancer patients presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.
A few of the topics covered include research on immunotherapy and trials studying:
– MSI-H (review of the Anti-PD-1 trial)
– HER2 amplification
– BRAF mutations
For more updates on colorectal cancer research, visit our blog: http://fightcolorectalcancer.org/category/research-treatment/
This document discusses a case of a 55-year-old non-smoking woman presenting with left hip and shoulder pain for 9 months. Imaging showed metastatic lesions and biopsy revealed adenocarcinoma positive for TTF1 and Napsin A. Genotyping found an EGFR L858R mutation but no ALK mutation. She began treatment with afatinib and experienced disease control for 8 months before progressing. Osimertinib was then initiated but also resulted in progression after 9 months, at which time crizotinib was added for a MET amplification, maintaining disease control for over 20 months. The document also reviews data on outcomes from trials of first-line afatinib versus chemotherapy in EGFR
The document discusses staging of lung cancer, including the TNM system for describing the size and extent of the primary tumor (T stage), involvement of lymph nodes (N stage), and presence of distant metastasis (M stage). It provides details on lymph node stations evaluated in lung cancer and proposals to further subclassify N1 and N2 stages based on number and location of involved lymph nodes. Accurate staging is important for prognosis and determining appropriate treatment options for patients with lung cancer.
CES202002 - 09 - Cáncer de esófago y estómagoMauricio Lema
This document provides an overview of esophageal and gastric cancer management. It discusses the epidemiology, risk factors, workup, staging, and treatment approaches for squamous cell carcinoma of the esophagus and adenocarcinoma of the esophagus and stomach. Treatment options include endoscopic resection for very early stages, surgery with or without chemotherapy/radiotherapy for early-mid stages, and definitive chemotherapy/radiotherapy or palliative chemotherapy for advanced stages. The document aims to provide a general understanding of the usual management of patients with these cancers.
1. Colon cancer is the second and third most common cancer in males and females respectively and accounts for 9% of cancer deaths.
2. Screening and lifestyle changes have led to improved outcomes, with a 55% reduction in late-stage colon cancer cases over 3 decades from screening.
3. Adjuvant chemotherapy regimens including FOLFOX, CAPOX and XELOX have improved disease-free and overall survival rates compared to 5-FU/LV alone, particularly for stage III disease.
4. Ongoing research focuses on shortening treatment duration, identifying high-risk patients who may benefit from more intensive regimens, and incorporating molecular markers to optimize adjuvant therapy
The document discusses hypercalcemia associated with malignancy and neoplastic spinal cord compression. It provides information on:
1) Types of cancer that commonly cause hypercalcemia, including symptoms of hypercalcemia.
2) Mechanisms, epidemiology, locations, and causes of neoplastic spinal cord compression.
3) Clinical presentation of neoplastic spinal cord compression including back pain, weakness, sensory deficits, and autonomic dysfunction.
CES2021 - Clase 13 - Cáncer de pulmón (2/2)Mauricio Lema
The document discusses lung cancer treatment and biomarkers. It begins by covering small sample handling and immunohistochemistry markers like p63 and TTF1 that can help classify lung cancer subtypes. It then discusses genomic testing for drivers like EGFR, ALK, ROS1, and BRAF and associated targeted therapies. The TNM staging system and its impact on treatment options like surgery, chemotherapy, and immunotherapy are reviewed. About 35% of advanced non-small cell lung cancer patients have a targetable driver mutation that can be treated with approved targeted therapies to achieve longer survival compared to conventional chemotherapy.
CES2019-02: Cáncer de mama - visión del oncólogoMauricio Lema
This document discusses breast cancer management from diagnosis through treatment and follow-up. It covers breast cancer subtypes, staging, guidelines for workup and determining estrogen receptor, progesterone receptor and HER2 status. Treatment options are discussed for early, locally advanced and metastatic breast cancer including surgery, radiation, chemotherapy regimens and targeted therapies. Main toxicities of common breast cancer drugs are also summarized. The goal is to provide an overview of the usual management of breast cancer patients.
This document summarizes the optimal treatment of ovarian cancer. It presents two case studies, the first involving a 59-year-old woman with stage III ovarian cancer, and the second involving a 62-year-old woman with recurrent ovarian cancer. For the first case, the document suggests that paclitaxel plus carboplatin is the optimal initial treatment. For the recurrent case, it discusses whether debulking surgery is appropriate and different chemotherapy options. The document then outlines milestones in ovarian cancer treatment and strategies for improving outcomes, including increasing optimal debulking rates, adding new drugs, dose-dense therapy, targeted therapies like bevacizumab, and intraperitoneal chemotherapy.
Colorectal Cancer Research & Treatment News - recap from the May 2014 ASCO co...Fight Colorectal Cancer
This document summarizes key findings from the PRIME trial evaluating the addition of panitumumab to FOLFOX4 as first-line treatment for metastatic colorectal cancer. Biomarker analysis found that KRAS exon 2 wild-type tumors derived greater benefit from the addition of panitumumab, with a progression-free survival advantage compared to FOLFOX4 alone. Further biomarker testing found mutations in other RAS isoforms or BRAF reduced likelihood of benefit from panitumumab. The results support use of RAS/BRAF mutation testing to select patients for first-line anti-EGFR therapy in combination with chemotherapy.
Each January, the best and brightest minds in colorectal cancer research meet at the Gastrointestinal Cancers Symposium. Fight Colorectal Cancer and the Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the 2013 symposium.
Join us to learn more about these topics:
- Can aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) keep cancer from returning?
- The relationship of body mass index (BMI) and exercise in colorectal cancer
- What scientists are learning about how your immune system can fight cancer
- The latest on what biomarkers can tell us about your cancer
- Rectal cancer treatment that is based on your biological make-up
The webinar will be led by Dr. Richard Goldberg, an internationally renowned gastrointestinal oncologist who specializes in colorectal cancer. He is a tenured professor in the Department of Internal Medicine at The Ohio State University and serves as physician-in-chief at Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
1) Non-operative management or 'watch and wait' involves avoiding surgery for rectal cancer patients who achieve a complete clinical response after chemoradiation therapy.
2) The goal is to avoid the morbidities associated with surgery if the clinical response indicates the cancer has been eradicated.
3) Patients undergo regular examinations and imaging to monitor for tumor regrowth, with the first year involving examinations every 6-8 weeks and subsequent years every 3-6 months.
This document provides an introduction and overview for a webinar on molecular and genetic tumor testing for colorectal cancer. It discusses the importance of tumor testing to help determine treatment for stages II-IV colorectal cancer and highlights several key biomarkers such as KRAS, NRAS, BRAF and MSI status that can help predict response to targeted therapies like EGFR inhibitors and determine optimal treatment strategies. The webinar aims to explain how molecular profiling of tumors can personalized treatment decisions and improve outcomes for colorectal cancer patients.
1. Ovarian cancer is the second most common gynecologic malignancy in the US, with most cases presenting at advanced stages.
2. Recurrent disease is common, even after initial treatment, and targeting angiogenesis through VEGF inhibition has shown promising results both as single agent therapy and in combination with chemotherapy.
3. Bevacizumab has been approved as front-line treatment combined with chemotherapy based on improved progression-free survival seen in clinical trials, though no overall survival benefit has been proven.
This class covers what all physicians need to know about colorectal cancer (except prevention and screening, dealt with elsewhere). It is exceedingly simple, but accurate to the best of my knowledge. It is based on Harrison's 19th, Edition.
§ This study evaluated nivolumab in patients with metastatic squamous cell carcinoma of the anal canal (SCCA) who had progressed on at least one prior therapy.
§ Of the initial 12 patients treated with nivolumab, 9 patients (24.3%) had an objective response, meeting the threshold for expansion to additional patients.
§ The trial was then expanded to enroll 37 total patients. The overall response rate was 26.5% among evaluable patients, with 2 complete responses and 7 partial responses observed.
§ Nivolumab demonstrated promising antitumor activity in this heavily pretreated patient population with metastatic SCCA.
HTAi 2015 - Cost-effectiveness analysis of bevacizumab and cetuximab in advan...REBRATSoficial
This document summarizes a cost-effectiveness analysis of treatment strategies for metastatic colorectal cancer in Brazil. It finds that adding monoclonal antibodies like bevacizumab and cetuximab to chemotherapy improves survival but that the strategies are not cost-effective in Brazil's public health system as the cost per life year gained is over the hypothetical threshold of 3 times GDP per capita. The analysis uses a Markov model to compare costs and outcomes of 3 treatment sequences over a lifetime, finding that chemotherapy alone without antibodies has the best cost-effectiveness profile.
This document summarizes information on biomarkers for ovarian cancer, including CA-125, HE4, and risk algorithms like ROMA and OVA1. It discusses several studies on the diagnostic performance of these biomarkers alone and in combination for detecting ovarian cancer, especially early-stage disease. The document also reviews recommendations and guidelines for the use of CA-125 testing in different clinical contexts. Finally, it presents findings from a study showing that hormone receptor expression levels have prognostic value for survival in certain ovarian cancer histological subtypes.
This patient presented with rectal bleeding and weight loss and was found to have stage III adenocarcinoma. Given his family history of colorectal cancer in a first-degree relative at a young age, he is at high risk for hereditary non-polyposis colorectal cancer (HNPCC). HNPCC accounts for 5-7% of colorectal cancers and results from a mutation in DNA mismatch repair genes. Individuals with HNPCC have an increased lifetime risk of colorectal and other cancers. The patient was counseled on genetic testing and increased screening for relatives is recommended.
Este documento presenta información sobre el cáncer de próstata, incluyendo su epidemiología, factores de riesgo, métodos de detección, clasificación patológica, estadificación, pronóstico y opciones de tratamiento. Discute los beneficios y riesgos del tamizaje de PSA, así como las recomendaciones de varias organizaciones. También cubre temas como la biología molecular del cáncer de próstata, técnicas de diagnóstico y valoración pronóstica.
Telomeres are repetitive DNA sequences that cap the ends of chromosomes. They shorten with each cell division due to the end replication problem. When telomeres become critically short, cells enter a state of replicative senescence. Cancer cells express telomerase to maintain telomere length, avoiding replicative senescence and achieving immortality.
El documento proporciona información sobre el tamizaje para el cáncer de mama, incluyendo las características de un programa de tamizaje ideal, los sesgos asociados con el tamizaje, y la evidencia sobre la mamografía. Resume los factores de riesgo para el cáncer de mama, herramientas de evaluación del riesgo, la efectividad de la detección temprana, los posibles daños, y las pautas actuales para el tamizaje mamográfico.
El documento describe varias emergencias oncológicas, incluyendo obstrucciones de vísceras, compresión de la vena cava superior, hipercalcemia asociada a cáncer, y neutropenia febril. Explica los factores de riesgo, signos clínicos, evaluación diagnóstica y recomendaciones para el manejo antibiótico empírico de la neutropenia febril. También cubre temas como la fisiopatología, etiología y tratamiento de la hipercalcemia asociada a cáncer.
This document discusses oncological emergencies and fever neutropenia in cancer patients. It provides guidelines for the diagnosis and management of fever neutropenia, including recommending empiric antibiotic and antifungal therapy for high-risk patients. It also addresses the impact of time to antibiotic treatment, risk-stratification tools for outpatient management, and appropriate use of prophylactic antibiotics.
Este documento trata sobre la prevención y el diagnóstico oportuno del cáncer de pulmón. Resalta que el cáncer de pulmón es muy frecuente y letal, y que el factor de riesgo más importante es el tabaquismo. Aunque el cribado con tomografía computarizada de baja dosis puede reducir la mortalidad por cáncer de pulmón, su implementación es difícil. La única forma realmente efectiva de prevenir este cáncer es luchar contra el tabaquismo.
CES201701-Clase 5 (Tumores ginecológicos) por Milena RoldánMauricio Lema
Este documento describe los tumores ginecológicos, con un enfoque en el cáncer de cuello uterino y cáncer de ovario. Explica la epidemiología, factores de riesgo, histología, diagnóstico, estadificación y tratamiento de estos cánceres. También cubre la prevención a través de la citología, pruebas de HPV y vacunas contra HPV.
Este documento resume dos tipos de linfomas indolentes: el linfoma folicular y el linfoma del manto. El linfoma folicular es el segundo tipo más común de linfoma y representa casi el 20% de los casos. Afecta principalmente a personas mayores de 50 años. El linfoma del manto es menos frecuente y se caracteriza por linfadenopatías, esplenomegalia y compromiso de la médula ósea. Ambos tipos son tratados de manera diferente dependiendo del estadio y factores de riesgo del paciente,
Tratamiento inicial de pacientes posmenopáusicas con cáncer de mama HR+/her2-...Mauricio Lema
Versión 2 (definitiva): Presentado en la Clínica VIDA en 11.11.2016, por invitación de Jairo Estrada. Versión corregida (se corrigen errores en 3 diapositivas de la versión anterior).
El documento describe las gammapatías monoclonales y el mieloma múltiple. Las gammapatías monoclonales se caracterizan por la proliferación de un clon de células plasmáticas que producen inmunoglobulinas de forma anormal. El mieloma múltiple es una neoplasia caracterizada por la proliferación de células plasmáticas malignas en la médula ósea, asociada a disfunción de órganos. Es la segunda neoplasia hematológica más común y se manifiesta clínicamente por dolor
Estado actual de terapia sistémica en cáncer renal metastásicoMauricio Lema
This document discusses the current management of metastatic renal cell carcinoma (mRCC). It provides an overview of targeted therapies for mRCC including tyrosine kinase inhibitors (TKIs) such as sunitinib, pazopanib, and cabozantinib that target the VEGF pathway. Clinical trial results are presented comparing TKIs in first-line mRCC. Active surveillance is also discussed as a treatment option for select asymptomatic or minimally symptomatic mRCC patients. Toxicities of TKIs like fatigue, diarrhea and hand-foot syndrome are reviewed along with their negative impact on quality of life.
El documento discute la incidencia y mortalidad del cáncer a nivel mundial, en Estados Unidos y Colombia. Reporta que en Colombia se presentan aproximadamente 70,000 nuevos casos de cáncer por año, siendo los más comunes en hombres la próstata, estómago, pulmón, colon y recto, y linfomas, y en mujeres la mama, cuello uterino, tiroides, estómago, colon y recto, y ano. Además, señala que el tabaquismo es responsable de alrededor de la mitad de las
CES201701 - Principios de radioterapia (Dr. David Gómez)Mauricio Lema
Este documento trata sobre los principios de la radioterapia. Explica brevemente la historia de la radioterapia y el descubrimiento de los rayos X. Luego describe las diferentes fuentes de radiación ionizante, tanto externas como internas, y los diferentes tipos de radiación como rayos X, electrones, protones, partículas alfa y neutrones. Finalmente, aborda conceptos clave de radiobiología como la radiosensibilidad de los tejidos, el ciclo celular y los factores que modifican la respuesta de los tejidos a
Clase de linfomas y leucemias linfoides aguda y crónica para estudiantes de medicina y capacitación de médicos no especialistas en hematología/oncología
This document discusses gastric cancer including epidemiology, risk factors, clinical features, staging, prognosis, investigations, and treatment options. Gastric cancer risk increases after age 50 and is more common in males, smokers, and those with low socioeconomic status or pernicious anemia. Symptoms depend on tumor location but may include dyspepsia, bloating, or weight loss. Treatment involves surgery like gastrectomy, with chemotherapy and radiation used for advanced cases. Prognosis depends on stage, with 5-year survival rates ranging from 71% for stage IA to 4% for stage IV disease.
Este documento discute el cáncer de colon y recto, incluyendo factores de riesgo, prevención, detección, estadificación, tratamiento y pronóstico. El cáncer colorrectal es común en Colombia, con 12 nuevos casos y 5 muertes diarias. Los factores de riesgo incluyen dieta alta en grasas animales, síndromes hereditarios y enfermedad inflamatoria intestinal. La detección incluye análisis de sangre oculta en heces y colonoscopia. El tratamiento depende del estadio
Este documento explica la angiogénesis y su importancia en la investigación del cáncer. La angiogénesis es el proceso de crecimiento de nuevos vasos sanguíneos y es necesaria para que los tumores crezcan más allá de 1-2 mm. Se describen varios factores que regulan la angiogénesis como las células endoteliales, proteínas reguladoras y moléculas señalizadoras. También se explica cómo los inhibidores de la angiogénesis como la endostatina pueden detener el crecimiento
Este documento describe el cáncer de mama, incluyendo la incidencia y mortalidad en Colombia, los retos de la detección tardía, y los avances en la mejora de la estadificación, menor invasión quirúrgica y el uso de perfiles genómicos. En particular, se discute el uso del ensayo Oncotype DX de 21 genes para predecir el riesgo de recurrencia en pacientes con cáncer de mama temprano positivo para receptores hormonales.
nside Myriad. At Myriad, our goal is to make a difference in patients' lives and our work has been guided by this mission throughout the Company's history. ... Since 1991, Myriad has invested heavily in educating patients and healthcare professionals about the role genes and proteins play in disease.
This document discusses Daya Upadhyay, an Associate Professor at UCSF who is the Medical Director of the Lung Nodule Program and Director of Translational Research in Medicine. It provides information on lung cancer survival rates by stage and discusses reasons for the generally poor survival in lung cancer, such as late stage at diagnosis and continued smoking. It outlines goals and strategies to improve lung cancer survival through prevention, early diagnosis, and early treatment approaches including screening, diagnostic techniques, surgery, radiation, and personalized treatment based on cancer gene mutations.
This document outlines a seminar plan on carcinoma of the pancreas presented by Dr. Jyotindra Singh. The seminar will cover topics such as the anatomy and surgical anatomy of the pancreas, pancreatic tumors, modes of presentation, pre-operative workup, various surgeries and surgical videos, recent updates, studies and trials, and a take home message. The seminar introduction discusses that carcinoma of the exocrine pancreas accounts for over 90% of pancreatic tumors and remains an oncologic challenge with a 5-year survival rate of 3%.
APPROACH TO A BREAST CANCER CASE IN SURGICAL PRACTICEabinashchihnara1
The document summarizes information about breast cancer presentations and management. It describes common symptoms like lumps, nipple discharge, and pain. It provides details on patient history, risk factors, diagnostic workup including mammography and biopsy, staging, and treatment options like surgery and adjuvant therapies. Key points covered include distinguishing benign from malignant findings, hereditary risk factors, and predictive markers like hormone receptors that determine treatment responses.
Colorectal cancer is the second most common cause of cancer deaths in North America. Risk factors include family history, age over 50, inflammatory bowel disease, poor diet, smoking, and certain genetic conditions. Screening tools like fecal occult blood tests and colonoscopy can detect early-stage cancers. Treatment may involve surgery to remove the cancerous tissue, and sometimes chemotherapy or radiation. After treatment, regular follow-up via tests like CT scans and colonoscopies can help monitor for cancer recurrence.
WORK UP A CASE OF Endometrial cancer .pptPoonamJhamb3
This case study describes a 65-year-old obese woman with diabetes, hypertension, and dyslipidemia who presented with post-menopausal bleeding. She was non-compliant with recommendations for weight loss and lifestyle changes. Evaluation found endometrial carcinoma. The document then reviews endometrial cancer causes such as unopposed estrogen exposure, presentation with abnormal uterine bleeding, diagnostic workup including endometrial biopsy, staging, treatment with surgery with or without radiation, and prognosis. It also discusses endometrial hyperplasia risk factors and management.
The document discusses ovarian cancer treatment and management. It covers symptoms, risk factors, diagnosis methods, surgical staging and debulking, chemotherapy options including the gold standard of intravenous carboplatin and paclitaxel as well as emerging intraperitoneal chemotherapy showing increased survival. It emphasizes the importance of complete surgical staging and aggressive cytoreductive surgery for optimal outcomes and challenges of ensuring all patients receive standard of care treatment by gynecologic oncologists.
Talk by Sir. Michael Brady, given at the Department of Computer Science, University of Cyprus.
Date: 24 June, 2015
This talk has two inter-twined aims. First, it introduces the medical challenges, and the science that is being developed to address those challenges, that underlie my (current) companies: Mirada Medical, Volpara Solutions, Perspectum Diagnostics, ScreenPoint bv, further illustrated by Guidance Navigation Holdings, IRISS Medical Technologies, and Acuitas Medical. Second, it asks why I am driven by the translation of mathematics and computing (white board) to clinical practice (white coats).
Professor Sir Michael Brady is currently Professor in Oncological Imaging in the Department of Oncology at the University of Oxford, having recently retired as Professor in Information Engineering (1985-2010). Mike is co-Director of the Oxford Cancer Imaging Centre, one of four national cancer imaging centres in the UK. He is the author of over 750 articles and 45 patents in computer vision, robotics, medical image analysis, and AI, and the author or editor of ten books. He has successfully supervised the PhD theses of 115 students. He is particularly well known for his pioneering research in quantitative methods for mammography and breast cancer more generally. Mike has a continuing strong commitment to commercialisation of his science and to entrepreneurial activity more generally. Current companies he has founded are: Mirada Medical; Matakina; Perspectum Diagnostics; Guidance; and ScreenPoint. As well, he is an NED of IRISS Medical Technologies; Acuitas Medical; and colwiz. He recently stepped down after 19 years as Deputy Chairman of Oxford Instruments plc. Finally, he is a member of the Syncona Advisory Board and Chair of the Royal Society Publications Board.
This document discusses the role of chemotherapy in gynecological malignancies, specifically ovarian cancer. It notes that ovarian cancer is a leading cause of death from gynecologic cancer and chemotherapy has improved 5-year survival rates. For advanced stage ovarian cancer, the standard treatment is primary cytoreductive surgery followed by platinum-based chemotherapy. Optimal debulking to less than 1cm residual disease results in better outcomes. For unresectable tumors, neoadjuvant chemotherapy may be given followed by interval debulking surgery. The combination of carboplatin and paclitaxel is currently the standard first-line chemotherapy regimen.
The document summarizes benign prostatic hyperplasia (BPH), testicular cancer, and prostate cancer. It describes the etiology, epidemiology, pathophysiology, risk factors, signs and symptoms, diagnostic workup, and treatment for each condition. It compares the pathophysiology, clinical presentation, diagnostic workup and treatment of BPH and prostate cancer. BPH and prostate cancer are both common prostate disorders in aging men, but have different causes, presentations and treatments. Testicular cancer most often appears as a painless testicular mass in younger men and requires orchiectomy for diagnosis and treatment.
This document discusses colorectal cancer. Some key points:
- Colorectal cancer is the second most common cause of cancer deaths in North America. It affects the colon and rectum.
- Risk factors include family history, age over 50, inflammatory bowel disease, poor diet, smoking, and diabetes. Genetic changes like mutations in APC and DNA repair genes contribute to colorectal cancer development.
- Screening tools include fecal occult blood tests, sigmoidoscopy, colonoscopy, and virtual colonoscopy. Screening guidelines vary but generally recommend annual fecal tests, sigmoidoscopy every 5 years, or colonoscopy every 10 years starting at age 50. Family history of colorectal cancer may
Ovarian cancer accounts for 3-4% of cancers in women and is the fourth most common cause of cancer death in women in the US. There are several risk factors for ovarian cancer including family history, ethnicity, reproductive history, and use of hormones. Ovarian cancers are generally divided into epithelial, germ cell, and stromal cell tumors. Early symptoms are vague but may include pelvic pain or pressure, back pain, bloating, and digestive issues. As the cancer progresses, symptoms worsen and may include abdominal swelling, weight loss, and changes in bowel or urinary habits. Diagnosis involves physical exam, tumor marker tests, ultrasound or CT imaging, and surgical staging to determine if the cancer
This document discusses chemotherapy for breast cancer. It begins by introducing breast cancer as the second leading cause of cancer deaths in women. It then covers the epidemiology of breast cancer, noting that it is the most common cancer in women worldwide. Risk factors discussed include gender, age, family history, and lifestyle factors. The document outlines the various treatment options for breast cancer, which include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, and bone-directed therapy. It provides details on each of these therapeutic approaches.
Cancer is a disease characterized by abnormal cell growth that can invade nearby tissues and spread to other parts of the body. Cancer affects 1 in 3 people and is responsible for about 13% of deaths globally. The most common causes of cancer death are lung cancer, breast cancer, and prostate cancer. Symptoms vary depending on the cancer type and stage but may include lumps, bleeding, pain, weight loss, and fatigue. Diagnosis involves medical exams, biopsies, and medical imaging. Treatment options include surgery, chemotherapy, radiation therapy, immunotherapy, and other methods. Screening programs aim to detect cancers early through tests like mammograms, colonoscopies, and skin exams.
The document discusses cancer diagnosis and treatment during pregnancy. It provides recommendations for diagnostic imaging and staging tests during pregnancy to minimize radiation exposure to the fetus. Chemotherapy can be given in the 2nd and 3rd trimesters but is riskier in the 1st trimester due to risks of miscarriage and birth defects. Surgery is generally safe during pregnancy with highest risk of miscarriage for 1st trimester or abdominal operations. Prognosis for pregnant women with cancer is often similar to non-pregnant patients if diagnosed at the same stage.
Cancer is characterized by uncontrolled growth of cells that can invade other tissues and spread to distant areas. Early detection is key to survival, with seven warning signs including changes in bowel or bladder habits or unusual bleeding. The document then provides statistics on new cancer cases and deaths in women for various types of cancer like breast, lung and colon. It discusses causes of cancer, stages of cancer, types of cancer screening and treatments for cancers like breast, lung, uterine and skin cancer.
Colorectal cancer begins in the inner lining of the colon or rectum and can spread deeper into the wall of the colon/rectum and to other parts of the body. Risk factors include increasing age, family history, lifestyle factors like smoking, obesity, and lack of physical activity. Symptoms often include changes in bowel habits and bleeding. Screening is recommended regularly beginning at age 50. Treatment depends on the stage and may include surgery, radiation, chemotherapy, and targeted therapies. Prognosis depends on tumor stage and extent at diagnosis.
Carga tumoral de cáncer renal - ConsultorSaludMauricio Lema
El documento clasifica los tipos histológicos principales de neoplasias renales humanas y sus mutaciones asociadas. El cáncer renal claro celular representa el 75% de los casos y está asociado con mutaciones en el gen VHL. El tipo papilar 1 representa el 5% de los casos y está asociado con mutaciones en c-Met, mientras que el tipo papilar 2 representa el 10% de los casos y está asociado con mutaciones en el gen FH. El cáncer renal cromofóbico representa el 5% de los casos y está asociado con mutaciones en
Secuencia en cáncer gástrico metastásico (Versión 2)Mauricio Lema
The document summarizes key clinical trials in metastatic gastric cancer treatment. It discusses trials comparing different chemotherapy drugs and combinations, as well as trials investigating biologics and immunotherapy. The document notes that capecitabine is non-inferior to 5-fluorouracil, oxaliplatin is non-inferior and less toxic than cisplatin, and trastuzumab improves outcomes in HER2-positive cancer. Recent trials found nivolumab improves progression-free and overall survival, especially in patients with PD-L1 expression over 5%. Median overall survival across trials is approximately 10 months.
Secuencia en cáncer gástrico metastásicoMauricio Lema
Key trials in metastatic gastric cancer (1st-Line)
- Platinum + fluoropyrimidine (e.g. cisplatin or oxaliplatin + 5-FU or capecitabine) form the backbone of 1st-line treatment.
- Trastuzumab is added for HER2-positive cancers.
- Consider adding an anthracycline or taxane for younger fit patients.
- Immuno-oncology such as nivolumab shows promise when available, improving PFS and OS in some patients.
- Consider monotherapy with a fluoropyrimidine for those who cannot tolerate polychemotherapy.
The document discusses small-cell lung cancer (SCLC). Key points:
- SCLC accounts for 15% of lung cancers and is an aggressive neuroendocrine tumor that often spreads widely before diagnosis.
- Treatment options include chemotherapy with platinum agents and etoposide, sometimes combined with radiation therapy. Prophylactic cranial irradiation after treatment may help prevent cancer from spreading to the brain.
- The IMpower133 clinical trial showed that adding the immunotherapy drug atezolizumab to standard chemotherapy of carboplatin and etoposide improved outcomes for patients with extensive-stage SCLC, increasing median overall survival by 2 months.
The document summarizes key findings from the CASPIAN phase 3 clinical trial comparing durvalumab plus tremelimumab plus etoposide-platinum chemotherapy (D+T+EP) versus etoposide-platinum chemotherapy (EP) alone as first-line treatment for extensive-stage small cell lung cancer (SCLC). The trial found that D+T+EP improved overall survival compared to EP alone, with a median OS of 10.4 months versus 10.5 months and a hazard ratio of 0.82. Subgroup analyses showed consistent OS benefit across patient subgroups for D+T+EP. The combination of D+T+EP represents a new standard of care for extensive-stage S
This document summarizes information about immunotherapy for non-small cell lung cancer (NSCLC). It provides data on key clinical trials that evaluated immunotherapy drugs like nivolumab and pembrolizumab in previously treated NSCLC. It shows the efficacy results including overall survival benefits from these trials compared to chemotherapy. Long-term survival outcomes are also presented from pooled analyses of nivolumab trials with over 3 years of follow-up data.
CES202101 - Clase 15 parte 1 - Cáncer de cérvix Mauricio Lema
The document outlines the FIGO staging systems for ovarian cancer, endometrial cancer, and cervical cancer. It describes the stages from I to IV, defining the extent of primary tumor and metastasis involvement for each type of cancer. It then focuses on cervical cancer, discussing the TNM classification system and how it can guide therapy depending on whether the cancer is non-bulky or bulky. Treatment options including surgery, radiation, chemotherapy, and chemoradiation are covered.
CES202101 - Clase 15 parte 2 - Cáncer de endometrioMauricio Lema
El documento presenta información sobre la incidencia y mortalidad del cáncer de endometrio a nivel mundial, en Estados Unidos y Colombia. Se describen los diferentes tipos histopatológicos de cáncer de endometrio, factores de riesgo, síntomas, diagnóstico, estadificación, tratamiento y factores moleculares asociados.
CES202101 - Clase 14 - Cáncer de ovarioMauricio Lema
El documento trata sobre el cáncer de ovario. Resume los tipos principales de cáncer de ovario, incluyendo el carcinoma epitelial de ovario (EOC), los tumores de células germinales (GCT) y los tumores de cordón sexual y estromales (SCST). El EOC de alto grado seroso (HGSC) es el tipo más común, y describe sus características histológicas e inmunohistoquímicas. También resume los factores de riesgo, mecanismos de reparación del ADN y letalidad sinté
Lung cancer is the leading cause of cancer death worldwide, responsible for close to 2 million deaths per year. The main risk factor is tobacco, explaining about 90% of lung cancer cases. The two main types are small cell lung cancer (15% of cases) and non-small cell lung cancer (85% of cases). Diagnosis involves pathology to determine the histologic subtype and molecular testing to guide targeted therapy options. Staging uses the TNM system to classify tumors based on size, lymph node involvement, and metastasis. Treatment depends on the stage but may include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy.
CES202101 - Clase 11 - Cáncer de mama (2/2) (José Julián Acevedo)Mauricio Lema
1. El documento describe los subtipos y tratamiento del cáncer de mama, incluyendo las pruebas genómicas para determinar el riesgo y necesidad de quimioterapia.
2. OncotypeDx ayuda a omitir quimioterapia en el 80% de pacientes con cáncer luminal temprano de bajo riesgo.
3. El tratamiento depende del subtipo molecular y puede incluir cirugía, radioterapia, quimioterapia, terapia endocrina y terapia dirigida contra HER2.
Este documento presenta información sobre la emergencia oncológica y la neutropenia febril. Incluye estadísticas sobre la etiología, factores de riesgo y manejo de la neutropenia febril en pacientes oncológicos. También cubre temas como diagnóstico, tratamiento antimicrobiano, prevención y pronóstico de infecciones en este grupo de pacientes.
CES202101 - Clase 7 - Tamización para el cáncer (2/2)Mauricio Lema
Este documento presenta información sobre las pruebas de tamizaje para diferentes tipos de cáncer y las recomendaciones para su uso. Resume las guías del Ministerio de Salud de Colombia sobre el tamizaje para cáncer de mama, colon y recto, cérvix, y pulmón. Explica que la mamografía se recomienda cada 2 años para mujeres de 50 a 69 años, mientras que para otros tipos de cáncer se recomiendan pruebas como colonoscopia cada 10 años a partir de los 50, pruebas de ADN de VPH cada 5 años
Este documento resume información sobre el cáncer renal. El cáncer renal se origina en las células del riñón y representa entre el 2-3% de los diagnósticos de cáncer. Los factores de riesgo incluyen la edad, el sexo masculino, la obesidad e hipertensión. El tratamiento depende del estadio y puede incluir cirugía, ablación o terapia sistémica.
El cáncer de vejiga es más frecuente en hombres y personas mayores de 65 años. El principal factor de riesgo es el tabaquismo. La mayoría de los tumores son uroteliales y se presentan con hematuria. El tratamiento depende de si el cáncer es no muscular invasivo o muscular invasivo.
Este documento resume información sobre el cáncer de próstata, incluyendo que es el cáncer más común en hombres y el segundo más mortal. Explica factores de riesgo como la edad y raza, y grados de riesgo basados en el tamaño del tumor, grado de Gleason y niveles de PSA. También cubre opciones de tratamiento como cirugía, radioterapia y terapia hormonal, dependiendo del riesgo y extensión de la enfermedad.
CES202101 - Clase 3 - Cáncer de origen desconocido (Daniel González)Mauricio Lema
El documento presenta dos casos clínicos de pacientes con cáncer de origen desconocido. El primer caso es de una paciente de 77 años con síntomas constitucionales y tos que presenta adenocarcinoma bien diferenciado con marcadores CK7-, CK20+, CDX2+, TTF1+ sugiriendo cáncer colorrectal. El segundo caso es de una mujer de 50 años con adenopatía axilar izquierda que presenta adenocarcinoma moderadamente diferenciado, solicitándose imágenes y esperando encontrar marcadores en la inmunohisto
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
3. Page 3
Sobre el cáncer, en general…
Curable en casi 2/3 de los pacientes
Evento catastrófico para el paciente y su entorno
Cambio en la imagen propia, familiar y social
Todo el cuerpo está enfermo – es una traición…
Nada nunca será igual
1
2
3
4
5
Algunas notas
8. Page 8
Cáncer en el mundo
7.6 millones
Hepatocelular (2x)
Cérvix uterino (2x)
Esófago (2-3x)
12.7 millones
Pulmón (2x)
Mama (3x)
Próstata (2.5x)
Colon y recto (3x)
Estadísticas en 2008: Prevalencia – 25 millones
9. Cáncer:
7.6 millones de muertes / año
20.000/día… 14/minuto…
Aproximadamente la población de:
• Suiza
• Israel
• Bulgaria
19. Page 19
Epidemiología del cáncer
Pulmón
Estómago
Hígado
Colon y recto
Mama
Esófago
Mundo
Pulmón
Colon y recto
Mama
Páncreas
Próstata
Leucemia
Estados Unidos
Estómago
Próstata
Pulmón
Mama
Cérvix
Colon y recto
Colombia
Mortalidad - Mundo, Estados Unidos, Colombia
20. Testículo Mama Hodgkin Próstata Vejiga Colon Ovario Pulmón Páncreas
Supervivencia
masculina
Supervivencia
femenina
Muerte
No todos los cánceres son igualmente
letales
43. Pain
Setting Prevalence
Diagnosis 25-30%
Treatment associated 20%
Progressive disease 75%
Mechanism
By the tumor 70%
Caused by treatment 20%
Unrelated to cancer 10%
Treatment options
Pharmacologic intervention Will help in 85%
Antitumor therapy
Neurostimulation
Regional analgesia
Neuroablative
Refractory to all measures About 3%
Harrison’s, 19th Ed, 2015
48. Taste
Change
Taste
Change
C et al. Support Care Cancer. 2005C et al. Support Care Cancer. 2005
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Alopecia
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ConstipationLeg
pain
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painFatigue
Fatigue
Flu
Flu
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PeripheralNeuropathy
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Diarrhea
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Dysuria
CINV
4
CINV
4CINV
6
CINV
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5
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Death
PerfectHealth
CINV
2
CINV
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CINV
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Febrile
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CompleteComplete
ControlControl
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Death
Moderate Delayed NauseaModerate Delayed Nausea
Poorly ControlledPoorly Controlled
Acute & Delayed CINVAcute & Delayed CINV
Chemotherapy Experienced PatientsChemotherapy Experienced Patients
Rank Severe CINV Near DeathRank Severe CINV Near Death
49. 49
Mecanismos de las Náuseas y Vómito
inducidos por la quimioterapia
Quimioterapia
Central
Periférica
50. 50
Mecanismos de las Náuseas y Vómito
inducidos por la quimioterapia
C. Enterocromafín
Liberación de
serotonina
Quimioterapia
Periférica
51. 51
Mecanismos de las Náuseas y Vómito
inducidos por la quimioterapia
C. Enterocromafín
Liberación de
Serotonina
Aferentes vagales
receptores de 5-HT3
Quimioterapia
Periférica
52. 52
Quimioterapia
Mecanismos de las Náuseas y Vómito
inducidos por la quimioterapia
Complejo Dorsal
Vagal – área
postrema
Periférica
Central
C. Enterocromafín
Liberación de
Serotonina
Aferentes vagales
receptores de 5-HT3
53. 53
Quimioterapia
Mecanismos de las Náuseas y Vómito
inducidos por la quimioterapia
Receptores
NK1 de Sustancia P
Periférica
Central
Complejo Dorsal
Vagal – área
postrema
C. Enterocromafín
Liberación de
Serotonina
Aferentes vagales
receptores de 5-HT3
55. Nutrition
Weight loss Decreased appetite, citokynes, altered
metabolism
When to intervene?
10% unexplained weight loss
Serum transferrin 150 mg/dL or less
Ablumin 3.4 gr/dL, o less
How to intervene?
Enteral preferred over parenteral
Harrison’s, 19th Ed, 2015
56. RECIST: Response Evaluation Criteria In Solid Tumors
Change in the sum of the longest diameters
↑20% (or new lesion): Progressive disease
↓30%: partial response (PR)
↓100%: unconfirmed complete response (uCR)
↓100% + Negative biopsy: complete response (CR)
58. Tobacco Comments
Risk factor Cardiovascular disease, pulmonary
diseasse and cancer
Tobacco-related death 1/3 of smokers
Cancers Lung, laryng, oropharynx, esophagus,
kidney, bladder, pancreas, and stomach
Risk after quitting 30-50% lower 10-yr lung cancer
mortality
Second-hand smoke also harmful
Early adoption 80% smokers begin befor age 18
Cigars also increase cancer risk Oral and esophageal cancer
Smokeless tobacco also increases
cancer risk
Oral cancer
Benefits of e-cigarettes unclear
Harrison’s, 19th Ed, 2015
59. Physical inactivity Comments
Risk factor Colon and breast cancer
Some biases may obscure this relationship
Harrison’s, 19th Ed, 2015
60. Diet modification Comments
High fat diet increases risk of Breast, colon, prostate, endometrium
High dietary fiber decreases the risk Colonic polyps and colon cancer
High fruit and vegetable intake NOT
proven of benefit
RCT
Low-fat, High fiber diet faild to decrease
risk of colonic polyp
RCTx 2
No dietary intervention has proven
effective in preventing cancer
WHI
Harrison’s, 19th Ed, 2015
61. Energy balance Comments
Obesity increases risk of Colon, breast (postmenopausal),
endometrial, kidney, esophagus (GEJ)
Magnitud of the effect
Colon cancer RR 1.5-2 in males, 1.2-15 in females
Breast cancer Risk increases by 30-50%
Adipose tissue harbors aromatase that
can create estrogen from androgens
Harrison’s, 19th Ed, 2015
63. Sun avoidance Comments
Cumulative exposure to UV radiation Non-melanoma skin cancers
Intermittent acute sun exposure Melanoma (maybe)
Protective clothing, reduction of sun
exposure
Reduce risk of skin caner
Sunscreen Decreases risk of actinic keratoses
No evidence of decrease risk of
melanoma
Freckling High risk of skin malignancies
Risk factors for melanoma Sunburns, large number of melanocytic
nevi, and atypical nevi
Harrison’s, 19th Ed, 2015
65. Chemoprevention Comments
Upper aerodigestive tract and lung Smoking cessation
HPV vaccination
B-carotene increases lung cancer risk
Colon cancer Aspirin (75 mg QD) dicreases colon cancer risk by
24%
Cox-2 inhibitors increase CV risk, so studies on
cancer chemoprevention were abandoned
High calcium diets decrease CRC risk (not
supperted by the WHI)
Estrogen + progestin decreases CRC risk by 44%
(WHI)
Statins may decrease CRC risk
Breast cancer Tamoxifen dicreases BC risk by 49%
Raloxifen and Exemestane ara also effective
chemopreventive strategies for women with
high risk (1.55% 5-yr risk) of BC
Prostate cancer Finasteride and Dutasteride dcrease low-grade,
but increase high-grade prostatic cancer. No
survival benefit
Vitamin E supplementation increases prostate
cancer risk
Harrison’s, 19th Ed, 2015
66. Vaccine and cancer prevention Comments
Hepatitis B and C are related to
liver cancer
Hepatitis B vaccination has proven effective for
B-hepatitis and hepatomas
HPV are linked to cervical, anal
and head and neck cancers
HPV vaccination may decrease cervical cancer
risk by 70%, but studies are ongoing.
Vaccination of females and males is
recommendd in the US at ages 9-26
H. Pylori is related to gastric
adenocarcinomas and gastric
lymphoma
No vaccination stretegy exists
Surgical prevention of cancer
Cervical dysplasia Conization
FAP or UC Colectomy
BRCA1/BRCA2 Prophylactic bilateral mastectomy
Prophylactic oophorectomy
Breast cancer Prophylacti oophorectomy (in premenopausal
women)
Harrison’s, 19th Ed, 2015
68. Breast cancer screening Comments
Mammography Q1-2 years, 50 and older: decreases BC by 15-
30%
Benefits in less than 50 less clear
High false positive rates
High risk of overdiagnosis
Considerable amount of overdiagnosis has
ensued in the US
BSE No evidence of benefit in BC detection or
mortality
Breast MRI May be effective in BRCA1/2 carriers (not
proven in prospective trials)
Harrison’s, 19th Ed, 2015
69. Cervical cancer screening Comments
Pap-smear Begin at age 21, every 3 years, up to age 30.
At 30, Pap-smear + HPV testing may be offered. If
both negativa, screening can be decreased to q5
years
Stop at 65 in women with 10 years history of
normal screening tests
Screening may be discontinued after
histerectomy for non-oncologic reasons
Harrison’s, 19th Ed, 2015
70. CRC screening Comments
FOBT 15% risk reduction
False positive in 1-5%
Only 2-10% of positive tests have cancer
Fecal immunochemical tests have higher sensitiviity
Fecal DNA tests may be superior to FOBT, but studies are
ongoning
Sigmoidoscopy Decreases CRC risk by 18%, and mortality by 28%
Should be performed between ages 50-74
Optimal interval unknown, 5 year interval recommended
Colonoscopy Detects 25% more advanced lesions than FOBT +
sigmoidoscopy
Perforation risk 3/1000
Expensive
Start at 50, q10years, up to 70
CT colonography Comparable to colonoscopy
High incidence of incidental findings of unknown significance
(15-30%)
High radiation risk
Harrison’s, 19th Ed, 2015
71. Prostate cancer screening Comments
DRE + PSA Dramatic increase in prostate cancer diagnosis
Unclear overall benefit due to lead-time bias,
length-bias, and overdiagnosis
False positive results induce invasive testing
Even true positive results may not always detect
cancers that will impact survival
Two major trials with conflicting results
American PLCO: negativa (but close to half the
control group underwent opportunistic PSA
evaluation)
European ERSPC: positive. But, to avert 1 death,
more than 1000 patients needed to be screened,
and 37 prostate cancers needed to be detected
Screen detected low-grade prostate cancer
therapy may cause more harm than good.
UPSTF recommends against routing prostate
cancer screening
ACS recommends PSA and DRE starting at age 50,
in highly motivated men, fully informed of the
poetnatial consequences
Harrison’s, 19th Ed, 2015
72. Lung cancer screening Comments
LD CT 15-20% reduction of lung cancer mortality (about
3/1000 screened)
Yearly, 55-74, in heavy smokers (30ç ppy)
High incidence of incidental findings
Radiation exposure
CXR Ineffective
Harrison’s, 19th Ed, 2015
Editor's Notes
Preliminary preference (utility) data from nausea and vomiting health states from 3 studies involving ovarian cancer patients, clinicians, and healthy female controls were evaluated.
Preferences were assessed using the visual analog scale (VAS), with scores ranging from 0.0 (worst) to 1.0 (best).
Definitions of CINV were:
CINV 1 - Days 1-5 = little to no nausea or vomiting.
CINV 2 - Day 1 = complete control; Days 2-5 = moderate nausea, no vomiting.
CINV 3 - Day 1 = complete control; Days 2-5 = moderate nausea, severe vomiting.
CINV 4 - Day 1 = nausea and vomiting; Days 2-5 = moderate nausea.
CINV 5 - Day 1 = nausea and vomiting; Days 2-5 = moderate nausea, severe vomiting.
CINV 6 - Day 1 = complete control; Days 2-5 = severe nausea.
Patients rated significant CINV (CINV 3-6) comparable to the score for death.
1. Sun C, Bodurka D, Donato M et al. Nausea and vomiting side-effects of cancer therapies: preference assessments from patients, health care providers and healthy women. Support Care Cancer. 2002:10:378. Abstract #93.