Oncology care involves complex treatment regimens for cancer patients. New targeted drugs are more specific but adherence is challenging for oral therapies. Oncology Care provides intensive clinical assessments, education and support to help patients adhere to oral drug regimens and collaborate with physicians for optimal cancer treatment outcomes.
Hepatocellular carcinoma is one of the most common malignancies worldwide. Its incidence varies significantly between regions, from low rates in the United States and Africa to very high rates in parts of Asia. Major risk factors include chronic hepatitis B and C infections. Clinical features can include abdominal pain, weight loss, jaundice, and hepatomegaly. Diagnosis involves blood tests, ultrasound, CT scan, MRI and sometimes liver biopsy. High-risk groups are screened regularly through alpha-fetoprotein testing and ultrasound. Treatment options depend on the stage but may include surgical resection, ablation, chemotherapy, and transplantation.
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● Signs and symptoms of blood clots, also known as venous thrombosis
● What types of treatments are available
● Why people living with cancer should be aware of the dangers of blood clots and what to do if they occur.
View the video: https://youtu.be/PbZQCHRhoOQ
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The document discusses hepatocellular carcinoma (HCC). It is the most common type of primary liver cancer, accounting for 90% of cases. Risk factors include cirrhosis of the liver caused by hepatitis B, hepatitis C, alcohol use, and non-alcoholic fatty liver disease. Chronic hepatitis B infection significantly increases the risk. The risk of developing HCC is also higher in men than women and increases with age. Precancerous lesions can develop due to chronic liver damage and increase the risk of HCC.
This document summarizes the management of hepatocellular carcinoma. It begins by introducing HCC as the most common form of liver cancer. It then discusses risk factors, surveillance methods, diagnosis via imaging and biopsy, and the BCLC staging system. The BCLC system links stage of disease to treatment options and expected survival outcomes. For early stages, curative treatments like resection, transplantation, and ablation are recommended. Intermediate stages receive transarterial chemoembolization, while advanced stages are treated with sorafenib. End-stage disease involves symptomatic support only.
Oncology is the study of malignant diseases such as cancer. The oldest treatment is surgery, but now includes radiotherapy and drug treatments. Cancer prevalence is high, being the second leading cause of death in Western countries. The risk varies based on age, sex, geography, and lifestyle/environmental factors. Screening programs exist for some common cancers to facilitate earlier detection and improved outcomes. Treatment selection considers the patient's age, general health, and preferences.
Cancer is caused by uncontrolled cell growth that spreads locally and metastasizes throughout the body, with over 100 types of cancer that can develop. The four most common cancers are breast, lung, prostate, and colorectal cancer, which together account for around half of all new cancer cases diagnosed in the United States each year. The document discusses the causes of cancer from genetic mutations and carcinogens like tobacco, as well as types of treatment including chemotherapy, radiation therapy, and efforts toward prevention through lifestyle changes and cancer screening.
This document provides an overview of the management of hepatocellular carcinoma (HCC). It discusses the epidemiology, risk factors, diagnosis and staging, as well as treatment options for HCC. The major risk factors for HCC include hepatitis B virus, hepatitis C virus, and alcohol. Treatment depends on the stage and includes options such as liver transplantation, resection, ablation, transarterial chemoembolization, and the systemic therapy sorafenib. Prevention through vaccination and treating underlying liver diseases can help reduce cases of HCC.
The document outlines the presentation of an oncology lecture covering topics such as epidemiology, cancer etiology, biology, risk assessment, screening, diagnosis, staging, and treatment approaches including surgery, chemotherapy, and radiation therapy. It introduces cancer definitions and discusses factors influencing cancer risk like genetics and environmental exposures. It also explains concepts such as tumor initiation and progression, roles of oncogenes and tumor suppressor genes, angiogenesis, metastasis and cancer invasion.
Hepatocellular carcinoma is one of the most common malignancies worldwide. Its incidence varies significantly between regions, from low rates in the United States and Africa to very high rates in parts of Asia. Major risk factors include chronic hepatitis B and C infections. Clinical features can include abdominal pain, weight loss, jaundice, and hepatomegaly. Diagnosis involves blood tests, ultrasound, CT scan, MRI and sometimes liver biopsy. High-risk groups are screened regularly through alpha-fetoprotein testing and ultrasound. Treatment options depend on the stage but may include surgical resection, ablation, chemotherapy, and transplantation.
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● Signs and symptoms of blood clots, also known as venous thrombosis
● What types of treatments are available
● Why people living with cancer should be aware of the dangers of blood clots and what to do if they occur.
View the video: https://youtu.be/PbZQCHRhoOQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
The document discusses hepatocellular carcinoma (HCC). It is the most common type of primary liver cancer, accounting for 90% of cases. Risk factors include cirrhosis of the liver caused by hepatitis B, hepatitis C, alcohol use, and non-alcoholic fatty liver disease. Chronic hepatitis B infection significantly increases the risk. The risk of developing HCC is also higher in men than women and increases with age. Precancerous lesions can develop due to chronic liver damage and increase the risk of HCC.
This document summarizes the management of hepatocellular carcinoma. It begins by introducing HCC as the most common form of liver cancer. It then discusses risk factors, surveillance methods, diagnosis via imaging and biopsy, and the BCLC staging system. The BCLC system links stage of disease to treatment options and expected survival outcomes. For early stages, curative treatments like resection, transplantation, and ablation are recommended. Intermediate stages receive transarterial chemoembolization, while advanced stages are treated with sorafenib. End-stage disease involves symptomatic support only.
Oncology is the study of malignant diseases such as cancer. The oldest treatment is surgery, but now includes radiotherapy and drug treatments. Cancer prevalence is high, being the second leading cause of death in Western countries. The risk varies based on age, sex, geography, and lifestyle/environmental factors. Screening programs exist for some common cancers to facilitate earlier detection and improved outcomes. Treatment selection considers the patient's age, general health, and preferences.
Cancer is caused by uncontrolled cell growth that spreads locally and metastasizes throughout the body, with over 100 types of cancer that can develop. The four most common cancers are breast, lung, prostate, and colorectal cancer, which together account for around half of all new cancer cases diagnosed in the United States each year. The document discusses the causes of cancer from genetic mutations and carcinogens like tobacco, as well as types of treatment including chemotherapy, radiation therapy, and efforts toward prevention through lifestyle changes and cancer screening.
This document provides an overview of the management of hepatocellular carcinoma (HCC). It discusses the epidemiology, risk factors, diagnosis and staging, as well as treatment options for HCC. The major risk factors for HCC include hepatitis B virus, hepatitis C virus, and alcohol. Treatment depends on the stage and includes options such as liver transplantation, resection, ablation, transarterial chemoembolization, and the systemic therapy sorafenib. Prevention through vaccination and treating underlying liver diseases can help reduce cases of HCC.
The document outlines the presentation of an oncology lecture covering topics such as epidemiology, cancer etiology, biology, risk assessment, screening, diagnosis, staging, and treatment approaches including surgery, chemotherapy, and radiation therapy. It introduces cancer definitions and discusses factors influencing cancer risk like genetics and environmental exposures. It also explains concepts such as tumor initiation and progression, roles of oncogenes and tumor suppressor genes, angiogenesis, metastasis and cancer invasion.
1) Armand Trousseau was the first to associate thrombosis and malignancy in the 19th century and suggest screening cancer patients for thrombosis.
2) Cancer patients have a highly elevated risk of developing venous thromboembolism (VTE), which can occur in up to 20% and is a common cause of death.
3) The presence of VTE at cancer diagnosis is associated with worse prognosis and survival rates. Tissue factor expression by tumor cells contributes to increased coagulation and thrombosis.
The document summarizes hepatocellular carcinoma (HCC) and examines hepatitis C virus (HCV) as a risk factor. It provides descriptive epidemiology on HCC, identifying it as the 4th most common cancer worldwide. It then analyzes HCV as a major risk factor for HCC. Details are given on the virology, epidemiology, transmission routes, stages of infection, diagnosis and treatment of HCV, as well as its role in leading to HCC. Recommendations for primary prevention include national HBV vaccination programs and screening blood supplies.
Grading and staging of tumors and paraneoplastic syndromeShiksha Choytoo
This document discusses grading and staging of tumors and paraneoplastic syndrome. Grading is done based on differentiation and mitotic figures, with tumors graded on a scale of G1 to G4. Staging uses the TNM system to describe tumor size (T), lymph node involvement (N), and metastasis (M). Together, grading and staging provide information on prognosis and guide treatment. Paraneoplastic syndromes are unrelated to direct tumor involvement and may be caused by hormones or antibodies. Examples include endocrinopathies, neurological disorders, dermatological changes, and vascular/hematological syndromes associated with certain cancers. Grading, staging, and recognizing paraneoplastic syndromes help characterize cancers and their systemic
1) Adjuvant therapy refers to additional treatment given after primary treatment like surgery to eradicate micrometastasis and reduce the risk of cancer recurrence.
2) For colon adenocarcinoma, common adjuvant therapy options include chemotherapy regimens like FOLFOX and CapeOX. Clinical trials have shown these regimens improve disease-free and overall survival for stage III colon cancer patients.
3) Side effects of adjuvant chemotherapy include nausea, diarrhea, fatigue and neuropathy, though most symptoms improve after treatment completion. Elderly patients may receive less intensive regimens due to higher risk of side effects.
Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It has a high worldwide incidence, especially in areas where hepatitis B is prevalent like Southeast Asia. Major risk factors for HCC include hepatitis B and C infections, cirrhosis of the liver from any cause, and alcohol abuse. The disease progresses as hepatocytes undergo repeated cycles of cell death and regeneration due to chronic inflammation and cirrhosis, accumulating mutations over time that can lead to cancer. Diagnosis involves blood tests, imaging like ultrasound or CT scan, and often a biopsy. Staging systems evaluate tumor characteristics, liver function, and physical status to determine prognosis and treatment options. Treatment may include surgical resection, liver transplantation, ablation
This document discusses principles of oncology including cell number control, growth disorders, cancer classification, tumor spread and metastasis, stages of cancer, and an overview of carcinogenesis. It defines key terms like neoplasia, benign and malignant tumors, dysplasia, carcinoma and sarcoma. It also summarizes the hallmarks of cancer including self-sufficiency in growth signals, evasion of apoptosis, unlimited replicative potential, sustained angiogenesis, and genetic instability.
Risk Stratification in Stage II Colon Cancer PatientsRamzi Amri
Objective: AJCC Stage II colon cancer patients form a group where the choice to either undergo or forego adjuvant chemotherapy is far from evident and often remains controversial. This study analyzes several pathological characteristics in order to assess their predictive value for outcomes in stage II colon cancer.
Design: Retrospective review of a prospectively maintained, IRB-approved data repository.
Setting: Tertiary care center.
Patients: A series of 313 consecutive stage II patients treated surgically for colon cancer at our center (2004-2011) were included.
Main outcome measures: Mortality, disease-specific mortality and metastasis, including multivariable Cox regression adjusted for stage subdivisions (II-A/II-B/II-C) and potential confounders.
Results: Colon cancer-specific mortality was substage-independently increased in patients with baseline carcinoembryonic antigen (CEA) >5ng/L (HR=2.97;P=0.041), large vessel invasion (HR=3.93; P=0.002) and perineural invasion (HR=3.67; P=0.004). Overall mortality adjusted for substage, age and comorbidity was also significantly higher in patients with high-grade disease (HR=2.73; P<0.001)><0.001).>5ng/L (HR=2.37; P=0.046), large vessel invasion (HR=2.80; P=0.002), perineural invasion (HR=2.57; P=0.010), and extramural vascular invasion (EMVI) (HR=2.83; P=0.002). The number of high-risk features (0,1,2-3,4+) was associated with a clearly incremental increase in disease-specific mortality (P=0.008) and recurrence (P<0.001).>5ng/L, large vessel invasion, perineural invasion and EMVI are all independent risk factors for recurrence and disease-specific mortality in Stage II colon cancer patients. The number of factors present form risk strata that should be weighed heavily in decisions regarding adjuvant treatment.
This document discusses hepatocellular carcinoma (HCC), the most common type of primary liver cancer. It covers the epidemiology, risk factors, pathogenesis, clinical presentation, diagnosis, prognostic factors, and treatment options for HCC. The highest rates are seen in regions where hepatitis B is endemic, and major risk factors include chronic hepatitis B and C infections, cirrhosis, and aflatoxin exposure. Diagnosis involves imaging tests like ultrasound, CT, and MRI along with blood tests. Treatment depends on tumor size and liver function, and may include resection, transplantation, ablation, embolization, or chemotherapy.
Chemotherapy uses cytotoxic drugs to treat cancer by killing cancer cells. There are several types of chemotherapy treatments that are selected based on the type, stage, and genetics of the cancer. The goals of chemotherapy can be curative, aiming to eradicate the cancer through induction, consolidation, and maintenance therapy, or palliative to provide comfort and improve quality of life for advanced cancers. A case study is then presented to demonstrate chemotherapy treatment in practice.
Cancer is a leading cause of death that is increasing in incidence but decreasing in mortality. Risk factors include lifestyle choices like smoking and diet, as well as genetic predispositions. Cancer is typically detected through screening, clinical presentation of symptoms, or incidental findings. Treatment depends on the cancer type, stage, and patient characteristics, and may involve surgery, radiation, chemotherapy, targeted therapies, or palliative care. Improving prevention, early detection, and more effective treatments continue to help reduce the impact of cancer.
Liver cancer diagnostics and Future trendsThet Su Wynn
Liver cancer is usually diagnosed through a combination of tumor marker tests, imaging scans, and biopsy. Serum markers like AFP, AFP-L3, and PIVKA-II provide early screening but lack specificity. Ultrasound, CT, and MRI scans use contrast agents to detect hypervascular lesions during arterial wash-in and wash-out, but are not definitive. Biopsy confirms the diagnosis by examining tissue samples for liver cell abnormalities, fibrosis, and marker expression through histology and IHC staining. Future areas of research include improved non-invasive diagnostic tools using genetic markers like miRNA profiles and tumor-specific genes.
This presentation is about hepatocellular carcinoma. Discussing in detail about neoplasia and neoplasia progression,nomencleature, carcinogens, oncogenic microbes, serum tumor markers, pathogenesis, morphology and clinical features.
NEOPLASIA: Clinical Features of Tumors, Grading and Staging & Laboratory Diag...Dr. Roopam Jain
This document discusses neoplasia, including the clinical features and effects of tumors on the host. It describes local effects like compression and obstruction, as well as systemic manifestations such as cancer cachexia, fever, and paraneoplastic syndromes. Grading and staging of tumors is covered, examining differentiation and the prognostic value of staging. Methods for laboratory diagnosis of cancer are summarized, including histological analysis and the use of tumor markers.
1) Primary liver cancer (hepatocellular carcinoma or HCC) represents the 5th most common cancer worldwide and the 2nd leading cause of cancer death.
2) HCC has a dismal prognosis with a 5-year survival rate below 10% due to a lack of effective screening and early detection methods.
3) Chronic hepatitis B and C infections are the most important risk factors for HCC development, responsible for over 75% of cases globally. Other risk factors include cirrhosis, alcohol abuse, and aflatoxin B1 exposure.
The document discusses cancer risk factors and types of cancer like breast cancer and leukemia. It provides details on formation of cancer cells, types of tumors, risk factors for cancer like age, habits, family history and environment. For breast cancer, it discusses symptoms, risk factors, types, related genes and diagnostic tests. For leukemia, it covers types, effects, symptoms, risk factors, genetic mutations, diagnosis and treatment therapies.
Liver Tumors and Hepatocellular carcinoma supported by Hepatoblastoma. Most of the text are from Robbins Pathological basis of disease 9E, Goljan Review of pathology.
Venous thromboembolism (VTE) can be the first sign of an underlying occult or undiagnosed cancer. The risk of occult cancer is higher in patients with unprovoked VTE compared to those with VTE from a provoking factor. Limited screening is recommended for patients over age 40 presenting with unprovoked VTE, including a complete blood count, basic metabolic panel, chest imaging, and consideration of tumor markers based on risk factors. More extensive screening with CT scans is not supported by evidence of improved outcomes and poses risks of unnecessary anticoagulation withdrawal or additional testing. Ongoing surveillance beyond initial screening may be warranted in certain high risk cases such as recurrent unprovoked VTE
Chemo hormonal and targeted therapy in ca breast Rahul Sankar
This document discusses various treatments for breast carcinoma including chemotherapy, hormonal therapy, and targeted therapy. It provides details on:
- The indications for chemotherapy including tumor size, node involvement, and molecular factors.
- How prognostic factors like tumor grade and molecular markers help determine treatment.
- Studies that helped establish chemotherapy regimens and combinations like adding taxanes or using dose-dense schedules.
- The use of neoadjuvant chemotherapy and outcomes seen with complete responses.
- Hormonal therapies for hormone receptor positive cancers including tamoxifen, aromatase inhibitors, and ovarian ablation.
- Targeted therapies for HER2 positive cancers including trastuzumab and newer agents.
1) Armand Trousseau was the first to associate thrombosis and malignancy in the 19th century and suggest screening cancer patients for thrombosis.
2) Cancer patients have a highly elevated risk of developing venous thromboembolism (VTE), which can occur in up to 20% and is a common cause of death.
3) The presence of VTE at cancer diagnosis is associated with worse prognosis and survival rates. Tissue factor expression by tumor cells contributes to increased coagulation and thrombosis.
The document summarizes hepatocellular carcinoma (HCC) and examines hepatitis C virus (HCV) as a risk factor. It provides descriptive epidemiology on HCC, identifying it as the 4th most common cancer worldwide. It then analyzes HCV as a major risk factor for HCC. Details are given on the virology, epidemiology, transmission routes, stages of infection, diagnosis and treatment of HCV, as well as its role in leading to HCC. Recommendations for primary prevention include national HBV vaccination programs and screening blood supplies.
Grading and staging of tumors and paraneoplastic syndromeShiksha Choytoo
This document discusses grading and staging of tumors and paraneoplastic syndrome. Grading is done based on differentiation and mitotic figures, with tumors graded on a scale of G1 to G4. Staging uses the TNM system to describe tumor size (T), lymph node involvement (N), and metastasis (M). Together, grading and staging provide information on prognosis and guide treatment. Paraneoplastic syndromes are unrelated to direct tumor involvement and may be caused by hormones or antibodies. Examples include endocrinopathies, neurological disorders, dermatological changes, and vascular/hematological syndromes associated with certain cancers. Grading, staging, and recognizing paraneoplastic syndromes help characterize cancers and their systemic
1) Adjuvant therapy refers to additional treatment given after primary treatment like surgery to eradicate micrometastasis and reduce the risk of cancer recurrence.
2) For colon adenocarcinoma, common adjuvant therapy options include chemotherapy regimens like FOLFOX and CapeOX. Clinical trials have shown these regimens improve disease-free and overall survival for stage III colon cancer patients.
3) Side effects of adjuvant chemotherapy include nausea, diarrhea, fatigue and neuropathy, though most symptoms improve after treatment completion. Elderly patients may receive less intensive regimens due to higher risk of side effects.
Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It has a high worldwide incidence, especially in areas where hepatitis B is prevalent like Southeast Asia. Major risk factors for HCC include hepatitis B and C infections, cirrhosis of the liver from any cause, and alcohol abuse. The disease progresses as hepatocytes undergo repeated cycles of cell death and regeneration due to chronic inflammation and cirrhosis, accumulating mutations over time that can lead to cancer. Diagnosis involves blood tests, imaging like ultrasound or CT scan, and often a biopsy. Staging systems evaluate tumor characteristics, liver function, and physical status to determine prognosis and treatment options. Treatment may include surgical resection, liver transplantation, ablation
This document discusses principles of oncology including cell number control, growth disorders, cancer classification, tumor spread and metastasis, stages of cancer, and an overview of carcinogenesis. It defines key terms like neoplasia, benign and malignant tumors, dysplasia, carcinoma and sarcoma. It also summarizes the hallmarks of cancer including self-sufficiency in growth signals, evasion of apoptosis, unlimited replicative potential, sustained angiogenesis, and genetic instability.
Risk Stratification in Stage II Colon Cancer PatientsRamzi Amri
Objective: AJCC Stage II colon cancer patients form a group where the choice to either undergo or forego adjuvant chemotherapy is far from evident and often remains controversial. This study analyzes several pathological characteristics in order to assess their predictive value for outcomes in stage II colon cancer.
Design: Retrospective review of a prospectively maintained, IRB-approved data repository.
Setting: Tertiary care center.
Patients: A series of 313 consecutive stage II patients treated surgically for colon cancer at our center (2004-2011) were included.
Main outcome measures: Mortality, disease-specific mortality and metastasis, including multivariable Cox regression adjusted for stage subdivisions (II-A/II-B/II-C) and potential confounders.
Results: Colon cancer-specific mortality was substage-independently increased in patients with baseline carcinoembryonic antigen (CEA) >5ng/L (HR=2.97;P=0.041), large vessel invasion (HR=3.93; P=0.002) and perineural invasion (HR=3.67; P=0.004). Overall mortality adjusted for substage, age and comorbidity was also significantly higher in patients with high-grade disease (HR=2.73; P<0.001)><0.001).>5ng/L (HR=2.37; P=0.046), large vessel invasion (HR=2.80; P=0.002), perineural invasion (HR=2.57; P=0.010), and extramural vascular invasion (EMVI) (HR=2.83; P=0.002). The number of high-risk features (0,1,2-3,4+) was associated with a clearly incremental increase in disease-specific mortality (P=0.008) and recurrence (P<0.001).>5ng/L, large vessel invasion, perineural invasion and EMVI are all independent risk factors for recurrence and disease-specific mortality in Stage II colon cancer patients. The number of factors present form risk strata that should be weighed heavily in decisions regarding adjuvant treatment.
This document discusses hepatocellular carcinoma (HCC), the most common type of primary liver cancer. It covers the epidemiology, risk factors, pathogenesis, clinical presentation, diagnosis, prognostic factors, and treatment options for HCC. The highest rates are seen in regions where hepatitis B is endemic, and major risk factors include chronic hepatitis B and C infections, cirrhosis, and aflatoxin exposure. Diagnosis involves imaging tests like ultrasound, CT, and MRI along with blood tests. Treatment depends on tumor size and liver function, and may include resection, transplantation, ablation, embolization, or chemotherapy.
Chemotherapy uses cytotoxic drugs to treat cancer by killing cancer cells. There are several types of chemotherapy treatments that are selected based on the type, stage, and genetics of the cancer. The goals of chemotherapy can be curative, aiming to eradicate the cancer through induction, consolidation, and maintenance therapy, or palliative to provide comfort and improve quality of life for advanced cancers. A case study is then presented to demonstrate chemotherapy treatment in practice.
Cancer is a leading cause of death that is increasing in incidence but decreasing in mortality. Risk factors include lifestyle choices like smoking and diet, as well as genetic predispositions. Cancer is typically detected through screening, clinical presentation of symptoms, or incidental findings. Treatment depends on the cancer type, stage, and patient characteristics, and may involve surgery, radiation, chemotherapy, targeted therapies, or palliative care. Improving prevention, early detection, and more effective treatments continue to help reduce the impact of cancer.
Liver cancer diagnostics and Future trendsThet Su Wynn
Liver cancer is usually diagnosed through a combination of tumor marker tests, imaging scans, and biopsy. Serum markers like AFP, AFP-L3, and PIVKA-II provide early screening but lack specificity. Ultrasound, CT, and MRI scans use contrast agents to detect hypervascular lesions during arterial wash-in and wash-out, but are not definitive. Biopsy confirms the diagnosis by examining tissue samples for liver cell abnormalities, fibrosis, and marker expression through histology and IHC staining. Future areas of research include improved non-invasive diagnostic tools using genetic markers like miRNA profiles and tumor-specific genes.
This presentation is about hepatocellular carcinoma. Discussing in detail about neoplasia and neoplasia progression,nomencleature, carcinogens, oncogenic microbes, serum tumor markers, pathogenesis, morphology and clinical features.
NEOPLASIA: Clinical Features of Tumors, Grading and Staging & Laboratory Diag...Dr. Roopam Jain
This document discusses neoplasia, including the clinical features and effects of tumors on the host. It describes local effects like compression and obstruction, as well as systemic manifestations such as cancer cachexia, fever, and paraneoplastic syndromes. Grading and staging of tumors is covered, examining differentiation and the prognostic value of staging. Methods for laboratory diagnosis of cancer are summarized, including histological analysis and the use of tumor markers.
1) Primary liver cancer (hepatocellular carcinoma or HCC) represents the 5th most common cancer worldwide and the 2nd leading cause of cancer death.
2) HCC has a dismal prognosis with a 5-year survival rate below 10% due to a lack of effective screening and early detection methods.
3) Chronic hepatitis B and C infections are the most important risk factors for HCC development, responsible for over 75% of cases globally. Other risk factors include cirrhosis, alcohol abuse, and aflatoxin B1 exposure.
The document discusses cancer risk factors and types of cancer like breast cancer and leukemia. It provides details on formation of cancer cells, types of tumors, risk factors for cancer like age, habits, family history and environment. For breast cancer, it discusses symptoms, risk factors, types, related genes and diagnostic tests. For leukemia, it covers types, effects, symptoms, risk factors, genetic mutations, diagnosis and treatment therapies.
Liver Tumors and Hepatocellular carcinoma supported by Hepatoblastoma. Most of the text are from Robbins Pathological basis of disease 9E, Goljan Review of pathology.
Venous thromboembolism (VTE) can be the first sign of an underlying occult or undiagnosed cancer. The risk of occult cancer is higher in patients with unprovoked VTE compared to those with VTE from a provoking factor. Limited screening is recommended for patients over age 40 presenting with unprovoked VTE, including a complete blood count, basic metabolic panel, chest imaging, and consideration of tumor markers based on risk factors. More extensive screening with CT scans is not supported by evidence of improved outcomes and poses risks of unnecessary anticoagulation withdrawal or additional testing. Ongoing surveillance beyond initial screening may be warranted in certain high risk cases such as recurrent unprovoked VTE
Chemo hormonal and targeted therapy in ca breast Rahul Sankar
This document discusses various treatments for breast carcinoma including chemotherapy, hormonal therapy, and targeted therapy. It provides details on:
- The indications for chemotherapy including tumor size, node involvement, and molecular factors.
- How prognostic factors like tumor grade and molecular markers help determine treatment.
- Studies that helped establish chemotherapy regimens and combinations like adding taxanes or using dose-dense schedules.
- The use of neoadjuvant chemotherapy and outcomes seen with complete responses.
- Hormonal therapies for hormone receptor positive cancers including tamoxifen, aromatase inhibitors, and ovarian ablation.
- Targeted therapies for HER2 positive cancers including trastuzumab and newer agents.
- Chemotherapy began during WWII after observing bone marrow aplasia and lymphoid tissue dissolution in soldiers exposed to nitrogen mustard.
- Chemotherapy can be used definitively, as neoadjuvant therapy before surgery/radiation, adjuvantly after other treatments, or concurrently with radiation therapy.
- Common drugs include alkylating agents, antimetabolites, platinum compounds, taxanes, and antibiotics. They work by alkylating DNA, inhibiting DNA/RNA synthesis, or interfering with microtubule formation.
- Major toxicities include bone marrow suppression, gastrointestinal issues like mucositis, alopecia, and increased risk of infection. Careful patient monitoring is important during chemotherapy treatment.
1) Recent advances in cancer chemotherapy include the development of newer alkylating agents, platinum compounds, antimetabolites, mitotic spindle inhibitors, and topoisomerase inhibitors with improved efficacy and reduced toxicity profiles.
2) Many newer agents aim to overcome resistance to existing drugs by bypassing drug efflux pumps or having activity in cisplatin/taxane resistant settings.
3) Several new drugs have received FDA approval in the last decade for cancers like breast cancer, lung cancer, and leukemia, offering additional treatment options.
- German chemist Paul Ehrlich coined the term "chemotherapy" to refer to treatment of disease with chemical drugs. By the 1950s, the term was primarily used to refer to drugs used to treat cancer.
- Chemotherapy involves using drugs to treat cancer and typically involves drugs that interfere with cell division, such as methotrexate or fluorouracil.
- The choice of chemotherapy depends on factors like the location and stage of the tumor and the patient's health. While it can cure some cancers, it is most effective against cancer before metastasis.
Basic principles of chemotherapy/ AMAs covers definition, history of AMAs development, principles of AMAs, problems associated with AMAs, failure of therapy with examples.
Chemotherapy involves the use of cytotoxic drugs to treat cancer. The goals of chemotherapy are to cure cancer, improve survival rates, or relieve symptoms. Key principles of chemotherapy include: (1) using drug combinations to increase efficacy and decrease resistance, (2) treating micrometastatic disease early on, and (3) dose intensity being important for response. Adjuvant chemotherapy after surgery or radiation has improved survival rates for several cancers like breast cancer and osteosarcoma by targeting remaining micrometastatic disease.
Chemotherapy uses anti-cancer drugs to destroy cancer cells. It can be curative for some cancers like leukemias, Wilms tumor, and Hodgkin's lymphoma. The drugs work by interfering with cell division through different mechanisms and can be cell cycle specific or non-specific. Alkylating agents are a common class of chemotherapy drugs that work by transferring alkyl groups to DNA, causing cross-linkages and strand breaks to damage DNA and inhibit cell proliferation. Combination chemotherapy and intermittent dosing regimens are often used to improve outcomes.
This document summarizes various classes and subclasses of cancer chemotherapy drugs, including their mechanisms of action, toxicities, and therapeutic uses. It discusses cell cycle-specific agents like alkylating agents, antimetabolites, plant alkaloids, and hormones. Alkylating agents like cyclophosphamide can alkylate DNA. Antimetabolites like methotrexate and 5-fluorouracil interfere with DNA synthesis. Plant alkaloids including vinca alkaloids and taxanes affect microtubules. Hormonal therapies include tamoxifen, aromatase inhibitors, and gonadotropin-releasing hormone agonists. The document provides detailed information on numerous chemotherapy drugs.
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7 Active Technology Solutions Pvt.Ltd. is an educational 3D digital content provider for K-12. We also customise the content as per your requirement for companies platform providers colleges etc . 7 Active driving force "The Joy of Happy Learning" -- is what makes difference from other digital content providers. We consider Student needs, Lecturer needs and College needs in designing the 3D & 2D Animated Video Lectures. We are carrying a huge 3D Digital Library ready to use.
WTF - Why the Future Is Up to Us - pptx versionTim O'Reilly
This is the talk I gave January 12, 2017 at the G20/OECD Conference on the Digital Future in Berlin. I talk about fitness landscapes as applied to technology and business, the role of unchecked financialization in the state of our politics and economy, and why technology really wants to create jobs, not destroy them. (There is a separate PDF version, but some readers said the notes were too fuzzy to read.)
The document provides an overview of cancer biology, including key terminology, epidemiology, etiology, prevention, screening, diagnosis, staging, treatment, and biomarkers. It defines various types of cancers and neoplasms, describes the cellular and genetic events leading to cancer development, and outlines the general principles and goals of cancer treatment, which may include surgery, chemotherapy, radiation therapy, and palliative care.
This document provides information about cancer nursing management. It discusses the roles and responsibilities of oncology nurses, which include assessing patient needs, providing education and support, administering chemotherapy safely, and managing side effects. It also summarizes common cancer types, treatments including chemotherapy, and the nurse's role in assessing and managing issues like infection risk, bleeding, skin integrity, oral health, alopecia, pain, and supporting patients' emotional well-being.
Oncology is the study of malignant diseases such as cancer. The oldest treatment is surgery, but now includes radiotherapy and drug treatments. Cancer prevalence is high, being the second leading cause of death in Western countries. The risk of developing certain cancers varies based on age, sex, geography, genetics, lifestyle, and environmental factors. Screening programs exist for some common cancers to facilitate earlier detection and improved treatment outcomes.
This document discusses cancer and disasters. It notes that cancer patients are vulnerable during disasters as infrastructure damage can disrupt treatment and medical records. Access to oncologists, medications, treatment continuity and transportation are challenges. Social isolation is a risk, and chronic illnesses may be exacerbated by disaster conditions like lack of resources. The document provides recommendations for cancer patients during disasters such as keeping medication logs, drinking fluids, and educating on their disease and resources. It also recommends outreach programs and incorporating local chronic needs into disaster planning and response.
Integrative Cancer - New theories and Advances in Treatment From Hippocrates ...Sheldon Stein
Professor Serge Jurasunsas' recent paper on Integrative Cancer, From Hippocrates to the Human Genome - posted on his behalf. Discusses testing, protocols and case discussion.
The document discusses cancer, including its definition, prevalence, risk factors, types, stages, and services available in Nepal. Some key points:
- Cancer is characterized by abnormal cell growth that can invade tissues and spread to other parts of the body. It is one of the leading causes of death worldwide.
- Major risk factors include tobacco use, chronic infections, alcohol consumption, dietary factors, obesity, radiation, and genetic predisposition.
- Common cancers in Nepal are cervical, lung, breast, oral, and stomach cancers. Cancer services have expanded in recent decades with four radiation therapy centers now available.
- Staging involves determining how much cancer is present and where, in order to select the most
Cancer development and cancer nursing created by Marsha Woodall MBA, MSN, RNnursemba
The document outlines objectives and content for a nursing course on cancer, including defining cancer, risk factors, screening and prevention strategies, stages and treatment options like surgery, chemotherapy, and radiation therapy. It discusses the side effects of cancer treatment like nausea, fatigue, and myelosuppression and provides an overview of chemotherapy drugs and their mechanisms of action.
This document provides an overview of cancer care including characteristics of cancerous growth, risk factors, prevention, detection, diagnostic tests, treatment options, common problems, nursing management, and care of the dying patient. Key points covered include the stages of cancer progression, common cancers and their risk factors, screening recommendations, surgery, radiation, chemotherapy, and nursing interventions to address side effects and provide psychosocial support.
Venous Thromboembolism in the Cancer Patientlarriva
Cancer patients are at an increased risk of venous thromboembolism. There have been several guidelines published on the topic from the American College of Chest Physicians (ACCP), the American Society of Clinical Oncology (ASCO), and the National Comprehensive Cancer Network (NCCN). Although they agree on some issues regarding prophylaxis and treatment there are several areas that vary. This presentation covers the varying recommendations and the areas of consensus (yellow boxes) among the guidelines while using a patient case to guide their interpretation.
Treatment of Acute Myeloid Leukemia & Supportive CareJoseph Helms
This document discusses treatment and supportive care for a patient with acute myeloid leukemia (AML) that developed after myelodysplastic syndrome (MDS). It provides details on the patient's history, diagnostic testing results showing the presence of AML, and an overview of AML including typical treatment approaches. The document outlines the patient's induction therapy of 7+3 chemotherapy and supportive medications. It also reviews guidelines for post-remission treatment and monitoring, as well as approaches for relapse.
This document provides information about oncology and cancer including definitions of key terms, characteristics of benign and malignant neoplasms, cancer etiology, methods of detection and prevention, risk factors, and warning signs. It defines terms like alopecia, carcinogenesis, chemotherapy, and metastasis. Benign tumors are well-differentiated, slow growing, and localized while malignant tumors are undifferentiated, infiltrative, and can metastasize. Cancer prevention focuses on reducing risks through healthy behaviors and early detection through screening.
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.
Multiple primary cancers arise independently in the same or different organs and have different histologies. They occur in 2-17% of cancer patients, with the most common being lung, bladder, and lymphomas. Risk factors include family history, cancer predisposition syndromes, environmental exposures, and prior therapies. Diagnosis requires histologic confirmation of independent primaries. Management involves an multidisciplinary approach considering goals of care, interactions between treatments, residual toxicities from prior therapies, and surveillance for secondary malignancies.
This document provides an outline and learning objectives for a presentation on cancer. The outline includes sections on solid tumors, hematological malignancies, and chemotherapy complications. The learning objectives cover topics such as the difference between cancer and tumors, epidemiology of cancer in Palestine, cancer mechanisms, screening, staging, signs and symptoms, diagnosis, and treatment. Statistics are provided on cancer incidence and mortality rates in Palestine in 2016. Risk factors, prevention strategies, and genetic factors involved in carcinogenesis are discussed.
Nursing management of patients with oncological conditionsANILKUMAR BR
Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells.
Cancer is caused by external factors and internal factors which may act together to initiate or promote carcinogenesis.
External Factors - chemicals, radiation, viruses, and lifestyle.
Internal Factors – hormones, immune condition, and inherited mutations.
Oncology branch of medicine deals with etiology, diagnosis, treatment and prevention of cancer.
Onco - is a Greek word meaning tumor .
Running head INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS1.docxcowinhelen
Running head: INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS 1
INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS 18
Ineffective Cancer treatments leading to deaths
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Abstract
The main focus of the report will be to research on the various methods through which cancer can be treated with a keen eye on why some methods are ineffective and lead to death. A discussion on different cancer treatment will be done followed by the types of cancer that cause millions of death today. Presentation of answers to the research questions will be done in line with ineffective cancer treatment methods. Relevant literature review will be conducted and used to support the claims of ineffective cancer treatments. Lastly, recommendations on the best cancer treatment will be done.
Introduction
Cancer is an ailment caused by the unrestrained division of abnormal cells in the body. The cancer cells are malignant meaning they can spread from the origin to distant organs and tissues. The disease can be genetically hereditary hence can be crossed over from one generation to another. Some of the forms of cancer treatment include targeted therapy, hormone therapy, chemotherapy, precision medicine, surgery, immunotherapy, and stem cell transplant. Some of the common types of this disease include lung, liver, stomach, and bowel cancers.
Cancer is also called as malignancy which means abnormal cells growth. More than 100 types of cancer are found in this world today, including breast cancer (widely spread among women), skin cancer (found in the person of almost every age), lung cancer (common among smokers), colon cancer, lymphoma and prostate cancer. Each kind of cancer has varying symptoms. Cancer differs with respect to the cell it affects first. The uncontrollable division of cells harm the body and form lumps and the masses of tissues which are known as tumors. The tumor grows in size and sometimes even intervene the digestive system, circulatory system, excretory system and nervous system. In the case of leukemia, cancer inhibits the normal blood functioning which is caused due to the abnormal cell division into the blood stream. Cancer also causes the systems of the body to secrete hormones that alter the body functioning. Tumors that do not grow and remain limited to one spot are considered to slightly less harmful and benign. The sign of the more dangerous and malignant cells is:
1. The harmful cancerous cells move from one spot to another throughout the body using blood as a medium and invade the organs and the healthy tissues of the body.
2. These cells grow and divide rapidly, they make blood vessels of their own which are used by them in the process of feeding, called as angiogenesis.
Then comes a stage is known as metastasized in which the tumor spread successfully to the other parts of the body, penetrating into the healthy tissues of the body and damaging them badly. The process is known as metastasis. It cause ...
Deep Venous Thromboembolism in Gynecological Malignanciessemualkaira
Deep venous thrombosis is a severe complication often following
gynecological malignancy. It presents a main reason of post-operative complication, morbidity and mortality in these patients. It is
crucial to know risk factors and to diagnose possible early manifestations of the disease in time [1]. DVT is the second leading
cause of death in patients with gynecologic cancer and the risk of
DVT in women underwent gynecologic surgery ranged from 17%
to 40%, while the rate of pulmonary embolism (PE) was about 1%
to 26% [2].
Deep Venous Thromboembolism in Gynecological Malignanciessemualkaira
Deep venous thrombosis is a severe complication often following
gynecological malignancy. It presents a main reason of post-operative complication, morbidity and mortality in these patients. It is
crucial to know risk factors and to diagnose possible early manifestations of the disease in time [1]. DVT is the second leading
cause of death in patients with gynecologic cancer and the risk of
DVT in women underwent gynecologic surgery ranged from 17%
to 40%, while the rate of pulmonary embolism (PE) was about 1%
to 26% [2].
Similar to Oncology Care Clinical Review For Clinical Program Managers (20)
2. Objectives Provide background clinical information about oncology Review the basics of oncology pharmacotherapy Discuss obstacles in treating oncology patients and the role of Oncology Care 2
3. Oncology: A Payer Priority US cancer spend was $72 billion in 2004 US oncology spend is growing at 14% and rising Pharmaceutical researchers working on 750 medicines for cancer Utilization shifts to new drugs, increasing cost 565,650 Americans are expected to die of cancer this year, >1500 per day 3
4. Cancer Statistics US Mortality, 2006 Cause of Death No. of deaths % of all deaths Rank 1. Heart Diseases 631,63626.0 2. Cancer559,888 23.1 3. Cerebrovascular diseases 137,1195.7 Highest Incidence Cancer Sites From 2004 SEER data Lung & bronchus 13% Colorectal 12% Prostate 11% Breast 11% .Source: US Mortality Data 2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.
5. What is cancer? Cancer consists of over 100 different diseases with similar characteristics Three characteristics of cancer uncontrolled cellular growth local tissue invasion distant metastasis 5
8. 8 Self-sufficiency in growth signals Loss of tumor suppressor genes leads to “immortal” cells Oncogenes signal cells to survive and continue proliferating Insensitivity to antigrowth signals Evading Apoptosis Stimulate growth of blood supply Metastasis via blood and lymph vessels Tissue Invasion and metastasis Sustained angiogenesis Invasion of surrounding vasculature Produce telomerase to replace lost telomeres Limitless replicative potential
9. How does cancer spread? Metastases- the spread of cancer from the primary site to a distant site Occurs via blood and lymph vessels Most common sites are: Brain Bone Lungs liver 9
10. How is cancer diagnosed? Screening: Breast cancer Colorectal cancer Prostate Cancer Cervical cancer Diagnosis is made by BIOPSY! 10
11. Cancer’s Seven Warning Signs for Adults Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in breast or elsewhere Indigestion or difficulty in swallowing Obvious change in wart or mole Nagging cough or hoarseness 11
17. May be a sore or inflammation rather than a noticeable bump
18. i.e. skin cancer, inflammatory breast cancerOncology Care Drugs for Solid Tumors Thalomid, Tarceva, Hycamtin, Temodar, Nexavar,Tykerd, Xeloda, Sutent, Afinitor, Iressa Nature Publication Group
19. 14 Hematological Malignancies Oncology Care Drugs these uses: Gleevec, Thalomid, Tasigna, Revlimid, Sprycel, Zolinza http://www.healthsystem.virginia.edu/internet/hematology/hessedd/malignanthematologicdisorders/leukemias/atl-l.cfm
20. Modalities for treatment Surgery Oldest modality Treatment of choice for most solid tumors diagnosed in early stage Provides local control Radiation Local treatment for tumor, can also be to surgical bed where a tumor was Chemotherapy Provides local and systemic control Can treat local tumor and distant metastasis Designed to target rapidly dividing cells Biologic and Targeted Therapy Systemic control Targeting features specifically found on the cancer cells More specific targets than traditional chemotherapy 15
30. 22 Oncology Pipeline Glutamine Approvable Adjuvant Afibercept Phase III Ovarian CA Genasense Complete CLL Apthera Phase III Breast CA Sarasar Phase III MDS, CMML Onconase 2009 NSCLC AastromReplicell Phase III Solid Tumors Mepact Phase III Osteoscarcoma S-1 Phase III Gastric CA Lestaurtinib Phase III AML Deforolimus Phase II Soft Tissue Sarcomas TNFerade Phase III Pancreatic CA Saforis Approvable Adjuvant Picoplatin Phase III SCLC Pixantrone Phase III NHL Galiximab Phase III NHL Provenge 2009 Prostate CA Biovest 2009 NHL Virulizin Phase III Pancreatic CA Bosutinib Phase III Leukemia Afinitor 2009 Pancreatic CA Ipilimumab Phase III Melanoma Telcyta Phase III Ovarian and Lung CA Prochymal Phase III BMT, Leukemia Arzerra 2009 NHL Pazopanib Phase III Renal CA Romidepsin Phase II Lymphoma Zactima Phase III NSCLC Trabectedin Phase III Ovarian CA Opaxio Phase III NSCLC Phenoxodiol Phase III Prostate CA
31. Advantages of Oral Chemotherapy Greater patient convenience Flexibility for timing and location of administration (home vs. physician office) Flexibility of drug exposure Potential to reduce the use of healthcare resources including supplies, services, and personnel Better quality of life 23
32. Challenges Associated with Oral Chemotherapy Interactions with other drugs, supplements and food Dysphagia, nausea, vomiting can preclude the oral route More diverse toxicity profiles associated with targeted therapies Non-adherence Patient confusion and misunderstanding Patient drug rationing due to cost Inadvertent exposure of family members to hazardous substances 24
33. Challenges Associated with Oral Chemotherapy Interactions with other drugs, supplements and food Difficulty swallowing, nausea,andvomiting can preclude the oral route More diverse toxicity profiles associated with targeted therapies Non-adherence Patient confusion and misunderstanding Patient drug rationing due to cost Inadvertent exposure of family members to hazardous substances 25
34. Adherence Rates of adherence to oral chemotherapy vary from less than 20% up to 100% Factors affecting adherence: Patient’s knowledge and understanding of the disease Beliefs and attitudes about health Quality of interaction between patient and healthcare providers Social and financial resources Complexity and duration of the treatment 26
35. Why is adherence important? Physician may attribute progression of disease to lack of activity unnecessarily change a regimen drug waste Non-adherence associated with: Increase consumption of healthcare resources More physician visits Higher hospitalization rates and longer stays Toxicities may be increased due to taking doses to close together or at the wrong time of day 27
36. Barriers to Timely Fills at Retail Pharmacies Restricted distribution Prior authorizations Limited retail stock 28 http://www.yorkdownspro.com/canadapharmacy.htm http://www.yorkdownspro.com/canadapharmacy.htm
61. References Ainse, J. “Overview of the changing paradigm in cancer treatment: Oral chemotherapy.” American Journal of Health-System Pharmacists. 1 May 2007; 64: S4-S7. Bartel, S. "Safe practices and financial considerations in using oral chemotherapeutic agents." American Journal of Health-System Pharmacists. 1 May 2007; 64: S8-S14. Campbell, M. "Oral Oncology Drugs." Drugs Topics. Advanstar Communications, 1 Feb. 2009. Accessed 9 July 2009. <http://drugtopics.modernmedicine.com/drugtopics/Modern+Medicine +Now/Oral-oncologydrugs/ArticleStandard/Article/detail/578180?contextCategoryId=42534>. Ruddy K, et al. Patient adherence and persistence with oral anticancer treatment. CA: A Cancer Journal for Clinicians. 2009; 59: 56-66. Vielle, C. Managing oral chemotherapy: The healthcare practitioner’s role. American Journal of Health-System Pharmacists. 1 May 2007; 64: S25-S32. 33
62. Summary Oncology drug therapy is complex and unique to each patient. New oncology drugs are targeted at specific cancer types, cause less overall side effects than older therapies, and are often orally dosed. Oncology Care helps to increase patient adherence by providing high touch clinical care. 34
Editor's Notes
Welcome to the Oncology Care Review for CPMs.
This presentation will provide background clinical information on oncology, review the basics of pharmacotherapy used in oncology and discuss the advantages and challenges relating to oral chemotherapy as well as how our Oncology Care program can assist with those challenges.
Oncology is a payer priority because of its high cost and rapid market growth. In 2004 the US spent $72 billion on cancer alone. The US oncology spend is growing at a current rate of 14% per year and that number is expected to rise in the next few years. This trend of growth is driven by the vast oncology pipeline. Currently there are over 750 new medications in the oncology pipeline and as these drugs are approved, it is expected that utilization will shift to them, causing an increase in cost. Despite these new drugs developments, cancer is still highly prevalent and continues to cause over 1500 deaths per day in the US alone.
Oncology is the science of cancer and cancer is a collective term for over one hundred different disease states that have similar characteristics. These three similar characteristics are uncontrolled cell growth, invasion by the cancer into local tissues, and eventually a spread of the diseased cells to distant areas of the body, known as metastasis.
Carcinogenesis is the process by which healthy cells are transformed into cancer cells. There are many steps to this process and it can take years to progress to the point where cancer is detectable.The first step is initiation, where cells are exposed to carcinogenic substances that cause damage to the cell DNA. Some carcinogens that cause this damage are UV light, radiation, tobacco, asbestos, and many others, some of which have not yet been identified. Due to the cell mutations caused by carcinogens, the cells may develop an enhanced ability to grow and replicate.The second step is promotion which is when an altered cellular environment leads to favored growth and replication of the mutated cells over the healthy cells. Transformation is when the mutated cells become cancerous cells. This step could take up to 20 years to see.After transformation is progression where further genetic changes within the cell leads to increased proliferation which may lead to invasion of the local tissues and the development of metastasis.
In this slide we see the process by which cancer occurs. At the top of the slide you see normal cell division where the cell has become mutated, but due to internal signaling, the cell goes through programmed cell death, known as apoptosis and the mutation has been eliminated. In cancer cell division, there is a problem in the mechanism telling the mutated cell to die so it continues to proliferate and make more mutated cells, which eventually lead to a tumor.
This slide depicts the many mechanisms by which cancer cells can survive and proliferate. These mechanisms are important to pharmacists because they are often the targets of pharmacotherapy used to fight the cancer. This slide is busy, so we will focus on it piece by piece. In the center we have a cancer cell and around it the circle shows all of the different mechanisms by which the cancer cells thrives.As mentioned on the previous slide one mechanism by which cancer cells thrive is to evade apoptosis. This evasion is related to lack of tumor suppressor genes and the over expression of oncogenes. These 3 mechanisms are all located on the top portion of the diagram. Oncogenes provide cancer cells with growth signals so they survive and continue to proliferate far beyond what a healthy cell would. On the top right of the diagram is insensitivity to anti-growth signals. Tumor suppressor genes provide anti-growth signals to cells and when these genes are lost or suppressed you can have immortal cells that will continue to rapidly grow and proliferate. On the bottom of the slide is mechanism by which cells are able to continue proliferating. Each cell has a set number of telomeres which are cells parts used in division. In healthy cells, once these telomeres run out the cell can no longer divide and proliferate. However, cancerous cell produce telomerase which replaces those lost telomeres and allows the cancer cell to continue dividing. As theses cells proliferate and form a tumor, they need more and more blood supply to support their increasing mass. To do this cancer cells secrete substances that stimulate the growth of blood vessels, known as angiogenesis. After all these other mechanisms are in place the tumor can then grow and invade local tissues as well as break off and invade surrounding blood and lymph vessels which may eventually lead to metastasis.
Metastasis is the spread of the cancer from the primary tumor site to distant unrelated sites. The primary tumor site cells are transferred to a new site, so breast cancer cells that move to the lungs become breast cancer of the lung. Metastasis occurs through the blood and lymph vessels. Tumor cells break off, travel through these vessels and then seed and begin growing in a new site. This new site may be lymph nodes where doctors check first for signs of metastatic disease or it may be the brain, bone, lungs, or liver which are the most common sites that solid tumors metastasize to.
Cancer is diagnosed by biopsy, but can often be found on screenings. Currently only four cancers are routinely screened for. Cancer may also be detected by changes noticed by patients. These changes that people are warned to watch for are known as the 7 warning signs of cancer.
The acronym for these 7 signs is CAUTION and they are listed here. However, many people will have no signs of cancer at all until the disease is advanced.
The over 100 cancer diseases can be split into two general categories: Solid tumors and hematological tumors. The next slides will discuss each of these in more detail.