introduction to cancer and on various tissue

1. Submittedto-
MR.SUMIT BERA (GUIDE)
NSHM KNOWLEDGE
CAMPUS KOLKATA
PRESENTED By-
Kumari Swarupma
Pharmacology
M.pharma

2. WHAT IS CANCER?
Cancer is a disease characterized by a loss in the
normal control mechanisms that govern cell survival,
proliferation, and differentiation.
Cancer cells originate from normal cells in which
the DNA within the cell nucleus has become
damaged or mutated.
Neoplastic cell comptite with normal cell for
nutritional substence,energy supplies and other
requirement articles for growth.
These rapidly dividing cell pile upon top of each
other to from a tumor.
These are of two type –
i. Benign tumor-in which metastasis doesn't
occur
ii. Malignant tumor- in which metastasis occur
(i.e secondary grouth originate from primary
tumor any where alse in the body).
Overview of changes in cells that
cause cancer.

3. Molecular pathology of cancer
GAUTAMCHATTERJEE@GMAIL.COM

4. Special characteristic of
cancer cell-
1. Uncontrolled proliferation
2. Dedifferentiation and loss of
function
3. Invasiveness
4. metastasis
Cause of cancer-
a. Carcinogenic chemical
b. Radiation
c. Diet and exercise
d. Infection
e. Heredity
f. Physical agent
g. Chemical agent
h. Environmental factor
i. Some viruses
j. Hormones
k. Autoimmune diseases
l. Mutation

5. Development of cancer
• Cancers are caused by a series of mutations. Each
mutation alters the behavior of the cell.
• Mutations is of two types-
a) proto-oncogenes (promote cell growth)
b) tumor-suppressor genes.
• Cancer develops only after a cell experience 6
key mutation.
i. Unlimited growth
ii. Ignore checkpoint
iii. Escape apoptosis
iv. Immortality
v. Promotes blood vessel growth
vi. Overcome anchor and density dependent

6. GAUTAMCHATTERJEE@GMAIL.COM 2017

7. GAUTAMCHATTERJEE@GMAIL.COM 2017
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9. Classification Of CANCER by site of origin
By primary site of origin, cancers may be of specific types like
i. breast cancer
ii. lung cancer
iii. prostate cancer
iv. liver cancer
v. renal cell carcinoma (kidney cancer)
vi. oral cancer
vii. brain cancer etc.
 This type of cancer originates from the epithelial layer of cells that form the lining
of external parts of the body or the internal linings of organs within the body.

10. Breast Cancer
STAGE I & STAGE II DISEASE
 Breast cancer is the 2nd leading cause of cancer,and 2nd most common cancer.
 It is always caused by genetic abnormality.
 Women with stage I disease (small primary tumors and negative axillary lymph node
dissections) are currently treated with surgery alone, and they have an 80% chance of
cure.
 A combination of medicines is typically used to treat breast cancer.
Chemotherapy often uses several medicines together. Some of the most commonly
used medicines are: Capecitabine,Carboplatin,Cyclophosphamide,Doxorubicin,
Gemcitabine,Paclitaxel,Vinorelbine.
Breast cancer was the first neoplasm shown to be responsive to hormonal manipulation.
Tamoxifen * is beneficial in postmenopausal women when used alone or in combination
with cytotoxic chemotherapy.
The present recommendation is to administer tamoxifen for 5 years of continuous therapy
after surgical resection.
STAGE III & STAGE IV DISEASE
About 50–60% of patients with metastatic disease respond to initial chemotherapy.
A broad range of anticancer agents have activity in this disease, including the
anthracyclines (doxorubicin,mitoxantrone,and epirubicin),the taxanes(docetaxel,paclitaxel,
and albumin-bound paclitaxel)along with the microtubule inhibitor ixabepilone, navelbine,
capecitabine, gemcitabine, cyclophosphamide,methotrexate,and cisplatin.
The anthracyclines and thetaxanes are two of the most active classes of cytotoxic drugs.

11. PROSTRATE CANCER
Prostate cancer was the second cancer shown to be responsive to hormonal manipulation
The treatment of choice for patients with advanced prostate cancer is elimination of
testosterone production by the testes through either surgical or chemical castration.
The preferred approach is to use luteinizing hormone-releasing hormone (LHRH)
agonists—including leuprolide and goserelin agonists, alone or in combination with an
antiandrogen (eg, flutamide, bicalutamide, or nilutamide.)
Second-line hormonal therapies include amino glutethimide plus hydrocortisone, the
antifungal agent ketoconazole plus hydrocortisone, or hydrocortisone alone.
Nearly all patients with advanced prostate cancer eventually become refractory to hormone
therapy.
when used in combination with either etoposide or a taxane such as docetaxel or
paclitaxel, response rates are more than doubled to 40–50%.

12. G A S T R O I N T E S T I N A L C A N C E R
Gastrointestinal cancer refers to malignant conditions of the gastrointestinal tract (GI
tract) and accessory organs of digestion, including the esophagus, stomach, biliary
system, pancreas, small intestine, large intestine, rectum and anus.
Colorectal cancer (CRC) is the Third most common type of gastrointestinal
malignancy.At the time of initial presentation,only about 40–45% of patients are
potentially curable with surgery.
Esophageal cancer is the sixth-most-common cancer in the world. There are two main
types of esophageal cancer—adenocarcinoma and squamous cell carcinoma.
Cancer of the stomach, also called gastric cancer, is the fourth-most-common type of
cancer and the second-highest cause of cancer death globally. The most common type of
gastric cancer is adenocarcinoma.
Pancreatic cancer is the fifth-most-common cause of cancer deaths in the United
States,and the seventh most common in Europe.Pancreatic cancer is the fifth-most-
common cause of cancer deaths in the United States, and the seventh most common in
Europe.
Cancers of the gallbladder are typically adenocarcinomas, and are common in elderly
women. Gallbladder cancer is strongly associated with gallstones, a porcelain
gallbladder appearance on ultrasound, and the presence of polyps within the gallbladder.
Gallbladder cancer may manifest with weight loss, jaundice, and pain in the upper right
of.

13. LUNG CANCER
Lung cancer is of two types,Non-small cell lung cancer(NSCLC)prevalence is more (75–
80%) and this group includes adenocarcinoma, squamous cell cancer, and large cell cancer.
Small cell lung cancer (SCLC) makes up 20–25%. When diagnosed at an early stage,
surgical resection results in patient cure.
Adjuvant platinum-based chemotherapy provides a survival benefit in patients with
pathologic stage IB, II, and IIIA disease.
Platinum agents (cisplatin or carboplatin) appear superior to non-platinum agents in patients
with advanced disease
For the second drug, paclitaxel and vinorelbine appear to have activity.
Antifolate pemetrexed should be used for non-squamous cell cancer,and gemcitabine for
squamous cell cancer.
chemotherapy with pemetrexed is now used in patients with non-squamous NSCLC whose
disease has not progressed after four cycles of platinum-based first-line chemotherapy.
The topoisomerase I inhibitor topotecan is used as second-line monotherapy in patients who
have failed a platinum-based regime.

14. OVARIAN CANCER
Ovarian cancer is a results in abnormal cells that have the ability to invade or spread to
other parts of the body.
It is the 4th most frequent cause of cancer related death in female in united states.
Ovarian cancer is a disease of the postmenopausal women with the highest incidence
among patient ages 65-74 year.
Ovarian cancer can be divided into two major categories based on the cell type of
origin.

15. BRAIN CANCER
Chemotherapy has only limited efficacy in the treatment of malignant gliomas. In general,
the nitrosoureas, because of their ability to cross the blood-brain barrier, are the most active
agents in this lomustine (CCNU) can be used in combination with procarbazine and
vincristine (PCV regimen).
the newer alkylating agent temozolomide is active when combined with radiotherapy and
used in patients with newly diagnosed glioblastoma multiforme (GBM) as well as in those
with recurrent disease.
Bevacizumab curently used as a single agent for GBM in the setting of progressive
disease following first-line chemotherapy.
A brain tumor or intracranial neoplasm occurs when abnormal cells form within the brain

16. A plane for the diagnosis and treatment of cancer is a key component of any
overall cancer control plan. Its main goal is to cure cancer patient.

17. REFERENCE
1)KD TRIPATHI Essentials of Medical Pharmacology Sixth Edition 2003 pg-819-834.
2) H.P.Rang, J M Ritter, R J Flower, G Henderson RANG AND DALE’S Pharmacology
Eight Edition 2014 pg -676-691.
3)lippincott’s pharmacology Second Edition pg no-383-398
4) JAMES M RITTER A Textbook of Clinical Pharmacology and Therapeutics Fifth Edition
pg-337-385
5)Bertram G.Katzung,Susan B.Masters,Anthony J.Treor Basics and Clinical pharmacology
12th edition 2012 pg-949-974