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First Class Lecture notes Cancer Biology (DNA and Disease)
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Conventional cancer therapy lecture notes
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Conventional Cancer Therapy!Diagnosing cancer…
Early cancer may not have any symptoms
Methods of cancer detection and diagnosis include:
Mammograms
Papanicolou Test
Blood tests:
Prostate-specific antigen (PSA)
Carcinoembryonic antigen (CEA)
Fecal Occult Blood Test (FOBT)
Tissue Biopsy: enables the right kind of drug treatment
Tumour Grading: microscopic examination of the tumour to reveal likely
behaviour and responsiveness to treatment types.
‘Grade’:
a low number grade (grade I or II) refers to cancers with fewer cell
abnormalities than those with
higher numbers (grade III, IV).
Hence, low grade has a better
prognosis than high grade.
Low grade: the nuclei show
clumped chromatin and
inconspicuous multiple small
nucleoli.
High Grade: crowded crypts
with more severe nuclear
stratification. The nuclei
reach the luminal surface in the deeper portions of the crypts.
In addition, there is mild architectural distortion.
Tumour Staging: the earlier the tumour is picked up, the better
the patient’s survival chances.
I. How large is the tumour, and how far has it invaded into
surrounding tissues?
II. Have cancer cells spread to regional lymph nodes?
, III. Has the cancer spread (metastasized) to other regions of the body?
Conventional therapies…
Many drugs used come from a history of agents that actively damage DNA – this
is non-specific, so affects surrounding tissues. Chemo and radiotherapy still
contribute to the vast majority of 5 year survival rates in cancer patients,
however success rates of rational therapy is increasing.
1. Surgery
Only applies to solid tumours, not blood cancers (leukaemia).
Advantages:
Quick & effective
Largest number of cures
Confirmation of excision
Disadvantages:
X No guarantee of complete removal
X Critical normal tissues invasion
X Ineffective for metastasis as the primary source of the tumour is still
there. Some evidence even implies that surgery increases metastasis.
X Limited use in some areas of the body e.g. the brain, as it would be
dangerous to excise the surrounding tissues
2. Radiotherapy
Radiotherapy sources/ types:
Internal radiotherapy (Brachytherapy) – radioactive implants (insert
radioactive compound into tumour site, such as ferromagnetic beads
coated with radioisotope).
Destroys surrounding tissues.
Localised form of destroying tumours.
Doesn’t apply to all solid tumours.
External radiotherapy – external
source, e.g. X-ray or gamma radiation
from external machine used to blast
tissues.
The dosage of radiation the body is
exposed to normally is very tiny, so does
not produce DNA damage like this
dosage does.
In terms of EM wavelengths, X-rays and
gamma rays are at the extreme ends of
the EM spectrum.
Intranuclear = unstable isotope inside the atom. Extranuclear = unstable
isotope outside the atom
Biological effects of radiation: addition of a photon to an atom causes
transition from the ground state (lowest energy state) to the excited state
(higher energy level) by causing the electron to jump to a higher shell.
Radiation destabilises the electron, therefore effects the inside of the cell.
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