This is a summary of the notes obtained in the lecture theatre and from further online research for Oncology. It explains the molecular basis of cancer, the molecular pathways and mechanisms involved in malignasis and metastasis, different types of cancer, statistics of cancers, prognosis and diagn...
How old is cancer?
- This is a hominid food bone cancer from thousands of years ago
Epidemiology of cancer
- Cancer is the second cause of death
worldwide.
- The rates f death have been rising and it
has been predicted that there will be over
10 million deaths from cancer in 2030.
Cancer statistics
- In 2000: 5.3 million men and 4.7 million women developed a malignant tumour and 6.2 died
from cancer.
- The number of new cancer cases is expected to increase by 50% over the next 20 years and
reach 15 million by 2020.
- Cancer is. Major health issue of our time and is responsible for more than 10% of deaths
worldwide and more than 25% in some countries.
- The most common cancer worldwide is lung cancer, accounting for 1.2 milllii new cases per
year, followed by breast and colorectal cancers, with around 1 million new cases per year.
- The high incidence of this disease, it life-threatening nature and unsatisfactory management
has motivated researchers from biotechnology and pharmaceutical industries to focus o the
causes and treatments.
- There are more than 500 products I clinical trials of which 100 are in phase III, with breast
cancer and non-small lung cancer receiving the most attention.
, Trends in death rates in males, US, 1930-2008
- People have started to smoke more and more
every year and this can be depicted in the lung
cancer line on the graph which we can see in red.
More people smoking, means that more of them
will eventually die of lung cancer.
- Lately there is a decrease in the deaths and this is
because scientific achievements about lung cancer
have been improved.
3 Questions to understand cancer:
1. Who are you? - What is your genetic background and identity. Cancer is a genetic disease. When
the genes in our cells are mutated, the cells become abnormal and may become cancer cells. There
are efforts to sequence the genes of populations in order for the majority of the population to have
their DNA sequenced and they will know if they have defective genes that are related to cellular
function that are responsible for the development of cancer.
2. Where do you live? - Many of the mutations that are caused in our cells are caused by
environmental factor. For example if you live in an area with high air population, or high radioactivity
(next to a nuclear plant, such as Chernobyl), high UV.
3. How do you live your life? - Habits such as smoking, exercise, good or bad diet. It is very well
known and 100% proved that smoking is causing cancer. So therefore if you smoke you have a high
probability to develop cancer. The majority of people are sensitive to carcinogens.
Cause of cancer Major risk factors for cancer is ageing
- Inherent susceptibility:
1. Monogenic - one gene related and
mutated in cancer
2. Polygenic - multiple of genes are related
and mutated in cancer (that is usually the
case)
3. In utero programming
- Environmental/ lifestyle factors:
1. Avoidable
2. Unavoidable (if you live in a polluted big
city)
3. Consequences of exposure may be
affected by inherited factors
, Prevention of cancer
1. Avoid smoking
2. Adopt a healthy diet and remain in healthy weight: 5-fruits-a-day,
fibre diet
3. Moderate alcohol
4. Exercise: avoid obesity, avoid raised insulin and IGF
Treatment
1. Surgery - remove and direct out the tumours off our organs. Thisis a way to remove cancer cells, but
it is not enough to treat cancer in general, as some cancer cells might still remain in the body. So
radiation or chemotherapy needs to be used additionally to kill the resining cancer cells
2. Chemotherapy - You dont only kill cancer cells, but you also kill normal healthy cells. That is what is
causing side affects many times. So specific target drugs need to be found so that the normal and
healthy cells are intact.
3. Radiotherapy
Classifying cancers
- Tumours are classified as solid and as liquid tumours.
- Solid tumours include: epithelial or mesenchymal cella’s that are usually immobile
- Liquid tumours include: leukemias and lymphomas, comprising neoplastic cells whose precursors
are usually motile.
- Pathological cancers are classified as:
1. Carcinoma: originating from epithelial cells in the skin or tissues that line or cover internal organs.
They typically represent more than 80% of diagnosed human cancer each year.
2. Sarcoma: originating in bone, cartilage, fat, muscle, blood vessels and other connective and
supportive tissues.
3. Leukemias: cancer originating I blood-forming tissues such as the bone marrow and causes large
numbers of abnormal blood cells to be produced and enter the bloodstream.
4. Lymphoma: originated from cells of the immune system
Cells and genes
- The adult human has many cells: around 50 billion of cells die every day, many cells multiply every
day, so we have 50 billion opportunities for a cell to multiply in an incorrect way and therefore
develop a cell with a mutation (damaged DNA). So a massive amount of actions are happening in our
cells every second.
- The cellular mechanisms are working 24/7, producing DNA, replicating DNA, translating DNA to
protein, cells dividing and cell apoptosis etc.
- In all these processes there might be a mistake that might cause mutation. Cells have ways to
repair the mistake. If these mechanisms are not enough to correct the mistake and the balance is lost
cancer might be caused.
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