Oncology
MID TERM
LECTURE 1: Introduction to the Nature of Cancer
Incidence of cancer: the absolute number of new patients diagnosed with cancer in a
year or any particular period of time
Prevalence of cancer: All people have been diagnosed with cancer over a certain
period of time (5 years) even if they are cured
Mortality: number of patients that died due to cancer within a certain period mostly
1 year
Survival: Percentage of people still living at a certain period after diagnosis (5 years)
Mortality trends of 2000 and 2010 Lung cancer increase in women as women
have started smoking and decrease in me as men have been smoking for years and
have started reducing now
Cancer group of diseases invasive and forming metastasis
Malignant tumour can cause death invades and disturbs organ fiction and take
nutrients from cells
Carcinomas from epithelia most common (85%) epithelia most exposed to
carcinogens (alters DNA)
Adenocarcinoma from glandular cells
, Sarcomas from mesodermal tissues
Lymphomas from progenitors of WBC
Oncogenesis
Cancer is clonal and heterogenous all tumour cells come from each other
(daughter cells) however during the process daughter cells can metastasise
differently so heterogenous
Cancer is not inheritable somatic mutations are not inherited you can pass
germline mutations that increase your chance to develop cancer
Cancer risk increases with age
Hallmarks of cancer (Hanahan & Weinberg) 10 now 14
Tumour consists of other cells that are not cancerous but part of tumour
fibroblasts, immune cell etc.
Oncogenes drive cancer and tumour suppressor genes stop them
, Characteristics of cancer cells:
Have different morphology
Do not need substrate to grow on
Can grow in low serum media
Don’t stop proliferation even when in contact with neighbouring cells
Oncogenes can be checked for these characteristics isolation of gene
transfection of DNA into immortalized primary cells check if transfected cells have
altered growth if it grows on agar then oncogene
Treatment of cancer surgery, radiotherapy, chemotherapy either cytostatic
(prevent cell division) or cytotoxic (kill cells)
Chemotherapy side effects therapeutic window is small (max tolerated dose –
min dose to get some effect)
Chemotherapy window isn’t big enough novel anticancer agents with selective
activity against cancer targeted drugs being developed mediocre efficacy only
small number of patients benefit
Mediocre efficacy because some of these targets not present in cancer cells or 50%
present in patient different patient need different treatments personalized
medicine
Personalized medicine diagnostics genetics, imaging, and immunochemistry
, LECTURE 2: DNA Structure and Stability
Cancer from epigenetic alteration
Stability genes for repair mutated become inactivated
Changes in DNA base pair sub, deletions, insertions, single or double strand
breaks
Large DNA changes chromosome rearrangements
DNA aberration causes
Exogenous smoking, alcohol, sun (UV), radiation
Endogenous ROS (oxidative phosphorylation in mitochondria causes
release of ROS)
n
Modified base example oxoguanine caused by ionizing radiation or normal
aging DNA polymerase reads oxoguanine as thymine
DNA repair mechanism
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