1. Bios E-162b FALL 2010 Cancer review session Carlos O. Mendivil-Anaya, MD

2. Neoplasia Tumor Cancer, carcinoma Sarcoma Lymphoma Leukemia New growth: Includes benign disease Swelling: Includes benign disease Malignancy of epithelial origin Malignancy of mesothelial origin Malignancy of lymphoid organs Malignancy of blood cells (usually WBC) Jargon

4. Lethality

5. Cancers with potential for screening Breast Cervical Prostate Colorectal Mammography Cervical smear cytology (Pap smear) Serum PSA Flexible sigmoidoscopy Fecal occult blood test

6. Stages of cancer

8. The cell cycle

9. Genetic origin of cancer (proto) Oncogenes Tumor suppressor genes

10. Chemotherapy agents target the cell cycle

11. Genetic Predisposition (familiar mutations) Chemical Carcinogenesis Excessive hormonal stimulus Ionizing Radiation Light (Ultraviolet Radiation) Repeated localized trauma Tumor Viruses (Oncogenic viruses) - HIV/Epstein-Barr virus - Human Papilloma Virus - Hepatitis B Virus Etiology of cancer

12. Carcinogenic mechanism of retroviruses

13. The key role of angiogenesis

14. Some cancers are hormone-sensitive

15. And some others are driven by environmental factors

16. Metastases prefer some organs

17. Chemotherapy can be highly toxic

18. Testicular cancer Rare Happens early in life (average age=30) Main risk factor: Undescended testis (Cryptorchidism) However, most common cancer in young adult males

19. Testicular cancer

20. Prostate cancer Most common cancer in men Lifetime risk of developing it is about 17% ! Increased urinary frequency and urgency Prostate gland grows normally during life in response to androgens Strong genetic/ethnicity influence Overweight  high IGF-1 levels  increased risk Treated with surgery / radiation / androgen deprivation

21. Breast cancer Most common cancer in women Much more prevalent in industrialized countries

22. Breast cancer Can be detected early by breast self-exam http://medicalimages.allrefer.com/

23. Breast cancer Can be detected early by breast self-exam http://medicalimages.allrefer.com/

24. All women 40 and older should get a mammogram Breast cancer http://commons.wikimedia.org/wiki/File:Mammogram.jpg www.hastingsimagingcenter.com

25. Breast cancer Incidence increases with age Premenopausal and posmenopausal have different risk factors Risk proportional to estrogen exposure Old hormonal contraceptives increase risk, New hormonal contraceptives decrease it Estrogen-like substances in food or environment increase risk Pregnancy and lactation are protective BRCA1 and BRCA2 genes mutated in about 10% of cases