In high-income countries, cancer has received considerable public attention
because it is one of the major causes of mortality, morbidity, and
disease burden. In middle- and particularly in low-income countries,
cancer has received less public attention because other diseases, especially
infectious diseases, have historically been far more pressing. Although less
prominent in relative terms, as this report documents, cancer is a major
burden in low- and middle-income countries (LMCs) today.
Harrison's Internal Medicine Chapter 78. Prevention and Early Detection of Cancer
Prevention and Early Detection of Cancer: Introduction Improved understanding of carcinogenesis has allowed cancer prevention and early detection (also known as cancer control) to expand beyond the identification and avoidance of carcinogens. Specific interventions to prevent cancer in those at risk, and more sensitive and specific screening for early detection of cancer are the goals.
Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: Cancer control through principles of systems science, complexity, and chaos theory: A model...
This publication is the product of a comprehensive consultation undertaken by WHO in 2001 involving leading experts in the field of cancer epidemiology, screening and treatment. It is part of WHO's commitment to provide evidence-based guidelines to decision makers, and a recognition of the priority that should be given to cervical cancer screening and treatment as an essential component of any comprehensive national cancer control program. The report focuses particularly on the situation in low and middle income countries - countries in......
Since the first edition of Breast Cancer: Prognosis, Treatment and Prevention was
published there has been a tremendous amount of new information related to the basic
and clinical applications of this disease which can affect 1 of 8 people in the USA and
1 of 12 in European countries.
We have been able to develop 23 Regional Cancer Centres and several Oncology Wings
in India, which provide comprehensive cancer care services. One of the major limitations
of the programme is the late stage at presentation of common cancers thus reducing the
chances of survival. There is a need to increase awareness among the community regarding
prevention and early detection of cancers. The programme is developing IEC materials
for the same.
Accurate statistics on cancer occurrence and outcome are essential both for the purposes of
research and for planning and evaluation programmes for cancer control (Parkin, 2006).
Although tumours of thyroid account for only 1% of the overall human cancer burden, they
represent the most common malignancies of the endocrine system and pose a significant
challenge to pathologists, surgeons and endocrinologists. Among epithelial tumors,
carcinomas of follicular cell origin far outnumber those of C-cell origin.
Breast self-examination, clinical breast examination by a care giver, and mammography have been advocated as useful screening tools. Only screening mammography alone and screening mammography with clinical examination have been evaluated in randomized controlled trials. MRI is being assessed and is more accurate than mammography in women at high risk due to genetic predisposition or in women with very dense breast tissue.
The potential value of artificial neural networks (ANNs) as a predictor of malignancy has
now been widely recognised. The concept of ANNs dates back to the early part of the 20th
century; however, their latest resurrection started in earnest in the 1980s when they were
applied to many problems in the areas of pattern recognition, control, and optimisation.
In the past 15 years, molecular biologists and geneticists have uncovered
some of the most basic mechanisms by means of which normal stem cells
in a certain organ or tissue develop into cancerous tumors. This biological
knowledge serves as a basis for various models of carcinogenesis.
Given the range of treatment modalities and their serious side effects, men with prostate cancer
who are candidates for radical treatment should have the opportunity to discuss their treatment
options with a specialist surgical oncologist and a specialist clinical oncologist.
Men presenting with symptoms consistent with radiation-induced enteropathy should be fully
investigated (including using flexible sigmoidoscopy) to exclude inflammatory bowel disease or
malignancy of the large bowel and to ascertain the nature of the radiation injury.
General Classes of Cancer Genes There are two major classes of cancer genes. The first class comprises genes that directly affect cell growth either positively (oncogenes) or negatively (tumor-suppressor genes). These genes exert their effects on tumor growth through their ability to control cell division (cell birth) or cell death (apoptosis). Oncogenes are tightly regulated in normal cells. In cancer cells, oncogenes acquire mutations that relieve this control and lead to increased activity of the gene product.
It has been said that the control of disease has three goals, which, in
increasing order of attraction are palliation, cure, and prevention. For most types
of disseminated cancer, medical science has achieved only the first of these
objectives, while for some malignancies the side effects of the therapeutic agents
employed rival the disease itself in precluding a desirable quality of life.
This book represents an attempt to bring together the latest information and
analysis to assist in meeting the challenge of cancer. Some of the most eminent
European experts in cancer control have contributed to the book. Many of
them will also contribute to the EU Cancer Conference in Slovenia, in
February 2008. The aim of the conference is also to strengthen links between
health-care professionals, cancer patients, policy-makers and other
stakeholders in the cancer community, by sharing their knowledge, experience
and best practices.
Chemoprevention of Breast Cancer Hormonal manipulation is being tested in the primary prevention of breast cancer. Tamoxifen is an antiestrogen with partial estrogen agonistic activity in some tissues, such as endometrium and bone. One of its actions is to upregulate transforming growth factor β, which decreases breast cell proliferation. In randomized placebo-controlled trials to assess tamoxifen as adjuvant therapy for breast cancer, tamoxifen reduced the number of new breast cancers in the opposite breast by more than a third.
Palliation Surgery is employed in a number of ways for supportive care: insertion of central venous catheters, control of pleural and pericardial effusions and ascites, caval interruption for recurrent pulmonary emboli, stabilization of cancerweakened weight-bearing bones, and control of hemorrhage, among others. Surgical bypass of gastrointestinal, urinary tract, or biliary tree obstruction can alleviate symptoms and prolong survival. Surgical procedures may provide relief of otherwise intractable pain or reverse neurologic dysfunction (cord decompression).
Application to Patients
Radiation therapy can be used alone or together with chemotherapy to produce cure of localized tumors and control of the primary site of disease in tumors that have disseminated. Therapy is planned based on the use of a simulator with the treatment field or fields designed to accommodate an individual patient's anatomic features. Individualized treatment planning employs lead shielding tailored to shape the field and limit the radiation exposure of normal tissue. Often the radiation is delivered from two or three different positions.
Improved understanding of carcinogenesis has allowed cancer prevention and early detection (also known as cancer control) to expand beyond the identification and avoidance of carcinogens. Specific interventions to prevent cancer in those at risk, and more sensitive and specific screening for early detection of cancer are the goals. Carcinogenesis is not simply an event but a process, a continuum of discrete cellular changes over time resulting in more autonomous cellular processes.
Breast cancer remains the most feared disease of all women, regardless of age, race, ethnicity, or culture. The causes of breast cancer remain a mystery, with a few exceptions. About 70% of women diagnosed with breast cancer have no known risk factors. This implies that there are risk factors that haven’t yet been identified. Doctors are beginning to identify lifestyle choices that can influence our cancer risk. These lifestyle choices include diet, exercise, smoking, alcohol, and many other factors. We have control over how we nourish our bodies.
Psychological distress increases with the intensity of cancer pain. Cancer pain is often under-reported
and under-treated for a variety of complex reasons, partly due to a number of beliefs held by patients,
families and healthcare professionals. There is evidence that cognitive behavioural techniques that
address catastrophising and promote self-efficacy lead to improved pain management. Group format pain
management programmes could contribute to the care of cancer survivors with persistent pain.