Cancer remains a major clinical challenge as a cause of death due to its frequent poor
prognosis and limited treatment options in many cases.
Cancer management book addresses various cancer management related topics
including new approaches for early cancer detection and novel anti‐cancer therapeutic
This book is a collection of studies and reviews written by experts from different parts
of the world to present the most up‐to‐date knowledge on cancer management.
The goals of cancer prevention are to reduce the incidence, morbidity and mortality due
to cancer through the identification and elimination of precancerous lesions (termed
intraepithelial neoplasias or IENs) and/or the early detection of minimally invasive cancers.
Between 2002 and 2004, the United States (US) saw a 2.1% annual reduction in the total
number of cancer deaths (Epsey et al. 2007).. This reduction was primarily due to advances
in cancer detection and prevention efforts.
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Minireview cung cấp cho các bạn kiến thức về ngành y đề tài: IDo we use the appropriate controls for the identification of informative methylation markers for early cancer detection?
Over the past 20 years, technological advances in molecular biology have
proven invaluable to the understanding of the pathogenesis of human cancer.
The application of molecular technology to the study of cancer has not only
led to advances in tumor diagnosis, but has also provided markers for the
assessment of prognosis and disease progression. The aim of Molecular Analysis
of Cancer is to provide a comprehensive collection of the most up-to-date
techniques for the detection of molecular changes in human cancer.
A lifetime risk of melanoma development of 6% has been estimated. The risk is greatest before age 5 and next greatest between ages 5 and 10. Early detection of melanoma is difficult in these lesions because of the deep dermal or subcutaneous origin of primary melanoma and because of the large and varied surface of the nevus. Prophylactic excision early in life can be accomplished by staged removal with coverage by split-thickness skin grafts. Surgery cannot remove all at-risk nevus cells as some may penetrate into the muscles or central nervous system below the nevus. At present there are...
Head and Neck Cancer: Treatment Patients with head and neck cancer can be categorized into three clinical groups: those with localized disease, those with locally or regionally advanced disease, and those with recurrent and/or metastatic disease. Comorbidities associated with tobacco and alcohol abuse can affect treatment outcome and define long-term risks for patients who are cured of their disease.
Nearly one-third of patients have localized disease; that is, T1 or T2 (stage I or stage II) lesions without detectable lymph node involvement or distant metastases.
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.
Harrison's Internal Medicine Chapter 86. Breast Cancer
Breast Cancer: Introduction
Breast cancer is a malignant proliferation of epithelial cells lining the ducts or lobules of the breast. In the year 2007, about 180,510 cases of invasive breast cancer and 40,910 deaths occurred in the United States. Epithelial malignancies of the breast are the most common cause of cancer in women (excluding skin cancer), accounting for about one-third of all cancer in women.
The urgent need for computer-assisted detection of tumors and lesions in medical
images becomes clear when one considers the state of affairs in X-ray film mammography
for breast cancer screening. In the United States it is estimated that
there are currently more than 50 million women over the age of 40 at risk of contracting
There have been a significant number of advances
in the field of cancer research since the
first edition of Cancer Biology, which was published
in 1981. These include advances in defining
the genetic and phenotypic changes in cancer
cells, the genetic susceptibility to cancer, molecular
imaging to detect smaller and smaller tumors,
the regulation of gene expression, and the
‘‘-omics’’ techniquesofgenomics, proteomics,and
metabolomics, among others.
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.
Cells respond to environmental cues through a complex and dynamic
network of signaling pathways that normally maintain a critical balance
between cellular proliferation, differentiation, senescence, and death. One
current research challenge is to identify those aberrations in signal transduction
that directly contribute to a loss of this division-limited equilibrium and
the progression to malignant transformation. The study of cell-signaling molecules
in this context is a central component of cancer research.
Colorectal cancer (CRC) represents a major public health problem worldwide. Fortunately most CRCs originate from a precursor lesion, the adenoma, which is accessible and removable. This is the rationale for CRC screening programs, which are aimed to diagnose CRC at an early stage or even better to detect and resect the advanced adenoma before CRC has developed. In this background colonoscopy emerges as the main tool to achieve these goals with recent evidence supporting its role in CRC prevention....
Physical Activity Physical activity is associated with a decreased risk of colon and breast cancer. A variety of mechanisms have been proposed. However, such studies are prone to confounding factors such as recall bias, association of exercise with other health-related practices, and effects of preclinical cancers on exercise habits (reverse causality). Recommending adults to engage in at least 30 min of vigorous activity for ≥3 days a week is good health advice, though its effects on cancer incidence are unproven.
Cancer Chemoprevention Chemoprevention involves the use of specific natural or synthetic chemical agents to reverse, suppress, or prevent carcinogenesis before the development of invasive malignancy.
Cancer develops through an accumulation of genetic and epigenetic changes that are potential points of intervention to prevent cancer. The initial changes are termed initiation. The alteration can be inherited or acquired through the action of physical, infectious, or chemical carcinogens.
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.
Cancer Screening Screening is a means of detecting disease early in asymptomatic individuals, with the goal of decreasing morbidity and mortality. While screening can potentially save lives and has been shown to do so in cervical, colon, and probably breast cancer, it is also subject to a number of biases that can suggest a benefit when actually there is none. Biases can even mask net harm. Early detection does not in itself confer benefit. To be of value, screening must detect disease earlier, and treatment of earlier disease must yield a better outcome than treatment at the onset of...
Potential Biases of Screening Tests The common biases of screening are lead time, length-biased sampling, and selection. These biases can make a screening test seem beneficial when actually it is not (or even causes net harm). Whether beneficial or not, screening can create the false impression of an epidemic by increasing the number of cancers diagnosed. It can also produce a shift in proportion of patients diagnosed at an early stage that improves survival statistics without reducing mortality (i.e.
Screening for Specific Cancers Widespread screening for cervical, colon, and likely breast cancer is beneficial for certain age groups. A number of organizations have considered whether or not to endorse routine use of certain screening tests. Because these groups have not used the same criteria to judge whether a screening test should be endorsed, they have arrived at different recommendations. The U.S. Preventive Services Task Force (USPSTF), the Canadian Task Force on Preventive Health Care, and the American Cancer Society (ACS) publish screening guidelines (Table 78-3).