MICROBIO 160 1st Edition Lecture 14Outline of Last Lecture I. Facts about Addiction to Nicotine II. What’s in Cigarettes?III. Linking Cigarettes to CancerIV. Mutations of p53 and K-ras in Lung CancerV. Non-small Cell Lung Cancer: VI. Small Cell Carcinoma VII. Renal Cell Carcinoma and SmokingVIII. Diagnosis IX. Treatments X. Exposure to SmokingXI. Electronic CigarettesOutline of Current Lecture I. Alcohol and Cancer II. Alcohol, Tobacco SynergisticIII. Signs and SymptomsIV. 5-Year Survival RatesV. Liver Cancer VI. Staging VII. Treatments Current LectureAlcohol and Cancer These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- Alcohol consumption is associated with increased risk of some, but not all cancers of theoral cavity and pharynx, esophagus, larynx, breast and liver o Contact derived cancer—tissues that come in contact o Liver is the filter for everything that you’re consumingo Alcohol is an estrogen mimic- Alcohol is only a weak carcinogen- Alcohol is not a mutagen- Moderate alcohol consumption (2 drinks/day) is associated with a 25% decreased risk of heart disease o Red wineMechanism of action: - Repeated exposure to alcohol causes tissue damage and cell death in areas f the body with direct alcohol contact - In response, surviving cells grow and replace destroyed cells- The ability to trigger cell proliferation is the mechanism by which alcohol causes cancero Start replicating out of control in order to fix the alcohol damageStudy looked at several different types of cancer- Relative risk: how many drinks did people take per day in comparison to someone who didn’t drink alcoholAlcohol and Tobacco Ac† SynergisticTrend between people who smoked and people who drank: higher cancer rates - If you drink and smoke you are increasing your chances by 38% o Why is there a synergistic effect? You are trying to heal the damage with already damaged cellsAlcohol and Tobacco are a deadly combination:- Tobacco contains potent carcinogens- Alcohol stimulates cell division - Rapid proliferation of genetically damaged cells Cancers of the mouth, esophagus, pharynx, and larynx:- Signs and symptoms: o Leukoplakia: white lesions; Erythroplakia: red lesionso Lump, thickening in oral soft tissues, soreness/feeling something caught in throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw ortongue, hoarseness, numbness of the tongue or other areas of the mouth, swelling of the jaw - Detection/diagnosis:o Visual exam, palpation, endoscopy, MRI, CT, endoscopy (bleeding)o Biopsy- Treatment: o Surgery, radiation, chemo- Rehabilitation and plastic surgery5-Year survival rates: - Oral cancer claims a high number of deaths worldwide as almost 2/3 of the cases are detected in the advanced stages of the disease- 90% for initial stages- 20-25% in advanced stages (usually detected in this stage)- One American dies from one of these types of cancer every hour—the rate has increased in the past 40 years (increase in smoking)Liver Cancer—Main Types:- Hepatocellular Carcinoma (HCC): The most frequent liver cancer- Variant type= patient has both HCC and cholangiocarcinomao Rarer forms: Mesenchymal tissue sarcoma Hepatoblastoma: primarily developing in children Cholangiocarcinoma: bile duct cancers (the small tubes that carry bile to the intestines) Angiosarcoma and Hemangiosarcoma: blood vessel and blood (by the time it is detected, it is usually fairly widespread) Lymphoma: blood cancer but it can start to grow inside of the organs Liver Cancer Symptoms:Fever, weight loss, loss of appetite, nausea or vomiting, an enlarged liver, felt as a mass under the ribs on the right side, yellowing of the skin and eyes (jaundice), pain in the abdomen or near the right shoulder blade, feeling very full after a small meal, itching, swelling or fluid build-up in the abdomen, enlarged veins on the belly that become visible through the skin, worsening of your condition if you have chronic hepatitis or cirrhosis, an enlarged spleen, felt as a mass under the ribs on the left side Diagnosis: - Medical history and physical exam- Imaging, x-ray, CT, MRI- Angiography—inserting a flexible catheter into a large vein and injecting a dye to enhance vasculature during imaging (uncomfortable)- Laparoscopy: inserting flexible camera tube into abdomen (bleeding)- Biopsy: bleeding and spread of tumorStaging Liver Cancer—TNM- TX: primary tumor cannot be assessed- T0: no evidence of primary tumor - T1: a single tumor (Any size) that hasn’t grown into blood vessels- T2: either a single tumor (Any size) that has grown into blood vessels, OR more than one tumor where no tumor is larger than 5cm across- T3A: more than one tumor, with at least one tumor larger than 5cm across- T3B: at least one tumor (Any size) that has grown into a major branch of a large vein of the liver (the portal or hepatic vein)- T4: the tumor (Any size) has growninto a nearby organ (other than the gallbladder) OR the tumor is growing into the thin layer of tissue covering the liver (Called the visceral peritoneumo NX: cannot be assessed o N0: no spread to nodeso N1: spread to nodes M0: no mets M1: mets (belly, lungs, bones)Staging:- Once individual T, N, and M scores have been determined they are combined to generate an overall cancer stageso Stage I: T1, N0, M0: There is a single tumor (any size) that has not grown into anyblood vessels. The cancer has not spread to nearby lymph nodes or distant siteso Stage II: T2, N0, M0: Either there is a single tumor (any size) that has grown into blood vessels, OR there are several tumors, and all are 5 cm (2 inches) or less across. The cancer has not spread to nearby lymph nodes or distant siteso Stage IIIA: T3a, N0, M0: There is more than one tumor, and at least one is larger than 5 cm (2 inches) across. The cancer has not spread to nearby lymph nodes ordistant siteso Stage IIIB: T3b, N0, M0: At least one tumor is growing into a branch of a major vein of the liver (portal vein or hepatic vein). The cancer has not spread to nearbylymph nodes or distant siteso Stage IIIC: T4, N0, M0: A tumor is growing into a nearby organ (other than the gallbladder), OR a tumor has grown into the outer covering of the liver. The cancer has not spread to nearby lymph nodes or distant siteso Stage IVA: Any T, N1, M0: Tumors in the liver can be any size or number and theymay have grown
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