Human Diseases A Systemic Approach CHAPTER 4 Cancer HLTH 335 Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved The Enemy Within http www worldcancerday org understand ing cancer enemy within documentary Combination Therapy Politics Clinical trials Survivors Prevention Palliative care Personalized medicine Targeted therapy Surgery Genetics Imaging Radiotherapy People power Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Today s Objectives Define neoplasia and related terminology Describe differences between benign and malignant tumors and classification of cancers Explain the biology of human cancer and the role of oncogenes tumor suppressor genes and DNA repair genes Discuss etiology of cancer Describe the current treatments of the most common cancers Discuss warning signs of cancer Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Neoplasia Uncontrolled growth of cells Neoplasm a mass of cells that grow more rapidly than normal cells Benign noncancerous Malignant consists of rapidly dividing cells that accumulate uncontrollably and invade normal tissue and have the ability to metastasize generate independent tumors at distant sites There are over types and subtypes of malignancies a k a cancersCopyright 2010 by Pearson Education Inc Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Upper Saddle River New Jersey 07458 All rights reserved Characteristics of Benign Tumors Grow slowly Remain Do not metastasize or recur following surgery Well differentiated cells that resemble the tissue from which it grew May push on other tissues but does not localized invade Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Characteristics of Malignant Tumors Grow rapidly by bloodstream or lymphatic channels leading to establishment of secondary sites of tumor growth differentiated cells Infiltrate invade surrounding tissues metabolize Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Crowley L 2010 An Introduction to Human Disease 8th Ed Jones Bartlett Sudbury MA Classification Nomenclature of Cancers By type of cell it originates in Carcinoma epithelial cells Sarcoma connective tissue Mixed Cancer epithelial and connective tissue Lymphoma Lymphoid tissue Leukemia white blood cells Melanoma melanin There are various exceptions e g originates in cells Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Cancer Statistics Cancer is the leading cause of death worldwide and afflicts two of every three families Deaths from cancer in the world are projected to continue to rise according to WHO 9 million estimated deaths projected for 2015 11 4 million estimated deaths for 2030 In the United States approximately 2 1 of every men and 1of every women 3 will be diagnosed with an invasive cancer in their lifetime Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved normal 4 factors that regulate cell growth Growth Factors keep eachother in check programed cell death Apoptosis Regulators Cyclins Growth Inhibitors cell cycle proteins Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Biology of Carcinogenesis How Cancer Begins Transformation Mutations in 3 classes of genes are responsible for the development of cancer Oncogenes Tumor suppressor genes DNA repair genes 1 Initiation 2 Promotion Change in genetic material mutation prepares the cell to become cancerous 3 Progression Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Biology of Carcinogenesis cont d Oncogenes When mutated or expressed at abnormally high levels contribute to conversion of normal cells to cancer cell growth regulation cells by interfering with and apoptosis 100 Over oncogenes have been identified Tumor suppressor genes TSG If inactivated or deleted cancer progression more likely due to a loss of normal TSG function DNA repair genes a k a genes caretaker Normally repair DNA replication errors when supply is lowered cancer progression more likely Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved be able to give example Table 4 3 Cancers Associated with Selected Genetic Mutations Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Important Note Although a specific genetic mutation might be identified the cause of that mutation may still be unknown Copyright 2010 by Pearson Education Inc Upper Saddle River New Jersey 07458 All rights reserved Etiology of Cancer Types of research to understand cancer etiology In vitro laboratory Epidemiology population based studies Endogenous internal factors Environmental external factors Human Diseases A Systemic Approach Seventh Edition Mark Zelman Elaine Tompary Jill Raymond Paul Holdaway and Mary Lou Mulvihill Copyright 2010 by Pearson Education