Alcohol and Cancer Alcohol consumption associated with increased risk of some but not all cancers Many potential pathways to lead to cancer Moderate alcohol consumption 2 drinks day is associated with a 25 decreased risk of heart disease Mechanism of action Repeated exposure to alcohol cause tissue damage and cell death in areas of the body with direct alcohol contact In response surviving cells grow and replace destroyed cells The ability to trigger cell proliferation is one mechanism by which alcohol causes cancer Ethanol metabolism activates other pro carcinogens which is destructive to DNA Disrupts folate metabolism important in DNA synthesis and repair Suppresses the immune system which may facilitate tumor cell spread Mechanism by Site Digestive tract cancers Variation in ethanol metabolizing enzymes modulates cancer risk Oral cavity larynx pharynx and esophagus cancers synergistic effect of carcinogens in tobacco and alcoholic drinks lead to mucosal hyper proliferation Breast cancer increases estrogen and androgen levels induces expression of Er PR hormone receptors Liver cancer mediates cirrhosis of the liver which is associated with cancer development Alcohol and tobacco Both are a deadly combination Tobacco contains potent carcinogens Alcohol stimulates cell division Men 2X likely than women Result of both is rapid proliferation of genetically damaged cells Signs and symptoms leukoplakia white lesions and erythroplakia red lesions lump thickening in oral soft tissues soreness in throat difficulty chewing or swallowing Detection diagnosis visual exam palpation endoscopy MRI CT endoscopy bleeding Treatment surgery radiation chemo Rehabilitation and plastic surgery Photodynamic therapy PDT for esophageal cancer Combines a drug with a specific type of light to kill cancer cells Chemical remains in cancer cells longer than normal cells so exposure to light is 24 72 post injection Light causes the chemical to release an active form of oxygen which enters and kills nearby cells kills blood vessels supporting tumor and activates immune system to attack tumor Cancers of the mouth esophagus pharynx and larynx are increasing especially in developed countries HPV is suspected culprit Liver cancer Overall 10 15 5 year survival rate Top 10 deadliest cancers in the US SCREENING increased survival rates Main types Hepatocellular carcinoma HCC most frequent liver cancer variant type patient has both HCC and cholangiocarcinoma Mostly asymptotic until later stages silent killer Symptoms fever weight loss nausea itching swelling yellowing of the skin pain in abdomen or near the right shoulder blade Hepatitis B Virus and liver cancer chronic HBV infections linked to 80 of the world wide liver cancer many infected people unaware and can infect others increase in incidence of liver cancer Interactions between alcohol cirrhosis or liver hepatitis B and C and oral cancers It damages liver cells cirrhosis Alcohol leads to build up acetaldehyde in liver Acetaldehyde is a mutagen cancer HBV and HCV damages liver cirrhosis HBV and HCV causes changes in DNA cancer Cirrhosis creates hyproliferation of cells in tissue repair cancer Diagnosis Imaging Medical history and physical exam Angiography Laparoscopy Biopsy TNM Staging system T size of primary TUMOR N extent to which nearby lymph NODES involved M description of distant METASTASIS Liver cancer treatments PET CT scan Correct treatment of liver cancer can mean the difference between life and death Not all patients with liver cancer are potentially curable Ablation radio frequency heat microwaves heat ethanol freeze Surgery chemotherapy immunotherapy radiation therapy and radiosurgery Embolization physical blockage of blood supply artery feeding tumor delivery of chemotherapy radiation Liver cancer and 5 year survival rates 60 70 for people with early stage liver cancers who are able to have a liver transplant all stages combined for a 5 year survival rate 15 low survival rate is because patients with liver cancer also have other liver problems like cirrhosis which itself can be fatal
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