| A | B |
|---|
| Cancer's overall effect | 1 in 3 people in the U.S., and kills 1 in 5; higher incidence in males versus females; |
| tumor | an overgrown, solid mass of cells; benign tumors are often arranged in an orderly fashion and are encapsulated within connective tissue (do not move from primary site) |
| cancerous cells: structural and functional abnormalities | lack of differentiation |
| cancerous cells: uncontrolled growth rate | and lack of normal death-inducing signals required for apoptosis; production of growth factors; angiogenesis via angiogenic factors |
| cancerous cells: metastasis | cells that break away from a primary tumor and enter the blood or lymph to establish new cancers in bone marrow, gut, lymph nodes ... ; malignant tumors |
| cancerous cells: angiogenesis | blood supply to solid tumors (potential for angiostatin, endostatin and thalidomide??) |
| Incidence of breast cancer | new 210,000 deaths 50,000 |
| Incidence of ovarian cancer | new 26,600 deaths 14,500 |
| Incidence of vaginal cancger | rare |
| Incidence of prostate cancer | new 317,000 ideathsn 41,400 |
| Incidence of testicular cancer | new 7,400 deaths 370 |
| Incidence of penile cancer | rare |
| Breast cancer frequency | 10% of women in the U.S. will develop breast cancer at some point in their life. ~210,000 new cases will develop this year; 46,000 deaths. 26% of |
| duct carcinoma | Breast cancer - (epithelial lining), 90% of |
| carcinomas of the alveolar lobules | Breast cancer - 2nd most prevalent |
| cancers that have spread | less common |
| spread of cancer to bone or other parts of | also uncommon |
| early menarche (puberty) | increases risk of Breast cancer |
| weight gain in adults (>18 | >45 lbs, breast cancer risk increased x 2; due to E conversion from body fat) |
| post-menopausal obesity | increases risk of Breast cancer |
| post-menopausal ERT | increases risk of Breast cancer (but risk/benefit ratio?) |
| mutations of the BRCA1 gene (chromosome 17); | inheritance results in a 90% lifetime risk of developing breast cancer |
| lactation, early menopause/oopherectomy | decreases risk of Breast cancer |
| breast implants | don't effect risk of breast cancer |
| abortion in middle-aged women | increased risk of breast cancer |
| Early detection of breast lumps | important for biopsy to determine benign (e.g., fibroadenomas) vs. malignant! |
| fibroadenomas | benine tumor |
| Herceptin | an antibody directed against E receptor; not a cure vs. breast cancer |
| Tamoxifen | (estrogen analogs) may reduce the risk but not in all women! (raloxifene [tamoxifen], to treat osteoporosis) |
| Vitamin D | (exposure to sunlight) a preventative measure? |
| Breast Cancer in Men | The disease appears similar in both sexes, but is uncommon in males (1% vs. incidence in women; 0.2% of all malignancies in men) |
| The male breast | similar to the preadolescent girl; drugs (cardiovascular, digitalis; high blood pressure, reserpine) may have estrogen-like effects. |
| Breast Cancer Risk Factors in men: | age - rare before age 35, ethnicity - Jewish males of European ancestry, geography - Egyptian males represent 6% of all male breast cancers; Zambian males account for 15% (E from parasite infection? from malnutrition?), testicular disorders - abnormal estrogen profilces |
| Ovarian cancer | fourth leading cancer and cause of cancer-, 5 year survival rates: early treatment, 90% (but only 23% of cases detected); overall rate, 42%, 90% of ovarian cancers are of epithelial cell origin; rest include granulosa, theca, stromal, germ cell cancers (relatively rare) |
| Ovarian cancer increased risk | women over 60; use of fertility drugs (x 2.5); women without children; women diagnosed with breast, intestinal, rectal cancer; mutated BRCA1 and -2 genes - 50% reduction in incidence by use of oral contraceptives!!! |
| Ovarian cancer decreased risk | associated with use of oral contraceptives; increased parity; early first pregnancy, early menopause |
| Ovarian cancer treatment | no proven early detection benefit to serum tests or ultrasound, surgical oophorectomy plus hysterectomy, radiation, chemotherapy (e.g., paclitaxel, cisplatin) |
| Cervical cancer occurence | In 1996, 15,700 cases, 4,900 deaths; cervical neoplasia a precondition to cervical cancer; screened for by the Pap test (cervical scrapings to evaluate histology) |
| Cervical cancer and assoc. with HPV | infection with human papilloma virus (HPV) found in 90% of cervical cancers |
| increased rick of Cervical cancer | risk with multiple partners, early first intercourse |
| Uterine (endometrial) cancer | critical role of estrogen |
| Uterine (endometrial) cancer increased risk | decreased by early age of menopause, increasing parity, use of oral contraceptives (containing progesterone) |
| Uterine (endometrial) cancer decreased risk | increased by obesity in pre- and post-menopausal women (25-50 lbs, 3-fold increase), ERT in post-menopausal women, PCO syndrome |
| increased rick of the rare Vaginal cancer | women whose mothers were given DES during pregnancy |
| Vaginal cancer treatment | surgery (including laser surgery), chemotherapy, radiation |
| DES | diethystilbestrol, used to prevent miscarrages, but caused cancers and miscarrages |
| Prostate cancer | most prevalent cancer in men (U.S., 1:11); second leading cause of cancer deaths (after lung cancer). In 1996, 317,000 men were diagnosed with prostate cancer (vs. 182,000 women with breast cancer), >40,000 die each year. |
| Risk factors of Prostate cancer | none confirmed |
| ethnic influence on Prostate cancer | higher in African-American men, and older men (average age of diagnosis, 65); |
| genetic influence on Prostate cancer | 10% of cases may be inherited; Recent studies have begun to identify the gene responsible for inherited forms of prostate cancer, and have thus far localized the gene to chromosome 1 |
| hormonal influence on Prostate cancer | increased risk with androgen replacement therapy or DHEA? |
| Prostate cancer symptoms | often asymptomatic in earliest stages; by the time it is diagnosed, it is often metastatic (50-60% of diagnosed cases), symptoms may include urinary problems, but this may also be due to enlarged prostate; rectal examination, transrectal ultrasoundsymptoms may include urinary problems, but this may also be due to enlarged prostate; rectal examination, transrectal ultrasound |
| Prostate cancer detection | prostate-specific antigen (PSA) in serum, but only a ‘marker’; other tumor-specific antigens??, rectal exam + PSA can detect 85% of cancers, early detection results in 90% cure rate! |
| Prostate cancer Treatment | none - elderly males (common in Sweden) , chemo, radiation, hormone therapy , removal of prostrate |
| hormone therapy for prostrate cancer | to reduce androgen (DHT) levels (also orchiectomy) 80% successful, but not curative, as after 2-3 years cancers will begin to grow again ; tumors are androgen-independent |
| removal of prostate | fairly standard, especially when cancer is localized to prostate; but may result in impotence due to removal of nerves that lead to the penis, and incontinence |
| Penile cancer | rare and highly curable; epidermal cancers only; predisposition for men not circumsized at birth, screening by self-examination (lumps), treatment with chemo- /radio-therapy, biopsy |
| freq of Testicular cancer | Only 1% of cancers in men; 7,400 diagnoses, 370 deaths; mostly found in young men (ages 20-34); increased risk in white vs African American (by 4.5-fold) |
| survival of Testicular cancer | 96% are of germ cell origin, but prognosis is good (5-year survival, 92%), even with advanced stages (5-year survival, 70%) |
| screening testicular cancer | screening by self-examination for lump; 26-56% of patients are first diagnosed with epididymititis, testicular trauma, hydrocele, or other benign disorders; tumor-specific antigens not useful in early screening |
| testicular cancer treatment | treatment by radiation therapy or chemotherapy (followed by bone marrow transplantation) or surgery |
