Natural Solution for Cancer

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

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Do I Have Cancer

This ebook from medical practitioner and family doctor Dr. Parajuli gives you all of the signs and symptoms that you need to know in order to catch cancer in the very early stages and protect yourself from it. You don't have to worry about if you have cancer anymore, and better yet you don't have to spend thousands of dollars to make sure of that either! All it takes is a bit of knowledge and you are on your way! This book also teaches about other aspects of cancer patients, such as how to live with different kinds of cancer, how to prepare yourself mentally to accept this reality if it IS a reality for you, and how to deal with doctors and insurance companies. This book is easy to read and in PDF format, so you don't have to worry at all about reading it. Make it easy on yourself!

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Early Concepts Of Cancer Causation

Because cancer was defined only by its clinical behavior, it was impossible for the clinician of the period seeing a lesion for the first time to recognize it as malignant. He could not even call a hard tumor a scirrhus if by that term he meant a definitely cancerous lesion. A suspicious growth could at best be considered only potentially malignant until its subsequent behavior could be ascertained. Nevertheless, popular theory of tumor causation throughout most of the 17th century continued to embrace vital, humoral theory, in the form of the so-called lymphatic humoralism of Astruc and Peyrilhe (28). The lymphatic vessels had been discovered in 1628, and scirrhus was now considered to be the product of an abnormal accumulation of lymph, which could later degenerate into cancer (29). The cause of a Cancer is An alteration in the Circulation of Humors, from the Menstrua, Hemorroids or any other Hemorragy being suppress'd Barrenness, abstinence from all Venereal Acts the leaving off of...

Introduction Intraperitoneal Chemotherapy for Advanced Ovarian Cancer Finally a Standard of Care

Key Words Intraperitoneal chemotherapy, ovarian cancer, IP cisplatin, IP paclitaxel, cancer survival Epithelial ovarian cancer is the fourth leading cause of cancer death in women in the United States, with an estimated incidence of 20,180 and 15,310 deaths in 2006 (1). According to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program, the five-year relative survival rates for women with localized ovarian cancer is 93.6 , whereas for those with distant disease it is 29.1 (2). Unfortunately, these data have changed minimally over the past decade. In comparison to all other common solid cancers (including lung and pancreatic cancers), ovarian cancer is diagnosed far more frequently with regional or distant disease (i.e., approximately 80 of all new diagnoses) (1). These late diagnoses occur because there are no ovarian cancer specific symptoms and because of the propensity for tumor cells that invade through the capsule of the ovary to be swept into...

Why Proteomics Has Not Succeeded In The Past Cancer As An Example

The inability of these protein biomarkers to detect all cancers (false negatives) reflects both the progressive nature of cancer and its heterogeneity. Cancer is not a single disease but rather an accumulation of several events, genetic and epigenetic, arising in a single cell over a long period of time. Proteins overexpressed in late stage cancers may not be overexpressed in earlier stages and, therefore, are not useful for early cancer detection. For example, the CA125 antigen is not highly expressed in many Stage I ovarian cancers. Also, because tumors are heterogeneous, the same sets of proteins are not necessarily overexpressed in each individual tumor. For example, while most patients with high-grade prostate cancers have increased levels of PSA, approximately 15 of these patients do not have an elevated PSA level. The reciprocal problem of biomarkers indicating the presence of cancer when none is present (false positives) results because these proteins are not uniquely produced...

Evidence for Systemic Immune Deviation in Cancer

In patients with cancer, alterations also occur in systemic antitumor immunity 56, 131, 190, 192 . In a tumor-bearing host, dissemination of antigens released from the growing (shed or secreted antigens) or dying (apoptotic necrotic debris) tumor cells assures their access to APC and allows for the cross-priming of immune effector cells in lymphoid tissues draining the site of the tumor. It is likely that the composition, number and the state of activation differentiation of the immune infiltrate at the local site will vary over time, depending on the evolving (constitutive or therapy induced) systemic immune response of the host to TAA and the ability of these cells to be recruited into and survive function within the tumor microenvironment. Circulating T cells obtained from patients with cancer are either biased in their cytokine profile or otherwise functionally compromised 17, 131, 171 . Furthermore, dysfunctions in circulating lymphocytes was linked to the extent of dysfunction...

Biomarker of cancer susceptibility

To exert their carcinogenic effect, aromatic amines, like most chemical carcinogens, require metabolic activation to reactive species that bind to DNA. The activation of aromatic amines is performed by some enzymes, whose polymorphic distribution in the population may give rise to a genetically determined different individual susceptibility. In particular, N-acetyltransferase (NAT) is an enzyme whose activity may result in detoxification of aromatic amines. In humans it is coded by two genes, NAT1 and NAT2.80 The NAT2 enzyme is polymorphic, and in about 50 of Caucasians, the so-called 'slow acetylators', the activity of this enzyme is reduced. In a case-control study of bladder cancer, a large proportion of slow acetylators was observed among cases of bladder cancer occupationally exposed to aromatic amines, but not in smoking-related bladder cancer patients.81 Other studies reported an excess of slow acetylators in bladder cancer patients with a history of smoking or occupational...

Introduction Proteomics In Cancer Research

Proteomics is the study of all expressed proteins. A major goal of proteomics is a complete description of the protein interaction networks underlying cell physiology. Before we discuss protein computational tools and methods, we will give a brief background of current proteomic technologies used in cancer diagnosis. For cancer diagnosis, both surface-enhanced laser desorption ionization (SELDI) and two-dimensional gel electrophoresis (2DE) approaches have been used.1,2 Recently protein-based microarrays have been developed that show great promise for analyzing the small amount of samples and yielding the maximum data on the cell's microenvironment.3-5 Isotope-coded affinity tags (ICAT)11 is a technology that facilitates quantitative pro-teomic analysis. This approach uses isotope tagging of thiol-reactive group to label reduced cysteine residues, and a biotin affinity tag to isolate the labeled peptides. These two functional groups are joined by linkers that contain either eight...

Mechanisms Responsible for Dysfunction of Immune Cells in Cancer Patients

To date, many different mechanisms that are responsible for immune dysfunction have been identified. Some are directly mediated by factors produced by tumors, while others result from alterations of normal tissue homeostasis occurring in the presence of cancer. Until recently, little was known about molecular alterations in tumor cells in situ as they progressed from the pre-malignant to metastatic phenotype. Genetic instability, now recognized as a principal characteristic of all tumors, may result in changes in their epitope profile. Molecular changes, already detectable during early stages of tumorigenesis, become more pronounced as the tumor progresses. The net result of these changes is increased resistance of tumor cells to immune surveillance. Remarkably, tumors appear to be able to interfere with immune cell development, differentiation, function and even their elimination. Thus, all stages of antitumor immune response are subject to adverse intervention in the tumor...

Preclinical Experience With Intraperitoneal Therapy Of Ovarian Cancer

Further, in the case of the use of cisplatin in the treatment of ovarian cancer, provocative data suggested resistance to the agent was really quite relative, In addition, several randomized trials have revealed that doubling the dose of a platinum agent in the treatment of ovarian cancer, although producing increased side effects, does not favorably impact outcome (16-18). Yet, it remained possible that after IP platinum delivery, tumor exposures > 10-fold, compared with the systemic compartment, could be observed. Finally, several studies revealed perhaps the major limitation of regional drug delivery in the management of ovarian cancer, the depth of penetration of drugs directly into tumor tissue. Several model systems, employing a variety of cytotoxic agents (e.g., cisplatin, carboplatin, doxorubicin, and methotrexate) (21-25), demonstrated the drugs were capable of penetrating a distance of only a few cell layers to a maximum of several millimeters from the tumor surface into...

Lymphatic Mapping In Genitourinary Cancer

Canabas described the pattern of lymphatic drainage from the penis using radiographic lymphangiography 22 . He found that this drainage occurred to ''sentinel lymph nodes'' in the superficial inguinal area. He was the first to use the term ''sentinel nodes'' in reference to lymph nodes draining a particular part of the body. His contention was that metastasis would occur first to this group of superficial inguinal nodes, so that if these nodes were normal, then all other nodes would also be normal. Subsequent studies showed a false-negative rate of 25 for this approach 75 . Work is continuing using radiocolloid or blue dye or both to map lymphatic drainage in patients with penile cancer to locate the actual sentinel node or nodes, just as has been done in melanoma and breast cancer 76 . Some early experience in patients with vulva cancer has been encouraging and suggests that this technique can be successfully applied to patients with this malignancy 77,78 . There have also been...

Ovarian Stimulation And Ovarian Cancer

Concern has been expressed that exposure to fertility drugs might be associated with a risk of ovarian cancer. In particular, pooled analysis of three case-controlled studies by Whittemore et al. (75) suggested an odds ratio of 2.8 (95 CI 1.3-6.1) for invasive ovarian cancer infertile women treated with fertility drugs compared with women with no diagnosis of infertility or infertility drug treatment. This study, suggesting an apparent trebling In 1994, Rossing et al. undertook a study that yielded the best data, to this time, examining the role of clomiphene citrate and ovarian cancer. Rossing et al. used record linkage with a population-based cancer register. They identified an increased incidence of ovarian cancer comprising both borderline malignant tumors and invasive disease. They found a standardized incidence rate (SIR) of 2.5 with 95 confidence intervals (1.3-4.7) in a cohort of infertile women compared with age-standardized general population rates (76). This, of course, is...

Impact Of Changing Concepts Of Ovarian Cancer Treatment On Ip Drug Delivery Strategies

Further, early phase I (and some phase II) trials of IP cisplatin explored the potential of substantially increasing the administered dose using this route of delivery (8,18,20,21). During this era of drug development in oncology, there was a fundamental belief that more is better when delivering cytotoxic agents, and this general treatment philosophy played a major role in many chemothera-peutic approaches in ovarian cancer (and other malignancies). However, a series of highly negative prospective phase III randomized trials in the treatment of ovarian cancer have convincingly demonstrated that this concept is seriously flawed, at least at the concentrations of currently available cytotoxic agents that can be safely attained within the systemic compartment after intravenous drug delivery (26-29). These trials revealed that by doubling the dose intensity of systemically delivered platinum (e.g., cisplatin from 50 mg m2 to 100 mg m2 and carboplatin from AUC 6 to AUC 12), toxicity...

Evaluation Of The Biological Activity Of Ip Cytotoxic Chemotherapy In The Management Of Ovarian Cancer

After the completion of phase I studies, which defined the pharmacokinetic properties and safety of both single-agent and several combination chemotherapy IP programs, investigators in several centers and cooperative groups initiated a series of platinum-based phase II IP efficacy trials in patients with ovarian cancer (24,30-40). However, although such an approach could have been used to evaluate the effectiveness of an IP regimen in a phase II trial, a decision to perform this type of analysis would have been a serious error. As previously noted, the setting where the benefits of an IP treatment program might be rationally anticipated would be in patients with either documented microscopic IP cancer, or where only very small-volume macroscopic disease was present (< 0.5-cm-1-cm tumor masses) when the regional strategy was initiated (41-43). Conversely, extensive preclinical evaluation (discussed in the preceding chapter) had strongly suggested there would be minimal (or no)...

Lung cancer screening

Lung cancer is the leading cause of cancer death in the United States. Yet unlike breast, prostate, and colon cancer, there is not currently a widely accepted screening protocol for lung cancer. Studies of chest radiography and sputum cytology conducted in the 1970s did not reveal a decrease in mortality that justified the expense and complications of widespread lung-cancer screening.22 However, interest in lung-cancer screening was reinvigorated in 1999 with a report by Henschke et al. on the Early Lung Cancer Action Project (ELCAP), which is studying the use of low-dose helical CT in 1,000 volunteers age 60 or greater with at least a 10 pack-year history of smoking.23 The authors have thus far concluded that low-dose CT can greatly improve the likelihood of detection of small non-calcified nodules, and thus of lung cancer at an earlier and potentially more curable stage. Despite the lack of long-term mortality data for these patients, the preliminary ELCAP results were so promising...

Implications Of The Current Ip Chemotherapy Data For The Primary Chemotherapeutic Management Of Smallvolume Residual

The data from these three randomized phase III trials have now firmly established a new standard of care in the primary chemotherapeutic management of small-volume residual advanced ovarian cancer (16,59,62). Collectively, they indicate that patients treated with cisplatin by the IP route experience a 20 -30 reduction in the risk of death compared with intravenous drug delivery. These results are similar to those previously documented when paclitaxel was substituted for cyclophosphamide in the management of ovarian cancer (60,61). Of great importance, it is now clear the use of IP cisplatin adds to the benefits attained by using intravenous paclitaxel.

Future Directions In The Use Of Ip Chemotherapy In The Management Of Ovarian Cancer

The results of three large prospective randomized phase III trials have now established IP chemotherapy as the standard of care in the primary chemothe-rapeutic management of small-volume residual advanced ovarian cancer (16,59,62). Much research remains to be done in this arena, including focusing major efforts to improve methods of drug delivery (discussed in Chapter 5), exploring novel antineoplastic agents administered regionally, and developing innovative strategies to enhance drug penetration and distribution. Further, based on currently available data and knowledge of the natural history of the course of this disease, it is reasonable to propose the conduct of prospective randomized phase III trials in other settings involving patients with ovarian cancer (Table 5). In conclusion, what has been accomplished to date in the area of regional treatment of ovarian cancer has been a major advance in the management of this difficult malignancy. What began as a hypothesis based on a...

Local Tumor Growth and Spontaneous Systemic T Cell Responses in Cancer Patients A Paradox and Puzzle

Abstract We describe and discuss the paradox situation that in many cancer patients functional antitumor memory T cells can be detected in their bone marrow which coexist with a growing tumor in the periphery. This phenomenon, known as concomitant immunity suggests that the tumor and its microenvironment prevent systemic antitumor immunity to become effective. Strategies of intervention at the tumor microenvironment are being discussed.

Identification Of Marker Genes From Highdimensional Microarray Data For Cancer Classification

Knowledge discovery in bioinformatics is driven largely by available biological experimental data and knowledge. Cancer research is a major research area in the medical field and accurate classification of tumor types is of great importance in cancer diagnosis and drug discovery (Lu and Han, 2003). Traditional cancer classification has always been based on morphological and clinical measurements, but these conventional methods are limited in their diagnostic ability. To achieve more accurate cancer classification, researchers have proposed approaches based on global genetic data analysis. expression of a gene provides a measure of gene activity under certain biochemical conditions. It is known that certain diseases, including cancer, are reflected in the changes of the expression values of certain genes. The advent of DNA microarray techniques has supported effective identification of a variety of gene functions for cancer diagnosis. Microarray analysis is a relatively new molecular...

Spontaneous Systemic T Cell Responses in Cancer Patients

During the last few years, numerous studies have emerged that clearly demonstrate the spontaneous induction of functional, TAA-specific T cell responses in many tumor patients. We observed in the bone marrow of mice bearing disseminated lymphoma cells TAA-reactive CD8 T cells that conferred protection against (i) expansion of tumor cells in situ as well as (ii) against the formation of distant metastases 6, 7 . Based on this observation, we analyzed the possibility that the presence of tumor antigen in the bone marrow might also trigger the generation of functional, tumor-specific T cells in tumor patients. We therefore evaluated by HLA-tetramer analyses as well as by short term IFN-y Elispot assays the presence of such cells in the peripheral blood and bone marrow of breast cancer patients 8 . We detected high frequencies of tumor-specific CD8 T cells in the blood and bone marrow of most patients. However, only BM-resident T cells exerted functional capacities such as IFN-y secretion...

Role of Altered Expression of HLA Class I Molecules in Cancer Progression

HLA class I antigens play a key role in immune recognition of transformed and virally infected cells via binding to the peptides of non-self' or aberrantly expressed proteins and subsequent presentation of the newly formed HLA-I-peptide complex to T lymphocytes. Consequently, a chain of immune reactions is initiated leading to tumor cell elimination by cytotoxic T cells. Altered tumor expression of HLA class I is frequently observed in various types of malignancies. It represents one of the main mechanisms used by cancer cells to evade immunosurveillance. Because of immune selection, HLA class I-negative variants escape and lead to tumor growth and metastatic colonization. Loss or downregulation of HLA class I antigens on tumor cell surface is a factor that limits clinical outcome of peptide-based cancer vaccines aimed to increasing specific anti-tumor activity of cytotoxic T lymphocytes. Thus, gaining more knowledge regarding frequency of HLA class I defect, its tissue...

Altered Phenotypes of HLA Class I in Various Types of Cancer

All of these phenotypes can be found in various types of tumor, regardless of the tissue origin or of the carcinogen inducing the tumor. Differences are observed in the distribution of the phenotypes and in the combination of molecular mechanisms leading to each phenotype. An example of such distribution in various types of solid tumors and melanoma cell lines (ESTDAB project, http www.ebi.ac.uk ipd estdab ) (Pawelec and Marsh 2006) is presented in Table 1.

Association of HLA Class I Alterations with Tumor Escape and Cancer Progression

The identification of the genes encoding tumor-associated antigens (TAAs) and the development of means for immunizing against these antigens have opened new avenues for the development of an effective anti-cancer immunotherapy. However, current protocols of cancer immunotherapy aimed at enhancing anti-tumor T cell activity cause cancer regression only in a small number of patients (Rosenberg et al. 2004). Immune selection of CTL- and NK-cell-resistant tumor cells might explain the rapid progression and poor prognosis of cancers that exhibit HLA class I down-regulation. Thus, HLA class I downregulation represents a significant challenge for the successful application of cancer immunotherapy.

Implication of HLA Class I Defects for Cancer Immunotherapy

Tumor peptide-based immunotherapy is an established approach of cancer treatment, with the aim of boosting anti-tumor T cell reactivity by stimulation with tumor-specific peptides. However, the overall clinical outcome of this type of treatment is poor. In many cases, the failure of this therapy and the progression of the cancer are associated with total loss of HLA class I tumor expression. Normal expression of HLA class I molecules on tumor cell surface is crucial for the successful outcome of peptide-based cancer therapy, since cytotoxic T cells can only recognize tumor-derived peptides in a complex with self-MHC class I molecules.

Some cancers are caused by viruses

Peyton Rous's discovery in 1910 that a sarcoma in chickens is caused by a virus that is transmitted from one bird to another spawned an intensive search for cancer-causing viruses in humans. At least five types of human cancer are probably caused by viruses (Table 17.1). Hepatitis B, a liver disease that affects people all over the world, is caused by the hepatitis B virus, which contaminates blood or is carried from mother to child during birth. The viral infection can be long-lasting and may flare up numerous times. The hepatitis B virus is associated with liver cancer, especially in Asia and Africa, where millions of people are infected. But it does not cause cancer by itself. Some gene mutations that are necessary for tumor formation occur in the infected cells of Asians and Africans, although apparently not in those of Europeans and North Americans. An important group of virally induced cancers among North Americans and Europeans is the various anogenital cancers caused by...

Most cancers are caused by genetic mutations

Worldwide, no more than 15 percent of all cancers may be caused by viruses. What causes the other 85 percent Because most cancers develop in older people, it is reasonable to assume that one must live long enough for a series of events to occur. This assumption turns out to be correct, and the events are genetic mutations. DNA can be damaged in many ways. As we saw in Chapter 12, spontaneous mutations arise because of chemical changes in the nucleotides. In addition, certain mutagens, called carcinogens, can cause mutations that lead to cancer. Familiar carcinogens include the chemicals that are present in tobacco smoke and meat preservatives, ultraviolet light 171 Human Cancers Known To Be Caused by Viruses 171 Human Cancers Known To Be Caused by Viruses

The pathway from normal cell to cancerous cell is complex

Because colon cancer progresses to full malignancy slowly, it is possible to describe the oncogene and tumor suppressor gene mutations at each stage in great molecular detail. Figure 17.18 outlines the progress of this form of cancer. At least three tumor suppressor genes and one oncogene must be mutated in sequence for an epithelial cell in the colon to be- In cancer, mutations of these genes cause cells to lose adhesion to their neighbors and spread. In cancer, mutations of these genes cause cells to lose adhesion to their neighbors and spread. 17.17 Tumor Suppressor Gene Products Inhibit Cell Division and Cancer Mutations can affect any of the several ways in which tumor suppressor genes inhibit cell division, allowing cells to divide and form a tumor. 17.17 Tumor Suppressor Gene Products Inhibit Cell Division and Cancer Mutations can affect any of the several ways in which tumor suppressor genes inhibit cell division, allowing cells to divide and form a tumor.

IL10 Gene Polymorphisms and Cancer

The literature concerning IL-10 polymorphism in cancer is very recent and is therefore still relatively small, but growing rapidly, with all publications dating from 2001. Results from these studies are summarised in Table 2 and each disease is considered in more detail below. From a casual inspection of Table 2, it will be noted that while all except one study is of case-control design, several studies have also investigated associations between particular IL-10 polymorphisms and markers of disease prognosis. Of the 15 studies listed, 6 have studied the IL-10 -1082 SNP alone and 8 have studied the IL-10 -1082, -819, -592 SNPs and haplotypes in case-control studies (in one study, cases only) of the malignancy in question. The IL-10G and IL-10R microsatellites were examined in the remaining study. Therefore all studies published thus far have focussed upon those polymorphisms for which there is direct evidence for a causal association with differential IL-10 expression (IL-10 -1082),...

Immunological Role of Dendritic Cells in Cervical Cancer

Cervical cancer is the second most frequent gynecological malignancy in the world. Human papillomavirus (HPV) infection is the primary etiologic agent of cervical cancer. However, HPV alone is not sufficient for tumor progression. The clinical manifestation of HPV infection depends also on the host's immune status. Both innate and adaptive immunity play a role in controlling HPV infection. In untransformed HPV-infected keratinocytes, the innate immunity is induced to eliminate the invading HPV pathogen through sensitization to HPV-related proteins by epithelial-residing Langerhans cells (LCs), macrophages, and other immune cells. Once the HPV infection escapes from initial patrolling by innate immunity, cellular immunity becomes in charge of killing the HPV-infected keratinocytes of the uterine cervix through systemic immune response developing by dendritic cells (DCs) in the regional lymphoid organs or through local immune response developing by LCs in the cervix. Thereby,...

Human Papillomavirus and Cervical Cancer

Although the recent advances in cervical cancer diagnosis and treatment reduce the mortality of women with cervical cancer from the second leading cause of death to fifth place worldwide, still about 500,000 new cases are reported annually, and one-third of them are under the high risk of death (Sasagawa et al. 2005). Clinically, cervical cancer is an advanced stage of cervical intraepithelial lesions manifested from pre-invasive cervical intraepithelial neoplasia (CIN) due to the progressive infection of human papillomavirus (HPV) in keratinocytes of the uterine cervix (Walboomers et al. 1999). HPV belongs to a family of 120 double-stranded DNA viruses that have been linked to a number of epithelial cancers, and more often with the uterine cervix, where more than 90 of tumors contain HPV DNA (Tindle 2002). The abnormal uterine cervical clinical features as a result of HPV infection have a wide spectrum of diseases including warts (skin disease), low-grade dysplasia cervical...

DCBased Vaccines for Cervical Cancer

The unique ability of DCs to induce and sustain primary immune responses makes them optimal candidates for vaccination protocols in cancer. DCs derived from cultured hematopoietic progenitors appear to have an antigen-presenting function similar to that of purified mature DCs. Ex vivo generation of DCs, therefore, provides a source of professional APCs for the use in experimental immunotherapy. There are several vaccine strategies utilizing DCs prepared with HPV-16 E6 E7. Vaccine strategies using DC-generated ex vivo can be classified as follows (i) DCs pulsed with tumor peptides proteins (ii) DCs transduced with tumor antigen and cytokine genes or tumor RNA (iii) DCs that have engulfed HPV virus capsids or virus-like particles (iv) DCs that are loaded with killed allogeneic tumor cells and (v) DCs that have fused with tumor cells (Biragyn and Kwak 2000 Ling et al. 2000 Tindle 2002). Phase 1 trial using immature DCs pulsed with the autologous or allogeneic tumor lysates has been...

Post Transplant Squamous Cell Skin Cancer

Malignancies arise in 20 to 40 of transplant recipients within 20 years of receipt of graft.141 Skin carcinomas account for up to 50 of these cancers. Viruses, including HPVs, Epstein Barr virus and human herpes virus-8 are involved in the pathogenesis of post-transplant tumors, especially skin carcinomas, B-cell lymphomas and Kaposi's sarcoma. Impaired host immune defences, resulting from heavy immunosuppression are also associated with an increased risk of malignancy. Genetic risk factors are also suspected. Accordingly, genetic polymorphisms associated with differential levels of cytokine production may have an important effect on tumorigenesis after organ transplantation. In this context, IL-10 plymorphism is of particular interest, since, in addition to the biological functions of IL-10 discussed in some detail above, ultraviolet-induced DNA damage, a risk factor for skin cancer, also increases production of IL-10.142 For the above reasons, Alamartine et al,84 in a French-based...

Rationale For Sentinel Lymph Node Biopsy In Vulvar Cancer Patients

Several of the characteristics of vulvar cancer as described earlier suggest the need for less invasive diagnostic techniques for evaluation of clinically unin-volved inguinofemoral lymph nodes. The majority of patients with vulvar cancer present with early-stage disease and have a low frequency of nodal involvement. At present, no reliable noninvasive techniques for the detection of inguino-femoral lymph node metastases are available. Physical examination of the groins is inaccurate in 25 of cases 4 . The percentage of error in clinical appraisal increases progressively with the stage of disease from 18 for Stage I to 44 for Stage IV 4 . Little information exists on the value of imaging techniques such as magnetic resonance imaging and computerized tomography. The results of the use of ultrasound and positron emission tomography are disappointing 42,43 . All these reasons provide a rationale for lymphatic mapping with sentinel lymphadenectomy in patients with vulvar cancer.

Studies On Lymphatic Mapping And Sentinel Lymphadenectomy In Patients With Vulvar Cancer

DiSaia in 1979 was the first to postulate that the superficial groin nodes may serve as sentinel lymph nodes for more deeply situated nodes in patients with vulvar cancer 18 . Patients with clinically normal nodes underwent intraoperative mapping through a modified incision. No complete lymphadenectomy was performed if frozen-section analysis of the superficial lymph nodes did not show metastasis. However, in later studies of early vulvar cancer, femoral node metastasis was reported after biopsy of tumor-free superficial inguinofemoral nodes 44 . In 1983, Iversen and Aas presented a scintigraphy study of lymph drainage of the vulva in patients with cervical cancer scheduled for radical surgery 45 . The conclusions of this study were as follows in all patients, the vulvar lymph flow passes to the inguinofemoral and pelvic lymph nodes clitoris and perineum have bilateral drainage the main lymphatic pathway is ipsilateral after injection in the labium, but nearly 70 also have some...

Inhibition of Dendritic Cell Generation and Function by Serum from Prostate Cancer Patients Correlation with Serum Free

Tumor produces a number of immunosuppressive factors that block maturation of dendritic cells (DCs). Here, we demonstrated that endogenous factors presented in the serum of patients with prostate cancer (CaP) inhibited the generation of functionally active DCs from CD14+ monocytes in vitro. We have shown a significant inhibitory potential of serum obtained from patients with CaP and benign prostate hyperplasia benign prostatic hyperplasia (BPH) when compared with serum from healthy volunteers. As assessed by flow cytometry, expression of CD83, CD86, and CD40 molecules was strongly inhibited by CaP and BPH serum. In addition, these DCs were weak stimulators of allogeneic T cell proliferation when compared with DCs produced in the presence of healthy volunteer serum. Statistical analysis of the results revealed a positive relationship between the inhibition of expression of DC markers CD83 and CD80 and the levels of serum-free prostate-specific antigen (PSA). These data...

Cell Cycle and Cancer

Cavenee, W.K. & White, R.L. (1995) The genetic basis of cancer. Sci. Am. 272 (March), 72-79. Chau, B.N. & Wang, J.Y.J. (2003) Coordinated regulation of life and death by RB. Nat. Rev. Cancer 3, 130-138. Fearon, E.R. (1997) Human cancer syndromes clues to the origin and nature of cancer. Science 278, 1043-1050. Intermediate-level review of the role of inherited mutations in the development of cancer. Kinzler, K.W. & Vogelstein, B. (1996) Lessons from hereditary colorectal cancer. Cell 87, 159-170. Evidence for multistep processes in the development of cancer. Intermediate coverage of the function of protein p53 in the normal cell cycle and in cancer. C. (2003) The significance of unstable chromosomes in colorectal cancer. Nat. Rev. Cancer 3, 695-701. Sherr, C.J. & McCormick, F. (2002) The RB and p53 pathways in cancer. Cancer Cell 2, 102-112. Weinberg, R.A. (1996) How cancer arises. Sci. Am. 275 (September), 62-70. Yamasaki, L. (2003) Role of the RB tumor suppressor in...

Dietary lipids and cancer

There is a large body of evidence on the role of dietary lipids in cancer. It is based on epidemiolo-gical studies of various sorts in humans, and on feeding studies in animals. It should be stressed that the evidence is in all cases somewhat conflicting. In 1997-1998, two major reports on diet and cancer were published in which all existing evidence was reviewed (see Further Reading). The expert groups who compiled these reports assessed the literature and graded the evidence for associations between dietary components and specific cancers on a scale from 'convincing' to 'insufficient'. For dietary fat, no association was found to be convincing, and a few 'possible'. There was considered to be strong evidence, however, for a relationship between obesity (particularly central fat deposition) and risk of both endometrial cancer and breast cancer in post-menopausal women. Ken Carroll, a Canadian biochemist who studied this subject extensively, wrote two thorough review articles shortly...

Cellular lipid changes in cancer

Cells express a number of carbohydrate and lipid derivatives on their surfaces. Amongst these are glycosphingolipids, which are involved in cellular recognition, cell adhesion and regulation of cell growth. In 1968 the Japanese biochemist Hakomori observed that transformed tissues (i.e. cancer cells) expressed variant forms of glycosphingolipids, often in larger amounts than normal. These glyco-sphingolipids may play a role in the uncontrolled cell growth of cancer. There are characteristic changes in glycosphingolipids in different cancers. In general, there is a reduction in the more complex glycosphingolipids and an over-expression of some of the more unusual glycosphingolipids that may normally only be present in trace amounts. The more complex glycosphingolipids act as cell-surface antigens that is, they may be recognized by specific antibodies. The blood group antigens, which cause an immune reaction if blood of one group is infused into someone of another blood group, are of...

Lipids and the treatment of cancer

The expression of variant forms of glycolipids on cell surfaces may offer a means of directing specific drugs to kill the tumour cells, as discussed above. In addition, several potential new treatments based on phospholipid analogues have been developed and in some cases tested in clinical trials. These compounds are intended to incorporate into target membranes, either the cell membrane or intracel-lular membranes such as the endoplasmic reticu-lum. Thus, their mode of action differs from conventional anti-cancer drugs that target DNA replication. Several types of compounds have been tested, although most are analogues of phosphati-dylcholine or of lysophosphatidylcholine, e.g. with a sugar molecule ether-linked at the sn-2 position. They are believed to act in diverse ways, all of which could be seen as targeting cells with a high rate of cell division. They may act by disrupting signal transduction and signalling pathways, e.g. inhibition of the phosphoinositide-specific...

Classification of cancer by using diagnosis data

Li et al. show that they gain excellent results in comparison with See5, including the latest developments such as boosting, on a variety of classification problems taken from the bioinformatics literature. The results, which are based on the cross-validation of datasets, show that, as expected, the committee approach performs better on these problems than the single C4.5 results with boosting or bagging. The first experiment was conducted on ovarian cancer containing 253 mass spectrometry proteomic samples, 91 of which were controls and 162 of which represented ovarian cancer. Each of these samples contained 15 154 features which were the relative amplitudes of the intensities for each molecular mass charge identity. A 10-fold cross-validation procedure was used to ensure consistency of results. The results showed that the committee

Patient Measurements In Breast Cancer

Ten consecutive breast cancer patients, who were eligible for a sentinel node procedure according to the standard protocol of our hospital 11,14 were asked to cooperate with the measurements. Dose rates were registered at distances of 25, 50, and 100 cm from the injection site within 3 h after a peritumoral injection of 50 5 MBq 99mTc colloidal albumin (Nanocoll , Sorin Radiofarmaci S.r.I., Saluggia, Italy) in 4 mL of saline. Due to injecting the tracer at different depths, the depots will have a varying geometric relation to the dose-rate meter, which may influence the measured dose-rate at short distances. Therefore, the dose rates at 10 and 15 cm were calculated from measurements at 50 cm with multiplication factors of 16.7 and 8.3, respectively. These multiplication factors were obtained from the breast phantom results. The dose rates thus obtained are displayed in Table 2.

Cancer Stem Cells and their Dr Jekyll and Mr Hyde Antigens

The cancer stem cell hypothesis of tumor development has recently been proposed for many types of cancer 116 and therefore has replaced the older stochastic model of cancer development. It provides a likely explanation for failed cancer treatments and recurrences that are now considered to be due to therapy resistant cancer stem cells. Furthermore, this model is supported by the observations that cancer may arise from embryonic cells, as observed in childhood tumors, or through activation of hormone-sensitive stem cells in the case of breast cancer 117, 118 . Tissue committed stem cells or stem-like cells have been identified in both normal and cancerous human tissues such as mammary gland and breast cancer, skeletal muscle, lung, liver, epidermis and melanoma, forebrain and gliomas, testis, heart, kidney, limbal epithelium, gastrointestinal tract and prostate, as well as in several long-term tumor cell lines 122-135 . As an example, the existence of adult breast stem cells was...

Signaling Pathways that Control Cancer Stem Cell Function

Many important regulatory signaling pathways have been identified that contribute to stem cell survival and proliferation, malignant transformation as well as cell-cell and cell-matrix communication. For example, Wnt, a secreted highly hydrophobic signaling molecule controls stem cell activity and daughter cell fate through regulation of P-catenin 164-166 . In the absence of Wnt signaling, phosphorylated P-catenin is degraded by a complex of adenomatous polyposis coli (APC), Axin and glycogen synthase kinase-3P proteins via the ubiquitin pathway. Abnormal activation of Wnt signaling and accumulation of nuclear P-catenin in cancer stem cells can lead to a continuous targeting of a large number of downstream genes, such as the proto-oncogene c-myc, which allows undefined expansion of stem cells through inhibition of p21cip-1 WAF, a cell-cycle inhibitor 167 , as well as their migration out of the niche and accumulation of mutations that result in tumor progression 168, 169 . Another...

Papillomaviruses in Human Cancers

The conversion of virus-caused papillomas into carcinomas was initially observed by Rous and Beard (5) and carefully analyzed by Rous and his associates in cottontail rabbits (6-8). In these years, Rous analyzed synergistic effects of this virus infection with chemical carcinogens and formulated first ideas on tumor initiation. The frequent conversion of papillomas into carcinomas in the rabbit papillomavirus system has nevertheless for a long time been considered as a biological curiosity, particularly in view of the virtual absence of similar observations in humans. Only in the beginning of the 1950s a rare hereditary condition, epidermodysplasia verruciformis, a generalized ver-rucosis with frequent subsequent progression into squamous cell carcinomas of the skin, was recognized as a condition linked to wart virus infection (9-11). Although in the following decade human papillomavirus particles were demonstrated electron microscopically and in the 1960s characterized as DNA viruses...

Cancer Stem Cell Antigens and the Tumor Microenvironment

As was discussed earlier for mature tumor cells, expression of certain tumor-associated antigens on cancer stem cells can profoundly influence their microenvironment. Evidence is beginning to accumulate that some of the tumor antigens described on mature tumor cells are also present on cancer stem (like) cells. One of these antigens is MUC1. Because a lot is known about its immunoregulatory and oncogenic functions in mature tumor cells, we will present a hypothetical picture of its impact on the microenvironment of a cancer stem cell. A tissue specific adult stem cell that has accumulated a significant number of oncogenic mutations over its long life might eventually turn malignant if it successfully passes through the many survival checkpoints. In comparison to normal stem cells that reside in their niche and depend on interactions with the surrounding stromal cells that regulate survival and stem cell divisions, a transformed stem cell becomes independent from the niche. During this...

Cancers Linked To Hpv Infections

Initial identifications of human papillomaviruses in human cancers were made in squamous cell carcinomas of the skin of patients with a rare hereditary disorder, epi-dermodysplasia verruciformis (38). Jablonska and co-workers considered this condition already in 1972 (11) as a model to study the role of papovaviruses in human cancers. A very common human cancer presently known to be caused by specific papillo-mavirus types is cancer of the cervix. The link of this cancer to HPV infections was proposed between 1974 and 1976 (15,16). The first virus isolates from this tumor type, HPV-16 and HPV-18, were published in 1983 and 1984 (19,20). Today > 95 Cervical and other anogenical cancers 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 54, 56, 58, of cervical cancer biopsies contain HPV sequences. Although HPV-16 represents by far the most frequently identified virus, a number of additional genotypes has been identified in this tumor. Table 1 lists HPV genotypes found in cervical cancer...

Peritoneal Carcinomatosis Of Colorectal Cancer

Second to liver, the peritoneum is the most frequent site of metastases in colorectal cancer. In approximately 10 of patients, peritoneal carcinomatosis (PC) is already present at the time of initial diagnosis (1). PC is found in 30 of patients with recurrent colorectal cancer, either as part of more generalized metastases or as the only site. PC is the only site of tumor activity in 40 of cases (2). This means that approximately 8 of all colorectal cancer patients will have PC as their only site of cancer activity at some stage of their disease. PC is generally considered to represent distant metastasis and is staged as M1. Accordingly, until recently, treatment has been limited to palliative surgery, such as enterostomy or bypass to relieve obstruction, and systemic chemotherapy. There are few studies specifically reporting on the outcome of this approach in PC (3). Most studies on chemotherapy in metastatic colorectal cancer include all sites of metastases, with a dominance of...

Cancer Screening and Colonoscopy Surveillance

In the past, the indication for prophylactic colectomy for patients with longstanding ulcerative colitis was mainly based on the disease history and the clinical risk factors mentioned above. Today, with the availability of colonoscopy and the recognition of the dys-plasia-precancer-cancer sequence, surveillance colonoscopy with serial colonoscopic examinations and mucosal biopsies is thought to allow for a more adequate individual assessment of the cancer risk and firm recommendation for surgery before the development of cancer. Thus, it is stated that prophylactic surgery should be reserved for patients whose biopsy findings are indicative of heightened cancer risk based on the joint interpretation by the clinician and the pathologist.

Anal Cancer And Its Precursors

Anal cancer has traditionally been considered a rare disease, occurring in women at about one tenth the incidence of cervical cancer. However, unlike the declining incidence of cervical cancer, the incidence of anal cancer in women has been increasing at a rate of about 2 per year in the United States and also has been rising in European countries such as Denmark (107). Anal cancer is more common in women than in men, but its incidence is highest among men who have practiced receptive anal intercourse, among whom the incidence of anal cancer was estimated to be as high at 35 100,000 (2). Therefore, the incidence of anal cancer among these men is similar to that of cervical cancer among women prior to the introduction of routine cervical cytology screening. Moreover, because the data used to generate this estimate predated the onset of the HIV epidemic, they presumably reflect the incidence of anal cancer among HIV-negative men with a history of receptive anal intercourse (hereafter...

Liposomes For Lymphnode Cancer Targeting Nonliposome Drug Delivery to Lymph Nodes

One of the first studies to investigate the possible use of drugs delivered intralymphatically was performed by Hirnle (1). This study investigated the anticancer drug Bleomycin that was suspended in an oil suspension known as Oil Bleo. This Oil Bleo was injected directly into catheterized lymphatic vessels in dogs. The movement of this agent through the lymph nodes and lymphatic vessels was fairly rapid with peak drug concentrations reaching the blood 15 minutes after intralymphatic administration of Oil Bleo. The drug entering the blood was considered to be spillover from the lymphatic system. Spillover occurred because the drug moved completely through the lymphatic vessels and rejoined the circulation at the thoracic duct. Administering the drug this way required a very tedious catheterization process of the small lymphatic vessels of the extremities. Although drug concentrations were very high in the lymphatic vessels for a fairly short time, the retention of the oil emulsion in...

Long Term Risk of Dysplasia Cancer Development in Anal Transitional Zone Columnar Mucosa After Stapled IPAA

The largest criticism about stapled IPAA is the risk of leaving in situ a 1- to 2-cm-long columnar cuff of mucosa above the anal transitional zone (ATZ) area, with symptomatic sequelae and the potential for neo-plastic transformation over time 24, 52 . The risk of a dysplasia in the ATZ columnar mucosa may be connected with the stage of illness, follow-up duration and UC or FAP diagnosis. Risk is 25 if the proctocolectomy specimen shows cancer, 10 if there is concomitant dysplasia. In patients with FAP, the risk of adenoma is 4-12 and of dysplasia 10-12 53 . Considering that the risk of cancer onset after ileorectal anastomosis is 15-20 after 30 years since surgery 53 , a theoretical risk of 2 after 30 years since surgery was calculated for the ATZ columnar residual mucosa both in patients with UC and FAP. Neoplastic risk does not disappear after mucosectomy because in ileoanal pouches removed because of complications, residual islands of columnar mucosa between the reservoir serosa...

Long Term Risk of Cancer Development in the Pelvic Pouch

Adaptive alterations, both morphological and phlogistic, in the reservoir mucosa characterised by vil-lous atrophy and crypt hyperplasia 56 , and the report that some cases of dysplasia and cancer were found in ileal pouches 57, 58 caused concern that patients with IPAA might run the same risk in the long term as patients with long-lasting UC 46 . However, the supposed mucosal atrophy - dysplasia -cancer sequence 58 is not incontrovertibly corroborated, as the adaptation of the ileal mucosa is phe-notypical and subject to regression after control of chronic inflammation 59 . It is a much-debated subject 60 whether carcinoma development is directly ascribable to the pouch mucosa or to the residual rectal mucosa whatever anastomotic technique is used, as pointed out in various studies 57, 61, 62 .

Incidence and Distribution of Cancers

Cancer epidemiology is the study of the incidence (number of newly diagnosed cases), prevalence (number of existing cases), and mortality (number of deaths) of specific diseases in defined populations during specific periods of time. The ultimate aim is the determination of risk factors for individual cancers with respect to geographic, demographic, socioeconomic, behavioral, and genetic patterns. Descriptive epidemiology studies are used to determine a possible cause for a particular cancer and may be refined by inclusion of the time factor, such as cross-sectional studies (present time), case-control studies of past exposure (retrospective studies), and attempts to establish if selected exposed populations develop a disease in the future (prospective studies). The discipline of molecular epidemiology incorporates molecular, cellular, and other biological measurements into epidemiological research. According to the World Health Organization, in 1997, 10 million people were diagnosed...

The Immune System and Cancer

WHAT IS CANCER, AND HOW DO WE GET IT Just a few decades ago, our thinking about cancer, and especially its treatment, was as fragmented as the disease itself appeared to be. Oncologists were a frustrated lot there seemed to be as many different diseases called cancer as there were different cells in the body any one of them could become cancerous, and each of the resulting diseases seemed to require a completely different approach to treatment. Our thinking about cancer has changed remarkably in recent years. Bone cancer still looks different from brain cancer skin cancer is still treated differently than lung cancer. But the current focus is on understanding what causes cancer in the first place, and here the emphasis is on what cancers have in common, rather than on what makes them different. Cancer can be contributed to by external agents radiation, chemicals, and some viruses or by mistakes made within a cell when it reproduces its DNA. And indeed, any cell or tissue in the body...

Prevention and Treatment of Colorectal Cancer

Long-standing UC is a predisposing factor for development of CRC, as it is clear that cancer is more common in these patients compared to the age-matched general population 19, 20 . The actual prevalence varies in different series 21, 22 , and the cumulative probability of developing CRC is 18 after 30 years of disease 23 . In addition to disease duration, dis ease extent also correlates with an increased risk of cancer, with the risk being most significant in patients with pancolitis 24 . Another two independent risk factors for CRC in UC patients are family history of CRC 25, 26 and primary sclerosing cholangitis (PSC) 27 . Common practice is to start an annual or biannual surveillance colonoscopy, as cancer risk increases over that of the background population. This would usually mean 8-12 years after disease onset for patients with pancolitis or upon diagnosis of concomitant PSC. Confirmed precancerous lesions, such as high-grade dysplasia or dysplasia-associated lesion or mass...

Cancer Immunotherapy Via the Residual Repertoire

The available postthymic residual repertoire specific for self antigens, is, in part, comprised of clones that evaded negative selection, either because of their low affinity for antigen, or because their complementary self-determinant failed to gain access to the MHC to permit tolerance induction. This repertoire may serve as a convenient source of cells for generating an anticancer response, based on the contention that most tumor-associated antigens are actually highly expressed normal self-antigens. Most often, these clones will be directed against subdominant or cryptic determinants, and therefore attempts have been made to alter their target determinants to convert them into more effective immunogens, able to induce proinflammatory Th1 responses (29). Other approaches include the enhancement of costimulatory effects (30,31) and the neutralization of inhibitory elements such as CTLA-4 (32). It is evident that the interests of the autoimmunologist and the tumor immunologist merge...

Hbv As A Hepatocarcinogen

Direct Carcinogenicity by Integration Circumstantial evidence that HBV is directly carcinogenic comes from three sources. Although most HBV-related HCCs coexist with cirrhosis, supporting the belief that virally induced chronic necroinflammatory hepatic disease plays an important part in the pathogenesis of HCC (31,32), the remaining tumors arise in an otherwise normal liver. Moreover, in populations with a high incidence of HBV-related HCC, markers of current infection with the virus are present as often in serum and liver A number of putative mechanisms for direct oncogenicity of HBV are supported by experimental evidence. The finding of HBV DNA integrants in chromosomal DNA in HCC is consistent with insertionalse mutagenesis, a mechanism of oncogenesis described with nonacutely transforming viruses. Viral DNA integration in HCC appears, however, to occur at random sites (although some chromosomes are affected more often than others) (38), which argues against insertion in or near...

Cancer as a Genetic Disorder of Somatic Cells

Genes exert their effects by transcription of a specific section of the DNA into a messenger RNA (mRNA) molecule which is, in turn, translated into a protein that is the final effector of the gene's action. Proteins are not encoded by continuous segments of DNA. Most genes contain several noncoding, intervening regions (introns) whose sequences are not represented in the translated product. The relevant protein sequences are dictated by the coding sequences, the exons. By controlling the synthesis of proteins, genes may be the ultimate determinants of phenotypic expression. Cancer is often a consequence of pathological changes in the information carried by DNA. Although it is a simplified view, transformation of normal cells into malignant cells is likely to occur when genes whose products control signal transduction, the cell cycle, genomic stability, and cellular senescence and apoptosis are altered. The consequence of the alteration is that there is a failure of one or more of...

Immunotherapy And Gene Therapy For Cancer

How can we explore what we know about cancer, and the immune response to it, to our advantage, as early researchers had hoped a hundred years ago A number of approaches have been tried over the years. For example, we've learned a lot about the various cytokines that regulate immune responses, and some of these have been used as cancer-fighting drugs in an attempt to boost the body's response to tumors. There is a certain perverse satisfaction in enlisting one's own tumor to encourage the immune system to destroy it. And it works. In a recent study with non-small cell lung cancer patients, one such tumor-embedded cytokine, called GM-CSF, caused very significant increases in survival among patients who had failed all other treatments.

Hcv As A Hepatocarcinogen

Mechanisms of Carcinogenicity The possibility that HCV could also be directly carcinogenic was initially suggested by the observation that a few HCV-related tumors arose in normal or near normal livers (76). More convincing evidence was provided by the recent report that transgenic mice in which the core gene together with its regulatory sequences have been introduced develop HCC (77). HCV would have to exert its direct carcinogenic effect from an extrachrosomal position, and possible mechanisms have been proposed. The deduced amino acid sequence of the HCV core protein shows it to be a basic protein that contains a putative DNA binding motif, as well as triplicate nuclear localization signals and several putative protein kinase A and C recognition sites (78,79). These characteristics imply that the protein could function as a gene-regulatory protein. The nonstructural NS3 protein has both proteinase and helicase activity. NIH 3T3 cells transfected with the 5' half of the HCV sequence...

Testicular Cancer

The other group of patients in whom the effects of chemotherapy on testicular function have been widely investigated is those with testicular cancer (29-32). To attempt to delineate which abnormalities are a result of cytotoxic chemotherapy, several of these studies also examined pretreatment testicular function or compared chemotherapy-treated patients with those who underwent orchidectomy alone. Lampe et al. (31) analyzed data concerning 170 patients with testicular germ cell cancers, who underwent treatment with either cisplatin-based or carboplatin-based chemotherapy. Of the 170 patients, 40 (24 ) were azoospermic before treatment, with a further 41 (24 ) oligospermia At a median of 30 mo after the completion of chemotherapy, only 64 of those who were normospermic before therapy remained normospermic, whereas 54 (32 ) of the total cohort were azoospermic and 43 (25 ) were oligospermia The probability of recovery to a normal sperm count was higher for those men with a normal...

Intraperitoneal Liposome Administration for Cancer Therapy

One approach to prolong the retention of intraperitoneally administered drugs is to encapsulate the drug within a liposome (34-36). Administration of liposomes encapsulating therapeutic agents directly into the peritoneum increases and prolongs the concentration of drug in the peritoneum. Because liposomes are cleared from the peritoneum through lymphatic drainage, the delivery of therapeutic agents to the lymph nodes that filter lymph fluid that drains from the peritoneum can also be greatly increased. This lymphatic drainage is commonly taken as the passage of cancer cell invasion and these lymph nodes are one of the most common types of tumor metastasis. Second, the encapsulated drug is blocked from rapid direct absorption through the peritoneal lining, resulting in increased time for the liposome-encapsulated drug to reach tumor cells, while the encapsulated drug is cleared through the lymphatics. Many studies have clearly demonstrated that the pharmacokinetics of...

Potential Use of Liposome Therapeutic Agents for Prophylaxis Against Recurrent Peritoneal Cancer

An important potential application of the intraperitoneal delivery of liposomes that carry anticancer agents is in the prophylaxis of peritoneal carcinomatosis. Because 50 of patients with malignant gastrointestinal or gynecological diseases experience peritoneal carcinomatosis shortly after local curative resection, there is a great interest in delivering intraperitoneal chemotherapy during the perioperative period (2,50). One study found that the intraperitoneal administration of the chemotherapeutic agents, cisplatin and mitomycin, prevented perioperative peritoneal carcinomatosis in a rat model (51,52). The rats receiving cisplatin did, however, experience severe, local toxicity with bleeding into the peritoneum and toxic necrotic reactions of the colon. Liposomes encapsulating anticancer agents could potentially be used for this type of perioperative prophylactic chemotherapy. The potential for treatment of micrometastasis in lymph nodes is also great.

Carcinogenesis Requires an Accumulation of Mutations

Mutations may have a variety of consequences for the cells in which they occur. It is likely that in many instances the effects are either lethal or neutral and as such are impossible to detect. The third possible result is that the mutated cell acquires a competitive advantage over its normal neighbors, and multiplies. It is now accepted that transformation into malignancy, and the establishment of the full cancer phenotype, requires at least two, but often five or more, independent mutations. There is direct evidence for the serial accumulation of independent mutations during carcinogenesis. Mutant proto-oncogenes, tumor-suppressor genes, and mismatch-repair genes have been found by histopathological techniques at different stages during the progression of cells from normal to transformed malignant cells. The number of required mutations varies from one cancer type to another. For example, multiple gene alterations in breast carcinoma involve the c-myc and erbB2 neu oncogenes and...

Non CancerRelated Pain

The use of intrathecal opioids for pain not due to cancer has burgeoned in recent years in spite of a lack of prospective studies. The most definitive data to date supporting such an increase in use are provided by the survey of physicians in the United States by Paice, Penn, and Shortt,17 cited in connection with cancer-related pain and including data on pain not related to cancer, and in the retrospective study by European authors Winkelmuller and Winkelmuller.34 Specific outcome measures employed by Paice et al. included activities of daily living (ADLs), employment, percent pain relief, a global pain relief score incorporating intensity and pain medication changes, and activity levels.17 In 82 of respondents there was improvement in handling ADLs. Patients with visceral pain showed the greatest improvement in ADLs. Return to work occurred in 24 of the patients with non-cancer-related pain. In a long-term follow-up of 120 non-cancer-related pain patients in Europe with a mean...

Progression Markers during the Intestinal Carcinogenesis Intermediate Biomarkers

Colon carcinogenesis is a multistep process in which an accumulation of genetic events within a single cell line leads to a progressively dysplastic cellular appearance, deregulated cell growth, and, finally, carcinoma. The adenoma-carcinoma sequence occurs through a series of mutations in cancer-causing genes and usually takes about 11 years. These genes (oncogenes, tumour suppressor genes, DNA mismatch repair genes) encode proteins that control vital cell functions such as growth and survival. Development of intermediate markers for chemopre-vention trials is important. Premalignant lesions are a potential source of intermediate markers. Monitoring intermediate markers that correlate with a reduction in cancer incidence would allow a more expeditious evaluation of potentially active chemopreven-tive agents. If a disappearance of these lesions can be correlated with a reduction in cancer incidence, then markers of premalignancy may serve as intermediate endpoints for chemoprevention...

Hw to Prevent the Carcinogenic Progression b Chemical Aentsthe Chemoprevention

Cancer chemoprevention, as first defined by Sporn in 1976 2 , uses natural, synthetic, or biological chemical agents to reverse, suppress, or prevent carcinogenic progression. It is based on the concepts of mul-tifocal field carcinogenesis and multistep carcino-genesis. In field carcinogenesis, diffuse epithelial injury in tissues such as the aerodigestive tract, results from generalised carcinogen exposure throughout the field and clonal proliferation of mutated cells. Genetic changes exist throughout the field and increase the likelihood that one or more premalignant and malignant lesions may develop within that field. Multistep carcinogenesis describes a stepwise accumulation of alterations, both geno-typic and phenotypic. Arresting one or several of the steps may impede or delay the development of cancer. This has been described particularly well in studies involving precancerous and cancerous lesions of the head and neck, which focus on oral premalignant lesions (leukoplakia and...

Surgical Prevention of Colorectal Cancer in FAP

Familial adenomatous polyposis coli (FAP) may not be considered a single disease entity with standardised guidelines for operative treatment. However, prophylactic colectomy after the manifestation of polyps but prior to the development of colorectal cancer remains the most effective prevention of col-orectal cancer in FAP. The optimal timing of prophylactic surgery remains a clinical decision taken independently of mutation analysis. In the case of the classic FAP phenotype, restorative proctocolectomy and ileal pouch-anal anastomosis might be the procedure of choice. The development of reliable guidelines for attenuated FAP variants requires further evidence from clinical studies on surgical strategy and the advantages of prophylactic surgery over regular endoscopic screening with removal of polyps. A study by Winde et al. 15 has shown that low-dose rectal sulindac maintenance therapy is highly effective in achieving complete adenoma reversion without relapse in 87 of patients after...

Invasive transitional cell cancer biological considerations

Urothelial cancer initially presents as 'superficial' disease in 70 of patients and as muscle-invasive disease in the remaining 30 .1 In those patients who present with 'superficial' disease, 70 (50 of the total) have mucosally confined, generally low-moderate grade tumours, and only 2-4 of these will progress.2 In contrast, 30 of the remaining patients who present initially with 'superficial' disease (20 of the total) have tumours that have infiltrated the lamina propria and 30-50 of these may progress.2 Overall, 1-2 of mucosally confined disease, and 6-10 of lamina propria invasive These figures allow us to estimate the scope of the problem of bladder cancer in the general population. The 30 of all bladder cancers that are muscle-invasive at initial diagnosis and the 50-60,000 new diagnoses of bladder cancer in the United States annually account for 15-18,000 patients with muscle-invasive bladder cancer. The 10-15 of initially superficial tumours that develop into muscle-invasive...

Epidemiologic Evidence For A Link Between H Pylori And Gastric Cancer

Because H. pylori causes the vast majority of chronic gastritis and because gastritis is known to precede noncardia gastric cancer, there has been much interest in H. pylori as a cause of cancer. A number of ecologic studies have compared rates of H. pylori infection in different populations with rates of gastric cancer in those same populations. In most areas, cancer rates have correlated well with H. pylori prevalence (55,56). Temporal studies have also indicated a correlation between trends in H. pylori prevalence and trends in cancer incidence. Similar to the gastric cancer rate, H. pylori incidence has been declining over time (41,42). Many retrospective epidemiologic studies have evaluated whether H. pylori is more common in cancer patients than in persons without cancer. A number of these studies have been subject to bias, including poor control selection or lack of adjustment for known confounders or tumor site this would tend to mask any association between infection and...

Upper Gastrointestinal Polyps and Cancer

Stomach fundic gland polyps, adenomatous polyps, cancer Duodenum and small bowel duodenal adenomas, periampullary cancer, small-bowel adenomas, cancer, lymphoid polyps of ileum Gallbladder, bile duct, pancreas adenomas, cancer these lesions approaches 100 4-6 . Duodenal peri-ampullary adenocarcinoma is a leading cause of cancer death in FAP patients following colectomy. Duodenal cancer is rare in the general population, with an incidence of 0.01-0.04 7 . Compared with the general population, FAP patients have a 100-330-fold higher risk of duodenal cancer 8, 9 . The estimated cumulative lifetime risk of developing duodenal cancer in FAP range from 4 to 10 4,10,11 . The median age of duodenal cancer development is 52 years (range 26-58) 4 . Therefore, although most patients eventually develop duodenal polyps, these lesions occur at a later age and have lower potential for malignant change compared with colonic polyps. duodenal mucosa to bile acids in duodenal carcinogenesis 12,13 . Data...

Anticancer Vaccine Approaches Derived from Autologous and Allogeneic Tumor Cells

Many cancer vaccines currently being developed use autologous or allogeneic tumor cells as a source of antigen for immunizing patients. Live vaccines can be modified to enhance immunogenicity. Non-viable cell vaccines can be used as a source of antigenic peptides, RNA, or heat shock proteins. An autologous tumor cell vaccine is derived from a patient's own tumor. It offers the potential to immunize against antigens generated by tumor-specific gene mutations. An allogeneic tumor vaccine is derived from a cancer cell line or another patient's tumor. Allogeneic tumor cells are a more reliable and uniform source of antigens for the preparation of vaccines. These vaccines target antigens that are shared between the cell lines in the vaccine and patients' tumors. To avoid the possibility that live tumor cells may seed implants or metastasize, whole tumor cells are irradiated or otherwise killed before reinjection into patients. Thus, final preparations of autologous and allogeneic tumor...

Animal Models For H Pylori And Gastric Cancer

Evidence to link H. pylori with gastric cancer has been provided by animal models. In mice, H. hepaticus causes low-grade infection of intrahepatic bile canaliculi it produces hepatic carcinoma in males of the A JCr strain (74,75). Liver cells in these animals exhibit both increased cell turnover and increased oxidative damage they also demonstrate a range of mutations (75-77). This model, however, although useful for the understanding of carcinogenesis, has limited applicability to human gastric cancer. The most recent model to be identified has been that of the Mongolian gerbil (86). Readily infected with H. pylori, Mongolian gerbils develop gastritis, gastric ulceration, intestinal metaplasia, and gastric adenocarcinoma (87-89). Of note, H. pylori alone appears to be sufficient to cause cancer in this model. While much remains to be discovered, particularly with respect to epithelial alterations, this system should provide a particularly good model for the understanding of the...

Prevention Of H Pylorirelated Gastric Cancer

Within an individual, the development of cancer results from a combination of factors, including circumstances of infection, the individual's genetic makeup, H. pylori strain type, and other cofactors. Only some of these risk factors are amenable to intervention within a population. H. pylori-related gastric cancer could be prevented by preventing H. pylori infection (through either the interruption of H. pylori transmission or the immunization of susceptible people) by curing H. pylori infection (with the treatment of infected people via antibiotic therapy or therapeutic vaccination) or by removing other factors necessary for gastric cancer development. H. pylori infection can be eradicated by antibiotic therapy. To date, screening for and treatment of H. pylori are recommended only for persons in specific high-risk groups (186,187). A key reason for this selection is that it is not known whether eradication of infection prevents gastric cancer. If antibiotic therapies could prevent...

T Cell Tolerance to Tumors and Cancer Immunotherapy

2 Tumor Immunity and Tolerance Section, Laboratory of Molecular Immunoregulation, Cancer and Inflammation Program, CCR, NIH, Frederick, MD, USA, hurwitza ncifcrf.gov Abstract. It is widely recognized that the immune system plays a role in cancer progression and that some tumors are inherently immunogenic. The identification of tumor-associated antigens (TAAs) has stimulated research focused on immunotherapies to mediate the regression of established tumors. Cancer-specific immunity has traditionally been aimed at activating CD8+ cytotoxic T lymphocytes (CTLs) directed against major histocompatibility complex (MHC) class I-binding peptide epitopes. Other approaches utilize T cell adoptive therapy where autologous, tumor-specific T cells propagated in vitro are transferred back into recipients. However, these strategies have met with limited success in part due to the regulatory mechanisms of T cell tolerance, which poses a considerable challenge to cancer immunother-apy. Our laboratory...

Muscleinvasive bladder cancer MIBl

Dependent on age and co-morbidity, 64 of the patients with MIBC recorded erectile dysfunction present before any treatment was given, and 51 recorded decreased libido.8 Urinary symptoms were present in 2661 of the patients with muscle-invasive bladder cancer before the start of any treatment.

Cancer the genetics of aberrant cell number regulation

A basic article of faith in genetic analysis is that we learn a great deal about biology, both normal and diseased, by studying the properties of mutations that disrupt normal processes. It has certainly been true in regard to cancer. It has become clear that virtually all cancers of somatic cells arise owing to a series of special mutations that accumulate in a cell. Some of these mutations alter the activity of a gene others simply eliminate the gene's activity. Cancer-promoting mutations fall into a few major categories those that increase the ability of a cell to proliferate, those that decrease the susceptibility of a cell to apoptosis, or those that increase the general mutation rate of the cell or its longevity, so that all mutations, including those that encourage proliferation or apoptosis, are more likely to occur. Improvements in diagnosis and treatment of cancers have been dramatic, but, though some battles have been won, we are a very long way from declaring victory in...

How cancer cells differ from normal cells

Malignant tumors, or cancers, are aggregates of cells, all descended from an initial aberrant founder cell. In other words, the malignant cells are all members of a single clone. This is true even in advanced cancers having multiple tumors at many sites in the body. Cancer cells typically differ from their normal neighbors by a host of phenotypic characters, such as rapid division rate, ability to invade new cellular territories, high metabolic rate, and abnormal shape. For example, when cells from normal epithelial cell sheets are placed in cell culture, they can grow only when anchored to the culture dish itself. In addition, normal epithelial cells in culture divide only until they form a continuous monolayer (Figure 17-14a). At that point, they somehow recognize that they have formed a single epithelial sheet and stop dividing. In contrast, malignant cells derived from epithelial tissue continue to proliferate, piling up on one another (Figure 17-14b). Clearly, the factors...

A Metabolism and Biomarkers of Carcinogens

There are more than 6 million chemical compounds registered with the Chemical Abstracts Service. About 10 of these compounds are used commercially, and fewer than 1000 have been thoroughly evaluated with respect to their potential for cancer causation. In a large, ongoing study (> 100 books published), the International Agency for Research on Cancer (IARC) has been evaluating carcinogenicity in humans and laboratory animals based on the following groupings chemicals, groups of chemicals, complex mixtures, occupational exposures, behavioral and life-style exposures, biological agents, and physical agents. The IARC classifies the evidence of carcinogenicity into four categories.1 Group 1 members are carcinogenic to humans, based on sufficient evidence that a causal relationship has been established between exposure and cancer (Table 4.1). Group 2A members are probably carcinogenic to humans, and Group 2B possibly carcinogenic to humans (Table 4.2). Group 3 classification means that...

Mutations in cancer cells

Several lines of evidence point to a genetic origin of the transformation of cells from the benign into the cancerous state. 1. Most carcinogenic agents (chemicals and radiation) are also mutagenic, suggesting that they produce cancer by introducing mutations into genes. 2. In the past few years, several alleles that increase susceptibility to cancer have been cloned and mapped. 3. Mutations that are frequently associated with particular kinds of cancers have been identified. In some cases, investigators have created transgenic or knockout mimics of these naturally occurring mutations in cell lines in culture or in intact experimental models. These artificially created mutations produce cancerous or cancerlike phenotypes. A tumor does not arise as a result of a single genetic event but rather as the result of multiple hits that is, several mutations must arise within a single cell for it to become cancerous. Occasionally, a single mutation is powerful enough to guarantee that a cancer...

To cancer diagnostics and therapies

A goal of cancer diagnostics is to properly classify the type of cancer that a patient has contracted, often by inspecting tumor cells under the microscope. However, ge-nomic approaches have revealed that tumors that look the same under a microscope may have very different molecular bases. Let's examine how genomics can be used to address this diagnostic problem. As an example, we will consider a form of lymphoma. Lymphomas and leukemias are cancers of the white blood cells the cells that make up the immune system. In these diseases, certain white blood cells massively overproliferate, leading to an imbalance in immune cells and, ultimately, a failure of the immune system. One class of lymphoma is called diffuse large B-cell lymphoma (DLBCL), the most common form of non-Hodgkin's lymphoma. In the United States alone, about 25,000 new cases of DLBCL are diagnosed every year. The diagnosis is based on finding a characteristic set of symptoms and on the histology (microscopic examination...

Modulating Tolerance of Tumor Specific T cells in a Murine Model of Prostate Cancer

The development of genetically modified murine models of cancer has profoundly aided in understanding T cell responses to tumor antigens. To study T cell tolerance and tumor immunity, we utilize the TRAMP model, an autochthonous model of prostate cancer that highly resembles the pathogenesis and progression of prostate cancer in humans. TRAMP mice carry the -426 +28 fragment of the androgen-driven, prostate-specific rat Probasin (PB) regulatory element fused to the SV40 T t antigen gene (TAg) (Greenberg et al. 1995). The TRAMP model system has been proven by us and others to be a valid model to study immunological tolerance and potential immunotherapeutics aimed at overcoming T cell tolerance to tumors (Granziero et al. 1999 Hurwitz et al. 2000 Tourkova et al. 2004).

The complexities of cancer

We have seen that numerous mutations that promote tumor growth can arise. These mutations alter the normal processes that govern proliferation and apoptosis (Figure 17-24). The story does not end here, however. There is evidence that other modes of gene inactivation, such as epigenetic imprinting, can produce tumor-promoting lesions. There is also evidence that the overexpression of telomerase is another condition required for cell immortality, a feature of cancer cells. (Normal human somatic cells can undergo only a relatively small number of divisions before their telomeres are reduced in size to the point at which the cells can no longer grow. In human tumor cells, however, the length of the telomeres appears to be substantially extended, proba-

Occupational Carcinogens

Although only 2 to 8 of human cancers are of occupational origin, the risks are high for specific populations of exposed workers. For example, employment in the rubber industry has been strongly associated with bladder, stomach, and lung cancers and leukemia. The following are manufacturing production environments in which there is exposure to known human carcinogens (IARC Group I) aluminum production, auramine manufacture, boot and shoe manufacture and repair, coal gasification, coke production, furniture and cabinet making, hematite mining, iron and steel founding, isopropanol and magenta manufacturing, painting, the rubber industry, and heavy exposure to sulfuring acid mists. Probable human carcinogen exposure (Group 2A) occurs for hairdressers and barbers. Possible human carcinogens (Group 2B) affect workers in the carpentry and textile industries. The types of occupation-related epidemiology studies include case reports, sentinel events, ecologic investigations, and analytic...

Schistosomal Epidemiology And Incidence Of Bladder Cancer

From Infectious Causes of Cancer Targets for Intervention Edited by J. J. Goedert Humana Press Inc., Totowa, NJ The mean age at presentation of carcinoma of the bladder in endemic areas of Malawi is also lower (44.9 yr) than and in nonendemic areas (15) similar patterns are seen in Zambia (16), where most of the people are younger than 50 yr. In Iraq, bladder carcinoma is the second most common malignancy recorded, with areas bordering Kuwait showing bladder carcinoma to be the third most common malignancy reported in men (17). An interesting observation with respect to the differences in epidemiology is that cryptogenic or aromatic amine-induced cancers seen in Western countries occur in the most dependent trigonal region of the bladder whereas the schistosome-associ-ated group rarely affects that trigone (18-20).

Schistosomal Eggs And Cancer

A published series from Egypt showed squamous carcinomas to be the most common, with ratios of 70 25 5 between squamous carcinomas, transitional cell carcinomas, and adenocarcinomas (18). This contrasts sharply with squamous carcinoma, transitional carcinoma, and adenocarcinoma ratios of 5 94 1, respectively, reported in Western countries (24,25). It thus becomes evident that the ratio between transitional cell carcinoma and squamous carcinoma clearly differs when comparing tumor incidence in endemic and nonendemic areas with urinary bladder schistosomiasis. However, not all bladder malignancies in endemic schistosomiasis areas are associated with the parasite 17.6 of bladder cancers in Egypt do not harbor eggs of S. hematobium (21). These cases represent either patients with schistosomiasis from nonbilharzial areas, patients with mild schistosomal disease or those in whom the disease had burnt itself out, or those patients who have been successfully treated and cured (21). In the...

Animal Models Of Leptomeningeal Cancer

Mechanisms and the development of therapeutic strategies. Since the 1970's, numerous syngeneic and allogeneic rodent models of leptomeningeal cancer have been developed in this chapter, we present representative models and discuss their clinical and translational implications. leptomeningeal cancer translational research

Inflammation and the development of cancer

The association between inflammation and cancer has been recognised for many years. One clearly established example is the correlation between inflammatory bowel disease and colorectal cancer. The mechanisms behind this association are unclear. The ''landscape theory'' suggests that abnormal cells from stromal tissues, influenced by factors in the local environment, cause susceptibility to malignant transformation in epithelial cells. These environmental factors include those that favour genomic changes (resulting in the loss of tumour suppressor function or activation of oncogenes) or enhanced growth, thus providing transformed cells the opportunity to proliferate. The association between H. pylori infection and gastric cancer is another example where inflammation is clearly related to tumour development. H. pylori causes mucosal inflammation and can persist as a chronic inflammatory response associated with the release of reactive oxygen intermediates and tissue cell proliferation....

Molecular Events Underlying Schistosomiasisrelated Bladder Cancer

And multiple etiologic agents are implicated in progression, shows interesting findings H-ras activation (59-61), p53 (62) and retinoblastoma gene (Rb) (63) inactivation and overexpression of the epidermal growth factor receptor (EGFR) (64) and C-erbB-2 (65). The prospective analysis of bladder tumors involving each of the genetic loci implicate p53 inactivation as a late event associated with the transition of tumor from a low-grade to a high-grade lesion (66). Loss of expression of the Rb gene product and overexpression of the EGFR are correlated with the invasive phenotype and along with p53 have been proposed as independent prognostic indicators of progression in bladder cancer. In contrast, H-ras activation has been consistently found to be represented in all grades of bladder tumors. Ramchurren et al. (67) examined the molecular alterations reported in transitional cell carcinomas from Western countries in schistosomiasis-related squamous cell carcinomas of the bladder and...

Hpv And Schistosomiasisassociated Bladder Cancer

Cooper et al. (77) examined the human papillomavirus (HPV) DNA status in schistosomal associated squamous cell carcinoma of urinary bladder in South Africa by using nonisotopic in situ hybridization (NISH) and polymerase chain reaction (PCR) against 6, 11, 16, 18, 31, and 33 genotypes. None of the cases was shown to harbor HPV DNA. This study abrogates the role of HPV in schistosoma-associated bladder cancer in South Africa. Other factors including nitrosamine exposure, p53 mutations, and additional unknown chromosomal events may play a major role in the development of this parasite-associated neoplasm.

DNA Repair and Cancer

Human cancer develops when certain genes that regulate normal cell division (oncogenes and tumor suppressor genes Chapter 12) fail to function, are activated at the wrong time, or are altered. As a consequence, cells may grow out of control and form a tumor. The genes controlling cell division can be damaged by spontaneous mutation or overridden by the invasion of a tumor virus (Chapter 26). Not surprisingly, alterations in DNA-repair genes that result in an increase in the rate of mutation can greatly increase an individual's susceptibility to cancer. Defects in the genes encoding the proteins involved in nucleotide-excision repair, mismatch repair, recombinational repair, and error-prone translesion synthesis have all been linked to human cancers. Clearly, DNA repair can be a matter of life and death. Nucleotide-excision repair requires a larger number of proteins in humans than in bacteria, although the overall pathways are very similar. Genetic defects that inactivate...

Surveillance for Dysplasia and Cancer

The clinical heterogeneity of IBD is reflected in the heterogeneity in the macro and microscopic feature and makes cancer surveillance in this population much more challenging than in the general population. IBD associated risk factors for colorectal cancer are well known and this is the reason why any patient with a history of extensive disease, whether UC or CD, of more than 10 years must undergo a complete colonoscopy with multiple biopsies every 2 years. Any dubious situation should be carefully discussed by the gastroenterologist, the surgeon and the pathologist and the maximal alert in case of dysplasia or cancer on flat inflamed mucosa should be given. The best way to manage dysplasia and colorectal cancer is via a surveillance program however, in this case the patients have to be correctly and clearly informed that dysplasia and cancer can still arise despite the program of close observation and the skilfulness of the medical staff 24 . In our opinion, the development of...

Cell Technologies in Immunotherapy of Cancer

Tumor growth is accompanied by active immune reactions even on the early stages. Vaccine therapy implies the use of single antigen or combination of antigens, either with or without adjuvants, for the modulation of immune response. N.N. Petrov Institute of Oncology joined the field of antitumor vaccine therapy and related cellular technologies in 1998. The following activities are held (1) Optimization of the preparation of autologous and allogeneic antitumor vaccines and development of tumor cell culture bank for the experiments on allogeneic vaccination. (2) Clinical evaluation of autologous vaccine therapy by (a) bone marrow precursors of dendritic cells (DCs), which are loaded with tumor lysates (b) genetically modified tumor cells (c) intact tumor cells used in combination with various adjuvants (BCG, IL-1P, and IL-1P combined with low doses of cyclophosphamide) in patients with disseminated melanoma, metastatic kidney cancer, and colorectal cancer. Total 117 patients...

Designing Phase I Cancer Trials

Different from other phase I clinical trials, phase I clinical trials in cancer have several main features. First, the efficacy of chemotherapy or any cancer treat- ment is, indeed, frequently associated with a nonnegligible risk of severe toxic effect, often fatal, so that ethically, the initial administration of such drugs cannot be investigated in healthy volunteers but only in cancer patients. Usually, only a small number of patients are available to be entered in phase I cancer trials. Second, these patients are at very high risk of death in the short term under all standard therapies, some of which may already have failed. At low doses, little or no efficacy is expected from the new therapy, and a slow intrapatient dose escalation is not possible. Third, there is not enough information about the drug's activity profile. In addition, clinicians often want to proceed as rapidly as possible to phase II trials with more emphasis on efficacy. The lack of information about the...

Evaluation Investigations And Management Of Late Effects Of Childhood Cancer

Currently the overall 5-year survival rate in childhood cancer is 75 . The prevalence of U.S. childhood cancer survivors among young adults 15-45 years of age has been estimated to be 1 in 900 persons. Late effects are defined as any physical or psychological outcome that develops or persists beyond 5 years from the diagnosis of cancer. Up to two thirds of childhood cancer survivors are likely to experience at least one late effect, with one fourth of survivors experiencing severe or life-threatening side effects. The most common late effects of childhood cancer are neurocognitive, psychological, cardiopulmonary, endocrine, musculoskeletal, and second malignancies. Chemotherapy, radiation therapy, and surgery may all cause late effects involving any organ system. The three most common treatment-related causes of death are the development of a secondary cancer, cardiac toxicity, and pulmonary complications. Information to be elicited in the follow-up of cancer survivors is listed in...

Cancer Associated Genes Have Many Functions

Homeostasis in normal tissue is maintained by a highly regulated process of cellular proliferation balanced by cell death. If there is an imbalance, either at the stage of cellular proliferation or at the stage of cell death, then a cancerous state will develop. Oncogenes and tumor suppressor genes have been shown to play an important role in this process, by regulating either cellular proliferation or cell death. Cancer-associated genes can be divided into three categories that reflect these different activities, summarized in Table 22-1.

Killing of Metastatic Cancerous Cells by NK

In order to form metastases, tumor cells must leave the protective tumor microenvironment and travel to distinct sites, being exposed to destruction by NK and other immune cells. However, unique shield is provided to the cancerous cells in the blood stream by the form of platelets that form micro thrombi around them 15 . Experimentally, anticoagulant drugs treatment in mice inhibited metastases in an NK-dependent mechanism, and increased acute tumor cells clearance in vivo 156 , suggesting that platelets aggregation and fibrin coating provide tumor protection of NK cell destruction in the blood. Clinical evidences have also pointed to coagulation role in tumor metastasis 157 . In vitro, fibrin coagulation around tumor cells, or around effector cells, reduced cytotoxicity by preventing cell-cell contact 158 . Thrombin was shown to contribute to platelet aggregation with tumor cells in vitro and consequently to enhance metastasis in vivo 159 . Thus, metastases which are the main cause...

Early Searches For A Human Breast Cancer Virus

Based on the extensive studies of MMTV, the hypothesis that a retrovirus might also cause human breast cancer was compelling, and rigorously pursued in the 1970s. The methodology at the time included not only electron microscopy, but much more sensitive biochemical techniques for detecting the signature enzyme of retroviruses, RT, as a footprint of a retroviral agent, and a simultaneous detection technique for detecting RT activity in association with the viral 60-70S RNA genome. Using such methodology, evidence accumulated in support of a retroviral agent-human breast cancer link. The findings included detection of type B and D retroviral-like particles in milk of women from familial breast cancer families and certain ethnic groups with high breast cancer incidence (28-30), detection of RT activity in particulate fractions of human milk (31), detection of RNA homologous to MMTV in human breast tumors (32), detection of retrovirus-like particles associated with RT activity in the...

Other Candidate Breast Cancer Agents

Because many of the attempts to find an MMTV-related exogenous human agent have led to endogenous elements with no conspicuous relationship to breast cancer, Pogo and her colleagues have searched for evidence of an agent closely resembling MMTV but with no homology to HERVs. They used the polymerase chain reaction (PCR) to probe normal and malignant breast tissue DNAs for a 660-bp sequence with 98 homology to the MMTV env gene and minimal homology to HERVs. They recently reported that 40 of breast cancer patients possessed this sequence compared to only 2 of normal donors (81). In a follow-up study they observed that 66 of the samples positive for the MMTV env DNA sequence also transcribed the sequence (82). Their results have not yet been independently confirmed by any other investigator. The involvement of several other viruses with human breast cancer has also been suggested, but again, the findings have not been confirmed and causal relationships have not been established. The...

Regional Chemotherapies for Cancer Treatment

Chemotherapeutic agents have been used for cancer therapy for almost 50 years, and today more than 50 such compounds are in frequent use. These cytostatic agents impact upon the genetic system of cells, interfering with metabolic pathways or destroying cellular structures, and this results in a suppression of tumor cell proliferation. Cytostatic agents are classified according to their mechanism of action into several groups Unfortunately, cytostatic agents cannot discriminate between tumor and healthy tissues, and consequently chemotherapy also impairs healthy (especially growth-intensive) cells and united cell structures. This results in cellular toxic effects on the bone marrow, gastrointestinal tract and germ cells that may be mutagenic, teratogenic, and or cancerogenic. The risk of second tumors induced by chemotherapy has been estimated at up to 3 (Neglia et al., 2001). These second tumors are caused by long-term therapy with high cytostatic dosages, predominantly with 4.8.3...

Interleukin10 in Cancer Models

Experimental cancer models are of particular interest because in most circumstances they seem to support a role for IL-10 as a powerful anti-cancer agent. Theoretically, this surprising anti-cancer activity could be rationalized in two ways. First it could be accepted that IL-10 is an immune suppressive anti-inflammatory agent and, this could slow cancer progression by antagonizing inflammatory processes within the tumor microenvironment that could be beneficial for cancer growth. It has been suggested by animal models that inflammation may be beneficial to tumor growth 20 the presence of inflammatory bioproducts in the tumor microenvironment such as metalloproteinase-9 or CD4+ cells may promote a vasculogenic switch or induce other critical events favorable for tumor progression21,22 An opposite view may propose a pro-inflammatory role for IL-10 that could lead to cancer rejection. While the answer to this opposite interpretation of experimental models is not available, it may be of...

Circulatory Analgesic and Cancer Fighting Drugs

The primary plant-derived anticancer agents are vincristine and vinblastine, extracted from Cather-anthus roseus, maytansinoids from Maytentus serrata, ellipticine and related compounds from Ochrosia elliptica, and paclitaxel (commonly known as taxol) from the yew tree Taxus baccata.