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CANCER LEARNING GOALS: I CAN… …understand how cancerous (malignant) tumors evolve within the body. …describe different stages in diagnosing cancer. …explain how different cancer treatments are used to reduce the growth and progression of cancerous cells. CANCER I. Causes of Cancer A. 1. The most correct answer to the question: “What Causes Cancer?” is m a n y d i f f e r e n t t h i n g s For cancer to occur, t h e r e i s u s u a l l y s o m e s o r t of malfunction in the process of mitosis t h a t c a u s e s h y p e r p l a s i a t o o c c u r. Hyperplasia – p r o c e s s t h a t p r o d u c e s t o o m a n y cells 2. Most cells that cause cancer are often produced by a process called a n a p l a s i a . Anaplasia – p r o c e s s b y w h i c h u n d i f f e r e n t i a t e d tumor cells are produced CANCER B. Some “suspects” that play a role n the development of cancer include: 1. CARCINOGENS: a g e n t s t h a t a f f e c t g e n e t i c activity in some way that cause abnormal cell growth. M U TA G E N S – a g e n t s t h a t c h a n g e a c e l l ’s DNA structures 2. AGE: A g e c h a n g e s g e n e t i c a c t i v i t y o v e r t i m e and there are some forms of cell damage that can accumulate in DNA that leads to difficulties regulating the cell cycle. CANCER 3. ENVIRONMENT: E x p o s u r e t o d a m a g i n g radiation or repetitive mechanical injury 4. VIRUSES: C u r r e n t l y H P V ( h u m a n p a p i l l o m a virus) is being linked to 90% of cervical cancer cases. CANCER 3. GENETIC FACTORS: o n c o g e n e s ( a . k . a . “ c a n c e r g e n e s ” ) c a n b e i n h e r i t e d d i r e c t l y. C a n c e r g e n e s d o n o t g u a r a n t e e y o u g e t c a n c e r. They are faulty genes in repair mechanisms of the cell cycle. Tu m o r S u p r e s s o r O n c o g e n e s : I f s o m e t h i n g goes wrong during cell division, the cell doesn’t have a way to fix the problem and the cells grow out of control. Tu m o r I n d u c i n g O n c o g e n e s : o v e r e x p r e s s i o n of proteins that stimulate cell reproduction Proto-oncogenes: genes that are normal but have the potential to cause a cell to become cancerous if mutated (mutations caused by other risk factors) CANCER CANCER II. Pathogenesis of Cancer A. Typical signs that a person with a malignant tumor may observe are: Ch a n g e i n b o w e l o r b l a d d e r h a b i t s A sore that doesn’t heal Un u s u a l b l e e d i n g o r d i s c h a r g e Th i c ke n i n g o r l u m p i n a b r e a s t o r e l s e w h e r e In d i g e s t i o n (d i f f i c u l t y s w a l l o w i n g ) Ob v i o u s c h a n g e i n a w a r t o f m o l e Na g g i n g c o u g h o r h o a r s e n e s s CANCER The most important step in treating cancer is d e t e c t i n g it early before it metastasizes. B. 1. Self-Examination: o n e l o o k s a t t h e i r b o d y o r b o d y parts for any abnormalities. 2. Diagnostic Imaging: m u l t i p l e m e t h o d s / p r o c e d u r e s are currently in use for making images of internal organs (p. 106-107 in text) 3. Biopsy: u s u a l l y p e r f o r m e d a f t e r a n e o p l a s m h a s already been detected. The neoplasm is removed and examined for abnormal tissue cells 4. Blood Test: B l o o d i s s c r e e n e d f o r c h a n g e s i n blood chemistry or cell composition. These signs could be changes in ion concentration, enzymes, proteins, or cell numbers. Once these signs have been confirmed other diagnostic technique may be used. CANCER The diagnosis of cancer and the type of cancer can lead a physician to make a prognosis. C. Prognosis – a s t a t e m e n t a b o u t t h e p r o b a b l e outcome of the disease 1. Usually without treatment t h o s e w i t h c a n c e r d i e because the cancer spreads and effects multiple parts of the body Metastasis – The cancer resulting from the spread of the primary tumor 1. When a cancer patient dies it is usually because o f a secondary infection, organ failure, hemorrhage, and other factors left undetermined Cachexia – a s y n d r o m e i n v o l v i n g t h e l o s s o f appetite, severe weight loss and general weakness CANCER III. Treatments of Cancer A. The first step to treating cancers is the r e m o v a l of t u m o r s . This isn’t possible for all cancers because: (1) some tumors are in areas surgeons can’t each without causing too much harm, (2)some tumors are too large and widespread, and (3)some cancers do not have localized tumors. CANCER Methods of Cancer Treatment include: B. 1. Surgery: c a n b e u s e d t o d i a g n o s e , t r e a t , o r h e l p prevent cancer depending on the case. Offers the greatest chance for a cure, especially if the cancer has not metastasized 2. Chemotherapy: i s t h e u s e o f m e d i c i n e s o r d r u g s t o t e a c h c a n c e r. A l k y l a t i n g d r u g s d a m a g e t h e DNA of cancer cells, antimetabolites substitute normal building blocks of the DNA and RNA, anti-tumor antibiotics interfere with enzymes involved in DNA replication, topoisomerase inhibitors interfere with enzymes that separate DNA strands for synthesis, mitotic inhibitors interrupt the M phase of cancer growth SURGERY CHEMOTHERAPY CANCER 3. Radiation Therapy: h i g h - e n e r g y p a r t i c l e s o r waves destroy or damage cancer cells. 4. Targeted Therapy: u s e s d r u g s o r o t h e r substance to more precisely identify and attack cancer cells either by the enzymes the produce or the proteins on their surfaces usually while doing little damage to normal cells. 5. Hyperthermia: i n c r e a s i n g t h e t e m p e r a t u r e o f cancer cells makes them more likely to be affected by radiation therapy or c h e m o t h e r a p y. RADIATION THERAPY HYPERTHERMIA CANCER 6. Immunotherapy: t r e a t m e n t t h a t u s e s y o u r b o d y ’s o w n i m m u n e s y s t e m t o h e l p f i g h t c a n c e r. A c t i v e i m m u n o t h e r a p i e s s t i m u l a t e t h e b o d y ’s o w n i m m u n e s y s t e m t o f i g h t t h e disease Passive immunotherapies use immune system components made in the lab. 7. Bone marrow and Peripheral Blood Stem Cell Transplant: hematopoietic stem cells (blood -forming cells) from a donor are transplanted when bone marrow cells in the patient are destroyed by disease. 8. Photodynamic Therapy: u s e s s p e c i a l d r u g s (called photosensitizing agents) that work when they are “turned on” by certain kinds of light. IMMUNOTHEAPY PHOTODYNAMIC THERAPY BONE MARROW TRANSPLANT CANCER 9. Laser Therapy: l a s e r s , w h i c h a r e p o w e r f u l , precise beams of light, can be used instead of blades (scalpels) for very careful surgical work, including treating some cancers. 10. Hormone Treatment: d o c t o r s a t t e m p t t o b l o c k the production of hormones that are f e e d i n g t h e g r o w t h o f c a n c e r. 11. Molecular Targeted Therapy: t h e r a p i e s t h a t i n h i b i t the proteins and genes of different types o f c a n c e r.