disease mgmt
TRANSCRIPT
G I TRACK: CANCER
Sumit Mohite 11
Vishal Mangukiya 12
Jitendra Mourya 13
Prasad Bhandlikar 14
Sanjeev Kumar 15
Cancer: General Etiology and Pathogenesis
What is cancer?
Abnormal cell growth (neoplasia)Malignant as opposed to benign
Benign: slow growth, non-invasive, no metastasisMalignant: rapid growth, invasive, potential for
metastasis
What causes the mutations that lead to cancer?
Viruses: HPV --> cervical cancerBacteria: H. pylori --> gastric cancerChemicals --> B[a]P --> lung cancerUV and ionizing radiation --> skin cancer
What do these agents have in common?
Mutagens
Viruses: insertional mutagenesis
Chemicals: DNA adducts
UV and ionizing radiation: single and double strand DNA breaks
What types of genes get mutated in cancer?
Oncogenes are activatedNormal function: cell growth, gene transcription
Tumor suppressor genes are inactivatedNormal function: DNA repair, cell cycle control, cell
death
Phenotype of a cancer cell
The Six Hallmarks of CancerSelf-sufficient growth signals
Constitutively activated growth factor signalling
Resistance to anti-growth signalsInactivated cell cycle checkpoint
ImmortalityInactivated cell death pathway
Phenotype of a cancer cell (cont'd)
The Six Hallmarks of CancerResistance to cell death
Activated anti- cell death signalling
Sustained angiogenesisActivated VEGF signalling
Invasion and metastasisLoss of cell-to-cell interactions, etc.
p53—a classic tumor suppressor
“The guardian of the genome”Senses genomic damageHalts the cell cycle and initiates DNA repairIf the DNA is irreparable, p53 will initiate the
cell death process
Esophageal cancer :-Esophageal cancer usually develops in the inner layer cells and grows outward.
Treatment :-Endoscopic treatments such
as photodynamic therapyRadiofrequency ablation
Sign & Symptoms :-chronic irritation and inflammation resulting from a backwash of acidic stomach.Painful or difficult swallowing.Weight loss.Pain behind the breastbone.Hoarseness and cough.Indigestion and heartburn.
Stomach Cancer
What is Stomach Cancer? Stomach Cancer (Gastric cancer)-malignant tumor arising
from the lining of the stomach. Stomach cancers are classified according to the type of tissue
where they originate. Most common type of stomach cancer-
Adenocarcinoma(Starts in the glandular tissue of the stomach)
Accounts-90% to 95% of all stomach cancers. Other forms of stomach cancer-lymphomas, which involve
the lymphatic system, and sarcomas, which involve the connective tissue (such as muscle, fat, or blood vessels).
Who Does it Effect? Males over the age of 55. A diet low in fruits and vegetables. A diet high in salted, smoked, or preserved foods. Chronic gastritis. Pernicious anemia. Family history of gastric cancer. Smokers People who use tobacco or drink alcoholic beverages
regularly. Workers in certain industries-the coal mining, nickel
refining, and rubber and timber processing industries.
Causes Gender - men have more than double the risk of getting stomach
cancer than women. Genetics - genetic abnormalities and some inherited cancer syndromes
may increase your risk. Advanced age -stomach cancer occurs more often around ages 70 and
74 in men and women, respectively. Family history of gastric cancer can double or triple the risk of
stomach cancer. Lifestyle factors such as smoking, drinking alcohol, and eating a diet
low in fruits and vegetables or high in salted, smoked, or nitrate-preserved foods may increase your risk
Helicobacter pylori (H. pylori) infection of the stomach. H. pylori is a bacterium that infects the lining of the stomach and causes chronic inflammation and ulcers.
Signs and Symptoms In the early stages of stomach cancer,Indigestion and stomach discomfort
A bloated feeling after eating
Mild nausea
Loss of appetite
Heartburn
Cont… In more advanced cancer,Discomfort in the upper or middle part of the abdomen.
Blood in the stool (which appears as black, tarry stools).
Vomiting or vomiting blood.
Weight loss.
Pain or bloating in the stomach after eating.
Weakness or fatigue associated with mild anemia (a deficiency in red blood cells).
Stomach Cancer Diagnosis
By physical examination-enlarged lymph nodes, an enlarged liver, increased fluid in the abdomen (ascites), or abdominal lumps felt during a rectal exam.
Test such as Upper GI series
Gastroscopy and biopsy
CT scans, PET scans, bone scans, laparoscopy and endoscopic ultrasound.( to check if cancer is spread)
How Is Stomach Cancer Treated?
Stomach cancer may be treated with the following, in combination, or alone:
Surgery, called gastrectomy, to remove all or part of the stomach, as well as some of the tissue surrounding the stomach.
Chemotherapy.
Radiation therapy.
Prognosis/ Survival Rate Prognosis depends on the stage of the disease. Stomach cancer metastasizes in as many as 80% of
cases, resulting in a very poor prognosis. In Japan, where stomach cancer often is diagnosed
early, the 5-year survival rate is about 50%. In the United States and most of the Western world,
the 5-year survival rate ranges from 5–15%.
ManagementFollow-up care is necessary for stomach cancer
patients. Regular physical examination and tests (e.g., CT scan,
MRI scan) are used to detect recurrent or advanced disease.
In addition, patient’s dietary intake must be monitored regularly to promote health.
Liver cancer :-•Starts somewhere else and spreads to the liver.•Reason viral hepatitis4 main types :-1) Angiosarcoma, A rare type of cancer that starts in the blood vessels of the liver.2) Hepatoblastoma, Another rare type of liver cancer occurring chiefly in young children.3) Cholangiocarcinoma, Which starts in the bile ducts4) Hepatocellular carcinoma, Also known as Hepatoma. The most common liver cancer is hepatocellular carcinoma which accounts for approximately 84% of liver cancers. As is the case with stomach cancer, liver cancer is hard to diagnose.
Treatment :-•Chemotherapy •Radiofrequency Ablation•Gene Therapy •Magnetic-Chemotherapy
Colorectal cancers :-• Colorectal cancers are common, and occur more frequently in people over the age of 50. • Colorectal cancers are highly treatable when detected early, but the symptoms are often not obvious in early stages.
Sign & Symptoms :-
•Blood (either bright red or very dark) in the stool.
•Diarrhea & constipation.
•Stools that are narrower than usual.
•Frequent gas pains, bloating, fullness, or cramps.
•Weight loss for no known reason.
•Feeling very tired.
•Vomiting.
Treatment :-
•Surgery (most often a colectomy) to remove cancer cells
•Chemotherapy to kill cancer cells Chemotherapy drugs are :-capecitabine, fluorouracil, irinotecan, leucovorin, oxaliplatin
•Radiation therapy to destroy cancerous tissue
Management of CancerKeep to a normal weightAvoid alcoholTake regular exerciseAvoid smokingAdd Garlic to everything you EatEat plenty of Fruits and VegetablesLimit Fats and oily foodAvoid unnecessary Scans