Sunday, December 15, 2013

What is Breast Cancer?

Breast cancer is a type of cancer that originates in the breast(s).Breast cancer forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women.

NHS Breast Cancer Programme

Breast screening is a way of picking up breast cancer at an early stage when it’s too small to be felt or seen. When breast cancer is diagnosed early, treatment is simpler and likely to be more effective.

Monday, March 18, 2013

Docetaxel is a chemotherapeutic agent of the taxane family.

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Generic Name: Docetaxel
Brand Name: Taxotere, Docefrez

Docetaxel is a drug that is used primarily for treating breast cancer. Docetaxel works by attacking cancer cells. Every cell in the body contains a supporting structure called the microtubular network. If this "skeleton" is changed or damaged, the cell can't grow or reproduce. Docetaxel makes the "skeleton" in cancer cells unnaturally stiff, so that these cells can no longer grow.

Docetaxel works by inhibiting cell division; it binds to tubulin and prevents the disassembly of microtubules in the cell, which stops the cell cycle and induces cell death (apoptosis).

Docetaxel (as generic or under the trade name Taxotere) is a clinically well-established anti-mitotic chemotherapy medication (that is, it interferes with cell division). It is used mainly for the treatment of breast, ovarian, prostate, and non-small cell lung cancer. Docetaxel has an FDA approved claim for treatment of patients who have locally advanced, or metastatic breast or non small-cell lung cancer who have undergone anthracycline-based chemotherapy and failed to stop cancer progression or relapsed nd a European approval for use in hormone-refractory prostate cancer.

Friday, March 8, 2013

CISPLATIN: Invention of an Anticancer Drug

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Cisplatin is best known anticancer drug. Cisplatin chemotherapy recognised for lengthening of survival for some common types of lung cancer.
Cisplatin represents today one of the most successful drugs in chemotherapy.

Cisplatin is a tiny little drug molecule that contains a platinum ion in the middle of a flat square with two chloride ions and two ammonia molecules making up the corners. Approved for use in humans in 1978, it was the first of a completely new type of anticancer drug and remains an extremely effective and common treatment for conditions such as testicular and ovarian cancer.

When cisplatin gets into the body, its neutral overall charge means that it can cross the cell membrane. Once in a cell it becomes activated by the replacement of one of the chlorides by a water molecule. The chloride falls off because the concentration of chloride within a cell is much less than it is in the bloodstream. The water itself is, in turn, easily displaced by the basic nitrogen atoms on DNA, specifically on a guanine nucleobase. Once bound to DNA the second chloride ion is replaced by a guanine nitrogen atom from an adjacent DNA strand.

Cisplatin Concept Map:

Cisplatin went through several phases of testing before it was approved by the Food and Drug Administration (FDA) for use in the United States.

Cisplatin is administered intravenously as short-term infusion in normal saline for treatment of solid malignancies. It is used to treat various types of cancers, including sarcomas, some carcinomas (e.g. small cell lung cancer, and ovarian cancer), lymphomas, and germ cell tumors. Cisplatin is particularly effective against testicular cancer; the cure rate was improved from 10% to 85%.

Cisplatin saved countless lives. Its available in tablet form as well as Injection. There are many brands available in market.

Saturday, February 16, 2013


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AIDS stands for acquired immune deficiency syndrome and is the final stage of the infection caused by the virus called HIV or Human Immunodeficiency Virus. The virus causes severe damage to the immune system.


H – Human – This particular virus can only infect human beings.
I – Immunodeficiency – HIV weakens your immune system by destroying important cells that fight disease and infection. A "deficient" immune system can't protect you.
V – Virus – A virus can only reproduce itself by taking over a cell in the body of its host.

Human Immunodeficiency Virus is a lot like other viruses, including those that cause the "flu" or the common cold. But there is an important difference – over time, your immune system can clear most viruses out of your body. That isn't the case with HIV – the human immune system can't seem to get rid of it. Scientists are still trying to figure out why.

We know that HIV can hide for long periods of time in the cells of your body and that it attacks a key part of your immune system – your T-cells or CD4 cells. Your body has to have these cells to fight infections and disease, but HIV invades them, uses them to make more copies of itself, and then destroys them. Over time, HIV can destroy so many of your CD4 cells that your body can't fight infections and diseases anymore. When that happens, HIV infection can lead to AIDS.


A – Acquired – AIDS is not something you inherit from your parents. You acquire AIDS after birth.
I – Immuno – Your body's immune system includes all the organs and cells that work to fight off infection or disease.
D – Deficiency – You get AIDS when your immune system is "deficient," or isn't working the way it should.
S – Syndrome – A syndrome is a collection of symptoms and signs of disease. AIDS is a syndrome, rather than a single disease, because it is a complex illness with a wide range of complications and symptoms.

Acquired Immunodeficiency Syndrome is the final stage of HIV infection. People at this stage of HIV disease have badly damaged immune systems, which put them at risk for opportunistic infections (OIs). You will be diagnosed with AIDS if you have one or more specific OIs, certain cancers, or a very low number of CD4 cells. If you have AIDS, you will need medical intervention and treatment to prevent death.


Scientists believe HIV came from a particular kind of chimpanzee in Western Africa. Humans probably came in contact with HIV when they hunted and ate infected animals. Recent studies indicate that HIV may have jumped from monkeys to humans as far back as the late 1800s.


AIDS is caused by HIV infection. The virus attacks the immune system leaving the individual susceptible to life-threatening infections and cancers. Common bacteria, yeast, parasites, and viruses that usually do not cause serious disease in people with healthy immune systems can turn deadly for AIDS patients.


HIV is found in all the body fluids including saliva, nervous system tissue and spinal fluid, blood, semen, pre-seminal fluid, which is the liquid that comes out before ejaculation, vaginal secretions, tears and breast milk. Only blood, semen, and breast milk have been shown to transmit infection to others.

The virus is transmitted by sexual contact including unprotected oral, vaginal, and anal sex and via transfusion of contaminated blood that contains HIV. Another mode of transmission is sharing needles or injections with HIV infected individuals. A pregnant woman can transmit the virus to her unborn baby through their shared blood circulation, or a nursing mother can transmit it to her baby in her breast milk. HIV infection does not spread by casual contact, mosquitoes, touching or hugging.


Those at highest risk include injection drug users who share needles, babies born to mothers with HIV (especially if the mother had not received anti- HIV therapy during pregnancy), those engaging in unprotected vaginal or anal sex with HIV positive individuals, and those who received blood transfusions or clotting products between 1977 and 1985 (before screening for HIV became standard practice).


The symptoms of HIV and AIDS vary, depending on the phase of infection.

Primary infection
The majority of people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible symptoms include:
  • Fever
  • Muscle soreness
  • Rash
  • Headache
  • Sore throat
  • Mouth or genital ulcers
  • Swollen lymph glands, mainly on the neck
  • Joint pain
  • Night sweats
  • Diarrhea

Although the symptoms of primary HIV infection may be mild enough to go unnoticed, the amount of virus in the blood stream (viral load) is particularly high at this time. As a result, HIV infection spreads more efficiently during primary infection than during the next stage of infection.

Clinical latent infection
In some people, persistent swelling of lymph nodes occurs during clinical latent HIV. Otherwise, there are no specific signs and symptoms. HIV remains in the body, however, as free virus and in infected white blood cells. Clinical latent infection typically lasts eight to 10 years. A few people stay in this stage even longer, but others progress to more-severe disease much sooner.

Early symptomatic HIV infection
As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such as:
  • Fever
  • Fatigue
  • Swollen lymph nodes — often one of the first signs of HIV infection
  • Diarrhea
  • Weight loss
  • Cough and shortness of breath
  • Progression to AIDS

If you receive no treatment for your HIV infection, the disease typically progresses to AIDS in about 10 years. By the time AIDS develops, your immune system has been severely damaged, making you susceptible to opportunistic infections — diseases that wouldn't trouble a person with a healthy immune system. The signs and symptoms of some of these infections may include:
  • Soaking night sweats
  • Shaking chills or fever higher than 100 F (38 C) for several weeks
  • Cough and shortness of breath
  • Chronic diarrhea
  • Persistent white spots or unusual lesions on your tongue or in your mouth
  • Headaches
  • Persistent, unexplained fatigue
  • Blurred and distorted vision
  • Weight loss
  • Skin rashes or bumps

When to see a doctor
If you think you may have been infected with HIV or are at risk of contracting the virus, see a health care provider as soon as possible.


There is no cure for AIDS once it develops. There are agents available that can help keep symptoms at bay and improve the quality and length of life for those who have already developed symptoms.

Drugs against HIV include antiretroviral therapy. These prevent the replication of the HIV virus in the body. A combination of several antiretroviral drugs, called highly active antiretroviral therapy (HAART), has been very effective in reducing the number of HIV particles in the bloodstream. Preventing the virus from replicating can improve T-cell counts or CD4 cell counts and help the immune system recover from the HIV infection. Medicines are also prescribed to prevent opportunistic infections if the CD4 counts are low.


Safe sex measures with use of condoms, shunning use of illicit drugs or shared needles or syringes, avoidance of contact with blood and fluids by wearing protective clothing, masks, and goggles etc. helps prevent transmission. HIV-positive women who wish to become pregnant may need therapy while they are pregnant to prevent transmission to their babies. The Public Health Service recommends that HIV-infected women in the United States avoid breastfeeding to prevent transmitting HIV to their infants through breast milk.

Saturday, February 9, 2013

Blood Cancer (Leukemia, Lymphoma, Myeloma)

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Blood cancer is a form of cancer which attacks the blood, bone marrow, or lymphatic system. This group includes cancers of the bone marrow, blood, and lymphatic system, which includes lymph nodes, lymphatic vessels, tonsils, thymus, spleen, and digestive tract lymphoid tissue. Leukemia and myeloma, which start in the bone marrow, and lymphoma, which starts in the lymphatic system, are the most common types of blood cancer. What causes these cancers is not known.

There are three main groups of blood cancers:

  1. Leukemia
  2. Lymphoma
  3. Multiple Myeloma

These malignancies have varying prognoses, depending on the patient and the specifics of the condition, but overall survival rates with blood cancer increased radically in the late 20th century with the development of advanced treatments. When caught early, blood cancer can be very manageable in some cases, which is one very good reason to make regular trips to the doctor a priority for people of all ages. In the case of leukemia, the cancer interferes with the body's ability to make blood. Leukemia attacks the bone marrow and the blood itself, causing fatigue, anemia, weakness, and bone pain. It is diagnosed with a blood test in which specific types of blood cells are counted. Treatment for leukemia usually includes chemotherapy and radiation to kill the cancer, and in some cases measures like bone marrow transplants may be required. There are several different types of leukemia, including chronic myelogenous leukemia, acute lymphoblastic leukemia, and hairy cell leukemia.


Leukemia, a type of cancer found in your blood and bone marrow, is caused by the rapid production of abnormal white blood cells. The high number of abnormal white blood cells are not able to fight infection, and they impair the ability of the bone marrow to produce red blood cells and platelets.

There are four main types of leukemia (and several other less common types):

  • Acute lymphocytic (or lymphblastic) leukemia ALL): The most common cancer in children, is highly curable with modern-day chemotherapy.
  • Acute myelogenous leukemia (AML): Most commonly affects those over 60 years of age but can occur in younger people. Requires intensive chemotherapy and often an allogeneic stem-cell transplant (blood stem cells from another individual) to be cured. New strategies are desperately needed for older individuals who cannot tolerate the standard, intensive approach.
  • CLL: Can be detected incidentally (example above) if not causing symptoms or when it presents aggressively with enlarged lymph nodes, a very high white blood cell count (the malignant lymphocytes), and profound fatigue. Those who have symptoms due to CLL require treatment, often a combination of chemotherapy and an immune therapy. Younger patients may require a stem-cell transplant for cure. Several newer therapies in the advanced stages of research (such as the drug PCI-32765) will likely revolutionize the treatment of this disease.
  • Chronic Myelogenous Leukemia (CML): The treatment of this previously fatal form of leukemia was revolutionized by the development of the drug imatinib, followed by nilotinib and dasatinib. These pills, which are very well tolerated, drive the leukemia into remission in the vast majority of patients.


Lymphoma is a type of blood cancer that affects the lymphatic system, which removes excess fluids from your body and produces immune cells. Lymphocytes are a type of white blood cell that fight infection. Abnormal lymphocytes become lymphoma cells, which multiply and collect in your lymph nodes and other tissues. Over time, these cancerous cells impair your immune system.

There are two main types of lymphoma, Hodgkin’s and non-Hodgkin’s, which are distinguishable by their appearance under the microscope to a pathologist examining a lymph node biopsy (most commonly). Hodgkin’s and 85% of non-Hodgkin’s lymphoma (NHL) are caused by the abnormal proliferation of an immune cell called a B-lymphocyte; 15% of NHLs are of T-cell origin. There are only a few types of HL whereas there are over 30 types of NHL. A precise diagnosis may require a second opinion on the pathology specimen. Treatments may range from observation to well-tolerated immune therapies (such as rituximab, which has revolutionized the treatment of NHL) to intensive chemotherapy and even a stem-cell transplant (using the patient’s own stem cells, called an autologous transplant, or an allogeneic transplant, depending on the situation). The evaluation of a patient with lymphoma will also involve CAT scans and often a PET scan.

Multiple Myeloma:

Myeloma is a type of blood cancer that specifically targets your plasma cells. Plasma cells are white blood cells that produce disease- and infection-fighting antibodies in your body. Myeloma cells prevent the normal production of antibodies, leaving your body’s immune system weakened and susceptible to infection.

This very complicated blood cancer is caused by the overgrowth in the bone marrow of an immune cell called a plasma cell, which secretes a protein into the bloodstream, called an “M-protein,” that can be detected by a test called an immunoelectrophoresis. The malignant plasma cells can also burrow into the hard bones of the body to cause little holes called “lytic lesions” that can weaken the bones and cause them to fracture. A revolution in the treatment of this cancer has occurred in the last 10 years with the introduction of an autologous stem cell transplant and new drugs such as lenalidomide (Revlimid) and bortezomib (Velcade).

Symptoms of blood cancer

Blood cancer can produce a variety of symptoms, or none at all.

Common symptoms of blood cancer:

  • Abdominal pain, especially in the upper abdomen
  • Bone or joint pain
  • Easy bleeding or bruising
  • Enlarged liver and glands, such as the spleen and lymph nodes
  • Fatigue
  • Fever and chills
  • Frequent infections
  • Frequent urination
  • Nausea, which may be described as feelings of wooziness, queasiness, retching, sea-sickness, car-sickness or upset stomach
  • Night sweats
  • Unexplained weight loss

Serious symptoms that might indicate a life-threatening condition

In some cases, blood cancer can be life threatening, especially if severe infections or uncontrollable bleeding occur. Seek immediate medical care if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions
  • Chest pain, chest tightness, chest pressure, palpitations
  • High fever (higher than 101 degrees Fahrenheit)
  • Rapid heart rate (tachycardia)
  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing
  • Seizure
  • Severe abdominal pain
  • Uncontrolled or heavy bleeding

Causes of blood cancer

Although the specific cause of blood cancer is not known, a number of factors are associated with its development. Many blood cancers are more common among older adults. Some tend to run in families. Certain infections also appear to increase the risk of some blood cancers, as does a weakened immune system.

Risk factors for blood cancer

A number of factors increase the risk of developing blood cancer. Not all people with risk factors will get blood cancer. Risk factors for blood cancer include:

  • Advanced age
  • Certain types of infections
  • Compromised immune system due to such conditions as HIV/AIDS, taking corticosteroids, or organ transplant
  • Exposure to certain chemicals
  • Exposure to radiation or certain types of chemotherapy
  • Family history of blood cancer
  • Personal history of certain blood disorders
  • Personal history of certain genetic disorders
  • Smoking

How to treat blood cancer?

The goal of blood cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.

Some blood cancers grow slowly enough that delaying treatment may be an option. If the decision to delay treatment is made, close follow-up, called watchful waiting, is needed so that significant progression can be identified and treatments can be started when needed.

Common Treatments for blood cancer:

  • Biological therapy to attack cancer cells
  • Chemotherapy to attack cancer cells
  • Participation in a clinical trial testing promising new treatments for blood cancers
  • Radiation therapy to attack cancer cells
  • Stem cell transplant to provide healthy stem cells that can make healthy blood cells
  • Targeted therapy to attack cancer cells
  • Watchful waiting to identify when to start treatment

Other treatments for blood cancer:

Other therapies may be added to help with your general state of health and any complications of the cancer or its treatment including:

  • Anti-nausea medications if needed
  • Antibiotics and other medications to reduce the likelihood of getting infections
  • Blood transfusions to temporarily replace blood components (such as red blood cells or platelets)
  • Dental care to manage oral symptoms of leukemia or chemotherapy
  • Dietary counseling to help people with cancer maintain their strength and nutritional status
  • Pain medications if needed to increase comfort
  • Surgery to remove an enlarged spleen or to treat bone fractures
  • Vaccinations to prevent diseases like the flu and pneumonia

Complementary treatments:

Some complementary treatments may help some people to better deal with blood cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for full medical care.

  • Complementary treatments may include:
  • Acupuncture
  • Massage therapy
  • Yoga

Hospice care:

In cases in which blood cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from curing the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.

Potential complications of blood cancer:

Complications of untreated or poorly controlled blood cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of blood cancer include:

  • Amyloidosis (rare immune-related disorder characterized by protein buildup in organs and tissues that can cause serious complications)
  • Anemia (low red blood cell count)
  • Broken bones
  • Hypercalcemia (increased calcium in the blood)
  • Hyperviscosity syndrome (thickened blood that is difficult for the heart to pump)
  • Immune deficiency and frequent Infections
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Kidney failure
  • Peripheral neuropathy (disorder that causes dysfunction of nerves that lie outside your brain and spinal cord)
  • Spread of cancer

Friday, February 1, 2013

Cervical Cancer Causes and Statistics

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Cervical Cancer

Cervical is a very slow growing type of cancer and therefore; it can sometimes take up to several years before any noticeable signs or cervical cancer symptoms usually start to show.  Normally, a pap smear should show any abnormal cells or dysplasia (abnormal changes in the cells); but finding abnormal cells doesn't actually mean you have cervical cancer. Sometimes a pap smear test does not pick abnormal cells or cancer, and they aren't always 100 percent accurate.  Try to understand your body; realize if something seems peculiar.

What is cervical cancer?

Cervical cancer occurs when abnormal cells on the cervix  grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be successfully treated when it's found early. It is usually found at a very early stage through a Pap test.

Causes of Cervical cancer:

Most cervical cancer is caused by a virus called human papillomavirus, or HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms. You can have HPV for years and not know it. It stays in your body and can lead to cervical cancer years after you were infected. This is why it is important for you to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.

There are several risk factors for the development of cervical cancer, both genetic and environmental. These include:

  • Human Papillomavirus (HPV) Infection
  • Family History of Cervical Cancer
  • Age
  • Sexual and Reproductive History
  • Socioeconomic Status
  • Smoking
  • HIV Infection
  • In Utero DES Exposure
  • Long-term use of oral contraceptives

Human Papillomavirus (HPV) Infection:

Human papillomavirus (HPV) produces epithelial tumors of the skin and mucous membranes. More than 100 HPV types are known, and the genomes of more than 80 have been completely sequenced. People with multiple sexual partners and those who already have persistent HPV infection are at increased risk for acquiring additional HPV strains.[1, 2, 3, 4] The current classification system, which is based on similarities in genomic sequences, generally correlates with the 3 clinical categories applied to HPV:
  • Anogenital or mucosal
  • Nongenital cutaneous
  • Epidermodysplasia verruciformis (EV)
The mucosal HPV infections are classified further as latent (asymptomatic), subclinical, or clinical. Clinical lesions are grossly apparent, whereas latent infections are detected only with tests for viral DNA. Subclinical lesions are identified by application of 3-5% acetic acid and inspection under magnification. Most HPV infections are latent; clinically apparent infections usually result in warts rather than malignancies.
Infections due to HPV are common and lead to a wide variety of clinical manifestations that involve the epidermal surfaces. Condylomata acuminata (genital warts) are generally recognized as benign proliferations of the anogenital skin and mucosa resulting from HPV infection. Genital warts are transmitted by sexual contact. Approximately two thirds of individuals who have sexual contact with an infected partner develop genital warts. The exact incubation time is unknown but estimated to be 3 weeks to 8 months.

There is no cure or treatment for HPV infection. Even without treatment, most infections are cleared by the immune system within two years. If the infection persists there is an increased chance of viral DNA integration and progression to cancer. Women can be tested to learn if they are infected with HPV. Even though there is currently no cure for HPV infection, the knowledge can help women make responsible choices regarding their sexual practices.

Family History of Cervical Cancer:

Women with a family history of cervical cancer, especially an affected mother or sister, have a two-fold risk of developing cervical cancer, suggesting an inherited susceptibility. However, there does not appear to be a correlation between a family history of other cancer types (i.e. colon cancer) and the risk of developing cervical cancer.


Very few women under the age of 20 are diagnosed with cervical cancer and more than half of those diagnosed are between the ages of 35 and 55. The risk decreases after age 55, but 20% of cases occur in women over 60 years old. The pattern seen is due to two conflicting factors, 
1) changes in sexual behaviors and 
2) the tendency of genetic mutations to accumulate over time.

Sexual and Reproductive History:

Epidemiological studies have shown an increased risk for invasive cervical cancer attributable to sexual and reproductive behavior. Increased numbers of sexual partners and lower age at first sexual act have both been associated with increased risk. Women who have had multiple pregnancies and are younger at the time of their first full-term pregnancy also demonstrate an increased risk. Long term use of oral contraceptives has been shown to increase risk in some studies, but this remains controversial. A 2007 study suggests that ongoing use of oral contraceptives raised the risk of cervical cancer but the risk diminishes when use of the contraceptives is stopped. Because HPV is a sexually transmitted disease, behaviors that increase sexual contacts are considered risk factors.

Socioeconomic Status:

Low socioeconomic status has proven to be a significant risk factor for invasive cervical cancer due to its large impact on education and medical resources. Results of the analysis of several epidemiological studies indicate that Hispanic and African-American women have a higher risk of invasive cervical cancer than Caucasian women.

Decreased risk is associated with increased education--women without a college degree have an increased risk, regardless of race. Therefore, it is possible that if access to screening and medical education were equalized, race would not prove to be a significant risk factor. The increased risk with low socioeconomic status is attributed to a lack of screening, failure to treat precancerous conditions, and lack of knowledge about prevention of HPV infection.


Current smoking is a risk factor for the development cervical cancer due to the ability of carcinogens in cigarette smoke to cause mutations in DNA. In the epidemiological studies that have been conducted, smoking was associated with an increased risk of squamous cell carcinoma of the cervix, but not adenocarcinoma.

Human Immunodeficiency Virus (HIV):

Women infected with HIV have been shown to have a five-fold risk of developing cervical cancer. HIV weakens the immune system, decreasing the ability to fight infection; therefore HPV infections are more likely to persist. This is thought to provide more time for the HPV to induce cancer. The high correlation between HIV infection and HPV infection is also partly due to the fact that both are sexually transmitted diseases and behaviors that put women at risk for one also put them at risk for the other. 

In Utero Diethylstilbestrol (DES) Exposure:

DES is a synthetic estrogen used from the 1930s to the 1970s to reduce complications during pregnancy. Use of this drug was discontinued after it was demonstrated that the drug could harm the developing baby. Elevated risk of cervical cancer is just one of the potential health effects for women who where exposed to DES while they were in their mothers womb; others include a variety of gynecological cancers, reproductive tract irregularities, infertility and complications during pregnancy.


Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:
  • Bleeding from the vagina that is not normal, or a change in your menstrual cycle that you can't explain.
  • Bleeding when something comes in contact with your cervix, such as during sex or when you put in a diaphragm.
  • Pain during sex.
  • Vaginal discharge that is tinged with blood.

Cervical cancer may spread to the bladder, intestines, lungs, and liver. Patients with cervical cancer do not usually have problems until the cancer is advanced and has spread. Symptoms of advanced cervical cancer may include:
  • Back pain
  • Bone pain or fractures
  • Fatigue
  • Leaking of urine or feces from the vagina
  • Leg pain
  • Loss of appetite
  • Pelvic pain
  • Single swollen leg
  • Weight loss

Exams and Tests:

Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to spot such conditions. Pap smears screen for precancers and cancer, but do not make a final diagnosis.
If abnormal changes are found, the cervix is usually examined under magnification. This is called colposcopy. Pieces of tissue are surgically removed (biopsied) during this procedure and sent to a laboratory for examination. 

  • Cone biopsy may also be done.
  • If the woman is diagnosed with cervical cancer, the health care provider will order more tests to determine how far the cancer has spread. This is called staging. Tests may include:
  • Chest x-ray
  • CT scan of the pelvis
  • Cystoscopy
  • Intravenous pyelogram (IVP)
  • MRI of the pelvis


Treatment of cervical cancer depends on:
  • The stage of the cancer
  • The size and shape of the tumor
  • The woman's age and general health
  • Her desire to have children in the future
Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. There are various surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future.

Types of surgery for early cervical cancer include:
A hysterectomy (removal of the uterus but not the ovaries) is not often performed for cervical cancer that has not spread. It may be done in women who have repeated LEEP procedures.

Treatment for more advanced cervical cancer may include:
  • Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina.
  • Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed.
Radiation may be used to treat cancer that has spread beyond the pelvis, or cancer that has returned. Radiation therapy is either external or internal.
  • Internal radiation therapy uses a device filled with radioactive material, which is placed inside the woman's vagina next to the cervical cancer. The device is removed when she goes home.
  • External radiation therapy beams radiation from a large machine onto the body where the cancer is located. It is similar to an x-ray.
Chemotherapy uses drugs to kill cancer. Some of the drugs used for cervical cancer chemotherapy include 5-FU, cisplatin, carboplatin, ifosfamide, paclitaxel, and cyclophosphamide. Sometimes radiation and chemotherapy are used before or after surgery.

Friday, January 25, 2013

Cancer Stages

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Cancer staging is the action of free the admeasurement to which a blight has developed by spreading. Contemporary convenance is to accredit a amount from I-IV to a cancer, with I getting an abandoned blight and IV getting a blight which has advance to the absolute of what the appraisal measures. The date about takes into annual the admeasurement of a tumor, how acutely it has penetrated aural the bank of a alveolate agency (intestine, urinary bladder), whether it has invaded adjoining organs, how abounding bounded lymph nodes it has metastasized to (if any), and whether it has advance to abroad organs.


  • Staging systems for cancer have evolved over time and continue to change as scientists learn more about cancer.
  • Staging describes the extent or severity of a person’s cancer. Knowing the stage of disease helps the doctor plan treatment and estimate the person’s prognosis.
  • Most tumors can be described as stage 0, stage I, stage II, stage III, or stage IV.
  • The TNM staging system is based on the extent of the tumor (T), whether cancer cells have spread to nearby (regional) lymph nodes (N), and whether distant (to other parts of the body) metastasis (M) has occurred.
  • Physical exams, imaging procedures, laboratory tests, pathology reports, and surgical reports provide information to determine the stage of the cancer. 

Staging helps the doctor plan the appropriate treatment. The stage can be used to estimate the person’s prognosis. Staging helps health care providers and researchers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials. Knowing the stage is important in identifying clinical trials that may be suitable for a particular patient. Staging is based on knowledge of the way cancer progresses. Cancer cells grow and divide without control or order, and they do not die when they should. As a result, they often form a mass of tissue called a tumor. As the tumor grows, it can invade nearby tissues and organs. Cancer cells can also break away from the tumor and enter the bloodstream or the lymphatic system. By moving through the bloodstream or lymphatic system, cancer cells can spread from the primary site to lymph nodes or to other organs, where they may form new tumors. The spread of cancer is called metastasis.

Stage 0Carcinoma in situ.
Stage I, Stage II, and Stage IIIHigher numbers indicate more extensive disease: Larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or organs adjacent to the location of the primary tumor.
Stage IVThe cancer has spread to another organ(s).

TNM Staging  System

'TNM' stands for Tumour, Node, Metastasis. The TNM system is one of the most widely used staging systems. The TNM system is based on the extent of the tumor (T), the extent of spread to the lymph nodes(N), and the presence of distant metastasis (M). A number is added to each letter to indicate the size or extent of the primary tumor and the extent of cancer spread.
  • 'T' refers to the size of the cancer - it can be 1, 2, 3 or 4, with 1 being small and 4 large
  • 'N' refers to whether the cancer has spread to the lymph nodes - it can be between 0 (no positive nodes) and 3 (lots of positive nodes)
  • 'M' refers to whether the cancer has spread to another part of the body - it can either be 0 (the cancer hasn't spread) or 1 (the cancer has spread)
Sometimes the letters A, B or C are used to further divide the number categories - for example, stage 3C cervical cancer. As well as T1 - T4, you can get 'Tis'. This means 'carcinoma in situ', which is a very small and very early stage cancer. It is such an early stage that it is sometimes called pre-cancer. P is sometimes be used before the letters TNM to mean a tumour that has been removed by surgery (the stage is based on a 'pathological' examination of the cells after surgery). So for example, a small cancer that has spread to the lymph nodes but not to anywhere else in the body may be T2N1M0. Or a more advanced cancer that has spread may be T4N3M1.

Number Systems:

These usually have a scale of 1 to 4 (or sometimes A to D). '1' typically means a small tumor that has not spread and no positive lymph nodes. '4' would mean that the cancer had spread to other major organs in the body. There is information about staging for each type of cancer in the treatment sections of your cancer type.  

The types of tests used for staging depend on the type of cancer
  • Physical exams: The doctor examines the body by looking, feeling, and listening for anything unusual. The physical exam may show the location and size of the tumor and the spread of the cancer to the lymph nodes and/or to other organs.
  • Imaging studies: These studies are important tools in determining stage. Procedures such as x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron emission tomography (PET) scans can show the location of the cancer, the size of the tumor, and whether the cancer has spread.
  • Laboratory tests: Its about studies of blood, urine, other fluids, and tissues taken from the body. For example, tests for liver function and tumor markers (substances sometimes present in increased amounts if cancer is present) can provide knowledge about the cancer.
  • Pathology reports: It include information about the size of the tumor, the growth of the tumor in to other tissues and organs, the type of cancer cells, and the grade of the tumor. A biopsy may be performed to provide information for the pathology document. Cytology reports also report findings from the examination of cells in body fluids.
  • Surgical reports: These reports explain the size and appearance of the tumor and often include observations about lymph nodes and nearby organs.

Monday, January 7, 2013

Basics of Cancer

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Basics: Cell Biology & Oncology

Structure and function of cell

Consist of
  • Cell membrane (Separates; Contact Inhibition)
  • Nucleus (Control Centre/Brain)
  • Mitochondria (Power house/energy)
  • Golgi complex: Packaging & Excretory function
  • Endoplasmic reticulum: Protein synthesis, excretory function
  • Microtubules: formation of mitotic spindle

Nucleus & DNA

  • The nucleus contains the genetic material of the cell, deoxyribonucleic acid (DNA).
  • Cell function is controlled by the genes in DNA
  • DNA is Composed of Nucleotides. Each Nucleotide made of Pentose sugar, Phosphate groups & Nitrogen base (Purines & Pyrimidines
  • Adenine (A) - Thymine (T) Cytosine (C) - Guanine (G); RNA has Uracil (U) instead of (T) 
  • Base pairing is always the same; A=T & C≡G

DNA Synthesis/Protein Synthesis


Cell Cycle

Illustration of the stages of cell cycle

Apoptosis & Mutation

Genes In Cancer

Oncogene: A gene with the potential to cause cancer.
Eg: HER-2 neu gene (Human epidermal growth factor) in breast ca
  • Proto-oncogene is a normal gene that can become an oncogene due to mutations or increased expression.
  • Mutated proto-oncogenes can become carcinogenic oncogenes and can promote uncontrolled cell division(cancer).
  • Tumour suppressor genes: These genes contribute to carcinogenesis when they are inactivated by mutation and can no longer provide a brake on cell division. Eg: pRb and p53

Chemotherapeutic Agents Act In Different Phases Of The Cell Cycle


  • Cancer refers to a group of different diseases that are characterized by DNA damage that causes abnormal cell growth & development.
  • As a result an extra mass of tissue is formed, this is called a growth or tumor. This tumour can be benign or malignant.
                                A comparison of benign and malignant tumor characteristics. (Reproduced by permission of The Gale Group.)

Causes of Cancer

1.  Environmental factors                                                2. Life Style
     Food additives                                                                   Tobacco
     Pollution                                                                            Alcohol
     Occupation                                                                        Diet
     Industrial                                                                           Sexual Behavior

                                              3. Infection
                                              4. Genetic
                                              5. Unknown

Types of Cancer

  • Carcinomas (derived from Epithelial Cells)
  • Sarcomas (derived from Connective tissue)
  • Leukemias, Lymphomas , Myelomas (derived from Blood & 
    Bone marrow)
  • Mesotheliomas (derived from mesothelial cells lining the 
    peritoneum & the pleura)
  • Glioma (derived from glia, most common type of Brain cell)
  • Germinomas (derived from germ cells, normally found in 
    testes & ovary)
  • Choriocarcinomas (derived from placenta)

Tumor Node Metastasis (TNM staging)

  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • Tis: Carcinoma in situ
  • T1 – T4: increasing size and/or local extent of the primary tumor
  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional node metastasis
  • N1 – N3: Increasing involvement of regional lymph nodes
  • M0: No evidence of metastatic spread
  • M1: Evidence of metastatic spread

Types Of Cancer Therapy

  • Surgery: It involves removal or resection of tumor mass surgically
  • Radiation therapy: It involves application of X-rays or Gamma rays to a tumor site, mostly in solid tumor.
  • Chemotherapy: It involves administration of chemotherapeutic agents systemically or by regional perfusion
  • Immunotherapy (Biotherapy): It involves administration of biological response modifiers systemically. Eg: interferon
  • Hormone therapy: hormone therapy involves blocking of particular hormone receptors to impede the progression of cancer. Eg: Leuprolide in prostate cancer.

Classification Of Chemotherapeutic/Anti-cancer Drugs

  1. Alkylating Agents (Nitrogen Mustards; Cyclophosphamide & Ifofsamide; Chlorambucil; Melphalan; Alkyl-Sulfonate: Busulfan; Nitrosoureas: Carmustine (BCNU), Lomustine (CCNU); Triazine: DTIC (Dacarbazine))
  2. Antimetabolites (Folate antagonists: Methotrexate (Mtx), Purine Antagonist: 6 Mercaptopurine (6 MP), 6 Thioguanine (6 TG), Azathioprine, Pyrimidine Antagonist: 5 Fluorouracil (5FU), Cytarabine)
  3. Vinca alkaloids (Vincristine, Vinblastine)
  4. Taxanes (Paclitaxel, Docetaxel)
  5. Epidophyllotoxin (Etoposide)
  6. Campothecan Analogues: (Topotecan, Irinotecan)
  7. Antibiotics (Actinomycin D, Doxorubicin, Daunorubicin, Mitoxantrone, Bleomycin, Mitomycin, Mithramycin)
  8. Miscellaneous (Hydroxyurea, Procarbazine, L Asparaginase, Cisplatin, Carboplatin)

Thursday, January 3, 2013


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The link between viruses & cancer was of the pivotal discoveries in cancer research.

  • In 2010, viruses were found to be linked to around 9,750 (3%) cancer cases in the United Kingdom, with human papillomavirus (HPV) responsible for around half of these.
  •  The Epstein-Barr virus has been linked to Burkitt's lymphoma. This virus infects B cells of the immune system and epithelial cells.
  • Worldwide, viruses are associated with the development of around 15% of cancers.
  •  Human herpes virus-8 has been linked to the development of Kaposi sarcoma. Kaposi sarcoma causes patches of abnormal tissue to create in various area of the body including under the skin, in the lining of the mouth, nose, and throat or in other organs.
  • Cancer develops in only a little proportion of individuals infected with cancer-linked viruses, usually.
  • The hepatitis B virus has been linked to liver cancer in people with chronic infections.
    Human papilloma viruses have been linked to cervical cancer. They also cause warts and benign papillomas. 

Viral infection is just one step in the process of cancer development. While this infection is necessary for certain cancers to develop, e.g. HPV in cervical cancer, the vast majority of these infected individuals will not develop cancer. Tumour viruses can therefore be described as risk factors for certain cancers.Viruses are parasites that require a host cell to replicate. Once inside a host cell, viruses hijack the cell’s replication machinery to make copies of themselves. The new virus particles can then spread to other cells in the same host or spread to a different host. Some viruses can persist in host cells without fully replicating for long periods of time, a process known as ‘latent’ infection. 

During latent infection, tumor viruses can cause genetic disruption to the host cell cycle machinery. Usually this disruption means activating genes that drive cell division forwards (oncogenes), or suppressing genes that restrict cell division (tumor suppressor genes). Together, these genetic disruptions act to drive host cell division forwards, predisposing the cell to further genetic mutations and increasing the likelihood of cancer development. These events occur by accident, as a result of the biological make-up of the virus.Some viruses are indirect tumor viruses. They do not genetically disrupt the host cell cycle machinery themselves. Instead, they set up an environment within the body that makes disruption from other sources more likely. For example, human immunodeficiency virus (HIV) depletes an individual’s immune system, making that person more susceptible to cancer caused by direct tumor viruses.

Cancer Treatment & Prevention:
The importance of the identification of an association between viruses & various types of cancer is that it opens up new possibilities for cancer prevention & treatment. Because virus-associated cancer cells express viral antigens, they can be recognized as 'foreign' by the immune technique. So vaccines can be developed which induce an effective immune response to the virus & can thereby prevent infection & consequent tumor production. Vaccines for HBV & HPV are at present being tested in clinical trials & are giving encouraging results. Also, where tumors create in the setting of immunosuppression, the key elements of the immune response controlling the virus infection, cytotoxic T cells, can be grown in the laboratory & given to patients to prevent or treat the tumor. With these various strategies, hopefully it won't be that long before the worldwide incidence of virus-associated cancers is dramatically reduced.