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Nov 23, 2007

Cancer-Classification-02

Adult cancers

In the U.S. and other developed countries, cancer is presently responsible for about 25% of all deaths. On a yearly basis, 0.5% of the population is diagnosed with cancer. The statistics below are for adults in the United States, and may vary substantially in other countries:

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Cancer-Classification-01

Nomenclature

The following closely related terms may be used to designate abnormal growths:

  • Neoplasm: a scientific term which refers to an abnormal proliferation of genetically altered cells.
  • Malignant neoplasm: synonymous with cancer.
  • Tumor: broadly defined, can be any swelling or mass. However, the vast majority of entities referred to as 'tumors' in common usage are in fact neoplasms. Specifically, a tumor is a solid neoplasm; some neoplasms, such as cancers of the blood, are not solid.
  • Benign tumor: a tumor (solid neoplasm) that has self-limiting growth and does not invade other tissues nor metastasize. Usually not cancerous.
  • Pre-malignancy or pre-cancer: A non-invasive neoplasm that may not form an obvious mass or lesion but has the potential to progress to cancer if left untreated. These lesions are, in order of increasing potential for cancer, atypia, dysplasia and carcinoma in situ.
  • Transformation: the concept that an indolent or minimally aggressive neoplasm can transition to a state of more malignant behavior over time. Example: Richter's transformation.

Cancers are classified by the type of cell that resembles the tumor and, therefore, the tissue presumed to be the origin of the tumor. Examples of general categories include:

  • Carcinoma: Malignant tumors derived from epithelial cells. This group represents the most common cancers, including the common forms of breast, prostate, lung and colon cancer.
  • Sarcoma: Malignant tumors derived from connective tissue, or mesenchymal cells.
  • Lymphoma and leukemia: Malignancies derived from hematopoetic (blood-forming) cells
  • Germ cell tumor: Tumors derived from totipotent cells. In adults most often found in the testicle and ovary; in fetuses, babies, and young children most often found on the body midline, particularly at the tip of the tailbone; in horses most often found at the poll (base of the skull).
  • Blastic tumor: A tumor (usually malignant) which resembles an immature or embryonic tissue. Many of these tumors are most common in children.

Malignant tumors are usually named using the Latin or Greek root of the organ of origin as a prefix and the above category name as the suffix. For instance, a malignant tumor of the liver is called hepatocarcinoma; a malignant tumor of the fat cells is called liposarcoma. For common cancers, the English organ name is used. For instance, the most common type of breast cancer is called ductal carcinoma of the breast or mammary ductal carcinoma. Here, the adjective ductal refers to the appearance of the cancer under the microscope, resembling normal breast ducts.

Benign tumors are named using -oma as a suffix with the organ name as the root. For instance, a benign tumor of the smooth muscle of the uterus is called leiomyoma (the common name of this frequent tumor is fibroid). However, some cancers also use this prefix for historical reasons, examples being melanoma and seminoma.

Cancer-The Deadly Crab

Cancer is a group of diseases in which cells are aggressive (grow and divide without respect to normal limits), invasive (invade and destroy adjacent tissues), and/or metastatic (spread to other locations in the body). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited in their growth and do not invade or metastasize (although some benign tumor types are capable of becoming malignant). Cancer may affect people at all ages, even fetuses, but risk for the more common varieties tends to increase with age. Cancer causes about 13% of all deaths. Apart from humans, forms of cancer may affect other animals and plants.

Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. Complex interactions between carcinogens and the host genome may explain why only some develop cancer after exposure to a known carcinogen. New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly being recognized as important.

Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are often activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. Tumor suppressor genes are often inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system.

Cancer is usually classified according to the tissue from which the cancerous cells originate, as well as the normal cell type they most resemble. These are location and histology, respectively. A definitive diagnosis usually requires the histologic examination of a tissue biopsy specimen by a pathologist, although the initial indication of malignancy can be symptoms or radiographic imaging abnormalities. Most cancers can be treated and some cured, depending on the specific type, location, and stage. Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy. As research develops, treatments are becoming more specific for different varieties of cancer. There has been significant progress in the development of targeted therapy drugs that act specifically on detectable molecular abnormalities in certain tumors, and which minimize damage to normal cells. The prognosis of cancer patients is most influenced by the type of cancer, as well as the stage, or extent of the disease. In addition, histologic grading and the presence of specific molecular markers can also be useful in establishing prognosis, as well as in determining individual treatments.

Nov 15, 2007

Vinflunine Improves Response and Survival in Mesothelioma

Source: CancerPage.com

A study on the benefits of vinflunine for the treatment of mesothelioma was published in the Journal of Clinical Oncology on October 20. Vinflunine is a microtubule inhibitor that is being studied for its therapeutic effects on a number of different cancers. This particular study was looking at the effects of vinflunine as a first line therapy against malignant pleural mesothelioma and the initial results were positive.

The study sampled a population of 67 patients with pleural mesothelioma. Overall, patients showed a response rate of 13.8% and most maintained upon (60%) or improved (13.8%) their performance status. The median progression-free survival was 3.2 months and the median overall survival was 10.8 months. 1-year survival rate was 36.9%.

Because of the positive results exhibited during the study, the authors have concluded that vinflunine merits further research. They suggest vinflunine may be beneficial to patients with disease progression after Alimta/cisplatin treatment and feel combination therapy with cisplatin itself should also be studied.