Cancer E-Book

Craig A. Almeida

• Herausgeber: John Wiley & Sons
• Kategorie: Wissenschaft und neue Technologien
• Sprache: Englisch

Seitenzahl: 658

Veröffentlichungsjahr: 2011

Beschreibung

“... Useful background information is displayed in blue boxes, and good use is made of numerous tables and diagrams... a useful book for the undergraduate medical or allied health professional...” –Oncology News, May/June 2010

This forward looking cancer biology book appeals to a wide ranging audience. Introductory chapters that provide the molecular, cellular, and genetic information needed to comprehend the material of the subsequent chapters bring unprepared students up to speed for the rest of the book and serve as a useful refresher for those with previous biology background. The second set of chapters focuses on the main cancers in terms of risk factors, diagnostic and treatment methods and relevant current research. The final section encompasses the immune system’s role in the prevention and development of cancer and the impact that the Human Genome Project will have on future approaches to cancer care.

While best suited to non-majors cancer biology courses, the depth provided satisfies courses that combine both majors and non-majors. Also, and deliberately, the authors have incorporated relevant information on diagnosis and treatment options that lend appeal to the lay reader.

Leseprobe

Contents

Preface

Acknowledgements

1 The basics of cancer

CANCER IS A COMPLEX ENTITY

CANCER THROUGH THE AGES

MODERN DAY CANCER RESEARCH AND TREATMENT

PREVALENCE AND MORTALITY VARIES WITH EACH CANCER

RISK FACTORS HAVE BEEN IDENTIFIED

WILL CANCER BE CONQUERED WITHIN OUR LIFETIME?

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

2 Cells: the fundamental unit of life

SEVEN HIERARCHAL LEVELS OF ORGANIZATION

FOUR TYPES OF MACROMOLECULAR POLYMERS

CELL STRUCTURE AND FUNCTION

RELATIONSHIP BETWEEN STRUCTURE AND FUNCTION IS IMPORTANT

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

3 The human genome and protein function

THE COMPOSITION AND FUNCTION OF THE HUMAN GENOME

Are all cells within a person genetically identical?

HAVING A DIPLOID GENOME HAS ITS ADVANTAGES

PROTEINS CARRY OUT DIVERSE FUNCTIONS

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

4 Cell cycle, oncogenes, and tumor suppressor genes

CELL DIVISION IN GERM-LINE AND SOMATIC TISSUES

CONSEQUENCES OF GERM-LINE AND SOMATIC TISSUE MUTATIONS

CELL DIVISION, DIFFERENTIATION, AND MATURATION OCCUR TO FORM FUNCTIONAL TISSUES

CELL DIVISION IS UNDER THE REGULATION OF THE CELL CYCLE

LOSS OF CELL CYCLE CONTROL LEADS TO UNCONTROLLED CELL GROWTH

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

5 Tumor formation, growth, and metastasis

TISSUE CHANGES THAT OCCUR IN RESPONSE TO STIMULI

Metaplasia is the presence of a normal cell type in the wrong location

Hypertrophy and hyperplasia are forms of tissue growth

Dysplasia can lead to neoplasia

FEEDING TUMOR GROWTH BY ANGIOGENESIS

CHARACTERISTICS OF BENIGN AND MALIGNANT TUMORS

EVENTS THAT OCCUR DURING THE PROCESS OF METASTASIS

Characteristics of metastatic cells

Lung is a common location for metastatic tumors

Reasons for metastatic sites other than the lungs

Appropriate designations for metastatic tumors

Lymph node analysis for determination of possible metastasis

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

6 Cancer screening, detection, and diagnostic procedures and tests

FACTORS THAT DETERMINE THE ACCURACY OF A DIAGNOSTIC TEST OR PROCEDURE

COMMON SCREENING TESTS

DIAGNOSTIC PROCEDURES FOR THE CONFIRMATION OF A DISEASE

Blood and urine tests can indicate changes in health

Imaging techniques that utilize X-rays

Magnetic resonance imaging utilizes radio waves

Sound waves can be used to produce images

Positron emission tomography detects differences in metabolic activity levels

Biopsies allow for detailed analysis of tissues

TUMOR GRADE AND STAGE FACTOR INTO THE TYPE OF TREATMENT REGIMEN AND PROGNOSIS

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

7 Cancer treatment modalities

SURGERY: THE OLDEST AND MOST COMMONLY USED TREATMENT METHOD

RADIATION KILLS BY CAUSING EXTENSIVE DNA DAMAGE

CYTOTOXIC EFFECTS OF CHEMOTHERAPEUTIC DRUGS

SIDE EFFECTS AND RISKS FROM THE USE OF CYTOTOXIC DRUGS

HORMONAL DEPRIVATION TREATMENT: USED FOR ESTROGEN- AND ANDROGEN-DEPENDENT CANCERS

CAN CANCER GROWTH BE CONTROLLED BY INHIBITING ANGIOGENESIS?

ADDITIONAL ENZYMES TARGETED FOR INHIBITION

BIOLOGICAL THERAPY STIMULATES THE BODY’S ABILITY TO FIGHT CANCER

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

8 Breast cancer

BREAST CANCER STATISTICS

WOMEN’S BREAST TISSUE: UNIQUE IN STRUCTURE AND FUNCTION

CAUSES OF BREAST CANCER

REGULAR EXAMINATIONS OF THE BREAST ARE IMPORTANT FOR EARLY DIAGNOSIS

WHAT FOLLOWS A POSITIVE DIAGNOSIS?

TREATMENT OPTIONS ARE UNIQUE FOR EACH INDIVIDUAL

MUCH HAS BEEN ACCOMPLISHED, MORE NEEDS TO BE DONE

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

9 Ovarian cancer

OVARIAN CANCER STATISTICS

STRUCTURE AND FUNCTION OF OVARIES

THERE ARE THREE TISSUE CATEGORIES OF OVARIAN CANCER

SYMPTOMS OF OVARIAN CANCER ARE VAGUE AND OFTEN MISSED

CERTAIN FACTORS HAVE BEEN ASSOCIATED WITH A HIGHER RISK

Increasing age and genetics are two significant factors

DIAGNOSTIC TOOLS ARE AVAILABLE BUT NOT ALWAYS USED OR RECOMMENDED

ADDITIONAL PROCEDURES ARE NECESSARY TO CONFIRM SUSPICIOUS RESULTS OR IF THERE IS METASTASIS

THE FIGO SYSTEM MAY BE USED TO STAGE OVARIAN CANCER

TREATMENT OPTIONS FOR OVARIAN CANCER

STEPS ARE TAKEN TO PREVENT RECURRENCE BUT DO NOT ALWAYS WORK WHEN THE CANCER IS ADVANCED

MUCH NEEDS TO BE DONE IN THE FUTURE

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

10 Cervical cancer

CERVICAL CANCER STATISTICS

STRUCTURE AND FUNCTION OF THE CERVIX

SYMPTOMS OF CERVICAL CANCER

PELVIC EXAMINATIONS AND PAP TESTS ENABLE EARLY DETECTION

RISK FACTORS FOR CERVICAL CANCER

THE HPV TEST IS A VITAL DIAGNOSTIC TOOL

ADDITIONAL TESTS ARE NECESSARY TO EXAMINE THE CERVIX

TREATMENT DEPENDS ON THE STAGE

A VACCINE WILL PREVENT MANY CASES OF CERVICAL CANCER

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

11 Prostate cancer

PROSTATE CANCER STATISTICS

FUNCTION OF THE PROSTATE GLAND

CERTAIN FACTORS INFLUENCE THE DEVELOPMENT OF PROSTATE CANCER

Age and family history are the principal risk factors

Certain races and nationalities are at higher risk

A person’s diet affects his risk

Prostate cancer is hormone dependent

SYMPTOMS OF AN ENLARGED PROSTATE

SCREENING AND DIAGNOSTIC TESTS FOR PROSTATE CANCER

Subsequent tests should be performed to confirm suspicious screening results

The results of a core needle biopsy are essential in diagnosis

The Gleason grading system is utilized to stage prostate cancer

A variety of tests are available to determine the stage of the disease

THERE ARE TRADITIONAL AND UNIQUE TREATMENT OPTIONS AVAILABLE

Radiation therapy can be either external or internal

PROSTATE CANCER MORTALITY RATES HAVE DECREASED

MUCH ATTENTION IS BEING GIVEN TO THE NUMBER ONE CANCER AFFECTING MEN

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

12 Testicular cancer

TESTICULAR CANCER STATISTICS

STRUCTURE AND FUNCTION OF TESTICLES

THERE ARE THREE TYPES OF TESTICULAR TUMORS

RISK FACTORS FOR THE DISEASE

SYMPTOMS OF TESTICULAR CANCER

TESTICULAR SELF-EXAMINATION (TSE) IS RECOMMENDED

BLOOD AND IMAGING TESTS ARE USED TO DETERMINE DIAGNOSIS AND POSSIBLE METASTASIS

TESTICULAR CANCER TREATMENT RESULTS IN A HIGH CURE RATE

CAUSES AND TREATMENTS ARE BEING STUDIED

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

13 Skin cancer

SKIN CANCER STATISTICS

STRUCTURE AND FUNCTION OF THE SKIN

THREE TYPES OF SKIN CANCER

RISK FACTORS FOR DEVELOPING SKIN CANCER

METHODS USED TO SCREEN FOR SKIN CANCER

SURGERY AND CHEMOTHERAPY ARE STANDARD TREATMENTS FOR METASTATIC SKIN CANCER

WHAT HAPPENS AFTER SKIN CANCER TREATMENT

LIMITED UV RADIATION EXPOSURE IS THE NUMBER ONE FORM OF PREVENTION

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

14 Lung cancer

LUNG CANCER STATISTICS

LUNGS ARE THE SITE OF THE EXCHANGE OF GASES

RISK FACTORS ASSOCIATED WITH THE DEVELOPMENT OF LUNG CANCER

LACK OF DISTINCTIVE SYMPTOMS MAKES EARLY DIAGNOSIS DIFFICULT

LUNG CANCER IS OFTEN DIAGNOSED AT AN ADVANCED STAGE

THERE ARE TWO MAIN CATEGORIES OF LUNG CANCER

THREE TRADITIONAL THERAPIES ARE USED IN LUNG CANCER TREATMENT

IS THERE DISCRIMINATION IN CANCER RESEARCH FUNDING?

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

15 Colorectal cancer

COLON AND RECTUM ARE THE LAST TWO SECTIONS OF THE GASTROINTESTINAL TRACT

RISK FACTORS FOR COLORECTAL CANCER

SCREENING TESTS

TREATMENT OPTIONS

TARGETED THERAPIES

SCREENING TESTS PERFORMED AFTER THE COURSE OF TREATMENT

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

16 Leukemia and lymphoma

LEUKEMIA STATISTICS

LEUKEMIA IS A CANCER OF THE BLOOD CELLS

THE EXACT CAUSE OF LEUKEMIA IS UNKNOWN

EARLY SYMPTOMS OF LEUKEMIA

LABORATORY STUDIES ARE NECESSARY TO DETERMINE THE DIAGNOSIS

THERE ARE MANY TYPES OF LEUKEMIA

NONCHEMOTHERAPEUTIC TREATMENT OPTIONS HAVE SIGNIFICANTLY IMPROVED SURVIVAL RATES

LYMPHOMA IS A MALIGNANCY OF THE LYMPHATIC SYSTEM

HODGKIN’S VS. NON-HODGKIN’S LYMPHOMA

CERTAIN RISK FACTORS ARE ASSOCIATED WITH AN INCREASED INCIDENCE OF LYMPHOMA

DIAGNOSING LYMPHOMA INVOLVES BIOPSIES AND IMAGING TESTS

LYMPHOMAS MUST BE CLASSIFIED TO DETERMINE APPROPRIATE TREATMENT

TREATMENT OPTIONS DEPEND ON THE TYPE OF LYMPHOMA, STAGE, AND EXTENT OF METASTASIS

EXPAND YOUR KNOWLEDGE

ADDITIONAL READINGS

Glossary

Index

I am indebted to Kevin, my parents, brothers, and sisters for their unconditional love, support, and understanding, especially through the process of writing this book.

Craig A. Almeida

This book could not have been made possible without the continuing love and support of my husband Richard and children Janine and Craig, all of whom were eternally patient and encouraging of this effort.

Sheila A. Barry

This book is accompanied by a companion website: www.wiley.com/go/almeida/cancer

This edition first published 2010, © 2010 by Craig A. Almeida and Sheila A. Barry

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Library of Congress Cataloguing-in-Publication Data

Almeida, Craig A.

Cancer: basic science and clinical aspects/Craig A. Almeida and Sheila A. Barry.

p.; cm.

Includes bibliographical references and index.

ISBN: 978-1-4051-5606-6 (pbk.: alk. paper) 1. Cancer-Textbooks. I. Barry,

Sheila A. II. Title.

[DNLM: 1. Neoplasms. QZ 200 A447c 2010]

RC262.A378 2010

616.99′4-dc22

2009015237

Preface

We have authored a textbook on cancer that is unique in its coverage in a number of respects. This book stands out from others because it is written for both nonscience and science majors. The coverage spans the spectrum from the molecular, cellular, and genetic through to the applied aspects of the disease. The book has been structured so that it will be an appropriate text for use by an instructor regardless of the depth to which he/she desires to cover any of the material. The amount of material is manageable within a single semester, and individual chapters can be excerpted for study on each of the major cancers.

We believe this book is appropriate for cancer courses offered to either science or nonscience majors at any level. A target audience with such a variant science background is accommodated by a series of introductory chapters that provide the molecular, cellular, and genetic information needed to comprehend the material of the subsequent chapters. A reader without a science background could study the chapter on breast cancer and learn the risk factors, symptoms, diagnostic testing, and treatment methods without being overwhelmed. If after reading about the risks associated with the BRCA1 and 2 genes, a student wants a better understanding of what a gene is, he or she could then refer back to the appropriate section of one of the introductory chapters. This cross-referencing ability is what we feel is the basis for the success of the text from the perspectives of both student and instructor. The introductory chapters can be used by lower or upper class science majors to review foundational information.

The chapters of the book are grouped into two sections. The first seven chapters contain introductory information that will be most helpful to the nonscientist while serving as a review for the scientist in training. The second section contains nine chapters, each focusing on a specific form of cancer in areas such as risk factors, diagnostic and treatment methods, and relevant current research. Each of the chapters includes review questions as marginal insertions at points through the text, key words/terms in bold in the text, boxed articles highlighting stories of an individual’s experience, and complex questions in the section “Expand your knowledge” for the student to answer with some additional reading.

We have taught an undergraduate biology of cancer course open to all majors since the fall of 2005. The organization of the book reflects the format that we have used successfully when teaching the course. Since this text is intended for use in either a nonscience or science course, it addresses a wide range of issues associated with cancer. Depending on each course design, it could be either an elective or satisfy a requirement within a general education program or a natural science or allied health major. One of the major strengths of the book is that it can be used in any level undergraduate course. There are no specific prerequisites assumed; the information in the introductory chapters is sufficient to bring the nonscientist to the level needed to read and understand the later chapters. The ultimate intent of the book is to have appeal to students who are either at the beginning or intermediate stages of scientific inquiry into the study of cancer.

Acknowledgments

We would like to thank the many editors from Blackwell and John Wiley and Sons that have worked with us during the development of the text for their thoughtful and creative contributions: Nancy Whilton, Elizabeth Frank, Humbert Haze, Steve Weaver, Karen Chambers, Kelvin Matthews, and Pat Croucher. We are appreciative of the talents of Ali McNeill, the illustrator of many of the text’s figures. A special thanks is extended to Sandy Parker for her enthusiastic Blackwell introduction. We are indebted to those who critically read and provided valuable feedback on draft chapters: anonymous faculty reviewers; our colleagues, Greg Maniero, Jane De Luca, David Gilmore, Lucy Dillon, and Brenda Sweeney; and our students, Jacqueline Tenaglia, Kristen McCarthy, Lauren Bennett, Samantha April, and Tyler Herbert. We are so appreciative of the valuable assistance provided by our administrative assistant Romelle Berry. Two additional students are due a tremendous thank you: Melissa Martin for her thoughtful insight and superior editorial skills, and Sarah Wilson for her creative draft illustrations. It is quite likely that our fellow faculty and administrators at Stonehill College are unaware of how truly grateful we are for their constant encouragement and generous support throughout the development and writing of this book.

A special appreciation goes to all of the students who have taken our biology of cancer course, for their subtle and unknowing influences can be found in the organization, content and pedagogy of this book.

Cells: the fundamental unit of life

The uniformity of Earth’s life, more astonishing than its diversity, is accountable by the high probability that we derived, originally, from some single cell, fertilized in a bolt of lightning as the Earth cooled.

Lewis Thomas, physician, researcher, educator, and essayist

CHAPTER CONTENTS

Seven hierarchal levels of organizationFour types of macromolecular polymersCell structure and functionRelationship between structure and function is importantExpand your knowledgeAdditional readings

When our bodies work properly we have the tendency to take their complex structure and functions for granted. It is important to realize that the more we know about healthy body function, the better the position we will be in to fix what is wrong when we are ill. This and the following two chapters will provide a basic understanding of the way cells function normally and how an attack on the body by rogue cells that divide uncontrollably and function abnormally can result in cancer. This chapter will take a stepwise approach to gradually build a working knowledge of subcellular components in order to understand how they work together as a single entity – the cell. The whole is more than the sum of its parts, and all components of the cell must work together seamlessly to carry out the processes that give rise to what we know as life.

SEVEN HIERARCHAL LEVELS OF ORGANIZATION

Using the stepwise approach to understand how a living organism as complex as a human is put together first requires some knowledge of the seven levels of biological organization (Figure 2.1), and there is no better place to start than at the beginning, at the level of the atom.

Atoms are the building blocks of all molecules

Everything around us is composed of atoms – the building blocks of matter (Figure 2.1a). An atom is composed of negatively charged particles called electrons that spin in orbitals around a central nucleus possessing positively charged protons and uncharged neutrons. A chemical or covalent bond can be created between two atoms when their orbitals overlap, allowing their electrons to be shared. A molecule is formed by such bonding of two or more atoms, and when molecules bond with other molecules they can serve as building blocks for the formation of macromolecules such as proteins, carbohydrates, fats, and DNA (Figure 2.1b). A cell is a collection of atoms, molecules, macromolecules, and macromolecular structures (Figure 2.1c). The coordinated aggregation of countless molecules and macromolecules results in complex cellular structures such as the cell membrane, nucleus, and mitochondrion, to name a few.

Cells are the simplest units of life

Life, in its simplest sense, is the collective reactions that occur between the atoms and molecules within cells. With a few rare exceptions, cells are unable to be seen with the unaided eye (Table 2.1). A compound microscope, an instrument that uses two lenses, one in front of the other, is needed to magnify cells in order to see them in sufficient detail.2.1 All cells possess an outer plasma membrane that acts as a semipermeable barrier between the external environment and the internal contents, enabling them to maintain a steady state of operation known as homeostasis. Without the integrity that the plasma membrane provides, the contents of a cell would not be maintained as a single unit, nor would their activities be coordinated. As a result, life processes would not occur.

What distinguishes livingorganisms from nonliving things?

Why is it important that amembrane be semipermeable?What are some characteristics ofa plasma membrane that allowfor this property?

Figure 2.1 The human body consists of seven hierarchal levels of organization. (a) Atoms combine to form (b) molecules, which combine to form (c) cells that work together to form (d) tissues, that work together to form (e) organs, that work together to form (f) organ systems, that work together to form an (g) organism.

Table 2.1 A range of cells and their sizes

CategoryCell typeSizeSmallest cellMicroplasma (bacterium)0.1 micrometer (μm) or 0.000004 inchSmallest human cellSperm3 μm or 0.0001 inchLargest human cellEgg35 μm in diameter or 0.0014 inch in diameterLongest cellNervesOver 3 meters long! or over 9.84 feet long!

There is a wide variety of cells in the body and each type has its own distinct shape, chemical composition, and internal structures that enable it to carry out its unique function. For example, red blood cells (RBCs) are small and packed with hemoglobin, a protein that has an ability to bind oxygen (Figure 2.2a).2.2