Health Screening

It is important to understand the difference between 'screening' and 'testing'. Screening is intended to look at large numbers of asymptomatic individuals in an attempt to identify a potential underlying problem at an early stage. Testing is a specific intention to find out the cause of an individual's symptoms. Individuals included in screening programmes tend to have generalized characteristics, for example they fall into a specific age band or are of the same sex. Since 2004 all women aged...

Introduction

As society becomes more affluent, so the incidence of cancer can be demonstrated to rise. There could be a number of explanations for this, including increased wealth and longevity (Gabriel, 2001 Richards, 2006). People are surviving previously life-threatening incidents, such as infectious diseases, major accidents and so on, only to live longer and potentially go on to develop cancer later in life. We know that more affluent societies consume higher amounts of convenience foods, alcohol and...

Some Facts

The bacterium Escherichia coli has a single circular DNA molecule of 4.6 million base-pairs, making the total length of this single DNA molecule around 1.4 mm. In humans there are around 3 billion letters in the DNA code. In a single diploid cell, if fully extended, the DNA would have a length of almost 2 m. If all the DNA of the roughly 50 trillion cells in the human body were unwrapped and placed end to end, it would reach from the earth to the moon roughly 100 000 times (Kothari and Mehta,...

Diagnostic And Staging Investigations

Today, a growing number of tests can be performed to identify the presence of abnormal cells or an abnormal structure. These tests can simply confirm or eliminate a primary cancer (diagnose), or they can help determine the spread of the malignancy (stage). Essentially these investigations fall into three main groups Radiology allows for visualization of the internal structures. Images are created, which the radiologist then interrupts. These images can be created in a number of ways X-rays....

Methylation In Tumourigenesis

Evidence has been accumulating which suggests that the methylation of cytosine bases has an important role in gene silencing (Antequera, Boyes and Bird, 1990). This 'epigenetic' mechanism of gene inactivation has now been discovered to play an increasingly great role in carcinogenesis (Baylin and Herman, 2000). In the mammalian genome, methylation occurs only at cytosines that are located 5' to guanosine bases, known as the CpG dinucleotide (Bird, 1992). These CpG dinu-cleotides have been...

Conclusion

A better understanding of our immune system and the way it can differentiate between self-antigens and non-self-antigens will have a huge impact on various areas of clinical medicine. Such developments could help treatment of patients with cancer, infection, autoimmune diseases, allergies, as well those undergoing organ transplants or requiring aggressive forms of chemotherapy or radiotherapy. In relation to cancer, it is clear that with the identification of novel antigens that not only play a...

The Application of Research Methodology to Cancer Research

The focus on the impressive list of advancements in the science of medicine leads us to sometimes neglect the art of medicine and potential for patients to feel somewhat dehumanized with 'high tech' medicine. Patients complain increasingly that 'high tech' medicine dehumanizes them. In the eternal quest for a new and better treatment for every known ailment, we have started to forget the other important needs of sick people (Fallowfield, 1990, p. 16). The preceding chapters of this book have...

Quantitative Research

Biomedical research is dominated by quantitative research, drawing from the positivist paradigm (Black, 1994) the underlying philosophical principle is that all human behaviour occurs through external stimuli, which can be observed and measured. A phenomenon is usually measured through quantitative research, which begins via the generation of ideas about the phenomenon of interest and subsequently develops ways to support or reject the hypothesis created. This form of research is particularly...

Cytotoxic Chemotherapy

Medicine is a collection of uncertain prescriptions the results of which, taken collectively, are more fatal than useful to mankind. In 1994 the World Health Organization (WHO) stated that just 24 drugs could be considered essential for the rational management of malignant disease. Despite this, the British National Formulary 52 lists over 50 cytotoxic agents available for prescription in the United Kingdom. There is little doubt that some of these represent major advances in the fight against...

The Definition Of Cancer

As humans we are comprised of many millions of cells. Some cells are specific to certain tissues, for example epithelial cells are found throughout the gastrointestinal tract, bladder, lungs, vagina, breast and skin. This group of cells accounts for approximately 70 of cancers (Venitt, 1978 Corner, 2001). However, any cell has the potential to undergo malignant changes and lead to the development of a carcinoma. Cancerous cells are not confined to localized 'overgrowth' and infiltration of...

Monoclonal Antibodies That Are Currently Used In Cancer Therapy

There are currently nine mAbs commercially available that have been approved for the treatment of haematological cancers and breast, colorectal and head and neck cancers (see Table 10.1). The characteristic features of these antibodies, together with the antigens recognized by them, are discussed below. Rituximab was the first monoclonal antibody to be approved by the US FDA for the treatment of cancer, in 1997. Rituximab is a chimeric mAb (34 mouse protein and 66 human protein) and is directed...

The First Line Of Body Defence

Our body has evolved three kinds of defence strategy against infectious agents, some of which (i.e. viruses) have been associated with the development of human cancers (Marieb and Hoehn, 2007). All viruses, and some bacteria, can live and multiply inside the host cells. These are called intracellular pathogens. In contrast, most bacteria and larger parasites live and multiply outside the cells, in the body tissues and fluids. These are called extracelluar pathogens. The first line of defence...

The Immune System And Cancer

THE INTERRELATIONSHIP OF IMMUNE RESPONSE, OLD AGE AND HIGH INCIDENCE OF CANCER In recent years, several factors have been associated with the development of human cancers including smoking, alcohol, diet, air pollution, infectious agents (viruses and bacteria), chemicals, radiation and hereditary factors (see Chapter 2). The treatment of normal cells with these factors results in the mutation of a wide range of genes, such as tumour suppressor genes or genes coding for growth factor, growth...

Mechanism Of Action Of Chemotherapy

The alkylating agents are amongst the oldest anticancer agents still in use today. They were initially investigated as therapeutic agents after it was noted during the First World War that troops exposed to nitrogen mustard 'nerve gas' subsequently developed bone marrow suppression (Hirsch, 2006). Their name reflects their mechanism of action. These agents add alkyl groups to other molecules, of most relevance to DNA (Hall and Tilby, 1992). They have a threefold effect which accounts for their...