Treatment for cancer

Presented by:
Md.Mustahasin Karim
(mustahasinkarim@gmail.com)

• Cancer – a large group of diseases characterized
by the uncontrolled growth and spread of
abnormal cells
• Neoplasm – new growth of tissue that serves no
physiological function
• Tumor – clumping of neoplasmic cells
• Malignant - cancerous
• Benign - noncancerous

 Metastasis – malignant tumors that are not
enclosed in a protective capsule have the
ability to spread to other organs
 Mutant cells – disruption of RNA and DNA
within normal cells may produce cells that
differ in form, quality and function from the
normal cell

Acquired mutation Inherited mutation
(chemical,virus,irradiations)
Altered gene expression
Proto oncogene⇨⇧oncogene
⇩expression of tumor Rb1,P53,Tsg
suppressor gene.
Alteration of normal cell
proliferation signals.
Unresponsiveness to apoptotic
signals.
Loss of cell cycle control.

Uncontrolled cell proliferation.
Tumor development.
Production of vascular
growth factors.
1.PDGF(PLATELATE DERIVED
GROWTH FACTOR.
2.EGF(Epithelial growth
factor)
Metalo proteinase.
Cancer
oTumor.
growth
oInvasion.
oMetastasis.

 A:Adrenal Cancer, Anal Cancer
 B:Bile Duct Cancer ,Bladder Cancer ,Bone
Cancer ,Brain/CNS Tumors In Adults
,Brain/CNS Tumors In Children ,Breast Cancer
,Breast Cancer In Men .
 C:Cancer in Adolescents ,Cancer in Children
,Cancer in Young Adults ,Cancer of Unknown
Primary , Castleman Disease ,Cervical Cancer
,Colon/Rectum Cancer.
 E:Endometrial Cancer ,Esophagus Cancer
,Ewing Family Of Tumors ,Eye Cancer.

 G: Gallbladder Cancer ,Gastrointestinal Carcinoid
Tumors ,Gastrointestinal Stromal Tumor (GIST)
,Gestational Trophoblastic Disease .
 H:Hodgkin Disease.
 K:Kaposi Sarcoma ,Kidney Cancer .
 L:Laryngeal and Hypopharyngeal Cancer
,Leukemia :Leukemia - Acute Lymphocytic (ALL)
in Adults ,Leukemia - Acute Myeloid (AML)
,Leukemia - Chronic Lymphocytic (CLL)
,Leukemia - Chronic Myeloid (CML) ,Leukemia -
Chronic Myelomonocytic (CMML) ,Leukemia in
ChildrenLiver Cancer ,Lung Cancer ,Lung Cancer
- Non-Small Cell ,Lung Cancer - Small Cell ,Lung
,Carcinoid Tumor ,Lymphoma ,Lymphoma of the
Skin.

 M:Malignant Mesothelioma ,Multiple Myeloma
,Myelodysplastic Syndrome .
 N:Nasal Cavity and Paranasal Sinus Cancer
,Nasopharyngeal Cancer ,Neuroblastoma
Non-Hodgkin Lymphoma ,Non-Hodgkin
Lymphoma In Children.
 O,P,R:Oral Cavity and Oropharyngeal Cancer
,Osteosarcoma ,Ovarian Cancer ; Pancreatic
Cancer ,Penile Cancer ,Pituitary Tumors
,Prostate Cancer, Retinoblastoma
,Rhabdomyosarcoma.

 S:Salivary Gland Cancer ,Sarcoma - Adult Soft
Tissue Cancer ,Skin Cancer ,Skin Cancer -
Basal and Squamous Cell ,Skin Cancer –
Melanoma ,Skin Cancer - Merkel Cell ,Small
Intestine Cancer ,Stomach Cancer.
 T:Testicular Cancer ,Thymus Cancer ,Thyroid
Cancer.
 U,V,W:Uterine Sarcoma. Vaginal Cancer
,Vulvar Cancer ,Waldenstrom
Macroglobulinemia,Wilms Tumor.

 Causes of cancer:
 Heredity
 Immunity
 Chemical
 Physical
 Viral
 Bacterial
 Lifestyle
 Heredetity:

 Heredetity:
Genes isolated for several classic
familial cancer syndromes:
 RB1 (retinoblastoma)
 APC (familial polyposis)
 Human Non Polyposis Colon Cancer (HNPCC)
 BRCA 1&2 (breast cancer)
 p53 (many cancers).

Immunity:
 HIV / AIDS
 Immuno suppression
Virus’s:
Hepatitis B
Human T-cell Leukaemia virus
Epstein Barr Virus
Human Papilloma Virus (HPV)
Bacterial:
H. pylori

 Other Parasites:
◦ Schistosoma spp
◦ Clonorchis sinensis

 Chemicals:
Alcohol
Asbestos
Wood dust
Rubber, plastics, dyes
Tar / bitumen
Aflatoxin
Alkylating agents
Tobacco

◦ Change in bowel habits or bladder function: Chronic
constipation, diarrhea, or a change in the size of the
stool may indicate colon cancer. Pain with urination,
blood in the urine, or a change in bladder function (such
as more frequent or less frequent urination) could be
related to bladder or prostate cancer.
◦ Sores that do not heal: Skin cancers may bleed and
resemble sores that do not heal. A persistent sore in the
mouth could be an oral cancer and should be dealt with
promptly, especially in patients who smoke, chew
tobacco, or frequently drink alcohol.
◦ Unusual bleeding or discharge: Unusual bleeding can
occur in either early or advanced cancer. Blood in the
sputum (phlegm) may be a sign of lung cancer. Blood in
the stool (or a dark or black stool) could be a sign of
colon or rectal cancer. Cancer of the cervix or the
endometrium (lining of the uterus) can cause vaginal
bleeding. Blood in the urine is a sign of possible bladder
or kidney cancer. A bloody discharge from the nipple
may be a sign of breast cancer.

◦ Thickening or lump in breast or other parts of
the body: Many cancers can be felt through the
skin, particularly in the breast, testicle, lymph
nodes (glands), and the soft tissues of the
body. A lump or thickening may be an early or
late sign of cancer. You may be feeling a lump
that is an early cancer that could be treated
successfully.
◦ Indigestion or trouble swallowing: While they
commonly have other causes, these symptoms
may indicate cancer of the esophagus,
stomach, or pharynx (throat).

◦ Recent change in a wart or mole: Any change in
color or shape, loss of definite borders, or an
increase in size should be reported to your
doctor without delay. The skin lesion may be a
melanoma which, if diagnosed early, can be
treated successfully.
◦ Nagging cough or hoarseness: A cough that
does not go away may be a sign of lung cancer.
Hoarseness can be a sign of cancer of the
larynx (voice box) or thyroid.

 Early detection of cancer can greatly improve the odds of
successful treatment and survival. Physicians use
information from symptoms and several other procedures
to diagnose cancer.
 Imaging techniques such as X-rays, CT scans, MRI
scans,PET scans, and ultrasound scans are used regularly
in order to detect where a tumor is located and what
organs may be affected by it. Doctors may also conduct
an endoscopy, which is a procedure that uses a thin tube
with a camera and light at one end, to look for
abnormalities inside the body.
 Extracting cancer cells and looking at them under a
microscope is the only absolute way to diagnose cancer.
This procedure is called a biopsy. Other types of molecular
diagnostic tests are frequently employed as well.
Physicians will analyze your body's sugars, fats, proteins,
and DNA at the molecular level. For example, cancerous
prostate cells release a higher level of a chemical called
PSA (prostate-specific antigen) into the bloodstream that
can be detected by a blood test. Molecular diagnostics,
biopsies, and imaging techniques are all used together to
diagnose cancer.
.

 After a diagnosis is made, doctors find out how far the cancer has
spread and determine the stage of the cancer. The stage determines
which choices will be available for treatment and informs prognoses. The
most common cancer staging method is called the TNM system. T (1-4)
indicates the size and direct extent of the primary tumor, N (0-3)
indicates the degree to which the cancer has spread to nearby lymph
nodes, and M (0-1) indicates whether the cancer has metastasized to
other organs in the body. A small tumor that has not spread to lymph
nodes or distant organs may be staged as (T1, N0, M0), for example.
 TNM descriptions then lead to a simpler categorization of stages, from 0
to 4, where lower numbers indicate that the cancer has spread less.
While most Stage 1 tumors are curable, most Stage 4 tumors are
inoperable or untreatable.
Recent developments on cancer diagnosis
 Blood test could replace biopsy for cancer diagnosis
A simple blood test could be on the way to replacing the biopsy as the gold
standard for detecting cancer, saving lives and money, according to
researchers in the UK. In their study, carried out on known or suspected
primary or secondary lung cancer who were about to undergo surgery,
the blood test was accurate in predicting the presence of cancer cells in
nearly 70% of cases.

 1) Surgery
 Surgery is the oldest known treatment for cancer. If a cancer has
not metastasized, it is possible to completely cure a patient by
surgically removing the cancer from the body. This is often seen
in the removal of the prostate or a breast or testicle. After the
disease has spread, however, it is nearly impossible to remove all
of the cancer cells. Surgery may also be instrumental in helping
to control symptoms such as bowel obstruction or spinal cord
compression.
 Innovations continue to be developed to aid the surgical process,
such as the iKnife that "sniffs" out cancer. Currently, when a
tumor is removed surgeons also take out a “margin” of healthy
tissue to make sure no malignant cells are left behind. This
usually means keeping the patients under general anesthetic for
an extra 30 minutes while tissue samples are tested in the lab
for “clear margins”. If there are no clear margins, the surgeon
has to go back in and remove more tissue (if possible). Scientists
from Imperial College London say the iKnife may remove the
need for sending samples to the lab.

 2) Radiation
 Radiation treatment, also known as radiotherapy, destroys
cancer by focusing high-energy rays on the cancer cells.
This causes damage to the molecules that make up the
cancer cells and leads them to commit suicide.
 Radiotherapy utilizes high-energy gamma-rays that are
emitted from metals such as radium or high-energy x-
rays that are created in a special machine. Early radiation
treatments caused severe side-effects because the energy
beams would damage normal, healthy tissue, but
technologies have improved so that beams can be more
accurately targeted. Radiotherapy is used as a standalone
treatment to shrink a tumor or destroy cancer cells
(including those associated with leukemia and lymphoma),
and it is also used in combination with other cancer
treatments.

 3) Chemotherapy
 Chemotherapy utilizes chemicals that interfere with the
cell division process - damaging proteins or DNA - so that
cancer cells will commit suicide. These treatments target
any rapidly dividing cells (not necessarily just cancer cells),
but normal cells usually can recover from any chemical-
induced damage while cancer cells cannot. Chemotherapy
is generally used to treat cancer that has spread or
metastasized because the medicines travel throughout the
entire body. It is a necessary treatment for some forms of
leukemia and lymphoma. Chemotherapy treatment occurs
in cycles so the body has time to heal between doses.
However, there are still common side effects such as hair
loss, nausea, fatigue, and vomiting. Combination therapies
often include multiple types of chemotherapy or
chemotherapy combined with other treatment options.

 Capecitabine
 Cladribine
 Cytarabine
 Floxuridine
 Fludarabine
 5-Fluorouracil
 Gemcitabine
 6-Mercaptopurine
 Methotrexate (MTX)
 6-Thioguanine

 Bleomycin
 Dactinomycin
 Daunorubicin
 Doxorubicin
 Epirubicin
 Idarubicin

 Docetaxel
 Paclitaxel
 Vinblastine
 Vincristine
 Vinorelbine

 Aminoglutethimide
 Anastrozole
 Bicalutamide
 Estrogens various
 Exemestane
 Flutamide
 Goserelin
 Letrozole
 Leuprolide
 Megestrol acetate
 Nilutamide
 Prednisone
 Tamoxifen
 Toremifene


 Bevacizumab
 Cetuximab
 Rituximab
 Trastuzumab

 Asparaginase
 Carboplatin
 Cisplatin
 Etoposide
 Gefitinib
 Imatinib
 Interferons
 Irinotecan
 Oxaliplatin
 Procarbazine
 Topotecan

 Immunotherapy aims to get the body's immune system to
fight the tumor. Local immunotherapy injects a treatment
into an affected area, for example, to cause inflammation
that causes a tumor to shrink. Systemic immunotherapy
treats the whole body by administering an agent such as
the protein interferon alpha that can shrink tumors.
Immunotherapy can also be considered non-specific if it
improves cancer-fighting abilities by stimulating the entire
immune system, and it can be considered targeted if the
treatment specifically tells the immune system to destroy
cancer cells. These therapies are relatively young, but
researchers have had success with treatments that
introduce antibodies to the body that inhibit the growth of
breast cancer cells. Bone marrow transplantation
(hematopoetic stem cell transplantation) can also be
considered immunotherapy because the donor's immune
cells will often attack the tumor or cancer cells that are
present in the host.

 Several cancers have been linked to some
types of hormones, most notably breast and
prostate cancer. Hormone therapy is
designed to alter hormone production in the
body so that cancer cells stop growing or are
killed completely. Breast cancer hormone
therapies often focus on reducing estrogen
levels (a common drug for this is tamoxifen)
and prostate cancer hormone therapies often
focus on reducing testosterone levels. In
addition, some leukemia and lymphoma
cases can be treated with the hormone
cortisone.

 The goal of gene therapy is to replace
damaged genes with ones that work to
address a root cause of cancer: damage to
DNA. For example, researchers are trying to
replace the damaged gene that signals cells
to stop dividing (the p53 gene) with a copy of
a working gene. Other gene-based therapies
focus on further damaging cancer cell DNA to
the point where the cell commits suicide.
Gene therapy is a very young field and has
not yet resulted in any successful treatments.

 Fatigue: Fatigue is feeling tired or exhausted almost all the time.
It is the most common side effect of chemotherapy. Learn more
about how to cope with fatigue.
 Pain: Chemotherapy sometimes causes pain. This can include:
 Headaches
 Muscle pain
 Stomach pain
 Pain from nerve damage, such as burning, numbness, or
shooting pains, usually in the fingers and toes
 Pain usually gets less with time. However, some people have
permanent nerve damage. This can cause symptoms for months
or years after treatment.
 Doctors can treat pain by:
 Treating the source of the pain
 Giving pain-relieving medications
 Blocking pain signals from the nerves to the brain with spinal
treatments or nerve blocks
 Learn more about cancer pain and how to manage it.

 Mouth and throat sores: Chemotherapy can
damage the cells inside the mouth and throat.
This causes painful sores in these areas, a
condition called mucositis.
 Mouth sores usually happen 5 to 14 days after a
treatment. The sores can get infected. Eating a
healthy diet and keeping your mouth and teeth
clean can lower your risk of mouth sores. Mouth
sores usually go away completely when treatment
ends. Learn more about managing
mucositis and oral health during cancer
treatment.

 Diarrhea: Some chemotherapy causes loose or watery bowel
movements. Preventing diarrhea or treating it early helps keep
you from getting dehydrated (losing too much body fluid). It also
helps prevent other health problems. Learn more
about managing diarrhea.
 Nausea and vomiting: Chemotherapy can cause nausea (feeling
sick to your stomach) and vomiting (throwing up). Whether you
have these side effects, and how much, depends on the specific
drugs and dose. The right medications given before and after
each dose of chemotherapy can usually prevent nausea and
vomiting. Learn more about nausea and vomiting. Read ASCO’s
guideline for preventing these side effects.
 Constipation: Chemotherapy can cause constipation. This means
not having a bowel movement often enough or having difficult
bowel movements. Other medications, such as pain medication,
can also cause constipation. Drinking enough fluids, eating
balanced meals, and getting enough exercise can lower your risk
of constipation. Learn more about managing constipation.

 Blood disorders: Your bone marrow is the spongy tissue inside your bones. It
makes new blood cells. Chemotherapy affects this process, so you might have side
effects from having too few blood cells.
 Your health care team uses the following tests to check for blood disorders:
 Complete blood count (CBC)– This test shows the levels of red blood cells (RBCs)
and white blood cells (WBCs) in your blood.
◦ Not enough RBCs causes a condition called anemia. Symptoms include fatigue, dizziness,
and shortness of breath.
◦ Not enough WBCs causes a condition called leukopenia. This raises your risk of getting
infections. Getting one when your WBCs are low can be serious. If you get an infection, you
need antibiotics as soon as possible.
◦ Platelet count – This test measures the number of platelets in your blood. Platelets are cells
that stop bleeding. They do this by plugging damaged blood vessels and helping blood
form clots.
 Not having enough platelets causes a condition called thrombocytopenia. You can bleed
and bruise more easily than normal.
 Medications can treat all these blood disorders, and prevent leukopenia for
patients with a high risk. The medications help your bone marrow make more
blood cells. Learn more about managing anemia, infection, andthrombocytopenia.

 Nervous system effects: Some drugs cause nerve damage.
This can cause the following nerve or muscle symptoms:
 Tingling
 Burning
 Weakness or numbness in the hands, feet, or both
 Weak, sore, tired, or achy muscles
 Loss of balance
 Shaking or trembling
 You might also have a stiff neck, headache, or problems
seeing, hearing, or walking normally. You might feel
clumsy. These symptoms usually get better with a lower
chemotherapy dose or after treatment. But damage is
sometimes permanent. Learn more about managing
nervous system side effects.

 Changes in thinking and memory: Some people have trouble
thinking clearly and concentrating after chemotherapy. Cancer
survivors often call this chemo brain. Your doctor might call it
cognitive changes or cognitive dysfunction.
 Sexual and reproductive issues: Chemotherapy can affect your
fertility. For women, this is the ability to get pregnant and carry a
pregnancy. For men, fertility is the ability to make a woman
pregnant. Being tired or feeling sick from cancer or treatment
can also affect your ability to enjoy sex. Talk with your doctor
about these possible side effects before treatment starts. Learn
more about managing sexual and reproductive side effects.
 Chemotherapy can harm a fetus (unborn baby). This is especially
true in the first 3 months of pregnancy, when the organs are still
developing. If you could get pregnant during treatment, use
effective birth control. If you do get pregnant, tell your doctor
right away. Learn more about pregnancy and cancer.

 Appetite loss: You might eat less than usual, not feel hungry at all, or feel full
after eating a small amount. If this lasts through treatment, you may lose weight
and not get the nutrition you need. You may also lose muscle mass and strength.
All these things lower your ability to recover from chemotherapy. Learn more
about managing appetite loss.
 Hair loss: Some types of chemotherapy cause hair loss from all over your body. It
may come out a little at a time or in large clumps. Hair loss usually starts after the
first several weeks of chemotherapy. It tends to increase 1 to 2 months into
treatment. Your doctor can predict the risk of hair loss based on the drugs and
doses you are receiving. Learn more about managing hair loss.
 Long-term side effects: Most side effects go away after treatment. But some
continue, come back, or develop later. For example, some types of chemotherapy
may cause permanent damage to the heart, lung, liver, kidneys, or reproductive
system. And some people have trouble with thinking, concentrating, and memory
for months or years after treatment.
 Nervous system changes can develop after treatment. Children who had
chemotherapy may develop side effects that happen months or years after
treatment. These are called late effects. Cancer survivors also have a higher risk of
second cancers later in life.

1. Filter your tap water.
2. Marinate meat first.
3. Caffeinate every day.
4. Water down your risk.
5. Load up on green greens.
6. Snack on nuts.
7. Burn off your risk.
8. Eat clean foods.
9. Do a folic acid check.
10. Up your calcium intake.
11. Avoid unnecessary scans.

Treatment for cancer

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