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The cell is the fundamental unit of life. It is the smallest structure of the body capable of performing all of the processes that define life. Each of the organs in the body such as the lung, breast, colon, and brain consists of specialized cells that carry out the organ's functions such as the transportation of oxygen, digestion of nutrients, excretion of waste materials, locomotion, reproduction, thinking, etc. If anything goes wrong during this complicated process, a cell may become cancerous. A cancer cell is a cell that grows out of control. Unlike normal cells, cancer cells ignore signals to stop dividing, to specialize, or to die and be shed. Growing in an uncontrollable manner and unable to recognize its own natural boundary, the cancer cells may spread to areas of the body where they do not belong.
The goal of oncogenomics is to identify new oncogenes or tumor suppressor genes that may provide new insights into cancer diagnosis, predicting clinical outcome of cancers and new targets for cancer therapies. Besides understanding the underlying genetic mechanisms that initiate or drive cancer progression, oncogenomics targets personalized cancer treatment. Cancer develops due to DNA mutations and epigenetic alterations that accumulate randomly. Identifying and targeting the mutations in an individual patient may lead to increased treatment efficacy. The completion of the Human Genome Project facilitated the field of oncogenomics and increased the abilities of researchers to find oncogenes. Sequencing technologies and global methylation profiling techniques have been applied to the study of oncogenomics.
A cancer biomarker refers to a substance or process that is indicative of the presence of cancer in the body. A biomarker may be a molecule secreted by a tumor or a specific response of the body to the presence of cancer. Genetic, epigenetic, proteomic, glycomic, and imaging biomarkers can be used for cancer diagnosis, prognosis, and epidemiology. Ideally, such biomarkers can be assayed in non-invasively collected biofluids like blood or serum. While numerous challenges exist in translating biomarker research into the clinical space; a number of gene and protein based biomarkers have already been used at some point in patient care; including AFP (Liver Cancer), BCR-ABL (Chronic Myeloid Leukemia), BRCA1 / BRCA2 (Breast/Ovarian Cancer), BRAF V600E (Melanoma/Colorectal Cancer), CA-125 (Ovarian Cancer), CA19.9 (Pancreatic Cancer), CEA (Colorectal Cancer), EGFR (Non-small-cell lung carcinoma), HER-2 (Breast Cancer), KIT (Gastrointestinal stromal tumor), PSA (Prostate Specific Antigen) (Prostate Cancer), S100 (Melanoma), and many others.
Organ specific cancers are concerned with the cancers based on location of cancer in the body organ. They include brain cancer, head and neck cancer, oral cancer, lung cancer, liver cancer, breast cancer, prostate cancer, gastric cancer, pancreatic cancer, kidney cancer, bone cancer, ovarian cancer, cervical cancer, leukemia, anal cancer, and metastasis cancer etc. These types of cancers come under the category of Organ Specific Cancers. These recent advances in diagnosis and treatment of cancer have led to an increase in cancer survival and hence, there is a greater emphasis on quality beside quantity of survival. Further investigation on the quality oriented cancer therapies leads to quality oriented lives in future.
Tumor markers are molecules produced in the body in response to cancer. Tumor markers are molecules produced by tumor cells or other cells of the body in response to cancer or certain benign conditions. Most tumor markers are secreted into blood and may be estimated in blood, but they may also be measured in urine, tissues etc. Tumor markers may be used for diagnosis, staging, and prognosis of cancer; they may also be used for monitoring treatment response as well as to check for cancer recurrence. There are a large number of tumor markers which are used for different types of cancers; many tumor markers may also be elevated in more than one type of cancer.
Surgical oncology is the branch of surgery applied to oncology. It focuses on the surgical management of tumors especially cancerous tumors. As one of several modalities in the management of cancer, the specialty of surgical oncology has evolved in steps similar to medical oncology like pharmacotherapy for cancer, which grew out of hematology, and radiation oncology which grew out of radiology. The Ewing Society known today as the Society of Surgical Oncology was started by surgeons interested in promoting the field of oncology. Complex General Surgical Oncology was ratified by a specialty Board certification in 2011 from the American Board of Surgery. The proliferation of cancer centers will continue to popularize the field as will developments in minimally invasive techniques, palliative surgery, and neo-adjuvant treatments.
Cancer is a genetic disease caused by certain changes to genes that control the way our cells function, especially how they grow and divide. Certain gene changes can cause cells to evade normal growth controls and become cancer. For example, some cancer-causing gene changes increase production of a protein that makes cells grow. Others result in the production of a misshapen and nonfunctional form of a protein that normally repairs cellular damage. Genetic changes that promote cancer can be inherited from our parents if the changes are present in germ cells, which are the reproductive cells of the body eggs and sperm. Such changes, called germline changes, are found in every cell of the offspring.
Clinical Oncology is concerned with the studies on oncology including the cellular and molecular characterization, prevention, diagnosis, and therapy of human cancer, medical and hematological oncology, radiation therapy, pediatric oncology, pathology, surgical oncology, and clinical genetics. The applications of the disciplines of pharmacology, immunology, cell biology, and molecular genetics to intervention in human cancer are also included. One of the main interests of Clinical oncology is on clinical trials that evaluate new treatments together with research on pharmacology and molecular alterations or biomarkers that predict response or resistance to treatment. Another priority for clinical oncology is laboratory and animal studies of new drugs as well as molecule-targeted agents with the potential to lead to clinical trials, and studies of targetable mechanisms of oncogenesis.
Cancer nursing research is aimed at developing or discovering knowledge to inform nursing practice. Cancer supportive care is one of the most disciplines engaged in improving the lives of patients with cancer and their families. Cancer Nursing is instrumental in educating patients about these treatment options and managing their individual toxicities during treatment. It plays a crucial part in supporting ongoing communication between patients and the multidisciplinary team. To succeed in this role, nurses require a thorough understanding of evidence-based symptom-management programs, and a good awareness of the efficacy and safety profiles of newer drugs. Time should be set aside for nurses to be educated and trained appropriately on topics identified in this review, and initiatives such as local myeloma learning programs may be useful.
Cellular Oncology is concerned with the high quality research of all aspects of cancer cell biology and cancer biochemistry. The aim of the cellular oncology is to cover the entire area devoted to the molecular and cellular characterization of cancer cells, irrespective of the precise type of malignancy. Cellular Oncology has a particular interest in the mechanistic characterization of oncogenes and tumor suppressor genes. It deals with the cellular and biochemical alterations that explain these hallmarks of cancer. It should be noted that solid tumors are composed of parenchymatous and stromal elements that form a sort of micro-ecosystem. It further deals with the crosstalk between cancer cells and stromal cells including immune effectors are welcome.
Cancer Pharmacology deals with anti-Cancer Drugs and its high quality research concerning all aspects of cancer and benign neoplasm drug treatment. It encompasses studies related to drugs targeting tumor cells, but also the various components of the tumor microenvironment, including non-tumor cells e.g. endothelial cells, macrophages, lymphocytes, and fibroblasts, and stress conditions such as hypoxia and acidity. It addresses the experimental, pre-clinical or clinical research on the potential and limitations of new antineoplastic and antimetastatic therapies issued from inventive drug design or bioguided isolation from plants. Cancer treatment is an area of medicine where the concepts of multi-modality, drug delivery, and personalized medicine are the most advanced.
Medical Oncology is a modality of treatment in cancer care which uses chemotherapy, immunotherapy, hormonal therapy and targeted therapy to treat cancer in an effective manner. Medical Oncology is usually works in conjunction with Surgical Oncology or Radiation Oncology to give the best clinical outcomes. It further works towards preventing, diagnosing and treating cancer by offering the highest levels of treatment protocols and customized multi-modality therapies. It further provides treatments for solid tumors, specialized outpatient chemotherapy with chemoports and hematological neoplasm in adults and children.
Interventional Oncology (IO) is a subspecialty field of interventional radiology that deals with the diagnosis and treatment of cancer and cancer-related problems using targeted minimally invasive procedures performed under image guidance. Interventional oncology has developed to a separate pillar of modern oncology and it employs X-ray, ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) to help guide miniaturized instruments such as biopsy needles, ablation electrodes, intravascular catheters to allow targeted and precise treatment of solid tumors also known as neoplasms located in various organs of the human body including the liver, kidneys, lungs, and bones. Interventional oncology treatments are routinely carried out by interventional radiologists in appropriate settings and facilities.
Tumor Imaging analyzes MRI image data to assess blood vessels in cancer tumors. Cancer occurs when abnormal cells grow out of control. Tumors can develop a network of new blood vessels in a process known as angiogenesis. This network supplies the tumor with nutrients and oxygen enabling the tumor to keep growing and spreading. The only ways to assess blood vessel architecture are to take a biopsy, a surgical procedure that can harm patients and often cannot be repeated; or PET scanning, which provides limited information and exposes patients to a dose of radiation. Taking advantage of a previously overlooked feature of MRI scans, the scientists developed and tested a new way of analyzing MRI data, which they termed vessel architectural imaging (VAI). VAI involves a single MRI exam that takes less than 2 minutes and, in most cases, can safely be repeated many times.
Chemotherapy is a type of cancer treatment that uses drugs to destroy cancer cells. Chemotherapy works in a pattern of stopping or slowing the growth of cancer cells, which grow and divide quickly. But it can also harm quickly dividing healthy cells, such as those that lie in the mouth and intestines or cause hair to grow. Damage to healthy cells may cause side effects. Often, side effects get better or go away after chemotherapy is over. Chemotherapy is divided into two categories neoadjuvant and adjuvant chemotherapies. Neoadjuvant chemotherapy is a type which is delivered before surgery or radiotherapy, while adjuvant chemotherapy is delivered after the surgery or radiotherapy. Chemotherapy may be used to destroy cancer cells that have come back recurrent cancer or spread to other parts of the body metastatic cancer. Earlier, there used to be less number of chemotherapy drugs.
Hormonal therapy medicines treat hormone-receptor-positive breast cancers in two ways. One is by lowering the amount of the hormone estrogen in the body. And the other is by blocking the action of estrogen on breast cancer cells. Most of the estrogen in women's bodies is made by the ovaries. Estrogen makes hormone-receptor-positive breast cancers grow. So reducing the amount of estrogen or blocking its action can reduce the risk of early-stage hormone-receptor-positive breast cancers coming back or recurring after surgery. Hormonal therapy medicines can also be used to help shrink or slow the growth of advanced-stage or metastatic hormone-receptor-positive breast cancers. There are several types of hormonal therapy medicines, including aromatase inhibitors, selective estrogen receptor modulators, and estrogen receptor down-regulators.
Cancer Therapy comprises treatment of cancers by surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy including immunotherapy such as monoclonal antibody therapy and synthetic lethality. The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient. A number of experimental cancer treatments are also under development. Complete removal of the cancer without damage to the rest of the body that is, achieving cure with near-zero adverse effects is the ideal goal of treatment and is often the goal in practice. Sometimes this can be accomplished by surgery, but the propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic metastasis often limits its effectiveness and chemotherapy and radiotherapy can have a negative effect on normal cells.
Phototherapy is a treatment that uses special drugs called photosensitizing agents, along with light to kill cancer cells. The drugs only work after they have been activated or turned on by certain kinds of light. Depending on the part of the body being treated, the photosensitizing agent is either put into the bloodstream through a vein or put on the skin. Over a certain amount of time the drug is absorbed by the cancer cells. Then light is applied to the area to be treated. The light causes the drug to react with oxygen, which forms a chemical that kills the cells. Phototherapy might also help by destroying the blood vessels that feed the cancer cells and by alerting the immune system to attack the cancer.
Proton Beam Therapy is a type of radiation treatment that uses protons to treat cancer. A proton is a positively charged particle. At high energy protons can destroy cancer cells. Proton Beam Therapy may be used alone or may combine it with other treatments, such as standard radiation therapy, surgery, chemotherapy, and or immunotherapy. Proton therapy is a type of external-beam radiation therapy. It painlessly delivers radiation through the skin from a machine outside the body. A machine called a synchrotron or cyclotron speeds up the protons. The protons speed determines the energy level. High-energy protons travel deeper in the body than low-energy ones. The protons go to the targeted place in the body. There, they deposit the specific radiation dose in the tumor.
Cancer vaccines are not just a dream for the future. Several FDA-approved vaccines are cancer prevention vaccines. The hepatitis B vaccine and the human papillomavirus (HPV) vaccines prevent infection with cancer-causing viruses. By preventing the viruses from infecting body cells, these vaccines block the process that might eventually result in runaway cancer cell growth and damage to the body. The challenge for researchers is to use the model of the immune response to viral infection of cells to develop vaccines for cancers not caused by viruses. Just as the immune system constantly works to protect the body from harmful viruses and bacteria, it also plays a vital role in protecting the body from cancer. Many cancerous cells express markers called antigens that act as targets for the immune system. Today, the researchers are devising vaccines they hope will trigger the immune system to attack cancer cells reliably and effectively.
Palliative treatment is designed to relieve symptoms, and improve your quality of life. It can be used at any stage of an illness if there are troubling symptoms, such as pain or sickness. It can also be used to reduce or control the side effects of cancer treatments. In advanced cancer, palliative treatment might help someone to live longer and to live comfortably, even if they cannot be cured. The treatment is not limited to painkillers and anti sickness drugs. Cancer treatments can also reduce or get rid of symptoms. Palliate Therapy can help to reduce pain by shrinking a tumor and reducing pressure on nerves or surrounding tissues. Treatments used in this way include chemotherapy, radiotherapy, hormone therapy, biological therapy, radiofrequency ablation, and cryotherapy.
There is at present, much optimism about the possibility of finding selective anticancer drugs that will eliminate the cytotoxic side effects associated with conventional cancer chemotherapy. This hope is based on uncovering many novel molecular targets that are cancer-specific, which will allow the targeting of cancer cells while normal cells are spared. Thus far encouraging results have been obtained with several of these novel agents at the preclinical level, and clinical trials have begun. These targets are involved at one level or more in tumor biology, including tumor cell proliferation, angiogenesis and metastasis. Novel targets for which advances are being made include the following growth factor receptor tyrosine kinases such as the epidermal growth factor receptor and HER-2/neu (proliferation); the vascular endothelial growth factor receptor and the basic fibroblast growth factor receptor (angiogenesis) etc.
Radiotherapy is therapy using ionizing radiation, generally as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor for example, early stages of breast cancer. Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers. The subspecialty of oncology concerned with radiotherapy is called radiation oncology. Radiation therapy is commonly applied to the cancerous tumor because of its ability to control cell growth.
Innovations in Prevention and Screening include studies on early detection that can save lives through diagnosis and treatment. Cancer screening research however, paints a more complex picture that has raised questions about screening effectiveness, benefits versus risks, and implementation. There is a consensus among cancer researchers that a decrease in cancer-specific mortality rates is the best indicator of screening's effectiveness. Analyses of randomized controlled trials comparing mortality rates of screened populations for breast, cervical, and colorectal cancers with non-screened populations indicate that screening is effective. For example, women ages 50 to 70 in the United Kingdom offered regular breast cancer screening had an estimated 20-percent reduction in deaths from breast cancer compared with women not offered screening.
Cancer Stem Cell Therapy employs stem cells showing increasing promise in the treatment of cancer. Stem cells can function as novel delivery platforms by homing to and targeting both primary and metastatic tumor foci. Stem cells engineered to stably express various cytotoxic agents decrease tumor volumes and extend survival in preclinical animal models. They have also been employed as virus and nanoparticle carriers to enhance primary therapeutic efficacies and relieve treatment side effects. Additionally, stem cells can be applied in regenerative medicine, immunotherapy, cancer stem cell-targeted therapy, and anticancer drug screening applications. While using stem cells to treat human cancers appears technically feasible, challenges such as treatment durability and tumorigenesis necessitate further study to improve therapeutic performance and applicability.