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  • Image not available. Carcinogenesis is a multistep process that includes initiation, promotion, conversion, and progression. The growth of normal and cancerous cells is genetically controlled by the balance or imbalance of oncogene and tumor suppressor gene protein products. Multiple genetic mutations are required to convert normal cells to cancerous cells. Apoptosis and cellular senescence (aging) are normal mechanisms for cell death.
  • Image not available. Several signaling pathways are dysregulated in many common cancers. Several agents have been developed to prevent signal transduction through these pathways. Monoclonal antibodies, which competitively bind to extracellular receptors or their natural ligands, and targeted drugs, which target a component of the intracellular signal transduction pathway, are available for several cancers.
  • Image not available. Tumors must develop new blood vessels through the process of angiogenesis in order to grow. This process, regulated by proangiogenic and antiangiogenic factors, becomes dysregulated in several cancers and can lead to tumor growth, invasion, and metastasis. New anticancer agents can target this process and decrease tumor growth.
  • Image not available. Because patients with clinically evident metastatic cancer can rarely be cured, early detection is critical. Screening programs are designed to detect cancers in asymptomatic people who are at risk of a specific cancer. Knowing the early warning signs of cancer is also important in early detection, when cancers are most likely to be localized.
  • Image not available. Treatment for cancer should not begin until the presence of cancer is confirmed by a tissue (e.g., histologic) diagnosis. Clinical cancer staging provides prognostic information, and in conjunction with the patient’s treatment goals, guides the selection of anticancer treatment. The goals include cure, prolongation of life, and palliation. Surgery and radiation provide the best chance of cure for patients with localized cancers, but systemic treatment methods are required for disseminated cancers.
  • Image not available. Adjuvant therapy is systemic therapy that is administered to treat any existing micrometastases remaining after surgical excision of localized disease. Because adjuvant therapy is given to patients with no remaining clinical evidence of cancer, the benefit of the treatment cannot be proven for an individual patient but only for patient populations. Treatment decisions are based largely on an assessment of the presence of risk factors in an individual patient and their estimated risk for cancer recurrence. The effectiveness of adjuvant therapy is measured by the relative and absolute reduction in the risk of recurrence.
  • Image not available. Traditional chemotherapy affects rapidly proliferating cells. Chemotherapy can be either “cell-cycle phase specific,” targeting one specific phase of the cell cycle, or “cell-cycle phase nonspecific,” targeting all proliferating cells regardless of their place in the cell cycle. Whereas cell-cycle phase-specific chemotherapies are generally given more frequently or as continuous infusions, cell-cycle phase-nonspecific chemotherapies are usually given as a single dose.
  • Image not available. Monoclonal antibodies recognize an antigen that is expressed preferentially on cancer cells or target growth factors responsible for cancer growth. These therapies can vary in the amount of foreign component that can be used to predict tolerability. Monoclonal antibodies that target cellular antigens induce cell death by a variety of mechanisms that involve the host immune system. These antibodies can also ...

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