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  • Image not available. Carcinogenesis is a multistep process that includes initiation, promotion, conversion, and progression. The growth of both normal and cancerous cells is genetically controlled by the balance or imbalance of oncogene, proto-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. 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 type of 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 cancer treatment. The goals of cancer treatment include cure, prolongation of life, and relief of symptoms. Surgery and radiation therapy 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 the patient’s estimated risk for cancer recurrence. The effectiveness of adjuvant therapies is measured by the relative and absolute reduction in the risk of recurrence.
  • Image not available. Traditional chemotherapy agents target rapidly proliferating cells. Agents 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. Cell-cycle phase-specific agents are generally given more frequently or as continuous infusions while cell-cycle phase-nonspecific agents 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 agents can vary in the amount of foreign component that can be used to predict tolerability of the agents. Monoclonal antibodies that target cellular antigens induce cell death by a variety of mechanisms that involve the host immune system. These agents can also be used to deliver drugs or radioisotopes to the antigen-expressing cells.
  • Image not available. The HER (human epidermal growth factor receptor) family contains four known receptor subtypes that regulate cell proliferation pathways through signal transduction. The HER family is dysregulated in many common tumors. Several agents have been developed to prevent signal transduction through this pathway. Monoclonal antibodies, which competitively bind to extracellular receptors, and small molecular inhibitors, which target intracellular signal transduction pathways, are commercially available for several malignancies.
  • Image not available. Tumors must develop new blood vessels through the process ...

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