SM_274b: Cancer Prevention Flashcards
Most common cancers are ____, ____, ____, ____, and ____
Most common cancers are lung, breast, colorectal, prostate, and stomach cancer
Describe how obesity causes cancer
Obesity causes cancer
- Chronic low level inflammatory state
- Excess estrogen production in adipose tissue after menopause
- GERD
- Non-alcoholic steatohepatitis
- Insulin resistance and T2DM
- Altered immune response and oxidative stress
Describe strategies for cancer prevention
Cancer prevention
- Diet and exercise
- Prevention of infections
- Smoking cessation
- Environmental regulations
Drugs for cancer prevention are ___
Drugs for cancer prevention are not successful
Many tumors have ____ with characteristic genetic changes
Many tumors have identifiable histological precursors with characteristic genetic changes
- Cervix
- Colorectal
- Breast
- Prostate
- Lung
- Oral cavity
Conversion to the metastatic phenotype begins in the ___
Conversion to the metastatic phenotype begins in the primary organ
- Provides opportunity for preventive intervention
Chemprevention is ___
Chemprevention is use of a specific chemical compound to prevent, inhibit, or reverse carcinogenesis
- Cornerstone of primary prevention
- Required to have minimal toxicity because used for long periods in healthy people
- Need to identify those who will benefit most: high risk for lethal disease, at-risk organ has molecular target to treat
- Need to identify effective drug: minimal side effects and inexpensive
Describe colorectal cancer
Colorectal cancer
- Average risk: age > 50
- Increased risk
- Adenomatous polyps / sessile serrated polyps
- Prior colorectal cancer
- Genetics
- Positive family history of colorectal cancer
- Lynch syndrome (hereditary nonpolyposis colorectal cancer): defect in DNA mismatch repair enzymes
- Familial adenomatous polyposis (mutated APC gene)
- Inflammatory bowel disease: UC or Crohn’s
Describe colorectal cancer risk reduction
Colorectal cancer risk reduction
- Diet and lifestyle: weight control, diet, physical activity, avoid alcohol
- Smoking cessation
- Increased screening / early detection
- Drugs (NSAIDs): aspirin, celecoxib and rofecoxib, and Vitamin D3 and calcium
Colonoscopy and flexible sigmoidoscopy have ___ incidence of colorectal cancer
Colonoscopy and flexible sigmoidoscopy have decreased incidence of colorectal cancer
___ is an NSAID beneficial for familial adenomatous polyposis
Sulindac is an NSAID beneficial for familial adenomatous polyposis
- Usual care is colectomy with ileorectal anastamosis
- Sulindac causes regression adenomas in retained rectal segment
COX inhibition ___ colorectal adenomas in people ___
COX inhibition prevents colorectal adenomas in people with a prior history of polyps and in those who are genetically susceptible
- Aspirin, sulindac
- Rofexocib is associated with cardiovascular events
Balance of benefits ___ chemoprevention in people at average risk for colorectal cancer
Balance of benefits does NOT favor chemoprevention in people at average risk for colorectal cancer
___ is associated with lower risk of invasive breast cancer
Tamoxifen is associated with lower risk of invasive breast cancer
- Uptake is greatest in women with biopsy-proven atypia and benefit is greatest in this group
___ and ___ prevent hormone receptor positive breast cancer
SERMs and androgen inhibitors prevent hormone receptor positive breast cancer
