Cancer immunology including hallmarks of cancers, the causes, clinical symptoms, risk factors, diagnosis and treatments of colorectal cancer and leukemia.

1. Cancer Immunology
Leukemia and Colorectal cancer

2. What is cancer
● Malignant growth of tumour resulted from uncontrolled division of
abnormal cells
Source:
http://arunnanomedicine.blogspot.com/2015/10/cell-d
ivision-and-cancer.html

3. Hallmarks of cancers
● Self-sufficiency in growth signals
● Insensitive to anti-growth signals
● Evade apoptosis
● Limitless replicative potential
● Angiogenesis
● Tissue invasion and metastases
● Evade immunosurveillance
Sourced from:
The Hallmarks of Cancer the next generation

4. Leukemia
Jake Smith

5. Leukemia
● Cancer that originates in bone marrow - affects lymphatic system
● Various risk factors
● Killed 281,500 people in 2010
● Symptoms-
○ Fatigue
○ Fever
○ Enlarged spleen
○ Increased susceptibility to infection
Source:
http://whataboutblood.com/index.php/2017/10/08/what-is-leukemia/

6. Source: https://straightfromthedoc.com/types-of-leukemia/

7. What can Cause this
Change?

8. P53 Protein
● “Tumor Suppressor”
● Highly polymorphic
● Prevention of altered DNA being
replicated in cell division leading to
tumor
● Triggered by cellular stresses such as the
presence of oncogenes
● Monitors the cell cycle - prevent cell
becoming tumor cell
● Works with MDM2 protein and p14ARF Source:
https://www.123rf.com/photo_18482715_ribbon-mod
el-of-p53-protein-bound-to-dna-molecule-p53-aka-tu
mor-protein-53-is-a-transcription-factor.html

9. P53 Pathways
Source:
https://slideplayer.com/slide/8106204/

10. P53 Mutation
● One of the most common
cancer causing mutations
● Commonly occur at R248
and R273
● Commonly in p53, less
commonly in MDM2 and
p14ARF
● Polymorphism leaves
susceptibility to mutation

11. Colorectal Cancer
Seok Shin Law

12. Colorectal Cancer
● Third most commonly diagnosed cancer
(1.36 million) after lung (1.82 million) and
breast cancer (1.67 million)
● Malignant transformation of normal
colonic epithelial cells
Source: Mayo Clinic
Proceedings
Source:
http://www.thepinsta.com/tumor-progression_Q9aB3pb%7CRnAX3hnV6K7CaiPPmF%7CHThDf%7CvLIGTXPGm
g/

13. Industrialized countries as high-risk regions
Table 1: Top 15 countries with highest rate of colorectal cancers for both sexes in 2018
Source:
World Cancer Research Fund,

14. Risk factors
● History : colorectal cancer, polyps
● Bile inflammations: ulcerative colitis, Crohn’s diseases
● Polyposis syndrome: familial adenomatous polyposis (FAP), hereditary
non-polyposis colorectal cancer (HNPCC) or Lynch syndrome
● Age: >50 years old
● Gender: man
● Cigarette smoking
● Diet: high red meat consumptions, low-fibre intakes
● Obesity
Lynch syndrome
Source:
http://www.murrasaca.com
/english/colon-cancer.html
Source: Genetics home
reference

15. Genetic instability promotes carcinogenesis
● Microsatellite instability (MSI):
Impaired DNA mismatch repair (MMR)
Source:https://coolscienceforyou.wordpress.com/2
014/01/18/cancer/
Source:https://biodiscovery.pensof
t.net/article/8961/
Source:https://www.omicsonline.org/article
s-images/JBABM-04-e108-g001.html
● CpG island methylator phenotype (CIMP):
Gene silencing
Three pathways:
● Chromosomal instability (CIN):
APC tumour suppressor and KRAS
gene mutations, other mutations
(eg: TGF-β)

16. Serrated polyps as pre-malignant polyps
● Hyperplastic polyps (HPs): polypoid lesion, left colon
● Sessile serrated adenomas/polyps (SSA/Ps): flat lesion, right colon
● Elongated crypts and a saw-toothed pattern of the crypt epithelium
Source:Oncology Reports

17. Symptoms
● rectal bleeding (angiogenesis)
● bowel habit alterations
● weight loss
● abdominal pain
● constipation
● diarrhoea
* * Depends on locations of tumour and
can vary among individuals
Source:
https://www.slideshare.net/csbr
prasad/git-8csbrp
Source: http://kimajafarwani.blogspot.com/2016/12/colorectal-cancer-colorectal-cancer.html

18. Diagnosis
Vikas Mandhan

19. Diagnosis of Leukemia
● Physical examination : swollen lymph nodes
● Blood cell count : High leukocyte levels
● Biopsy: Bone marrow and Lymph nodes
Tissue Biopsy
Source:
http://whataboutblood.com/index.php/2017/10/08/wha
t-is-leukemia/
Source: https://globalnews.ca/news/3805664/boosting-fat-cells-in-bone-morrow-suppressed-cancerous-leukemia-cells-study/

20. Diagnosis of colorectal cancer
Source:
https://www.medicinenet.com/colonoscopy
/article.htm
● Fecal blood test
● Colon and rectum biopsy
● Colonoscopy
Source:
https://www.123rf.com/photo_82039984_stock-vector-fecal-o
ccult-blood-testing-vector-illustration.html

21. Newer diagnostic approaches
● Biomarkers – a molecule which can be associated with disease
KRAS mutation in
colorectal cancer
Source: https://www.lungcancerdreamteam.org/kras-lung-cancer/the-kras-mutation/

22. Newer diagnostic approaches
● Biomarkers – a molecule which can be associated with disease
KRAS mutation in
colorectal cancer
Source: https://www.lungcancerdreamteam.org/kras-lung-cancer/the-kras-mutation/

23. Treatment
Stephen Scanlin

24. Treatment of Cancer is a diverse as the range of
cancers
● Chemotherapy
○ Chemicals to kill or inhibit growth of
cancer cells
● Radiation therapy
○ Ionising radiation to kill or inhibit
growth of cancer cells
● Surgery
○ Removal to cancerous tissue or
tumours
● Hormone therapy
○ Chemicals that block or inhibit
hormones that stimulate cancer cell
growth
● Targeted Therapy
○ Drugs that target specific features of
cancers cells to stop their growth or
spread
● Stem cell/bone marrow
transplant
○ Restoring the source of erythrocytes
and leukocytes (can follow chemo and
radiation)
● Immunotherapy
○ Uses immune system agents to treat
cancer and stimulate greater immune
responses

25. Treatment of Cancer can cause damage to the body
● Heart
○ Weakened heart muscles
○ Arrhythmia
○ Coronary heart disease
● Lungs
● Endocrine system
○ Infertility
○ Osteoporosis
○ Hot flashes
● Joint, bone and soft tissue
○ Pain
○ Osteoporosis
○ Rheumatological issues
● Nervous system
○ Hearing loss
○ Increased risk of stroke
○ Damage to Peripheral Nervous
system
● Surgery issues
○ Removal of key immune system
organs
■ Spleen
■ Lymph nodes
○ Phantom limb pain

26. Monoclonal antibodies are produced from a single
B cell lineage and initiates four pathways
● Single
● Generated from a “factory” cell
● Stimulates (classification by function)
○ Disturbing rumour cell signalling
○ Complement dependent cytotoxicity
○ Antibody dependent cellular cytotoxicity
○ Activation of Adaptive immune system

27. Monoclonal Antibodies for leukemia and colorectal
cancer
● Colorectal Cancer
○ Vascular endothelial growth factor
(VEGF)
■ bevacizumab
○ Epidermal growth factor receptor
(EGFR)
■ Cetuximab
■ panitumumab
● Leukemia
○ CD33
■ Gemtuzumab
○ CD52
■ Alemtuzumab

28. Summary
● Cancer
○ can be defined by the 10 hallmarks
● Leukemia
● Colorectal Cancer
● Diagnostic biomarkers could be used for cancer detection
● Treatment
○ Tailored
○ Some treatments can cause other side effects
○ Immunotherapy: Monoclonal antibodies