G I TRACK: CANCER
Sumit Mohite 11
Vishal Mangukiya 12
Jitendra Mourya 13
Prasad Bhandlikar 14
Sanjeev Kumar 15

Cancer: General Etiology and
Pathogenesis

What is cancer?
 Abnormal cell growth (neoplasia)
 Malignant as opposed to benign
 Benign: slow growth, non-invasive, no metastasis
 Malignant: rapid growth, invasive, potential for metastasis

What causes the mutations that lead to
cancer?
 Viruses: HPV --> cervical cancer
 Bacteria: H. pylori --> gastric cancer
 Chemicals --> B[a]P --> lung cancer
 UV and ionizing radiation --> skin cancer
 What do these agents have in common?

Mutagens
 Viruses: insertional mutagenesis
 Chemicals: DNA adducts
 UV and ionizing radiation: single
and double strand DNA breaks

What types of genes get mutated in
cancer?
 Oncogenes are activated
 Normal function: cell growth, gene transcription
 Tumor suppressor genes are inactivated
 Normal function: DNA repair, cell cycle control, cell death

Phenotype of a cancer cell
 The Six Hallmarks of Cancer
 Self-sufficient growth signals
 Constitutively activated growth factor signalling
 Resistance to anti-growth signals
 Inactivated cell cycle checkpoint
 Immortality
 Inactivated cell death pathway

Phenotype of a cancer cell (cont'd)
 The Six Hallmarks of Cancer
 Resistance to cell death
 Activated anti- cell death signalling
 Sustained angiogenesis
 Activated VEGF signalling
 Invasion and metastasis
 Loss of cell-to-cell interactions, etc.

p53—a classic tumor suppressor
 “The guardian of the genome”
 Senses genomic damage
 Halts the cell cycle and initiates DNA repair
 If the DNA is irreparable, p53 will initiate the cell
death process

Esophageal cancer :-
Esophageal cancer usually develops in the inner layer cells
and grows outward.

 Treatment :-
 Endoscopic treatments such
as photodynamic therapy
 Radiofrequency ablation
Sign & Symptoms :-
chronic irritation and inflammation
resulting from a backwash of acidic
stomach.
Painful or difficult swallowing.
Weight loss.
Pain behind the breastbone.
Hoarseness and cough.
Indigestion and heartburn.

Stomach Cancer

What is Stomach Cancer?
 Stomach Cancer (Gastric cancer)-malignant tumor arising
from the lining of the stomach.
 Stomach cancers are classified according to the type of tissue
where they originate.
 Most common type of stomach cancer-
Adenocarcinoma(Starts in the glandular tissue of the
stomach)
 Accounts-90% to 95% of all stomach cancers.
 Other forms of stomach cancer-lymphomas, which involve
the lymphatic system, and sarcomas, which involve the
connective tissue (such as muscle, fat, or blood vessels).

Who Does it Effect?
 Males over the age of 55.
 A diet low in fruits and vegetables.
 A diet high in salted, smoked, or preserved foods.
 Chronic gastritis.
 Pernicious anemia.
 Family history of gastric cancer.
 Smokers
 People who use tobacco or drink alcoholic beverages
regularly.
 Workers in certain industries-the coal mining, nickel
refining, and rubber and timber processing industries.

Causes
 Gender - men have more than double the risk of getting stomach
cancer than women.
 Genetics - genetic abnormalities and some inherited cancer
syndromes may increase your risk.
 Advanced age -stomach cancer occurs more often around ages
70 and 74 in men and women, respectively.
 Family history of gastric cancer can double or triple the risk of
stomach cancer.
 Lifestyle factors such as smoking, drinking alcohol, and eating a
diet low in fruits and vegetables or high in salted, smoked, or
nitrate-preserved foods may increase your risk
 Helicobacter pylori (H. pylori) infection of the stomach. H.
pylori is a bacterium that infects the lining of the stomach and
causes chronic inflammation and ulcers.

Signs and Symptoms
 In the early stages of stomach cancer,
 Indigestion and stomach discomfort
 A bloated feeling after eating
 Mild nausea
 Loss of appetite
 Heartburn

Cont…
 In more advanced cancer,
 Discomfort in the upper or middle part of the abdomen.
 Blood in the stool (which appears as black, tarry stools).
 Vomiting or vomiting blood.
 Weight loss.
 Pain or bloating in the stomach after eating.
 Weakness or fatigue associated with mild anemia (a
deficiency in red blood cells).

Stomach Cancer Diagnosis
 By physical examination-enlarged lymph nodes, an enlarged
liver, increased fluid in the abdomen (ascites), or abdominal
lumps felt during a rectal exam.
 Test such as
 Upper GI series
 Gastroscopy and biopsy
 CT scans, PET scans, bone scans, laparoscopy and
endoscopic ultrasound.( to check if cancer is spread)

How Is Stomach Cancer Treated?
Stomach cancer may be treated with the following, in
combination, or alone:
 Surgery, called gastrectomy, to remove all or part of
the stomach, as well as some of the tissue surrounding
the stomach.
 Chemotherapy.
 Radiation therapy.

Prognosis/ Survival Rate
Prognosis depends on the stage of the disease.
Stomach cancer metastasizes in as many as 80% of
cases, resulting in a very poor prognosis.
In Japan, where stomach cancer often is diagnosed
early, the 5-year survival rate is about 50%.
In the United States and most of the Western world, the
5-year survival rate ranges from 5–15%.

Management
Follow-up care is necessary for stomach cancer
patients.
 Regular physical examination and tests (e.g., CT scan,
MRI scan) are used to detect recurrent or advanced
disease.
 In addition, patient’s dietary intake must be monitored
regularly to promote health.

Liver cancer :-
•Starts somewhere else and spreads to the liver.
•Reason viral hepatitis
4 main types :-
1) Angiosarcoma,
A rare type of cancer that starts in the blood vessels of the liver.
2) Hepatoblastoma,
Another rare type of liver cancer occurring chiefly in young
children.
3) Cholangiocarcinoma,
Which starts in the bile ducts
4) Hepatocellular carcinoma,
Also known as Hepatoma.
The most common liver cancer is hepatocellular carcinoma
which accounts for
approximately 84% of liver cancers.
As is the case with stomach cancer, liver cancer is hard to
diagnose.

Treatment :-
•Chemotherapy
•Radiofrequency Ablation
•Gene Therapy
•Magnetic-Chemotherapy

Colorectal cancers :-
• Colorectal cancers are common, and occur more frequently in
people over the age of 50.
• Colorectal cancers are highly treatable when detected early,
but the symptoms are often not obvious in early stages.

Sign & Symptoms :-
•Blood (either bright red or very dark) in the stool.
•Diarrhea & constipation.
•Stools that are narrower than usual.
•Frequent gas pains, bloating, fullness, or cramps.
•Weight loss for no known reason.
•Feeling very tired.
•Vomiting.

Treatment :-
•Surgery (most often a colectomy) to remove cancer cells
•Chemotherapy to kill cancer cells
Chemotherapy drugs are :-
capecitabine, fluorouracil, irinotecan, leucovorin, oxaliplatin
•Radiation therapy to destroy cancerous tissue

Management of Cancer
Keep to a normal weight
Avoid alcohol
Take regular exercise
Avoid smoking
Add Garlic to everything you Eat
Eat plenty of Fruits and Vegetables
Limit Fats and oily food
Avoid unnecessary Scans