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Dr. L. Siva et al.

, IJSID, 2013, 3 (4), 85-101



International Journal of Science Innovations and Discoveries

Review Article

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CANCER: A BIOCHEMICAL PERSPECTIVE *Dr.L.Siva, Dr.Balaji Rajagopalan, Dr.Veerendra Kumar, Dr.B.Laxmikanth, Dept of biochemistry, Shri Sathya Sai Medical College and Research Institute, Chennai. India

Received: 10-07-2013 Accepted: 19-08-2013

*Corresponding Author


and in under developed countries next to cardivascular diseases.The emergence of cancer and prevention of cancer by altering our life style in organ specific cancers viz.,brain,head and neck, lung, stomach, kidney, liver, blood, etc., have been discussed with different treatment modalities. dietary habits have been discussed in detail.Further,different types of

Cancer is one of the leading cause of death in developed,developing

Address: Name: Place: Associate Professor in Biochemistry, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam-village, kanceepuram District, Tamil Nadu, India. E-mail:

International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 INTRODUCTION women will develop cancer during their lifetimes. Today, millions of cancer peoples life is extended due to early identification and treatment. Cancer is not a new disease and has afflicted people throughout the world. Some of the earliest evidence of human bone cancer was found in mummies in ancient Egypt and in ancient manuscripts dates about 1600 B.C. The worlds they are removed today. History of cancer: oldest recorded case of breast cancer hails from ancient Egypt in 1500 BC and it was recorded that there was no treatment for Cancer is the second leading cause of death in the world after cardiovascular diseases. Half of men and one third of

the cancer, only palliative treatment. According to inscriptions, surface tumors were surgically removed in a similar manner as Since the time of the discovery and nomenclature by the Greek physician Hippocrates (460-370 BC) cancer emerged

as a deadly disease of the modern days [1].. On an average, cancer contributes to 13% of the total deaths, worldwide. A series of genetic and epigenetic changes termed as carcinogenesis was proposed to be triggered by the combination of environmental

and genetic factors, during various stages in the development and progression of the disease [2]. Over the years outstanding

research was done in order to understand and cure complex malignancies[3]. The past three decades have observed a profound and new generation chemotherapy for cancer treatment has its own disadvantages in eradicating the cancer. Although therapy should be aimed at eliminating cancer cells, while at the same time sparing the normal tissue. Etymology of cancer

knowledge of cancer genes, but this has not translated into equivalent benefits to cancer patients. Certainly, a vast majority of chemotherapy improves disease-free and overall survival in cancer patients, it involves a number of side effects during the

the cases of increased success mostly reflect early diagnosis or prevention, rather than improved treatment [4]. Conventional course of the treatment or after the completion[5]. Thus, in order to protect normal cells and organ function, tumour-targeted The word cancer is derived from Latin word cancrum or Greek karkinoma that is equivalent to the term

karkitakam,which means crab.The disease is so called because of swollen veins around the area resemble a crabs limbs. extreme cellularity of the cancer tissue.[6] What is Cancer?

Indian Medical Science had identified cancer and gave the name arbuda, which literally means the number 10 8 ,identifying the Cancer develops when normal cells in a particular part of the body begin to grow out of control. There are different

types of cancers; all types of cancer cells continue to grow, divide and re-divide instead of dying and form new abnormal cells. Some types of cancer cells often travel to other parts of the body through blood circulation or lymph vessels (metastasis), called as breast cancer, not a liver cancer. Generally cancer cells develop from normal cells due to damage of DNA. Most of the time when ever DNA is damaged, the body is able to repair it,but unfortunately in cancer cells, damaged DNA is not repaired. becomes damaged by exposure to something in the environment, like passive smoking. People can also inherit damaged DNA from parents, which accounts for inherited cancers. Many times though, a persons DNA leukemia cells involve the blood and blood forming organs and circulate through other tissues where they grow. Not all International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013 Cancer generally forms as a solid tumor. Some cancers like leukemia (blood cancer) do not form tumors. Instead, where they begin to grow. For example when a breast cancer cell spreads to liver through blood circulation, the cancer is still

tumors are cancerous, some tumors are benign (non-cancerous). Benign tumors do not grow and are not life threatening. Different types of cancer cells can behave differently. The risk of developing many types of cancers can be reduced by changes


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 in lifestyle like quitting smoking and eating low fat diet. If cancer is identified in early stage it is easy to treat and may have better chances for living many years. ETIOLOGY OF CANCER (Carcinogenesis) 1. (a) Predisposing Factors:

Certain cancers are particularly common in children below 15 years of age, viz. sarcomas of bones and skeletal muscles. Examples are:

Age: Cancer can develop in any age, though it is most common in those over 55 years of age.

Retinoblastomas,neuroblastomas,Wilms tumours,certain tumors of haemopoietic tissues as lymphomas and leukaemias, 2. Heredity: Heredity plays an important role in carcinogenesis. Certain precancerous conditions are inherited. i)Susceptibility to childhood retinoblastoma is inherited as an autosomal dominant trait and approximately 40% of retinoblastomas are familial. ii)Susceptibility to multiple colonic polyposis is inherited as autosomal dominant trait and almost all cases develop into adenocarcinoma of colon in later life. some defect in DNA repair. UV rays of sunlight. iii)Chromosomal DNA instability may be inherited as an autosomal recessive trait. Conditions are characterized by iv)In xeroderma pigmentosa, a skin condition, the affected individuals develop carcinomas of skin in areas exposed to 3. Environmental Factors: Statistically it has been shown that 80% of human cancers are caused by environmental factors, principally chemicals, viz. Occupational: Lifestyle: Cigarette smoking, tobacco chewing, panparag usage. Iatrogenic: Certain therapeutic drugs may be carcinogenic. Dietary:bGroundnuts and other foodstuffs infected with fungus like Aspergillus produce aflatoxin B1 which is carcinogenic. Asbestos, benzene, naphthylamines, beryllium, etc. 4. Acquired Precancerous Disorders: Certain clinical conditions are associated with increased risk of developing cancers. Examples are: Leukoplakia of oral mucosa and genital mucosa developing into squamous cell carcinomas. Cirrhosis of Liver: A few cases can develop hepatoma (hepatocellular carcinoma). Ulcerative Colitis:can produce adenocarcinoma of colon. groups: Carcinoma in situ:Can produce squamous cell carcinoma of cervix. Physical: Radiant energy procarcinogens.

(b) Carcinogenic Agents (Agents Causing Cancer): Carcinogens that cause cancer can be divided into three main broad Chemicals: Variety of chemical compounds can cause cancer. Some of these can act directly and others can act as Biological: Oncogenic viruses. RADIANT ENERGY (RADIATIONS):


International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 Radiations can cause cancer mainly in two ways:

Direct Effect: By producing damage to DNA, which appears to be the basic mechanism but the details are not clear. Radiations like X-rays, -rays or UV rays are harmful to DNA of cells and they can be mutagenic and carcinogenic. Damages to DNA brought about by radiations may be as follows: dimers. single or double strand breaks,elimination of purine/pyrimidine bases,cross-linking of strands,formation of pyrimidine Indirect Effects: In addition to direct effects on DNA as stated above, radiations like -rays and X-rays produce free radicals, viz. OH-, superoxide and others which may interact subsequently with DNA and other macromolecules leading to molecular damage. greatest risk. Carcinomas and melanomas of exposed skin are particularly common in Australia and New Zealand. UV rays produce: Damage to DNA by formation of pyrimidine dimers, Secondly by immunosuppression. radiations like X-rays and -rays. UV rays: Natural UV rays from sun can cause skin cancer. Fair-skinned people living in places where sunshine is plenty are at Ionizing Radiations: This ability of ionizing radiations to cause cancer lies in their ability to produce mutations (mechanisms discussed above). Particulate radiations such as -particles and neutrons are more carcinogenic than electromagnetic Evidence in favour of carcinogenicity of ionizing radiations: II. CHEMICALS AS CARCINOGENS Incidence of leukaemias increased in Japan after atom bomb explosion.Development of thyroid cancer in later life in A large number of chemicals have been incriminated as carcinogenic. Some of these are direct reacting and majority Benzopyrene

children exposed to therapeutic radiation in neck. Lung cancer is more in miners who work in radioactive ores.

occur as procarcinogens which are converted in the body to ultimate carcinogenic chemicals. Many of the chemicals have been tested on animals (experimental carcinogenesis). 1.Polycyclic aromatic hydrocarbons: 2. Azo-dyes (Aromatic amines): Dimethyl benzanthracene -Naphthylamine

Note: Aromatic hydrocarbons are present in cigarette smoke and they are thus relevant in pathogenesis of lung cancer. N-methyl-4-amino azo benzene 2-acetyl amino fluorine Dimethyl nitrosamine Diethyl nitrosamine

Note: -naphthylamine, and aniline azo dye used in the rubber industries has been held responsible for bladder cancers in exposed workers. 3. Nitrosamines and amides

Note: Nitrosamines and amides can be synthesized in Gl tract from ingested nitrites or derived from digested proteins and may contribute to induction of gastric cancer. 4. Naturally occurring: Aflatoxin B1 produced by the fungus, Aspergillus flavus. in Africa, where the contaminated foods are eaten. Note: The fungus grows on groundnuts, peanuts and other grains in congenial environmental conditions, it produces International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013

aflatoxin B1 which is a potent hepatocarcinogen. This is believed to be responsible for high incidence of liver cell carcinoma


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 5.Various Drugs: Alkylating and acylating agents, e.g. cyclophosphamide and busulfan. risk for developing cancer. Diethyl stibestrol, Oestrogen. 6. Miscellaneous agents: Nitrogen mustard. -propiolactone Asbestos Beryllium, Cadmium, Vinyl chloride Nickel, Chromium, Arsenic Saccharin and cyclamates[7]

Note: The drugs are used in cancer treatment and also as immunosuppressants. Patients receiving such therapy are at a higher

cancer. Watson and Crick were awarded Nobel Prize in 1962 for the discovery of DNA helical structure. Later scientists learned how genes worked and how they could be damaged by mutations. Scientists identified that cancer could be caused by the 1970s, scientists discovered 2 important families of genes. Oncogenes chemicals (carcinogens), radiation, viruses and also inherited from ancestors. Most carcinogens, damage the DNA, which leads to abnormal growth of cells. Cancer cells with damaged DNA do not die, where as normal cells with damaged DNA die. During These genes that cause normal cells to grow out of control and become cancer cells. They are formed by the mutations

By the middle of the 20th century, scientists began solving the complex problems of chemistry and biology behind

of certain normal genes of the cell called proto-oncogenes (genes that normally control how often a cell divides and the degree to which it differentiates). Tumor suppressor genes

gene doesnt work properly, cells can grow out of control, which can lead to cancer. Scientists identified oncogenes and tumor suppressor genes that are damaged by chemicals or radiation. For example, the discovery of breast cancers genes BRCA1 and BRCA2. Other genes have been discovered that are associated with cancers that run in families, such as thyroid, pancreas, rectum, colon, kidney, ovary and skin cancers. Cancer causing viruses

These are normal genes that control cell division, DNA repair and inform cells when to die. When a tumor suppressor

(1) Hepatitis B or C viruses cause liver cancer. (2) Epstein- Barr viruses cause non-Hodgkin lymphomas and lymphoma and squamous cell carcinoma. (4) Human papilloma viruses(HPVs) are related with larynx, cervix, vulva Role of nutrition in cancer prevention and penis cancers.

nasopharyngeal cancer. (3) The Human Deficiency Virus(HIV) is related with Kaposi Sarcoma, non-Hodgkin

excessive intake of food is one of the main factors of neoplastic risk and it is proved that obesity is a condition that predisposes the development of malignant neoplasm. Overweight is responsible for 14% of cancer deaths in men and 20% in women[8]. International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013

A diet rich in selenium and Omega-3 fatty acid has a protective role in the prevention of prostate carcinoma. An


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 Fruits and citrus The greatest message is that this same diet protects against almost all other diseases, including cardiovascular disease and diabetes. There are many mechanisms by which fruits are protective, and a massive body of research supports the cancers of the oral cavity, esophagus, stomach and colorectum [9]. recommendation for people to eat more fruits and vegetables. Overall, a high intake of fruits probably reduces the risks of compounds in citrus fruits block cancer growth by direct action on the cancerous cells, restricting their ability to reproduce. Such fruits consumption, whether in, the form of whole fruit or juice, supplies the body with a unique source of specific anticancer molecules, while also provide the essential daily requirements of many vitamins and minerals. Cruciferous vegetables Cruciferous vegetables (broccoli, cauliflower, cabbage, Brussels sprouts) contain sulforophane, which has anti cancer Citrus fruits include Orange, Grapefruit, Lemon, and Mondrian. Studies have suggested that phytochemical One of the most important messages of recent nutrition research is that a diet rich in fruits protects against cancer.

properties. A case control study in China found that intake of cruciferous vegetables, measured by urinary secretion of isothiocyanates, was inversely related to the risk of breast cancer; the quartile with the maximum intake only had 50% of the hazard of the lowest intake group[9]. Flax seed and fish oils (omega 3 fatty acid) tumour growth and metastasis. Evidence is insufficient to recommend dietary supplementation of flax or fish oils to reduce risk of cancer occurrence or to improve prognosis[8]. Garlic Coupled with reduction of heart disease, preclinical studies show conflicting results for omega 3/lignin effects on

stomach pain, gas, vomiting, and inhibition of platelet formation[10]. Ginger

Garlic has antibacterial, or antifungal effects and also useful in preventing the cancer. Large doses potentially produce Has antinausea properties and is useful in management of motion sickness, when nausea is triggered by a local effect

(I.e. acts on stomach). Chemotherapy induced nausea is CNS stimulated response and therefore often requires specific activity[10]. Tea

medication to prevent stimulation of the emetic response. Large doses of ginger have been shown to have antiplatelet Epidemiologic evidence is mixed regarding cancer risk amongst black or green tea drinkers.Tea contain high levels of

catechins and polyphenols known to affect cancer cell growth in vitro.Very little research has been done on the effects of tea consumption among cancer patients. Moderate amounts of green or black tea can be considered safe and helpful in preventing the cancer[11]. Berries Most berries are an exceptionally abundant source of several classes of polyphenols that posses anticancer potential

ellagic acid, anthocyanidins, and proanthocyanidins. Eating cranberries should be preferred over drinking cranberry juice [12].

International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 Macronutrients overconsumption of any or a combination of these macronutrients may influence cancer risk. However, the question of whether individual macronutrients increase risk independent of energy balance remains controversial [13]. carbohydrate and/or protein. Other nutrients are likely to change as well. As a result, differentiating the effect of reduced fat the consequent weight gain). Epidemiologic studies of macronutrients must therefore carefully consider total energy and other energy-bearing nutrients in the analysis[13-15]. Fat For example, in intervention studies of low-fat diets under low caloric conditions, fat are replaced with calories from Carbohydrates, protein, and fat each contribute energy to the diet, so excess energy intake resulting from

intake from these other changes is difficult. Likewise, simply adding fat to the diet cannot be separated from adding energy (or

Much of the interest regarding nutrition and cancer originated from ecologic studies, in which countries with high per capita

The results of studies of fat consumption in relation to cancer have been incoherent, particularly across study designs.

fat intake were shown to have higher rates of cancers of the breast [16,17], colon, and prostate[18,19] than countries with lower fat these data, emphasized fat reduction for cancer prevention[20]. Carbohydrates

intakes. Fat intake has been hypothesized to increase the risk of breast and prostate cancer by modulating sex hormone levels,

and to increase colon cancer risk by stimulating mutagenic secondary bile acid secretion. Early dietary guidelines, based on Carbohydrates are heterogenous and probably have varying effects on health and disease [21]. Dietary carbohydrates

include starches, non-starch polysaccharides and sugars. Carbohydrates with a high glycemic index [22] are associated with higher postprandial blood glucose and insulin[23,24], and higher fasting insulin levels in insulin-resistant states, and are thus hypothesized to raise cancer risk. However, epidemiologic studies currently provide limited support for a direct role of diets high in glycemic load (which takes the total carbohydrate intake into account) in cancer development. and cancer, while others did[25-27]. The inconsistencies may result from difficulties in measuring the glycemic potential of diet,

Some studies of colon and breast cancer[23,,24] did not find an association between diets high in glycemic load or sugar

given the importance of meal composition, for example. However, glycemic load measured from FFQs has strongly predicted the risk of coronary heart disease[28] and type II diabetes[29]. Glycemic load may increase the risk particularly among Pancreatic cancer risk was increased by 53% with a high glycemic diet in a study of women, and by 170% among those who were sedentary and overweight. Meat susceptible subgroups; one study observed increased risk of breast cancer only among those with elevated BMI[30,31].

been fairly consistent over time and across study designs. Different Types of Cancers and treatment:

Evidence for a role of meat consumption in increasing cancer risk, especially of the colon, rectum, and prostate, has There are different types of cancers based on location of cancer in the body organ. For example: Brain cancer, Head

and Neck Cancer, Oral cancer, Lung cancer, Liver cancer, Breast cancer, Prostate cancer, Gastric cancer, Pancreatic cancer, Kidney (Renal Cell) cancer, Leukemia etc. These types of cancers come under the category of Organ Specific Cancers. International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 Brain cancer consequence of abnormal growths of cells in the brain. Tumors in the brain can be malignant or benign, and can occur at any age. Only malignant tumors are cancerous. The visibility of signs and symptoms of brain tumors mainly depends on two factors: tumor size (volume) and tumor location. Microwave exposure from the prolonged use of cellular telephones has been discussed in recent years as a potential One of the most devastating central nervous system pathologies is brain cancer. Cancers of the brain are the

risk factor for brain tumors. With regard to different tumor types, the highest risk was for acoustic neuroma (Odds-Ratio 3.5, 95% Confidence Intervals 1.8-6.8) among analogue cellular telephone users 32. Recent studies confirm that prolonged use of cell and cordless phone microwave can: spasms and tremors, create burning sensation and rash on the skin, alter the brains electrical activity during sleep, induce cells, cause digestive problems and raise bad cholesterol levels, stress the endocrine system, especially pancreas, thyroid, ovaries, testes. generation of commercially available DNA microarrays are proving to be technically vigorous and reliable [33]. Head and Neck Cancer year[34]. Cause memory loss and mental confusion,cause headaches and induce extreme fatigue, create joint pain, muscle

ringing! in the ears, impair sense of smell, precipitate cataracts, retina damage and eye cancer, open the blood-brain barrier to viruses and toxins, reduce the number and efficiency of white blood cells, stimulate asthma by producing histamine in mast

Numerous new therapies hold great promise for the treatment of patients with brain cancer. A review says that recent Head and neck cancers account for 6% of all cancers worldwide, with nearly 150,000 new cases in Europe alone each

Elevated Src (sarcoma) kinase activity is linked to the progression of solid tumors, like HNSCC. Src regulates HNSCC effects in preclinical studies[35]. Soft tissue sarcomas of the head and neck are rare mesenchymal malignant neoplasms accounting for less than 10% of

Head and neck squamous cell carcinoma (HSNCC) is highly invasive, frequently metastasizing to cervical lymph nodes.

proliferation and tumor invasion, with the Src-targeted small molecule inhibitor saracatinib displaying potent anti-invasive all soft tissue sarcomas and approximately 1% of all head and neck neoplasms.

treatment is the combination of chemotherapy and radiation however, grade 3 and 4 toxicity also significantly increase along

Locally advanced head and neck cancer is a great challenge for oncologists. The most aggressive non-surgical

with more intensive schedules. A study was intended to compare concomitant chemoradiation using newer active agent advanced head and neck cancers. Although no evidence was drawn as the optimal regimen based on this comparison,

paclitaxel in low dose weekly schedule versus most extensively used agent cisplatin with conventional radiation in locally concomitant chemoradiotherapy regimens were easily given in the outpatient clinic. The regimen based on paclitaxel was the most cancers in head and neck cancers. In the recent years, better techniques of radiotherapy and the use of concurrent seems that radiotherapy with or without chemotherapy can be an appropriate alternative to total laryngectomy in preserving of the larynx in different stages of laryngeal cancers[37]. International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013 more effective; however, the difference was not enormous because of the shorter duration of follow-up and small sample size. chemotherapy have been resulted in survival and local control comparable to surgery especially in early laryngeal lesions. It

Therefore, further studies are needed with large sample sizes and long duration of follow-up[36]. Laryngeal tumors are among


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 Oral cancer new cancer cases worldwide annually. S-1 is an oral anticancer drug comprised of tegafur (FT), a prodrug of 5-fluorouracil (5FU), 5-chloro-2, 4-dihydroxypyridine (CDHP), and potassium oxonate (Oxo). S-1 has been used for adjuvant chemotherapy after primary treatment of head and neck cancer. S-1 monochemotherapy of NAC was a useful and convenient method for outpatients and confirmation of safety and efficacy may result in increased use [38]. outpatients, because it has high effective antitumor activity and low toxicity. Further studies on administration of S-1 NAC to may be caused by an alteration in autonomic nervous system function localized to facial skin, resulting in increased vascular vitamins, Phenylbutazone, ACTH, oral and intralesional corticosteroids and boiled water injections have been used in the are considered the mainstay of therapy. CG remains an unknowable disorder with multiple causes. The dental practitioner is risk factors, human papilloma viruses (HPVs) have been found in a small proportion of Oral Squamous Cell Carcinomas. Lung cancer Cheilitis Granulomatosa (CG) is a rare granulomatous disorder of unidentified origin. The disorder is polyetiologic and Oral squamous cell carcinomas (OSCCs), the most widespread cancer of the head and neck, accounts for over 300,000

permeability and edema. Various treatment modalities such as surgery, drug therapy with antituberculous drugs, antibiotics, treatment of CG[39]. Corticosteroids have been shown to be effective in reducing lip swelling and preventing recurrences and likely to encounter patients with this disorder and a proper knowledge of this idiopathic condition is imperative and places a major role in its successful diagnosis and treatment [39]. Although tobacco, panparag usage and alcohol abuse are the dominant Different types of lung cancers are adeno carcinoma, squamous cell carcinoma,small cell carcinoma and large cell

carcinoma.Respiration causes tumors in the thoracic and the abdominal cavities to move appreciably in all directions. The range of that motion can be up to 5 cm. An investigation quantifying the relation between planning target volumes (PTV) size since this technique offers more conformal dose distributions than predictable 3D treatment technique. The presented results outline upper limits for both IMRT and 3D conformal irradiation, i.e. if PTV volume and/or range of motion is greater (for nominal lung volume) than the simulated sizes, then motion management strategy is necessary in order to limit healthy lung toxicity. lung. and its range of motion was presented. Intensity Modulated Radiation Therapy (IMRT) treatment strategy were considered,

IMRT is widely accepted as an appropriate method to treat tumors at many different anatomic locations including To determine the potential role of p53 on the growth inhibition observed with Docosa Hexaenoic Acid (DHA)

treatment of the human lung adenocarcinomas A549 (wildtype p53) and H441 (mutant p53, codon 158), p53-specific siRNAs p53 siRNA or pifithrin-a addition were observed only in the A549 cell lines expressing wildtype p53, and these correlated with with DHA treatment. DHA can exhort inhibitory effects independent of p53 status, it also seems apparent that in some cell models there may be a p53- dependent response. Liver cancer Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world, and the third commonest cause of International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013

and a chemical inhibitor of p53, pifithrin-a, were employed in vitro. Significant increases in the number of DHA-treated cells by a reduction in the percentage of apoptotic and necrotic cells[35]. This data confirms a role for p53-dependent growth inhibition

cancer mortality worldwide[41]. Hepatocellular carcinoma (HCC, also called malignant hepatoma) is the most common type of


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 liver cancer (primary hepatic malignancy) in the Asian countries. The clinicians and the pathologists should always be aware of such unusual presentation owing to the poor prognosis and the possibility of rapid deterioration [42]. is one such molecule secreted phosphoprotein which plays a critical role in metastasis of colon, liver, and breast cancers. interactions may reveal important insights into osteopontins role in cancer metastasis metastases from different tumors is a difficult goal to achieve in most tumors. Breast cancer

Cancer metastasis requires physiological changes which are regulated by cell signaling molecules. Osteopontin (OPN)

Osteopontin binds to it recognized receptors with substantially different affinities, receptor expression varies between cell

types, and significant osteopontin cell surface interactions that are integrin- and CD44-independent. These uncharacterized

The eradication of multiple liver

and 40,930 deaths in 2008[44]. It is a steroid hormonedependent tumor. The importance of hormone status in breast cancer can increase both normal and abnormal breast cell growth. Estrogen and progesterone receptors are highly foretelling of domain and a DNA binding domain. The ER complex binds directly to the DNA and regulates the expression of other genes but hormonal status is clearly important as foretelling and extrapolative factor for therapy. However, the study was limited up courses[45].

Breast cancer is one of the most frequently diagnosed cancers among women, with an estimated 184,450 new cases

patients is because estrogen and progesterone are the key determinants of the therapy. Estrogen (ER) and progesterone (PR) breast cancer that will benefit from endocrine therapy. The ER is a nuclear receptor protein that has an estrogen-binding including the PR. The traditional pathological and morphological examination may be linked to the clinical behavior of tumors, due to its small cohort of breast cancer patients also there was a drop-outrate of nearly one third of patients during the followfindings raise the question of whether HumanPapillomaVirus(HPV) may infect developing cancers and mediate their growth it is found as a concomitant infection in many other tumors. While HPV may initiate carcinogenesis in these tumors, recent studies suggest HPV may also modulate the progression or malignancy process in already transformed cancers. Determining HPV infections[46]. the effects of HPV on already transformed breast cancers is an important step towards understanding the factors that will ultimately lead to more accurate diagnosis and more effective treatment options for breast cancer patients with concomitant are promising emerging prognostic factors, which have been reported in several retrospective studies. Lymphopenia, breast cancer subtype and interval from primary tumor diagnosis to development of brain metastases Survivors of breast cancer experience many side effects that influence their quality of life. A study was carried out to Many viruses have been associated with human breast cancers, including Epstein-Barr and Cytomegalovirus. These

and development, as was recently observed with oral cancers. Although HPV is a primary cause of virtually all cervical cancers,

assess the quality of life of women with breast cancer at the time of diagnosis [47]. In a study[48] reported that almost 90% of all women with breast cancer reported that they felt depressed, irritable tense or worried [49]. Neutropenic enterocolitis (typhilitis) is a rare complication of chemotherapy-related neutropenia in breast cancer patients. Urgent CT scan evaluation and early surgery appear to be of great importance[50]. Prostate cancer

prostate cancer. It was anticipated that exposure to environmental factors such as infectious agents, dietary agents and International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013

Promising evidences suggest that among many risk factors, inflammation is the major risk factor for developing


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 saturated lipids leads to injury of the prostate due to chronic inflammation and regenerative risk factor lesions referred to as proliferative inflammatory atrophy[51]. may often be supplemented with hormonal therapies. A study reveals that two related drugs, finasteride and dutasteride, reduce the incidence of prostate cancer [52]. Pancreatic, gastric and colorectal carcinoma age, and some genetic disorders, although the primary causes are poorly understood [53]. Pancreatic cancer remains a major unsolved health problem. The main risk factors of pancreatic cancer are smoking, Gastric signet ring cell carcinoma (SRC) is poorly distinguished adenocarcinoma in which the tumour cells invade Now a days treatment of prostate cancer is taking new pathways from prostatectomy and radiation therapy, which

singly or in small groups. It occurs more commonly among women and young patients. A regulated course of Epirubicin, carcinoma[54]. deaths[56]. Gastric cancer is the 2rd most common tumor in the world. Incidence rates in men are twice those in women, in both

Oxaliplatine and Capecitabine (EOX) remains the standard treatment of advanced Primary gastric signet-ring cell low-risk and high-risk areas[55]. Overall, it still remains among the leading killer cancers representing 3% of all cancer superficial orthotopic implantation model of colon cancer was established by pulling out the cecum and suturing it to the

Colon, or colorectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). A

peritoneum. It is a valuable orthotopic implantation model for evaluating colon cancer[57]. Since the 1970s it was considered that bile acids are promoters of colon cancer, but lack carcinogenic activity. But recent evidences indicate that bile acids suggest that, in humans, the association of colon cancer with a high fat diet is mediated by persistent exposure to high physiologic levels of bile acids, especially DOC [58]. Renal cancer indeed, act as carcinogens. Bile acid deoxycholic acid (DOC) is a carcinogen, not merely a promoter. Further results of a study

treatment of choice in these patients. There is lack of evidence regarding survival benefit with chemo-radiation following surgery but it is still advocated by some with the hope of increasing survival. A study says that biopsy from the renal pelvis or stone disease[59]. calyceal wall should be considered during the treatment of stone disease, in patients having long-standing history of large renal calculi or staghorn calculus. Such patients are susceptible of harboring occult or overt malignancy along with the renal A study assessed toxicity and potential efficacy of low-dose granulocyte macrophage colony-stimulating factor (GM-

Squamous cell carcinoma of the renal pelvis and ureter is a rare malignancy. Nephrectomy with ureterectomy is the

CSF), interferon alpha and interleukin 2 (IL-2) postoperatively in patients with high-risk renal cell carcinoma (RCC)[60]. Sunitinib is a multitargeted receptor tyrosine kinase inhibitor approved for treatment of advanced renal cell carcinoma and pharmacovigilance is imperative to accurately quantify the possible risk of sunitinib-related hepatotoxicity[61]. Leukemia gastrointestinal stromal tumor. Clinicians should be aware of this possible adverse effect of sunitinib, and continued Leukemia is an unregulated proliferation of haematopoietic tissue that progressively displaces normal blood cell International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013

elements. A milestone in the treatment of chronic lymphocytic leukemia (CLL) was reached with the incorporation of

immunotherapy with conventional chemotherapy. The fludarabine/cyclophosphamide/ rituximab combination has


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 demonstrated survival advantage for the first time in the treatment of CLL [62]. Development of specific targetbased drugs for targets and to develop effective, less toxic, therapeutic interventions [63].Chronic myeloid leaukemia(CML) is a disease of adults but also occurs in children and adolescents. Common features are fatigubility,weakness, weight loss and anorexia. In CML in greater than 90% of patients,with few side effects[64]. Bone Cancer

Juvenile myelomonocytic leukemia (JMML) remains a big challenge and represents a promising direction in this field.

Scientists and clinicians should continue to study molecular defects in JMML in a concerted effort to define novel therapeutic treatment drugs are targeted against BCR-ABL gene product. The drug, imatinib, is useful in sustaining hematologic remission Osteosarcoma is a bone tumor and can occur in any bone, usually in the extremities of long bones near metaphyseal

growth plates. Radiographic evaluation plays an important role in the initial diagnosis of osteosarcoma. In addition, CT scans are excellent for demonstrating the degree of intramedullary extension, cortical involvement and soft tissue involvement. A surgery[65]. case study says that the treatment and prognosis for osteosarcoma depend to a large extent on early diagnosis and radical lead to establishment of prostate cancer skeletal metastasis. Interactions between prostate cancer cells and mature boneproducing osteoblasts resulted in gene expressional changes that may increase cells ability to establish bone metastasis. Cervical cancer Management of locally advanced cervical cancer is a challenge to oncologists[66]. One of the most common symptoms Prostate cancers often metastasize to bone. It is hypothesized that interactions between osteoblasts and cancer cells

of cervical cancer is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer has postradiological complications[67]. Ovarian cancer

progressed to an advanced stage. The mainstay of treatment in cancer cervix is radiotherapy. The hormonal treatment enabled

control of most climacteric symptoms, without any serious side-effects as well relieved rectal, bladder, and vaginal Ovarian cancer is a cancerous growth arising from the ovary. Symptoms may include bloating, pelvic pain, difficulty

eating and frequent urination, and are easily confused with other illnesses [68] . In some cases, radical surgery remains the best treatment in terms of survival and palliation[69]. A case study presents a rare case of ovarian mixed, trabecular and insular, carcinoid with lymph node metastases[70]. Anal cancer

number of patients affected by anal cancer, it remains as a most challenging cancer to treat. Centralized treatment of anal canal establishment of guidelines for monitoring the patients. A report was made on preliminary results of treatment of anal carcinoma by chemotherapy. It suggests that a greater number of patients and a longer follow up period is required to establish chemotherapy as a valid alternative to abdomino-perineal surgery for the treatment of anal carcinoma[71]. associated with AIDS. But a research study establishes a strikingly increased risk of anal cancer among people with AIDS. International Journal of Science Innovations and Discoveries, Volume 3, Issue 4, July-August 2013

Anal cancer is a type of cancer arising from the anus, the distal orifice of the gastrointestinal tract. Despite the small

neoplasms would allow the elaboration of clinical trials to determine the adequate treatment (chemotherapy) , and also the

Till now it was thought that Kaposis sarcoma, non-Hodgkin lymphoma are the only cancers that have been strongly

Clinicians should be aware that AIDS patients have an increased risk of anal cancer [72]. A case study says that early treatment strategies in this type of patients group employed reduced dosages of chemotherapy or radiotherapy alone to reduce toxicity.


Dr. L. Siva et al., IJSID, 2013, 3 (4), 85-101 It also suggests that radical chemoradiation may be given safely at conventional doses in HIV-positive patients, with a high complete response rate[73]. Advancement in cancer therapies promising targets for cancer treatments[74]. Development of inhibitors of TKI and siRNA, with effects better than or at least similar to conventional therapy must be given high priority. Tolerable side effects are also critical to successful to become a treatment option for some cancers, either alone or as a enhancement to traditional treatment. implementation. Only through such efforts may such treatment be fully developed and find its place in the treatment of malignant tumours, solely, as primary choice, or in combination with conventional cancer therapy. RNA interference is likely prevention and treatment of numerous diseases including inflammatory and infectious diseases, pre and post cancer therapy. Antioxidants are considered as one of the effective solutions for the oxidative stress. Now a days they are used in the Recently a research conveys that inhibitors of Tyrosine Kinases (TKI) and Small Interfering RNAs (siRNA) are

Potent antioxidant activities were observed from dendritic antioxidant (zero generation -G0) derived from syringaldehyde. Its analogs were derived from vanillin and 5-iodovanillin. A study presented the characterization and molecular interaction of the study concluded that syringaldehyde-derivatized G0 dendrimer was the most favorable entity for pBR322 DNA, followed by quercetin. CONCLUSION dendritic antioxidants with pBR322 plasmid DNA using computer simulation[75]. Based on interaction and binding energy the

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