K. Fust – The Gale Encyclopedia of Cancer (4th edition, 2015)

Автор: K. Fust
Название книги: The Gale Encyclopedia of Cancer (4th edition, 2015)
Формат: PDF
Жанр: Медицина
Страницы: 2083
Качество: Изначально компьютерное, E-book

The Gale Encyclopedia of Cancer: A Guide to
Cancer and Its Treatments is a health reference product
designed to inform and educate readers about a wide
variety of cancers; other diseases and conditions related
to cancers; diagnostic tests and procedures; nutrition and
dietary practices beneficial to cancer patients; and various
cancer treatments, including drugs. Cengage Learning
believes the product to be comprehensive, but not
necessarily definitive. It is intended to supplement, not
replace, consultation with a physician or other healthcare
practitioner. While Cengage Learning has made substantial
efforts to provide information that is accurate,
comprehensive, and up to date, Cengage Learning makes
no representations or warranties of any kind, including
without limitation, warranties of merchantability or
fitness for a particular purpose, nor does it guarantee
the accuracy, comprehensiveness, or timeliness of the
information contained in this product. Readers should be
aware that the universe of medical knowledge is
constantly growing and changing, and that differences
of opinion exist among authorities. Readers are also
advised to seek professional diagnosis and treatment for
any medical condition, and to discuss information
obtained from this book with their healthcare provider

Unfortunately, man must suffer disease. Some
diseases are totally reversible and can be effectively
treated. Moreover, some diseases with proper treatment
have been virtually annihilated, such as polio, rheumatic
fever, smallpox, and, to some extent, tuberculosis. Other
diseases seem to target one organ, such as the heart, and
there has been great progress in either fixing defects,
adding blood flow, or giving medications to strengthen
the diseased pump. Cancer, however, continues to
frustrate even the cleverest of doctors or the most
fastidious of health-conscious individuals. Why?
By its very nature, cancer is a survivor. It has only
one purpose: to proliferate. After all, that is the definition
of cancer: unregulated growth of cells that fail to heed the
message to stop growing. Normal cells go through a
cycle of division, aging, and then selection for death.
Cancer cells are able to circumvent this normal cycle and
escape recognition to be eliminated.
There are many mechanisms that can contribute to
this unregulated cell growth. One of these mechanisms is
inheritance. Some individuals can be programmed for
cancer due to inherited disorders in their genetic makeup.
In its simplest terms, a person can inherit a faulty gene or
a missing gene whose role is to eliminate damaged cells
or to prevent imperfect cells from growing. Without this
natural braking system, the damaged cells can divide and
lead to more damaged cells with the same abnormal
genetic makeup as the parent cells. Given enough time,
and our inability to detect them, these groups of cells can
grow to a size that will cause discomfort or other
symptoms.
Inherited genetics are obviously not the only source
of abnormalities in cells. Humans do not live in a sterile
world devoid of environmental attacks or pathogens.
Humans must work, and working environments can be
dangerous. Danger can come in the form of radiation,
chemicals, or fibers to which we may be chronically
exposed with or without our knowledge. Moreover,
humans must eat, and if our food is contaminated with
these environmental hazards, or if we prepare our food in
a way that may change the chemical nature of the food to
hazardous molecules, then chronic exposure to these
toxins could damage cells. Finally, humans are social.
They have found certain habits that are pleasing because
they are relaxing or help release inhibitions. Such habits,
including smoking and alcohol consumption, can have a
myriad of influences on the genetic makeup of cells.
Why the emphasis on genes in the new century?
Because they are potentially the reason as well as the
answer for cancer. Genes regulate our micro- and
macrosopic events by eventually coding for proteins that
control our structure and function. If environmental events
cause errors in those genes that control growth, then
imperfect cells can start to take root. For the majority of
cases, a whole cascade of genetic events must occur before
a cell is able to outlive its normal predecessors. This
cascade of events could take years to occur, in a silent,
undetected manner until the telltale signs and symptoms of
advanced cancer are seen, including pain, lack of appetite,
cough, loss of blood, or the detection of a lump. How did
these cells get to this state where they are now dictating
the everyday physical, psychological, and economic
events for the person afflicted?
At this time, the sequence of genetic catastrophes is
much too complex to comprehend or summarize, because
it is only in the past decade that we have even been able
to map what genes we have and where they are located in
our chromosomes. We have learned, however, that
cancer cells are equipped with a series of self-protection
mechanisms. Some of the altered genes are actually able
to express themselves more than in the normal situation.
These genes could then code for more growth factors for
the transforming cell, or they could make proteins that
could keep our own immune system from eliminating
these interlopers. Finally, these cells are chameleons: if
we treat them with drugs to try to kill them, they can
“change their colors” by mutation, and then be resistant
to the drugs that may have harmed them before.
Then what do we do for treatment? Humans have
always had a fascination with grooming, and grooming
involves removal—dirt, hair, waste. The ultimate
removal involves cutting away the spoiled or imperfect
portion. An abnormal growth? Remove it by surgery . . .
make sure the edges are clean. Unfortunately, the painful
reality of cancer surgery is that it is most effective when
performed in the early stages of the disease. “Early stages
of the disease” implies that there is no spread, or,
hopefully, before there are symptoms. In the majority of
cases, however, surgery cannot eradicate all the disease
because the cancer is not only at the primary site of the
lump, but also has spread to other organs. Cancer is not
just a process of growth, but also a metastasizing process
that allows for invasion and spread. The growing cells
need nourishment so they secrete proteins that allow for
the growth of blood vessels (angiogenesis); once the
blood vessels are established from other blood vessels,
the tumor cells can make proteins that will dissolve the
imprisoning matrix surrounding them. Once this matrix is
dissolved, it is only a matter of time before the cancer
cells will migrate to other places, making the use of
surgery fruitless.
Since cancer cells have a propensity to spread to
other organs, therapies must be geared to treat the whole
body and not just the site of origin. The problem with
these chemotherapies is that they are not selective and
wreak havoc on tissues that are not affected by the
cancer. These therapies are not natural to the human host,
and result in nausea, loss of appetite, fatigue, and a
depletion in the cells that protect us from infection and
those that carry oxygen. Doctors who prescribe such
medications must walk a fine line between helping the
patient (causing a “response” in the cancer by making it
smaller) or causing “toxicity,” which, due to effects on
normal organs, causes the patient problems. Although
these drugs are far from perfect, we are fortunate to have
them because when they work, their results can be
remarkable.
But that’s the problem—“when they work.” We
cannot predict who is going to benefit from our therapies,
and doctors must inform the patient and his/her family
about countless studies that have been done to validate
the use of these potentially beneficial/potentially harmful
agents. Patients must suffer the frustration that oncologists
have because each individual afflicted with cancer is
different, and each cancer is different. This makes it
virtually impossible to personalize an individual’s
treatment expectations and life expectancy. Cancer, after
all, is a very impersonal disease, with little regard to sex,
race, age, or any other “human” characteristics.
Cancer treatment is in search of “smart” options. Like
modern-day instruments of war, successful cancer treatment
necessitates the construction of therapies that can do
three basic tasks: search out the enemy, recognize the
enemy, and kill the enemy without causing “friendly fire.”
The successful therapies of the future will involve the use
of “living components,” “manufactured components,” or a
combination of both. Living components, white blood
cells, will be educated to recognize where the cancer is,
and help our own immune system fight the foreign cells.
These lymphocytes can be educated to recognize signals
on the cancer cell that make them unique. Therapies in the
future will be able to manufacture molecules with these
signature, unique signals that are linked to other molecules
specifically for killing the cells. Only the cancer cells are
eliminated in this way, hopefully sparing the individual
from toxicity.
Why use these unique signals as delivery mechanisms?
If they are unique and are important for growth of
the cancer cell, why not target them directly? This
describes the ambitious mission of gene therapy, whose
goal is to supplement a deficient, necessary genetic pool or
diminish the number of abnormally expressed genes
fortifying the cancer cells. If a protein is not being made
that slows the growth of cells, gene therapy would
theoretically supply the gene for this protein to replenish
it and cause the cells to slow down. If the cells can make
their own growth factors that sustain them selectively over
normal cells, then the goal is to block the production of this
growth factor. There is no doubt that gene therapy is the
wave of the future, and it is under intense investigation and
scrutiny. The problem, however, is that there is no way to
tell when this future promise will be fulfilled.
No book can fully describe the medical, psychological,
social, and economic burden of cancer, and if this is
your first confrontation with the enemy, you may find
yourself overwhelmed with its magnitude. Books are only
part of the solution. Newly enlisted participants in this war
must seek proper counsel from educated physicians who
will inform the family and the patient of the risks and
benefits of a treatment course in a way that can be
understood. Advocacy groups of dedicated volunteers,
many of whom are cancer survivors, can guide and advise.
The most important component, however, is an intensely
personal one. The afflicted individual must realize that he/
she is responsible for charting the course of his/her
disease, and this requires the above described knowledge
as well as great personal intuition. Cancer comes as a
series of shocks: the symptoms, the diagnosis, and the
treatment. These shocks can be followed by cautious
optimism or profound disappointment. Each one of these
shocks either reinforces or chips away at one’s resolve,
and how an individual reacts to these issues is as unique as
the cancer that is being dealt with.
While cancer is still life-threatening, strides have
been made in the fight against the disease. Thirty years
ago, a young adult diagnosed with testicular cancer had
few options for treatment that could result in cure. Now,
chemotherapy for good-risk stage II and III testicular
cancer can result in a complete response of the tumor in
98% of the cases and a durable response in 92%. Sixty
years ago, there were no regimens that could cause a
complete remission for a child diagnosed with leukemia,
but now, using combination chemotherapy, complete
remissions are possible in 96% of these cases. Progress
has been made, but more progress is needed. The first
real triumph in cancer care will be when cancer is no
longer thought of as a life-ending disease, but as a
chronic disease whose symptoms can be managed.
Anyone who has been touched by cancer or who has
been involved in the fight against it lives in hope that that
day will arrive.
Helen A. Pass, MD, FACS

The Gale Encyclopedia of Cancer: A Guide to Cancer
and Its Treatments is a unique and invaluable source of
information for anyone touched by cancer. This collection
of more than 600 entries provides in-depth coverage of
specific cancer types, diagnostic procedures, treatments,
cancer side effects, and cancer drugs. In addition, entries
have been included to facilitate understanding of related
concepts, such as cancer biology, carcinogenesis, and
cancer genetics, as well as cancer issues such as clinical
trials, home health care, fertility issues, and cancer
prevention. This easy-to-read encyclopedia defines medical
concepts and terminology in language that general readers
can understand while still providing thorough coverage.
SCOPE
Entries follow a standardized format to help users
find information quickly. Rubrics include the following
headings (as applicable):
Cancer types
• Definition
• Description
• Demographics
• Causes and symptoms
• Diagnosis
• Treatment team
• Clincial staging
• Treatment
• Prognosis
• Coping with cancer treatment
• Clinical trials
• Prevention
• Special concerns
• Resources
Drugs, herbs, and supplements
• Definition
• Description
• Recommended dosage
• Precautions
• Side effects
• Interactions
• Resources
Tests, treatments, and other procedures
• Definition
• Purpose
• Description
• Benefits
• Precautions
• Preparation
• Aftercare
• Risks
• Results
• Alternatives
• Health care team roles
• Research and general acceptance
• Caregiver concerns
• Training and certification
INCLUSION CRITERIA
A preliminary list of cancers and related topics
was compiled from a wide variety of sources,
including professional medical guides and textbooks
as well as consumer guides and encyclopedias. The
advisory board, made up of medical doctors and
oncology pharmacists, evaluated the topics and made
suggestions for inclusion. Final selection of topics to
include was made by the advisory board in conjunction
with the editor.

HOW TO USE THIS BOOK
The Gale Encyclopedia of Cancer has been designed
with ready reference in mind.
• Straight alphabetical arrangement of topics allows
users to locate information quickly.
• Bold-faced terms within entries indicate that fulllength
articles exist for those topics.
• Cross-references placed throughout the encyclopedia
direct readers from alternate names and related topics
to their intended entries.
• A list of key terms is provided in most entries to
define unfamiliar or complicated terms or concepts.
• A glossary, located at the end of volume 3, contains a
list of all key terms, arranged alphabetically.
• Questions to Ask Your Doctor sidebars are provided
when appropriate to help facilitate patient discussions
with physicians and other healthcare providers.
• See also suggestions at the end of some entries point
readers toward similar or related topics.
• Resources sections at the end of entries direct readers
to additional sources of information on a topic.
• Valuable contact information for organizations
and support groups is included with most entries.
All of the contact information is compiled in an
appendix in the back of volume 3, arranged
alphabetically.
• A comprehensive general index guides readers to all
topics mentioned in the text.
• Author and advisor bylines provide information on
who updated and reviewed the entries, including their
credentials. Advisor bylines are new to this edition and
are not yet present in every article, but the absence of
an advisor byline does not mean that the entry was
never reviewed.
A note about drug entries: Drug entries are listed in
alphabetical order by common generic names. However,
because many oncology drugs have more than one
common generic name, and because the brand name may
be used interchangeably with a generic name, drug
entries may be located in three ways: The reader may find
the intended entry under the generic drug name in
alphabetical order; may be directed to the entry from an
alternate name cross-reference; or may use the index to
look up a brand name, which will direct the reader to the
appropriate entry.
GRAPHICS
The Gale Encyclopedia of Cancer is enhanced by
275 color photographs, illustrations, and tables.