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Cancer research is at a crossroads. Traditionally, cancer has been thought of as a disease of gene mutation, where the stepwise accumulation of cancer gene mutations is the key, and the identification of common gene mutations has been considered to be essential for diagnosis and treatment. Despite extensive research efforts and accumulated knowledge on cancer genes and pathways, the clinical benefits of this traditional approach have been limited. Recently, cancer genome sequencing has revealed an extensive amount of genetic heterogeneity where the long-expected common mutation drivers have been difficult, if not impossible, to identify. These realities ultimately challenge the conceptual framework of current cancer biology.This book introduces a new concept of genome theory of cancer evolution, in an attempt to unify the field. Many important and representative, but often confusing, questions and paradoxes are critically analyzed. By comparing gene- and genome-based theories, the hidden flaws of many popular viewpoints are addressed. This discussion is intended to initiate a much-needed critical re-evaluation of current cancer research.
"Cancer research is at a crossroads. Traditionally, cancer has been thought of as a disease of gene mutation, where the stepwise accumulation of cancer gene mutations is the key, and the identification of common gene mutations has been considered to be essential for diagnosis and treatment. Despite extensive research efforts and accumulated knowledge on cancer genes and pathways, the clinical benefits of this traditional approach have been limited. Recently, cancer genome sequencing has revealed an extensive amount of genetic heterogeneity where the long-expected common mutation drivers have been difficult, if not impossible, to identify. These realities ultimately challenge the conceptual framework of current cancer biology. This book introduces a new concept of genome theory of cancer evolution, in an attempt to unify the field. Many important and representative, but often confusing, questions and paradoxes are critically analyzed. By comparing gene- and genome-based theories, the hidden flaws of many popular viewpoints are addressed. This discussion is intended to initiate a much-needed critical re-evaluation of current cancer research."--
This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
Updated and expanded, the third edition of Surgery for Ovarian Cancer focuses on essential techniques for the effective management of ovarian cancer. It reflects the most contemporary science and surgical applications for the management of patients with ovarian cancer and related peritoneal surface malignancies. This new edition takes a step-by-step approach and includes new intraoperative photographs and videos illustrating surgical procedures. It is principally devoted to the technical aspects of cytoreductive surgery, with chapters divided according to anatomic region. The chapters cover relevant anatomical considerations, surgical challenges specific to each region, and operative approaches and techniques favored by the authors. The list of contributing authors has been expanded from the previous edition and includes international and world-renowned experts from the fields of gynecologic oncology and surgical oncology. The topics of minimally invasive surgery, secondary cytoreduction, palliative surgery, and postoperative care are also covered in detail. New to the third edition are chapters on preoperative risk stratification, regional therapeutics and peritonectomy procedures, and quality assurance relating to ovarian cancer surgery. This comprehensive text is essential reading for all practitioners working with patients with ovarian cancers.
Since the 1970s, the origin of cancer is being explored from the point of view of the Somatic Mutation Theory (SMT), focusing on genetic mutations and clonal expansion of somatic cells. As cancer research expanded in several directions, the dominant focus on cells remained steady, but the classes of genes and the kinds of extra-genetic factors that were shown to have causal relevance in the onset of cancer multiplied. The wild heterogeneity of cancer-related mutations and phenotypes, along with the increasing complication of models, led to an oscillation between the hectic search of ‘the’ few key factors that cause cancer and the discouragement in face of a seeming ‘endless complexity’. To tame this complexity, cancer research started to avail itself of the tools that were being developed by Systems Biology. At the same time, anti-reductionist voices began claiming that cancer research was stuck in a sterile research paradigm. This alternative discourse even gave birth to an alternative theory: the Tissue Organization Field Theory (TOFT). A deeper philosophical analysis shows limits and possibilities of reductionist and anti-reductionist positions and of their polarization. This book demonstrates that a radical philosophical reflection is necessary to drive cancer research out of its impasses. At the very least, this will be a reflection on the assumptions of different kinds of cancer research, on the implications of what cancer research has been discovering over 40 years and more, on a view of scientific practice that is most able to make sense of the cognitive and social conflicts that are seen in the scientific community (and in its results), and, finally, on the nature of living entities with which we entertain this fascinating epistemological dance that we call scientific research. The proposed Dynamic and Relational View of carcinogenesis is a starting point in all these directions.
Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
There were no medical oncologists until a few decades ago. In the early 1960s, not only were there no such specialists, many practitioners regarded the treatment of terminally-ill cancer patients with heroic courses of chemotherapy as highly questionable. Physicians loath to assign patients randomly to competing treatments also expressed their outright opposition to the randomized clinical trials that were then relatively rare. And yet today these trials form the basis of medical oncology. How did such a spectacular change occur? How did medical oncology move from a non-entity and in some regards a reviled practice to the central position it now occupies in modern medicine? Cancer on Trial answers these questions by exploring how practitioners established a new style of practice, at the center of which lies the cancer clinical trial.
In Explaining Cancer, Anya Plutynski addresses a variety of philosophical questions that arise in the context of cancer science and medicine. She begins with the following concerns: · How do scientists classify cancer? Do these classifications reflect nature's "joints"? · How do cancer scientists identify and classify early stage cancers? · What does it mean to say that cancer is a "genetic" disease? What role do genes play in "mechanisms for" cancer? · What are the most important environmental causes of cancer, and how do epidemiologists investigate these causes? · How exactly has our evolutionary history made us vulnerable to cancer? Explaining Cancer uses these questions as an entrée into a family of philosophical debates. It uses case studies of scientific practice to reframe philosophical debates about natural classification in science and medicine, the problem of drawing the line between disease and health, mechanistic reasoning in science, pragmatics and evidence, the roles of models and modeling in science, and the nature of scientific explanation.
With the huge number of studies on nutrition and cancer available, it's impossible for a person to sort through them all to come up with practical recommendations. Now, Dr. David Khayat, a world-renowned oncologist, has done that hard work for you. In this international bestseller, Dr. Khayat provides easy-to-follow—and often surprising—guidelines on what are now known to be the foods most likely to reduce the risk of cancer. For those of a scientific bent, he explains what cancer is and how it develops. Bringing together his own research with that of other major cancer specialists, he breaks down what the studies mean, which ones provide the most solid evidence, and how to use their results in your and your family’s diet. Structured by the major food groups—as well as supplements, beverages, and exercise—The Anticancer Diet may surprise you by not disparaging red meat but alerting you to find out the source of your fish and suggesting sole over salmon. While highly recommending commercial pomegranate juice, it cautions people with fair hair and eyes against drinking orange juice. What stage of life a person is at will also affect what they should consume. Pregnant women, older women, men, and children may process foods differently. With numerous easy-to-read charts and tables along with a comprehensive food list at the back of the book, this accessible, user-friendly guide helps readers realize the power in their everyday choices.