Pre-Invasive Disease: Pathogenesis and Clinical Management

Springer, 2016

This book is written by International experts in their field and should appeal to students and seasoned researchers, to scientists and to clinicians. No prior knowledge of the topic is required to appreciate this text and yet the book charters new territory. New perspectives are given on how our knowledge of cancer development might lead us to reconsider our clinical approach to early detection and prevention of cancer at an individual and population level. At the molecular level we need to understand the pathways and molecular mechanisms, both genetic and epigenetic, by which cells achieve the capacity to invade. Thirdly, in order make clinical progress we need biomarkers to identify and risk stratify individuals with pre-invasive lesions. These biomarkers might be applied to the serum as in Prostate Specific Antigen in prostate cancer or be applied to tissue samples, such as oestrogen receptor status in breast cancer. In order to utilize biomarkers in the context of a screening programme there are issue around the invasiveness of the test as well as its positive and negative predictive value. With advances in molecular imaging there is now the exciting possibility of incorporating a molecular tag to a non-invasive imaging modality. Fourthly, in order to justify screening early detection must be coupled to a treatment strategy. If the chemopreventive agent is very well tolerated, then as well as targeting high risk groups, one might consider treatment at the population level. Aspirin is one such drug which has been extensively assessed in the context of colon cancer chemoprevention trials. Trials of aspirin chemoprevention are now being applied to other cancers such as oesophageal adenocarcinoma and since many individuals take aspirin for .chemoprevention of cardiovascular disease the cancer incidence can be ascertained in these populations. In order to understand the more general issues raised from the discussions above it is useful to consider disease specific examples. Our understanding of pre-invasive disease varies according to the organ site and there are lessons to be learned from these experiences. For example, there is now the prospect of a vaccine for cervical cancer with important questions about how this might be applied to the high incidence areas of the developing world. On the other hand, ductal carcinoma in situ is currently treated by mastectomy which is more radical than the treatment received by man

• Curatore: Rebecca C. Fitzgerald
• Anno edizione: 2016
• Editore: Springer
• Formato: EPUB2 con Adobe DRM
• Compatibilità: Tutti i dispositivi (eccetto Kindle)
• Layout: Reflowable
• EAN: 9781441966940

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