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Chapter 078. Prevention and Early Detection of Cancer (Part 3)

Cancer Chemoprevention Chemoprevention involves the use of specific natural or synthetic chemical agents to reverse, suppress, or prevent carcinogenesis before the development of invasive malignancy. Cancer develops through an accumulation of genetic and epigenetic changes that are potential points of intervention to prevent cancer. The initial changes are termed initiation. The alteration can be inherited or acquired through the action of physical, infectious, or chemical carcinogens. Like most human diseases, cancer arises from an interaction between genetics and environmental exposures (Table 78-1). Influences that cause the initiated cell to progress through the carcinogenic process and change phenotypically are termed promoters. . | Chapter 078. Prevention and Early Detection of Cancer Part 3 Cancer Chemoprevention Chemoprevention involves the use of specific natural or synthetic chemical agents to reverse suppress or prevent carcinogenesis before the development of invasive malignancy. Cancer develops through an accumulation of genetic and epigenetic changes that are potential points of intervention to prevent cancer. The initial changes are termed initiation. The alteration can be inherited or acquired through the action of physical infectious or chemical carcinogens. Like most human diseases cancer arises from an interaction between genetics and environmental exposures Table 78-1 . Influences that cause the initiated cell to progress through the carcinogenic process and change phenotypically are termed promoters. Promoters include hormones such as androgens linked to prostate cancer and estrogen linked to breast and endometrial cancer. The distinction between an initiator and promoter is sometimes arbitrary some components of cigarette smoke are complete carcinogens acting as both initiators and promoters. Cancer can be prevented or controlled through interference with the factors that cause cancer initiation promotion or progression. Compounds of interest in chemoprevention often have antimutagenic antioxidant anti-inflammatory antiproliferative or pro-apoptotic activity or a combination . Table 78-1 Suspected Carcinogens Carcinogens0 Associated Cancer or Neoplasm Alkylating agents Acute myeloid leukemia bladder cancer Androgens Prostate cancer Aromatic amines dyes Bladder cancer Arsenic Cancer of the lung skin Asbestos Cancer of the lung pleura peritoneum Benzene Acute myelocytic leukemia Chromium Lung cancer Diethylstilbestrol prenatal Vaginal cancer clear cell Epstein-Barr virus Burkitt s lymphoma nasal T cell lymphoma Estrogens Cancer of the endometrium liver breast Ethyl alcohol Cancer of the liver esophagus head and .