What is a biopsy?

What is a biopsy?

A A biopsy is the removal and examination of a small piece of body tissue. Biopsies enable cancer specialists to carefully examine cells that are suspected of having turned cancerous. Some biopsies are fairly simple to perform, such as those on tissue from moles or skin sores. Other biopsies may require the use of a needle or probe to remove tissue from inside the body, such as in the breast or stomach.

Are other cancer treatments available beyond surgery, chemotherapy, and radiation?

Some experimental techniques that show promise for some particular types of cancer include the following:

Bone marrow transplants. Healthy bone marrow cells from a compatible donor are transplanted following the elimination of the patient’s bone marrow by radiation or chemotherapy. Transplants of stem cells may provide a solution to the problem of donor incompatibility. These unspecialized cells can divide and produce many specialized cell types, including bone marrow cells. Stem cells can be grown outside the body and then transplanted back into the cancer patient, allowing safe repopulation of bone marrow.

Vaccines and genetically modified immune cells. These enhance the reaction of a patient’s own immune system.

Anti-angiogenesis agents. These starve tumors by blocking their blood supply.

Proteasome inhibitors. Proteasomes help control the cell cycle the process through which cells divide. If proteasomes malfunction, as is often the case in cancer cells, then cells may begin multiplying out of control. Proteasome inhibitors block the action of proteasomes, halting cell division and killing the cells. One proteasome inhibitor is now being used against certain cancers, and other such drugs are in development.

Enzyme activators/blockers. Normal cells die after dividing a given number of times. Scientists believe that the enzyme caspase triggers the death of normally functioning cells. In cancer cells, caspase activity may be blocked. Conversely, if the enzyme telomerase becomes active in cancer cells, the life/death cycle stops and the cells duplicate indefinitely. In effect, inactive caspase or active telomerase may make cancer cells “immortal.” Researchers are studying compounds that can either activate caspase or deactivate telomerase; either type of drug might lead cancer cells to self-destruct. No such drugs are now in clinical use.

In the future, gene sequencing techniques may allow treatments to be targeted at specific cancer subtypes, much as specific antibiotics are now used to treat specific bacterial diseases.

Monoclonal antibodies. The use of monoclonal antibodies to fight cancer mimics the way the immune system fights an infection. All cells in the body have markers on their surfaces, and the immune system develops antibodies, or special proteins, that can recognize these markers, bind to them, and trigger neutralization and destruction. Scientists carefully select cell-surface markers that are displayed on cancer cells and then administer antibodies to the patient. These monoclonal antibodies (the term monoclonal means they bind to only one particular cell-surface marker) target the cancer cells and enlist the help of the body’s own immune system to selectively kill these cells. Rituximab (Rituxan) has been one of the most successful monoclonal antibodies, used effectively for patients with lymphoma. Many other monoclonal antibodies are in use currently, and the list of potential new agents in this category is growing rapidly.

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SUMMARY

• Cancer is an abnormal and uncontrolled multiplication of cells; cancer cells can metastasize (spread to other parts of the body).

• Lung cancer kills more people than any other type of cancer; tobacco smoke is the primary cause.

• Colon and rectal cancer are linked to age, heredity, obesity, and a diet rich in red meat and low in fruits and vegetables.

• Breast cancer has a genetic component, but lifestyle and hormones are also factors. Prostate cancer is chiefly a disease of aging; diet, heredity, and ethnicity are other risk factors.

• Cancers of the female reproductive tract include cervical, uterine, and ovarian cancer. Cervical cancer is linked to HPV infection; the Pap test is an effective screening test. Vaccination is recommended for girls and young women.

• Melanoma is the most serious form of skin cancer; excessive exposure to UV radiation in sunlight is the primary cause.

• Oral cancer is caused primarily by smoking, excess alcohol consumption, and use of spit tobacco.

• Testicular cancer can be detected early through self-examination.

• The genetic basis of some cancers appears to be mutational damage to suppressor genes, which normally limit cell division.

• Cancer-promoting dietary factors include meat, certain types of fat, and alcohol. Dietary elements that may protect against cancer include antioxidants and phytochemicals. An inactive lifestyle is associated with some cancers.

• Some carcinogens occur naturally in the environment; others are manufactured substances. Occupational exposure is a risk for some workers.

• All sources of radiation are potentially carcinogenic, including X-rays and UV rays from the sun.

• Self-monitoring and regular screening tests are essential to early cancer detection.

• Methods of cancer diagnosis include MRI, CT scanning, and ultrasound.

• Cancer treatment usually consists of some combination of surgery, chemotherapy, and radiation.

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