Global Epidemiology of Cancer

Jahangir Moini, MD, MPH, is an international author of 46 medical textbooks for various publishers including Elsevier, McGraw-Hill, Pearson, Jones & Bartlett Learning, Cengage Learning, and Routledge. In addition to continuing his venture as an author, he has been a professor for over 40 years. He is a retired professor with the Eastern Florida State College Science & Health Department.

Nicholas G. Avgeropoulos, MD, is the co-director of the brain and spine tumor program at Orlando Health / UF Health Cancer Center. His specialties are in neuro-oncology and cancer neurology.

Craig Badolato, MD, is a medical oncologist at U.S. Oncology in Melbourne, Florida. He is board-certified in Internal Medicine, Hematology, and Medical Oncology.

About the Authors xv

Preface xvii

Acknowledgments xix

Part I Introduction 1

1 Pathogenesis of Cancer 3

The Origin of Cancer 3

Cancer Biology 7

Genetics and Cancer 9

Cell Division 11

Cell Cycle 12

Carcinogenesis 14

Mutation and Cancer 16

Metastasis 17

Key Terms 20

Bibliography 20

2 Global Epidemiology of Cancer 23

Incidence 23

Prevalence 24

Survival 26

Distribution of Cancer by Gender, Race, and Age 28

Global Burden of Cancer 29

Global Trends in Cancer 31

Global Prevalence of Cancer 32

Global Incidence and Mortality 32

Mortality due to Cancer in the United States 33

Risk Factors for Cancer Development 34

Years of Life Lost 36

Disability-Adjusted Life Years 36

Global Cancer Prevention 36

Key Terms 38

Bibliography 38

Part II Cancers of the Body Systems 41

3 Brain and Spine Tumors 43

Benign / Low Grade Tumors 43

Meningioma 44

Hemangioma 48

Neurofibroma 51

Schwannoma 53

Astrocytoma 55

Pituitary Adenoma 59

Malignant Tumors 62

Pituitary Carcinoma 63

Pineoblastoma 65

Anaplastic Oligodendroglioma 67

Anaplastic Ependymoma 69

Anaplastic Astrocytoma 70

Embryonal Carcinoma 73

Choriocarcinoma 74

Teratoma 75

Metastatic Tumors 77

Key Terms 80

Bibliography 81

4 Endocrine Tumors 85

Thyroid Adenoma 85

Thyroid Cancers 87

Papillary Carcinoma 87

Follicular Carcinoma 91

Medullary Carcinoma 93

Anaplastic Thyroid Carcinoma 96

Parathyroid Tumors 98

Adenoma 98

Carcinoma 100

Thymus Tumors 102

Thymoma 102

Thymolipoma 105

Thymoliposarcoma 106

Adrenal Tumors 108

Adenoma of the Cortex 108

Carcinoma of the Cortex 110

Pheochromocytoma 114

Neuroblastoma 116

Multiple Endocrine Neoplasia 119

Key Terms 124

Bibliography 124

5 Respiratory Tumors 127

Nasopharyngeal Tumors 127

Nasopharyngeal Angiofibroma 127

Nasopharyngeal Hemangioma 128

Nasopharyngeal Carcinoma 128

Laryngeal Cancer 131

Lung Cancer 135

Bronchial Carcinoma 148

Carcinoid Tumors 151

Mesothelioma 155

Key Terms 161

Bibliography 161

6 Digestive Tumors 165

Oral and Oropharyngeal Cancer 165

Esophageal Cancer 171

Stomach Cancer 176

Small-Bowel Tumors 180

Familial Adenomatous Polyposis 183

Colorectal Tumors 186

Anorectal Cancer 191

Pancreatic Cancer 194

Liver and Biliary Tract Cancers 198

Hepatocellular Carcinoma 198

Liver Metastases 201

Gallbladder Cancer 204

Key Terms 208

Bibliography 208

7 Lymphatic and Blood Cancer 211

Lymphomas 211

Non-Hodgkin's Lymphoma 211

Hodgkin's Lymphoma 216

Multiple Myeloma 222

Leukemias 225

Acute Lymphoblastic Leukemia 226

Acute Myeloid Leukemia 230

Chronic Lymphocytic Leukemia 234

Chronic Myeloid Leukemia 237

Key Terms 239

Bibliography 240

8 Male Reproductive Tumors 243

Benign Prostatic Hyperplasia 243

Prostate Cancer 248

Testicular Cancer 256

Penile Cancer 261

Key Terms 264

Bibliography 265

9 Female Reproductive Tumors 269

Benign Breast Tumors 269

Breast Cancer 272

Benign Ovarian Masses 286

Ovarian Cancer 290

Uterine Fibroids 296

Endometrial Cancer 300

Uterine Sarcoma 306

Choriocarcinoma 309

Cervical Polyps 311

Cervical Cancer 312

Vaginal and Vulvar Cancer 318

Key Terms 321

Bibliography 322

10 Skin Tumors 327

Moles 327

Dermatofibromas 331

Infantile Hemangiomas 332

Lipoma and Liposarcoma 335

Keloids 337

Melanoma 338

Basal Cell Carcinoma 343

Squamous Cell Carcinoma 347

Bowen Disease 350

Merkel Cell Skin Cancer 353

Kaposi Sarcoma 355

Key Terms 359

Bibliography 359

11 Bone Tumors 363

Benign Bone Tumors 363

Multiple Myeloma 368

Osteosarcoma 368

Chondrosarcoma 373

Ewing Sarcoma 376

Giant Cell Tumor of Bone 379

Metastatic Bone Tumors 383

Key Terms 386

Bibliography 386

12 Kidney and Urinary Bladder Tumors 391

Adenoma 391

Angiomyolipoma 393

Renal Cell Carcinoma 395

Renal Sarcoma 400

Wilms' Tumor 402

Metastatic Tumors 406

Urinary Bladder Cancer 408

Transitional Cell Carcinoma 408

Squamous Cell Carcinoma 411

Adenocarcinoma 413

Key Terms 415

Bibliography 415

13 Diagnostic Procedures 421

Traditional X-rays 421

Computed Tomography 424

Positron Emission Tomography 428

Magnetic Resonance Imaging 431

Doppler and Duplex Doppler Ultrasonography 434

Transrectal Ultrasonography 436

Mammography 436

Nuclear Medicine 439

Endoscopy 441

Endoscopic Retrograde Cholangiopancreatography 444

Biopsy 444

Lumbar Puncture 445

Hematology Tests 447

Urinalysis 448

Genetic Testing 450

Key Terms 451

Bibliography 452

Part III Treatment of Cancers 455

14 Surgical Oncology 457

Biopsy Techniques 457

Fine-Needle Aspiration 457

Core-Needle Biopsy 459

Open Biopsy 461

Endoscopic Biopsies 462

Cardiopulmonary Factors 462

Hematologic Factors 463

Gastrointestinal Factors 464

Geriatric Factors 464

Medications Affecting Surgery 467

Anesthesia 468

Resection 469

Tumor Margins 469

Sentinel Lymph Node Biopsy 470

Minimally Invasive Procedures 470

Emergent Surgery 472

Key Terms 472

Bibliography 473

15 Radiation Therapy 475

The Purpose of Radiation Therapy 476

Radiobiology 476

Cellular Response to Radiation 476

The Cell Cycle and Radiosensitivity 477

Cell Death 478

Factors Affecting the Biology of Cancers 479

Oxygen Effect 479

Dose Rate 480

Relative Biologic Effectiveness 480

Radiosensitivity 480

Apoptosis 480

Linear Energy Transfer 481

Fractionation 481

Types of Radiation Therapy 483

External Beam Radiation Therapy 483

Stereotactic Radiosurgery 485

Adaptive Planning 486

Charged Particle External Beam Radiation Therapy 487

Heavy Charged Particle External Beam Radiation Therapy 487

Brachytherapy 487

Radionuclide Therapy 489

Intraoperative Radiotherapy 489

Combined-Modality Therapy 489

Hyperthermia 490

Accidental Radiation Exposure 492

Acute Radiation Syndrome 493

Cutaneous Syndrome 493

Gastrointestinal Syndrome 493

Hematopoietic Syndrome 493

Cerebrovascular Syndrome 493

Radiation on the Embryo and Fetus 494

Radiation and Malignancies 494

Special Populations 495

Pregnant Women 495

Children 495

Elderly 495

Key Terms 495

Bibliography 495

16 Chemotherapy 499

Pharmacology of Chemotherapeutic Drugs 500

Principles of Pharmacokinetics 500

Pharmacogenomics 502

Drug Interactions with Chemotherapy 503

Antineoplastic Drugs 503

Classic Alkylating Agents 505

Platinum Analogs 507

Miscellaneous Alkylating Agents 508

Anthracycline Antibiotics 508

Miscellaneous Antitumor Antibiotics 510

Folate Antagonists 510

Purine Analogs 512

Pyrimidine Analogs 513

Vinca Alkaloids 514

Taxanes 515

Hormonal Therapies 517

Chemotherapy-Induced Adverse Effects 520

Bone Marrow Suppression 520

Anemia 520

Insomnia 521

Cognitive Dysfunction 522

Fatigue 522

Thrombocytopenia 522

Neutropenia 523

Tumor Lysis Syndrome 525

Gastrointestinal Tract Toxicity 526

Integumentary Toxicity 528

Cardiotoxicity 529

Neurotoxicity 531

Pulmonary Toxicity 536

Nephrotoxicity 538

Hepatotoxicity 540

Key Terms 542

Bibliography 542

17 Immunotherapy 545

Immunology Overview 545

Innate Immunity 545

Adaptive Immunity 546

Cytokines 546

Antigen Presentation Cell 546

Tumor Escape Mechanisms 547

Interleukin-2 548

Biological Activity 548

Indications of Interleukin-2 549

Interferons 550

Bacillus Calmette-Guerin 551

Cancer Vaccines 551

Major Histocompatibility Complex 552

Immunoadjuvants 553

Human Papillomavirus 553

Prostate Cancer 554

Clinical Studies of New Vaccines 554

Key Terms 556

Bibliography 556

18 Gene Therapy 559

Gene Therapy Regulation 559

Cancer Gene Therapy 560

Cancer Gene Therapy Protocols 560

Tumor-Directed Gene Therapy Protocols 560

Suicide Gene Therapy 560

Tumor-Suppressor Gene Therapy 561

Antisense Oligonucleotides 561

Oncolytic Viral Gene Therapy 562

Active Immunotherapy 562

Tumor-Infiltrating Lymphocytes 562

Cytokine Genes 563

DNA Vaccines 563

Adoptive Immunotherapy 563

Chimeric Receptors 564

Tumor-Specific T Cells 565

Pharmacogenetics and Pharmacogenomics 565

Ethical, Social and Legal Issues 566

Key Terms 569

Bibliography 569

Glossary 571

Index 593