Clinical Cancer Prevention (eBook)

Contents 5
Allocating Cancer-Directed Expenditures: Tensions Between Prevention, Early Detection and Treatment is Unnecessary 11
1.1 Introduction 11
1.2 Our Life Expectancy and Cancer Success Stories 12
1.3 No Cure in Sight: Costs of Drugs, Gadgets, Genomics and Technology 12
1.4 Bending the Cancer Cost Curve 15
1.5 Conclusion 18
References 18
Lessons Learned from Prevention Programs: Different Endpoints Should Be Used in Secondary and Tertiary Prevention 20
2.1 Introduction 20
2.2 Methods 21
2.3 Results 22
2.4 Discussion 25
References 27
Biomarkers for Early Detection and as Surrogate Endpoints in Cancer Prevention Trials: Issues and Opportunities 30
Abbreviations 30
3.1 Biomarkers: What They Are and How They Are Applied 32
3.2 Breast Precancer and Cancer Prevention 37
3.3 Prostate Cancer Prevention 44
3.4 Colorectal Cancer Prevention 46
3.5 Lung Cancer Prevention 47
3.6 Conclusions 49
References 51
Targeting Polyamines and Inflammation for Cancer Prevention 57
Abbreviations 57
4.1 Introduction 58
4.2 Polyamines, Inflammation, and Cancer 58
4.3 Roles of Inflammation and Polyamines in Prostate Cancer 61
4.4 Roles of Inflammation and Polyamines in Colon Cancer 63
4.5 Roles of Inflammation and Polyamines in Other Cancers 67
4.6 Conclusions 68
References 68
Thinking About the Role ( Largely Ignored) of Heavy Metals in Cancer Prevention: Hexavalent Chromium and Melanoma as a Case in Point 73
5.1 Background 73
5.2 Major Risk Factors for Cutaneous Melanoma 75
5.3 Metals 77
5.4 Future Prospects 80
References 80
Hepatitis B Virus and Cancer Prevention 83
6.1 Infection and Cancer 83
6.2 Disease Burden of Liver Cancer 85
6.3 Hepatitis B Virus Infection and Hepatocellular Carcinoma 85
6.4 Cancer Prevention Against Hepatocellular Carcinoma 86
6.5 Hepatitis B Vaccination Program 87
6.6 Effective Reduction of Chronic HBV Infection by Universal Hepatitis B Immunization 87
6.7 The Effect on Liver Cancer Prevention by Vaccination 88
6.8 Problems and Strategies of Successful HCC Prevention by Hepatitis B Vaccination 89
6.9 Implications and Future Prospects 89
References 90
Chemoprevention of Hepatocellular Carcinoma in Chronic Hepatitis C 93
7.1 Hepatitis C 93
7.2 Hepatocellular Carcinoma 94
7.3 Prevention of Hepatocellular Carcinoma 95
7.4 Conclusions 105
References 105
Nutritional Aspects of Primary Prostate Cancer Prevention 108
8.1 Introduction 108
8.2 Dietary/Nutritional Factors 109
8.3 American Cancer Society (ACS) Guideline 112
8.4 Conclusions 113
References 113
Prostate Cancer Prevention with 5 Alpha- Reductase Inhibitors 115
9.1 Rationale for the Chemoprevention of Prostate Cancer 115
9.2 The Prostate Cancer Prevention Trial 116
9.3 Pathologic Characteristics of the Cancers in the Prostate Cancer Prevention Trial 116
9.4 Finasteride Increases Sensitivity of Prostate- Specific Antigen, Digital Rectal Examination and Biopsy Detection for Prostate Cancer 117
9.5 Side Effects of Finasteride 119
9.6 Conclusion 119
References 119
Hormone Replacement Therapy and Breast Cancer 121
10.1 Background 121
10.2 HRT Use in Women Diagnosed with Breast Cancer 122
10.3 HRT and Risk of Breast Cancer 124
10.4 HRT After Oophorectomy in Women Less Than 50 Years of Age 125
10.5 Coronary Heart Disease 126
10.6 Potential Biological Explanations 127
10.7 Conclusions 128
References 128
Physical Activity and Breast Cancer: Review of the Epidemiologic Evidence and Biologic Mechanisms 131
11.1 Epidemiologic Evidence 132
11.2 Biologic Mechanisms 138
11.3 Conclusion 141
References 142
Prevention of Breast Cancer by Newer SERMs in the Future 146
12.1 Introduction 146
12.2 Arzoxifene 147
12.3 Lasofoxifene 147
12.4 Discussion 148
12.5 Conclusions 149
References 149
Chemoprevention of Hormone Receptor- Negative Breast Cancer: New Approaches Needed 151
13.1 Introduction 152
13.2 Endocrine Preventive Agents 152
13.3 Selective Estrogen Receptor Modulators 152
13.4 Aromatase Inhibitors 155
13.5 New Strategies to Prevent Hormone- Independent Breast Cancer 156
13.6 Cell Growth Inhibitors 157
References 163