Friday, March 11, 2016

Cancer diagnosis and chemotherapy Part-2 (AIDS Related Cancers)

Part-1 of series focused on diagnosis method for 12 most common cancer types. In the present series we have discussed about the other forms of cancers.  For the easement of reading about the cancer diagnosis procedure we have divided the series in segments. In this part of this series we will be discussing about AIDS (Acquired Immune Deficiency Syndrome) related cancer. There are three cancers that commonly occurs due to AIDS such as a) Kaposi Sarcoma, b)AIDS related lymphoma and c) Cervical cancer. Figure 1 shows incidence rates of all three types of AIDS related cancers. It indicates that NHL
Figure 1:  Incidence Rate of AIDS related cancers

a) Kaposi Sarcoma

Kaposi sarcoma is cancer where cells lining lymphs or blood vessels. It is marked by formation of black or purple colored lesions on skin or soft tissues. They usually appear on face and legs. These lesions are painful and swells. It is also possible to have such lesions/ tumors on soft tissues like mouth, lungs, digestive track or lymph nodes. There are different forms of Kaposi Sarcoma  that are divided by American Association Of Cancer based on the region they are formed viz. Epidemic AIDS related Kaposi Sarcoma, Mediterranean Kaposi Sarcoma, Endemic Kaposi Sarcoma, and Transplant related Kaposi Sarcoma. However, the Kaposi Sarcoma cells remain similar.

b) AIDS related Lymphoma

Lymphoma cancer is a type of problem cased due to uncontrolled growth of cells in lymph nodes. There are two types of lymphomas a) Hodgkin and b) Non-hodgkin lymphoma (NHL). People with Hodgkin lymphoma have abnormally large lymphocytes in lymph nodes. People with Hodgkin lymphoma can be cured easily. Whereas, Diagnosis method and treatment for NHL was discussed previously here. 

c) Cervical cancer

It is a cancer of cervix in females. The cells in cervix do not choiange suddenly change to cancerous. They convert to precancerous such as i) cervical intraepithelial neoplasia (CIN), ii) squamous intraepithelal lesion (SIL) and iii) dysplasia. These precancerous conditions changes to squamous cell carcinoma (where exocervix joins endocervix) and adenocarcinoma (mucus producing cells of endocervix). Cervical adenocarcinoma is most common type of cancers.

Table 1: Diagnosis & Therapy of AIDS Related Cancer


Cancer TypeTissue BiopsyBlood TestsBiomarker and Gene mutation TestsUrine TestImaging TestsOther Tests
Kaposi SarcomaPunch biopsy for skin lesionNANANAX-RaysNA
Excisional biopsy if entire lesion is removedBronchosopy
Bronchosopy or endoscopy is done for biopsy of lungs and intestinesUpper endoscopy
Colonoscopy
Capsulescopy
Double balloon enteroscopy
Hodgkin LymphomaExcisional or incisional biopsy of lymph node (microscopic identification of Reed-Sternber cells)NACD15 and CD30 positive on surface of Reed-Sternberg cellsNANANA
Fine needle aspiration (FNA) or core needle biopsy
Bone marrow aspiration and biopsy
Non-Hodgkin Lymphoma (NHL)Discussed Previously
Cervical CancerPap TestNANANACystoscopy, proctoscopy, and examination under anesthesiaNA
Colposcopic biopsyMRI
Endocervical curettageCT Scan
Cone biopsyChest X-ray
Intravenous Urography

Table 2: Chemotherapy for AIDS related cancers



CancerChemotherapySide Effects
Kaposi SarcomaDoxorubicinWeaknening of heart muscles causing decrease in blood pumping capacity
Daunorubicin
PaclitaxelPeripheral neuropathy, allergic reactions, low blood counts, low blood pressure
Gemcitabineflu like symptoms, fatigue, blood or protein in urine
VinorelbineMuscle weakness

VinblastineFever,extreme fatigue, black or tarry stools, chest pain, presistant headache, urinary retention
VincristineAbdominal cramps, peripheral neuropathy, severe abdominal pain, constipation
EtoposideMenopause, loss of fertility, peripheral neuropathy
Hodgkin LymphomaDoxorubicinDISCUSSED PREVIOUSLY
VinblastineDISCUSSED PREVIOUSLY
DacarbazineSlight risk of leukemia, fever, low blood counts leading to increased the risk of anemia
EtoposideMenopause, loss of fertility, peripheral neuropathy
CyclophosphamideLoss of fertility, discoloration of nails
Procarbazinelow platelet and white blood cell counts
PrednisoneIncreased apetite, insomnia, heartburn, muscle weakness
MechlorethamineRinging sensation in ears, taste change, increased uric acid levels
VincristineDISCUSSED PREVIOUSLY
Non Hodgkin Lymphoma (NHL)
Cervical CancerCisplatinPeripheral neuropathy (nerve damage)
5-fluorouracilCardiovascular problems
CarboplatinPeripheral neuropathy, central toxicity, hearing loss, infection
PaclitaxelDISCUSSED PREVIOUSLY

GemcitabineDISCUSSED PREVIOUSLY
DocetaxelPain and buring sensation in hand and feet, sensitivity to cold and heat
IfosfamideNeurotoxicity and there is a risk of developing leukemia
MitomycinPulmonary fibrosis, pneumonitis, hemolytic uremic syndrome
IrinotecanHeart burn, dehydration, head ache, flatulence

Thursday, February 18, 2016

Insilico Medicine launches Aging.AI -- deep-learned predictor of age trained on blood tests

Insilico Medicine launches Aging.AI -- deep-learned predictor of age trained on blood tests: Insilico Medicine launched aging.AI, a system allowing users to guess their age and gender by entering the results of their blood test.

Thursday, January 21, 2016

Chemotherapy for Most Common Cancers- Part 1

In part-1 of this series we are focusing on drugs that are used for most common cancer types that are discussed in our most viewed piece "Clinical Diagnosis of Cancer or Cancers"

Figure 1: Commonly diagnosed cancers. It shows estimated cases and
deaths due to these cancers


In our previous discussions, we showed how Oncofinder service introduced by Insilco Inc and Pathway Pharmaceutical helps in identification of chemotherapy drugs for patients on personalised basis. This se
rvice is accessible to patients and doctors. In addition we observed that in many cancer discussion forums there is a great confusion and anxiety about the use of correct chemotherapy.

Moreover, there were flooded with following questions:

a) What type chemotherapy to be used for breast cancer, pancreatic cancer etc.?
b) If "A" molecule worked for a specific person will it work in my case?
c) What are the specific side effect or toxicity of drug?
Figure 2: Word Cloud for Chemotherapy Drugs
d) Is there any alternative to "drug A" if it does not work in a cancer condition?
e) What are the new drugs introduced for cancer therapy?

To answer all these questions we have compiled a list of drugs that are being used for most common type of cancers in table 1. Further, we have also linked it to reliable sources so that readers can cross refer to the authenticated links for more details about side effects and pharmacology of the drugs used. Readers can also click on cancer types to locate the details of the therapies recommended for cancer type.


Most commonly seen side effects of chemotherapy are

a) Weight loss
b) Gastrointestinal abnormalities like diarrhoea and constipation
c) Hair loss
d) Severe muscles fatigue
e) Nausea and vomiting
f) loss of appetite
g) Rashes

In addition to this there are some serious and less common toxicities for specific drugs. We have listed them in the table 1. Readers can also cross check them by clicking on the drug type.

Table 1: Chemotherapy Drug and Its Side Effects


CancerChemotherapy Molecules/ DrugsSevere Side Effects
Bladder Fluorouracil (5-FU)Cardiovascular problems
MitomycinPulmonary fibrosis, pneumonitis, hemolytic uremic syndrome
CisplatinPeripheral neuropathy (nerve damage)
CarboplatinPeripheral neuropathy, central toxicity, hearing loss, infection
DocetaxelPain and buring sensation in hand and feet, sensitivity to cold and heat
DoxorubicinWeaknening of heart muscles causing decrease in blood pumping capacity
Vinblastin
Ifosfamide (Ifex ®)Neurotoxicity and there is a risk of developing leukemia
Permetrexed (ALIMTA ®)Low blood platelet count, flu like symptoms, depression, increase in blood creatinine level
Breast CancerDocetaxel ( Taxotere®)DISCUSSED PREVIOUSLY
PaclitaxelPeripheral neuropathy, allergic reactions, low blood counts, low blood pressure
Cisplatin and CarboplatinDISCUSSED PREVIOUSLY
VinorelbineMuscle weakness
Capecitabine (Xeloda®)Elevated liver enzymes, hand and foot syndrome (Palmar plantar erythrodysesthesia-PPE)
DoxorubicinDISCUSSED PREVIOUSLY
Gemcitabineflu like symptoms, fatigue, blood or protein in urine
MitoxantroneArrythmia, low blood pressure, blue/green discoloration of whites of eyes/ or urine for 1-2 days after treatment
IxabepilonePeripheral neuropathy, weakness, joint pain
Eribulin (Halaven ®)Constipation, muscle pain
Trastuzumab (Herceptin ®)Infection, cold symptoms, body pain
Pertuzumab (Perjeta™)Decreased apetite, fever, muscle weakness, weight gain, upper respiratory track infection
Colon Rectal Cancer5-FUDISCUSSED PREVIOUSLY
Capecitabine (Xeloda®)DISCUSSED PREVIOUSLY
Irinotecan (Camptosar®)Heart burn, dehydration, head ache, flatulence
OxaliplatinPeripheral neuropathy, diarrhea
TrifluridinNeuropathy
Endometrial CancerPaclitaxelDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
Doxorubicin (Adriamycin ®) DISCUSSED PREVIOUSLY
Doxorubicin liposome (Doxil ®)DISCUSSED PREVIOUSLY
CisplatinDISCUSSED PREVIOUSLY
Ifosfamide (Ifex ®)DISCUSSED PREVIOUSLY
DISCUSSED PREVIOUSLY
Kidney CancerVinblastineFever,extreme fatigue, black or tarry stools, chest pain, presistant headache, urinary retention
FloxuridineStomach ulcers, elevated liver enzyme, PPE, yellowing of skin and eyes
5-FUDISCUSSED PREVIOUSLY
CapecitabineDISCUSSED PREVIOUSLY
GemcitabineDISCUSSED PREVIOUSLY
Interferone alpha (Intron® A, Roferon®-A )Flu like symptoms, fatigue and low blood counts, injection site reaction, liver damage
Nivolumab (Opdivo)Lymphocytopenia, low sodium, potassium, magnesium levels, shortness of breath, pneumonia,
Interleukin 2 (IL-2)Extreme fatigue, low BP, kidney damage, heart attacks, intestinal bleeding, rapid heart beat
Soforanib (Nexavar ®)PPE, high BP, bleeding, increased heart rate, shortness of breath
Sunitinib (Sutent ®)Heart burn, hypertesnsion, increased liver enzyme
Temsirolimus (Torisel ®)Hyperglycemia, increased cholesterol levels, increased liver enzymes, black tarry stools, constipation
Everolimus (Afinitor ®)Anemia, increased cholesterol and triglycerides, black tarry stools
Bevacizumab (Avastin ®)Upper respiratory track infection, proteinuria, gastrointestinal perforations, fistula, hemorrhage, congestive heart failure
Pazopanib (Votrient ®)Hypertension, elevated liver enzymes, bilirubin, extreme fatigue
Axitinib (Iniyta ®)High bloood pressure, kidney disfunction
Leukemia (Chronic Lymphocytic Leukemia)Fludarabine (Fludara ®)Increased risk of infection
Pentostatin (Nipent ®)Easy bruising or bleeding
Cladribine (2-CdA, Leustatin ®)Fatigue
Chlorambucil (Leukeran ®)Tumor lysis syndrome
Cyclophosphamide (Cytoxan ®)Loss of fertility, discoloration of nails
Rituximab (Rituxan ®)Pharyngitis
Bendamustine (Treanda ®)Infertiliy, yellow of skin or eyes
Prednisone Increased apetite, insomnia, heartburn, muscle weakness
MethylprednisoloneAlmost similar to prednisone
DexamethasoneAlmost similar to prednisone
Doxorubicin (Adriamycin ®)DISCUSSED PREVIOUSLY
MethotrexateAlopecia, skin photosensitivity, kidney toxicity
OxaloplatinPeripheral neuropathy
Vincristine (Oncovin ®)Abdominal cramps, peripheral neuropathy, severe abdominal pain, constipation
Etoposide (VP-16)Menopause, loss of fertility, peripheral neuropathy
Cytarabine (ara-C)Skin Rash, blurred visions, dry eyes heart palpitations, chest pain, difficulty to pass urine
Leukemia (Acute Lymphocytic Leukemia)Vincristine (Oncovin ®) or Liposomal vincristine (Marqibo ®)DISCUSSED PREVIOUSLY
Daunorubicin (Daunomycin or Cerubidine ®) or Doxorubicin (Adriamycin ®)DISCUSSED PREVIOUSLY
Cytarabine (Cytocine arabinoside, ara-C or Cytosar ®)DISCUSSED PREVIOUSLY
L-asparaginase (Elspar ®) or PEG-L-asparaginase (pegaspargase or Oncaspar ®)DISCUSSED PREVIOUSLY
Etoposide (VP-16)DISCUSSED PREVIOUSLY
Teniposide (Vumon ®)Infection, shortness of breath, swelling of facial features, rapid heart beat
6-mercaptopurine (6-MP or Purinethol ®)Losss of fertility, hyperpigmentation
MethotrexateDISCUSSED PREVIOUSLY
Cyclophosphamide (Cytoxan ®)DISCUSSED PREVIOUSLY
PrednisoneDISCUSSED PREVIOUSLY
Dexamethasone (Decadrone ®)DISCUSSED PREVIOUSLY
DISCUSSED PREVIOUSLY
Leukemia (Chronic Myeloid Leukemia)Hydroxy urea (hydroxycarbamate, Hydrea ®)Discoloration of skin and nails, fertiilty may be affected
Cytarabine (Ara-C)DISCUSSED PREVIOUSLY
Imatinib (Gleevec ®)Risk of anemia, hemorrhage, heartburn, fertiility may be affected, elevation of transaminase, bilirubin and lactate dehydrogenase
BusulfanLung Damage
Cyclophosphamide (Cytoxan ®)DISCUSSED PREVIOUSLY
Vincristin (Oncovin ®)DISCUSSED PREVIOUSLY
Omacetaxine (Synribo ®)Thromocyteopenia, neutropenia, kidney problems, fever
Non Small Cell Lung CancerCisplatinDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
Paclitaxel (Taxol ®)DISCUSSED PREVIOUSLY
Albumin- bound Paclitaxel (nab-Paclitaxel, Abraxane ®)DISCUSSED PREVIOUSLY
Docetaxel (Taxotere ®)DISCUSSED PREVIOUSLY
Gemcitabine (Gemzar ®)DISCUSSED PREVIOUSLY
Vinorelbine (Navelbine ®)DISCUSSED PREVIOUSLY
Irinotecan (Camptosar ®)DISCUSSED PREVIOUSLY
Etoposide (VP- 16 ®)DISCUSSED PREVIOUSLY
Vinblastine DISCUSSED PREVIOUSLY
Pemetrexed (Alimta ®)Anemia, increased risk of infection, flu like symptoms, fertility problems
Bevacizumab (Avastine ®)DISCUSSED PREVIOUSLY
Cetuximab (Erbitux ®)Hypersenstivity reactions like shortness of breath, difficulty breathing
Melanoma CancerDacarbazine (also called DTIC)Slight risk of leukemia, fever, low blood counts leading to increased the risk of anemia
TemozolomideCentral neurotoxicity, edema, shortness of breath and other allergic reactions
Nab-paclitaxelDISCUSSED PREVIOUSLY
PaclitaxelDISCUSSED PREVIOUSLY
Carmustine (also known as BCNU)Anemia, low blood pressure, retinal bleeding, pulmonary toxicity, slight risk of blood cancer in long run
CisplatinDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
VinblastineDISCUSSED PREVIOUSLY
Non Hodgkin LymphomaCyclophosphamide (Cytoxan®)DISCUSSED PREVIOUSLY
ChlorambucilRisk of infection, anemia, leukemia, infertility, pulmonary toxicity
Bendamustine (Treanda®)DISCUSSED PREVIOUSLY
Ifosfamide (Ifex®)DISCUSSED PREVIOUSLY
PrednisoneDISCUSSED PREVIOUSLY
Dexamethasone (Decadron®)DISCUSSED PREVIOUSLY
CisplatinDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
OxaliplatinDISCUSSED PREVIOUSLY
Fludarabine (Fludara®)Lung problems, infections, anemia
Pentostatin (Nipent®)Muscle ache, itching, cough, anorexia, upper respiratory track infection
Cladribine (2-CdA, Leustatin®)Anemia, myelosuppression, neutropenic fever
Cytarabine (ara-C)DISCUSSED PREVIOUSLY
Gemcitabine (Gemzar®)DISCUSSED PREVIOUSLY
MethotrexateDISCUSSED PREVIOUSLY
Pralatrexate (Folotyn®)Decreased white blood cells, elevated liver enzyme, abdominal pain, upper respiratory track infection, shortness breath
Pancreatic CancerGemcitabine (Gemzar®)DISCUSSED PREVIOUSLY
5-FUDISCUSSED PREVIOUSLY
Irinotecan (Camptosar®)DISCUSSED PREVIOUSLY
Oxaliplatin (Eloxatin®)DISCUSSED PREVIOUSLY
Albumin-bound paclitaxel (Abraxane®)DISCUSSED PREVIOUSLY
Capecitabine (Xeloda®)DISCUSSED PREVIOUSLY
CisplatinDISCUSSED PREVIOUSLY
Paclitaxel (Taxol®)DISCUSSED PREVIOUSLY
Docetaxel (Taxotere®)DISCUSSED PREVIOUSLY
Irinotecan liposome (Onivyde®)DISCUSSED PREVIOUSLY
Erlotinib (Tarceva®) Shortness of breath, coughing, infection, eye irritation
Octreotide (Sandostatin®)Flu like syndrome, abdominal pain, constipation, flu-like syndrome
Lanreotide (Somatuline® Depot),Anemia, effects blood sugar levels
Prostate CancerDocetaxel (Taxotere®)Allergic reactions and peripheral neuropathy
Cabazitaxel (Jevtana®)Allergic reactions and peripheral neuropathy
Mitoxantrone (Novantrone®)Can cause leukemia several years later
Estramustine (Emcyt®)Increased risk of blood clot formation
Doxorubicin (Adriamycin®)DISCUSSED PREVIOUSLY
Etoposide (VP-16)DISCUSSED PREVIOUSLY
Vinblastine (Velban®)DISCUSSED PREVIOUSLY
Paclitaxel (Taxol®)DISCUSSED PREVIOUSLY
Carboplatin (Paraplatin®)DISCUSSED PREVIOUSLY
Vinorelbine (Navelbine®)DISCUSSED PREVIOUSLY
Thyroid CancerTositumomab and Radioactive Iodine (RAI) (Bexxar ®)Low blood pressure, cough, soar throat, hyopthyrodism, aches and pain

thyroid hormone (levothyroxine) pillsExtreme fatigue, chest pain, eye pain, dizziness    

Monday, December 28, 2015

Finding Appropriate or Personalised Chemotherapy (OncoFinder)


Pathway Pharmaceuticals Inc has a unique sell out used by physicians to help > 800 cancer patients in Asian and European countries for not only diagnosis cancer severity at molecular level but also to find out the specific drugs.

For cancer patients are usually under severe time crunch


Time spent is directly proportional the therapeutic efficiency. Quick diagnosis with correct therapy, provides greater chance to attain the cancer free state. Following are some important points stated by Cancer Research UK for early diagnosis of cancer:

a) 9/10 bowel cancer survives > 5 years if diagnosed in early stage
b) >90% breast cancer females survives atleast for 5 years compared to around 15% diagnosed in more advanced stage
c) >90% ovarian cancer females survives atleast for 5 years compared to around 5% diagnosed in advanced stage
d) Around 70% of patients with lung cancer will survive for atleast a year if diagnosed at early stage compared to 14% patients diagnosed with early sage condition.   (Ref)                                                                                           

Most of the time late diagnosis is attributed to a) delay in going to doctor or b) delay in diagnosis of disease and cancer type. Moreover, a recent study published showed that the condition worsens  for prostate cancer if wrong chemotherapy is given. This may also be possible for other cancer types as well. Suboptimal therapy may also lead to wastage of time to treat cancer efficiently. This may also increase the chance of recurrence of cancer or development drug resistance.                                                                                                                         

Quick identification of correct anticancer drug is need of an hour

In the previously published recommended diagnostic tests for most common cancer types; I had discussed about the most commonly used commercial methods in hospitals. Timely use of these methods helps in early diagnosis of cancer. But incorrect therapy can prove to be a spoiler. 

Oncofinder helps in determination of potential chemotherapy based on cancer type


Oncofinder is a computer aided, chemotherapy identification tool that is used by around four companies in United States, Asia and Europe as shown in figure below. Video provided shows the way by which Oncofinder works.


So basically with he help of Oncofinder computer does analyses of gene expression data from patient's tissue sample and provides best possible choices of drugs that can work on the patient's cancer condition. The method is validated on 240 patients and it works significantly. 

Patients interested to use Oncofinder identification of best possible anti-cancer drug can be accessed from here or via Pathway Pharmaceuticals. Oncofinder report generated for anti-cancer drugs can be seen here.  Oncofinder provides a unique personalised method for identification of anti-cancer drug suitable for patients based on their genetic make up or expression profiles. 

Sunday, December 20, 2015

In-Silico mergers & Drug Repurposing In Anti-Cancer Research

In our previous story on In Silico Inc mediated personalised medicine we had provided details on how this pharmaceutical company is gaining scientific momentum to come up with newer methods to fight cancer and ageing. It is important to note that while working with computers people often experience problems with simple methods analysis of large datasets. Further, it is also important that more companies should work with hand in hand in pursuit of single solution to fight against cancer and ageing. 


Recently, a Belgium based company, In SilicoScreen announced merger with In Silico Inc. We know that ageing and cancer are inter-related problems. And it is an extremely controversial concept if we can consider ageing a disease or not? But imagine 100 years ago if  some one would have said that man can fly; people would have seen that person with same gaze as they do when we say that there is a chance that ageing can be reversed.  It strengthens our belief when more people invest their precious time in solving most important and crucial problem of ageing.



In a recent press release of Eureka alert Quentin Vanhaelen, PhD, founder and ex-CEO of InSilicoScreen said he was happy to work with In Silico Inc. "The sole aim was to build models of human ageing and regenerative processes to find new interventions and test the current ones on multiple levels from single cells to entire organs".

Additionally  to the this merger we know that drug repositioning or finding newer application to the existing pool of approved drugs has been one the most economic and smarter way of using drugs. One of the most common example is Rapamycin once used as anti fungal is now used fighting cancer by targeting mTOR pathway. 

In the recent press release made in Interprise Tech Insilco Inc has been using Graphic Processing Unit (GPU)-accelerated NVIDIA for finding newer and faster ways of finding newer application for existing pool of 20,000 medicines that are already in use in market. They have their four DevBox desktop supercomputer, using TESLA K80 GPU accelerators and four Titan X graphics cards for a total of 28TF of processing power. 

Drug discovery is a tedious and time consuming process. In Silico Inc's newer idea has caught attention of investors (Deep Knowledge Ventures, Hong Kong), Industry Analysts and Pharmaceutical Companies. In Silico Inc. talks about the deep neural net concept of finding solution to anti ageing and age related problems. Various most commonly explored tools of the company includes

a) Deep Pharma: GPU based virtual laboratory to simulate tissue based testing of compounds on diseased or aged cells.

b) Onco finder: For checking the efficacy of anticancer drugs on patients cancer samples.

Onco finder is a decision making tool for doctors, which helps them to decide what type of anticancer to be used in specific cancer case. 
Important ongoing projects: Insilco's first project is to research on ageing of skin. It includes studying the impact of ultraviolet radiation on skin. Dr. Zhavaronkov said that Insilco have predicted few compounds, which may improve skin ageing that may be announced next year. They said if we can change the condition for skin then there is a possibility to do the same for other tissues of human body.

Additional info can be read from here:

http://www.enterprisetech.com/2015/12/09/gpu-accelerated-deep-neural-nets-look-for-cures-that-already-exist/

Saturday, December 5, 2015

Clinical Diagnosis of Cancer or Cancers



figure 1: Commonly diagnosed cancers. It shows estimated cases and
deaths due to these cancers
There is a major problem on internet discussion forums on the understanding of cancer. Some people say cancer as a general term but it is not a single disease we are dealing with. So let me clarify the meaning of cancer..

Cancer came from word "carcinoma". Cancer is not a single disease it is a generalised/ generic term used for multiple disease types. To simplify.. each organ in human body is made of a group cells with unique morphology and functional characteristics. As per nature each cell has definite life span. They are supposed to die after sometime. However, some of these group of cells has tendency to break the law of nature, go rogue and continue to multiply uncontrollably. This leads to formation of tumor like structures protruding out from the organs which we call cancer for e.g. Brain tumor, pancreatic tumor, breast tumor/ cancer, head and neck tumors and others.


Please note that all cancers can be tumours but vice versa is not true.

There are certain type of cancers where we don't see tumor formation for example Leukemia (blood cancer), stomach ulcers, skin cancer and others. It is important to note that each cancer type has its unique symptoms. Most common types of cancer, incidence rate and their death toll in America are discussed in detail by National Cancer Institute (NCI).

Most commonly seen basic symptoms that can be linked to cancer a
  1. Unexplained weight loss of 10 pounds or more
  2. Fever due to unknown reason. 
  3. Fatigue
  4. Severe chronic episodes of pain that does not go away.         
                                                                                                                    Details are available here.

We do not have single cure for cancer. But we do have relatively good therapies for it, which may or may not give favourable treatment. There are obvious reports which says that the same cancer from two different patients may behave differently to the same therapeutic regime. This mainly happens due to complex evolutionary advantage to cancer cells.

Commonly used diagnostic methods prescribed by American cancer society is given below. You can get more details on each tests by clicking on each cancer type.


Cancer TypeTissue BiopsyBlood TestsBiomarker and Gene mutation TestsUrine TestImaging TestsOther Tests
Bladder CancerYesYesNMP22 and BTA testUrine cytologyIntraveous Pyelogram
Immunocyt testUrine cultureRetrograde Pyelogram
UroVysion testUrine marker testsComputed Tomography (CT) Scan
Magnetic Resonance Imaging (MRI) Scan
Ultrasound
Breast CancerCore needle biopsyNANANAMammogramsNipple discharge examination
Fine needle aspiration (FNA)UltrasoundDuctal lavage and nipple aspiration
Surgical biopsyMRILymph node biopsy
Lymph node biopsy
Colon and Rectal CancerYesYesKRAS gene*NAColonoscopyLiver enzyme tests**
BRAF gene*MRImicrosatellite instability (MSI) testing
blood markers carcinoembryonic antigen (CEA) and CA 19-9CT Scan
Ultrasound
Positron Emission Ttomography (PET) Scan**
Angiography**
Chest X-ray**
Endometrial CancerYesYesCA 125 levels in bloodNAPelvic and transvaginal ultrasound (TVUS)Dilation and curettage (D&C)
Hysteroscopy
CT Scan
MRI
PET
Cytoscopy and proctoscopy
Kidney CancerFine Needle Aspiration and Core Needle BiopsyYes (check for polycythemia)NACyto analysis of urine sampleCT ScanBiochemical tests
Fuhrman gradeMRI
Ultrasound
PET Scan
Intravenous Pyelogram
Chest X-ray**
Bone Scan**
LeukemiaBone marrow aspiration and biopsyYes NANAmicroscopic examinationinationBiochemistry and coagulation tests
Lymph node biopsyX-raycytochemistry
Lumber puncture (spinal tap)CT Scanflow cytometry and immunohistochemistry
MRIPCR
Ultrasound
Gallium Scan and bone Scan**
Lung CancerNeedle biopsyYesEGFR testNAX-raySputum cytology
KRAS gene*CT ScanThoracentesis
ALK gene*MRIImmuno histochemistry (IHC)
ROS1 gene*Ultrasoundpulmonary function test
RET gene*PET Scan
Bronchosopy
Bone Scan**
MelanomaSkinYesBRAF gene*NAX-rayIHC
ShaveCT Scanfluoroscence insitu hybridization (FISH)
PunchMRIcomparative genomic hybridization (CGH)
Incisional and excisional biopsyPET Scan
Final needle aspiration (FNA)
Surgical lymph node
Sentinel lymph node
Non-Hodgkin LymphomaIncisional and excisional biopsyYesNANAX-rayflow cytometry
FNACT Scancytogenetics
Bone marrow aspirationMRIFISH
Lumber punctureUltrasoundPCR
Pleural or peritoneal fluid PET Scan
Gallium Scan
Bone Scan
Pancreatic CancerPercutaneous biopsyYesCA 19-9NACT ScanLiver function test
EndoscopyCEAMRI
surgical biopsygastrin measurementsabdominal ultrasound
glucagon measurementsendoscopic ultrasound
somatostatin measurementsEndoscopic retrograde cholangiopancreatography
pancreatic polypeptideMagnetic resonance cholangiopancreatography
vasoactive intestinal peptidePercutaneous transhepatic cholangiography
OctreoScan,
PET Scan
Angiography**
Prostate CancerProstate BiopsyProstate Specific Antigen (PSA)NANATransrectal ultrasound
Grading prostate Prostatic intraepithelial neoplasiaBone Scan
Lymph Node BiopsyAtypical small acinar proliferationCT Scan
Laparoscopic biopsyProliferative inflammatory atrophyMRI
FNAProstaScintTM Scan
Thyroid CancerThyroid gland biopsyYesThyroid function testNAUltrasoundVocal chord examinationination
T3 and T4 hormone levelRadioiodine Scan
ThyroglobulinX-ray
CalcitoninMRI
Carcinoembryonic antigenPET Scan

We have discussed more information on how ageing and its correlation with cancer. We are constantly working towards finding new ways of fighting these cancer types. Newest way is by personalised medicine. Pathway pharmaceuticals provides newer ways of diagnosis of cancer conditions please check here.

Tuesday, October 20, 2015

Cancer Research Funding And Major Questions


In my previous posts I have extensively reviewed about the importance of personalised medicine and companies which offers these services on commercial basis. This blog piece is intended for the health care professionals, academicians, students and post doctoral researchers to check about various opportunities in the field of cancer medicine and biology.

Identification of New Essential Genes In Human Genome 

A study was published recently in science magazine by collaborating efforts of MIT, Broad institute, Harvard Medical School and Whitehead Institute provided insight into bacterial clustered regularly interspaced short palindromic repeats (CRISPR) system to screen for genes required for proliferation and survival in human cancer cell.  Their efforts identified 300 genes most of them located in nucleolus that were previously uncharacterised. And most of the genes consists of domains associated to RNA processing. This study may play an important role in identification of novel potential drug targets for various cancers. Their results suggested the use of CRISPR-based screens and a general strategy for identifying liabilities in cancer cells.

Published work can be accessed here

Perhaps, this may also aid in the ongoing efforts of Personalised Cancer Medicine by Pathway Pharmaceuticals and Insilco Inc.


Recently, Cancer Research UK has announced £100 million for answering most important questions in the field of cancer medicine and biology. More details about this funding opportunity can be seen here.

Important questions in cancer research:

a) Vaccine therapy for cancer not caused by virus

b) Irradiate cancer caused by Epstein Bar virus

c) Preventing cancer by studying DNA damage caused by carcinogens

d) Diagnosis of cancer

e) Google street view for cancer

f) Targeting supper controller MYC gene

g) Development of smart drug for cancer therapy

More details of these important questions can be read from here.

Please post your suggestions and comments !!!


Signal Transduction Pathways

Signal Transduction Pathways
RTK, GPCR, GF, Cytokine, Wnt, Death Factors & Shh pathways