Whilst the concept of early detection and prevention of cancer is an attractive one there are many questions which remain unanswered. For example, what are the causes of pre-invasive lesions, are they as a result of inherited genetic susceptibility or environmental factors, and how then can we use this information to minimize risk? At a population level, one could intervene through promotion of a healthier diet or smoking cessation programmes; at an individual level, one could implement screening programmes to identify individuals at increased risk due to pre-invasive lesions. Screening is already widely adopted for colon, cervix, and breast cancers but remains a controversial subject. It is hotly debated whether the magnitude of the risk justifies screening interventions which incur individual and societal costs, both fiscal and psychological. Once pre-invasive lesions are identified the clinician is faced with complex management decisions which might entail monitoring (surveillance), chemoprevention, or removal through endoscopic or surgical means.
There are currently exciting opportunities to revolutionise our approach to preinvasive disease with an explosion of technological advances for understanding the cancer genome at an increasing level of detail. Clinical modalities have also progressed rapidly with the advent of new imaging and therapeutic options which incorporate knowledge of the molecular characteristics of the disease. Surgery is becoming less and less invasive and minimally invasive approaches using endoscopy and laparoscopy are ideally placed to treat small, early lesions.
Whilst cancer is widely studied and written about, pre-invasive disease has lagged behind. In addition, discourse on basic biology and clinical approaches to pre-invasive disease are seldom brought together. The purpose of this monograph is to bring together expert knowledge on this area in one volume.
Contents
Part I Pathogenesis
1 Stem Cells in Intraepithelial Neoplasia
2 The Inflammatory Tissue Microenvironment and the Early Stages of Malignancy
3 Hereditary Factors and Pre-invasive Disease
4 Epigenetic Alterations as Contributors to the Pathogenesis, Detection, Prognosis and Treatment of Human Pre-Neoplasia
5 The Progression of Pre-Invasive to Invasive Cancer
6 Contribution of the-Omics Era to our Understanding of Pre-Invasive Disease and Progression to Cancer
7 Somatic Evolution in Neoplastic Progression and Cancer Prevention
Part II Model Systems and Clinical Approaches
8 Precancer in animal Models: Sequentially Acquired or Predetermined
9 Biomarkers for Detection of Intra-epithelial Neoplasia
10 Molecular Imaging of Cancer and the Implications for Pre-Invasive Disease
11 Chemoprevention
12 Endoscopic Treatment of Early Lesions with Particular Reference to Barrett’s Oesophagus
13 Psychosocial Outcomes of Screening for Cancer and Pre-invasive Disease
Part III Disease Specific Examples
14 Pre-invasive Disease of the Lung
15 Progress in Early Detection and Management of Oral Dysplasia: Components for a Multifaceted Progression Risk Model
16 Barrett’s Oesophagus
17 Helicobacter Infection: Infection, Immunity and the Progression of Lesions to Invasive Gastric Cancer
18 Pathways and Crossroads to Colorectal Cancer
19 Precursor Lesions of Pancreatic Cancer
20 Breast: Ductal Carcinoma in Situ (DCIS)
21 Molecular Pathogenesis, Detection and Clinical Management of Pre-invasive Cervical Lesions
22 Pre-malignant Disease in the Prostate
Part IV Common Threads
23 Early Disease, Early Detection, Early Treatment: Some Common Threads and Some Important Problems
Index
Product Details
- Hardcover: 519 pages
- Publisher: Springer; 1st edition (October 15, 2010)
- Language: English
- ISBN-10: 1441966935
- ISBN-13: 978-1441966933
- Product Dimensions: 9.2 x 6.2 x 1.4 inches