Oncology1. Historical background ONCOLOGY science that deals with the study of tumors Greek words ONKOS tumor, mass LOGOS - study Study of cells with changed proliferative behavior due to basic reasons still unknown Cells that have lost their response to the influence of the normal control mechanism of the surrounding tissues 18th century Knowledge of neoplastic disease is limited to observation alone because of lack of technology Hallmark: discovery of scrotal skin cancer among chimney sweeps Sir Percival Pott 19th century Discovery of the microscope world of cells 1838, Johannes Muller cellular morphology 1847, Rudolf Virchow theory of local irritation 1882, Halsted 1st radical mastectomy 1887, Julius Cohnheim theory of embryonal rest 20th Century Further discoveries in the fields of biochem, patho, physio 1915-1918, Yamagiwa and Ichikawa hydrocarbons as carcinogens 1924-1932, Kennaway and Cook 3,4 benzopyrene as chemical carcinogen Viruses were linked to CA, such as virus causing sarcoma in chicken John Hunter and Berthold action of endocrines in prostate glands 1940, Higgins and Clasrk demonstrated that prostate tumors are androgen dependent and estrogen controlled Beatson and Schinzinger related breast CA and ovaries En bloc resection of the organ together with its draining lymph nodes 1950s organ transplantation

2. Divisions of Oncologya. Research Laboratory methods Clinical procedures Epidemiology b. Clinical Medical oncology Surgical oncology Radiologic oncology Immunotherapyc. Social Education and training Rehabilitation Prevention

3. Surgical oncology Deals with surgical principles applied in the treatment of malignant diseasses Surgeon is often responsible do r the initial diagnosis and management of solid tumors Modern cancer therapy : multidisciplinary Surgeons + medical oncologist + radiation oncologist + reconstructive surgeons + pathologists + radiologists + primary care physicians Primary )definitive) surgical therapy : en bloc resection + adequate margins of resection + regional LN dissection if necessary Adjuvant therapy: Chemo, RT, Hormonal, immunotherapy, biologic therapy Locoregional control: surgery or RT Systemic control: chemo, HRT, immunotherapy

4. Epidemiologya. Global statistics 2002: 10.9M new cancer cases estimated worldwide Lung CA most common 1.35M new cases 1.15M deaths/yr Breast CA- 2nd most common 1.15M cases/yr 5th most common cause of death Leading causes of death from cancer: Lung Gastric Liver Colorectal Breast

b. Stomach Cancer Incidence varies among different regions of the world: Japan: 62.1/100000 men; 26.1/100000 women North America: 7.4/100000 men; 3.4/100000 women Africa: 3.4-4.4/100000 men; 2.5-3.6/100000 women Varied incidence attributed to: Dietary Habits High consumption of preserved salted foods )meat, pickles) increases risk Consumption of fruits and vegetables decrease risk Prevalence of Helicobacter Pylori infectionc. Breast Cancer High incidence in developed countries (USA, Canada, Australia, Northern and Western Europe) 82.5-99.4/100000 women annually Low incidence in most of Africa and Asia: