Cancer secondary malignancy

The retinoid isotretinoin (68) has been found to reduce the incidence of secondary malignancies in patients treated for head and neck cancer. In addition, the use of trans-m m.oic acid in patients having M3 leukemia has been reported to induce complete, although temporary, remissions (32). 

Risk factors for the development of AML include exposure to environmental toxins, Hispanic ethnicity, and genetics.6 Of greater concern is the increased prevalence of AML as a secondary malignancy, resulting from chemotherapy and radiation treatment for other cancers. Alkylating agents, such as ifosfamide and cyclophosphamide, and topoisomerase inhibitors, such as etoposide, are linked to an increased risk of myelodysplastic syndrome (MDS) and AML.8... 

Ionizing radiation therapy is also a cause of secondary malignancies. These secondary tumors generally develop within or adjacent to the previous radiation field. These cancers often have... 

Now that 80% or more of children survive their primary cancers, the incidence of secondary neoplasms may increase. Recognizing this potential, many treatment regimens for children are being modified appropriately to reduce exposure to alkylators, topoisomerase inhibitors, and radiation. Late effects clinics screen for secondary malignancies and other disease and treatment-related disabilities that accompany childhood cancer. Similar screening and educational opportunities are not currently established in adult survivors. 

Long-term complications of radiotherapy, chemotherapy, and chemora-diotherapy include gonadal dysfunction, secondary malignancies, and cardiac disease. Patients treated for HL are at increased risk of developing leukemia, GI tumors, lung cancer, and breast cancer. 

Alkylating agents have been implicated in the causation of secondary tumors, including acute myeloid leukemia, myelodysplastic syndromes (69), solid tumors (70,71), Hodgkin s disease (72,73), ovarian cancer (74,75), and gastric cancer (69). Survival from the time of diagnosis of secondary malignancies is usually very short (69). 

Long-term complications of cancer treatment, such as infertility, secondary malignancies, effects on physical or intellectual development, and major organ damage, can negatively affect health and quality of life for cancer survivors. 

Hemorrhagic cystitis Moderately emetogenic worse with high doses nausea may be delayed 12-24 hours myelosuppression alopecia SIADH, typically with high doses (>2 g/m ) secondary malignancies (bladder cancers, acute leukemia) infertility, sterility... 

With the advent of modem radiotherapy, survival rates of people with certain types of cancers have increased significantly. Unfortunately, the side effects of radiation impose devastating effects on the quality of life of cancer patients. Moreover, radiation therapy often leads to secondary malignancies such as melanoma, medullablastoma, soft-tissue... 

Secondary malignancies (metastatic tumors) should be suspected in patients with a known diagnosis of cancer and present with new-onset priapism (involvement of the corpora cavernosa) or an unusual penile lesion. Metastatic lesions are often multiple, palpable, painless nodules that may mimic syphilitic chancres. The primarymalignancy is most often bladder, prostate, rectosigmoid areas, and the kidney, in 32, 30, 13, and 8%, respectively, and it is spread most commonly by retrograde venous dissemination (Hizli and Berkmen 2006). 

Primary and secondary malignant hepatic tumors are a major health problem worldwide. While metas-tases are common in western countries, primary liver cancers are frequently diagnosed in Asia and Africa. However, recent data suggest that the incidence and mortality of hepatocellular carcinoma (HCC) in Western nations are on the rise (Taylor-Robinson et al. 1997 Llovet et al. 2003). Likewise, the liver is the most common site for metastases. In 25%-50% of patients with malignancies liver metastases were observed at autopsy (Bernardino et al. 1982). The most frequent primary sites are colon, breast, pancreas, and lung. In the case of colorectal metastatic disease, the liver is the only metastatic site in 20%-30% of patients (Sasson and Sigurdson 2002). 

The parenchyma must be carefully screened for the presence of primary or secondary malignant disease. Most patients awaiting transplantation are cirrhotic, with a high risk of developing hepatoma, and as many as 20% of these patients will develop HCC (Fig. 4.2.6). Patients diagnosed with small hepatic cancer are moved up the transplantation list. On the basis of the natural doubling time of hepatoma, it has... 

Thus, expression of CXCR4 on tumor cells, which is common to many breast cancers as well as other cancer types, may contribute to malignant behavior in several ways. CXCR4 expression by tumor cells may interact with CXCL12 to facilitate tumor cell growth and escape from oxygen starvation-induced apoptosis and as a mechanism to home (metastasize) to secondary sites. 

It is important to state that not all malignant tumors give rise to metastases. Basal cell carcinoma of the skin, while capable of local invasion, rarely produces secondary growths. However, most other cancers give rise to metastases at some... 

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