The concept that
medications could be used to prevent cancer is an attractive
one, and many high-quality clinical trials support the use of
such chemoprevention in defined circumstances.
Daily use of tamoxifen, a selective estrogen receptor modulator
(SERM), typically for 5 years, has been demonstrated to reduce
the risk of developing breast cancer in high-risk women by about
50%. A recent study reported that the selective estrogen
receptor modulator raloxifene has similar benefits to tamoxifen
in preventing breast cancer in high-risk women, with a more
favorable side effect profile.
Raloxifene is a SERM like tamoxifen; it has been shown (in the
STAR trial) to reduce the risk of breast cancer in high-risk
women equally as well as tamoxifen. In this trial, which studied
almost 20,000 women, raloxifene had fewer side effects than
tamoxifen, though it did permit more DCIS to form.
Finasteride, a 5-alpha-reductase inhibitor, has been shown to
lower the risk of prostate cancer, though it seems to mostly
prevent low-grade tumors. The effect of COX-2 inhibitors such as
rofecoxib and celecoxib upon the risk of colon polyps have been
studied in familial adenomatous polyposis patients and in the
general population. In both groups, there were significant
reductions in colon polyp incidence, but this came at the price
of increased cardiovascular toxicity.
Prevention Genetic testing
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Cancer
Classification
1. Nomenclature
2. Adult cancers
3. Childhood cancers
Signs and symptoms
Diagnosis
1. Investigation
2. Biopsy
Treatment
1. Surgery
2. Radiation therapy
3. Chemotherapy
4. Targeted therapies
5. Immunotherapy
6. Hormonal therapy
7. Symptom control
8. Complementary and alternative
9. Treatment trials
Prognosis
1. Emotional impact
Causes
1. Chemical carcinogens
2. Ionizing radiation &
Infectious diseases
3. Hormonal imbalances
& Immune system dysfunction
4. Heredity & Other causes
Pathophysiology
1. Epigenetics
2. Oncogenes
3. Tumor suppressor genes
4. Cancer cell biology
4.1 Clonal evolution
4.2 Biological properties of cancer cells
Prevention
1. Modifiable ("lifestyle") risk factors
2. Diet
3. Vitamins
4. Chemoprevention
5. Genetic testing
6. Vaccination
7. Screening
Epidemiology
History
Research |
