Chemical and radiation carcinogenesis

Hematology Oncology Div. Child Health Dept. University of Sumatera Utara

Introduction
Many factor , including exposure to viruses, xenobiotic (foreign) chemicals and radiation contribute to camcer causation

Chemicals can cause cancer has been known since Pervical Potts observation in 1775 : scrotal cancer was linked to soot exposure in English chimney sweeps

Introduction
1918, Yamagiwa and Ichikawa : repetead painting of coal tar on the skin of rabbits ~ tumors Most chemicals were identified as carcinoges: petroleum,tobacco,benzidine, aromatic amine , aflatoxin B1,heteroxyclic amine derived amino acids during hightemperature cooking. Chemical pollution < 1% of human cancer.
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 UV and ionizing radiation ( medical xrays,atomic weapons,radon in house) are enviromental carcinogens . Ionizing radiation, critical damage instability of the DNA , increased errors in DNA replication occuring in subsequent cell cycle.

Multistep carcinogenesis: 1. initiation 2. promotion 3. progression

1.Initiation
Chemical carcinogen interacted with DNA carcinogen metabolism, DNA repair , cell proliferation mutation Irreversible, but not all initiated cells will establish a tumor , because many will die by apoptosis

2.Tumor promotion
Proliferation but not to terminally defferentiate ( latent period) proliferation of preneoplastic cells and the formation of : 1. benign lesions (papilloma, nodules, polyps) 2. regress 3. additional mutation progress to a malignant neoplasma
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3.Tumor progression
Tumor acquire to ability to grow , invade local tissue and distant metastases. Increase genetic instability and karyotypic alteration.

Ref.
1. The basic science of oncology: Ian F.tannock,Richard P.Hill,Robert G.Bristow, Lea Harrington 2. Ilmu dasar Onkologi : Prof.dr Siti Boedina Kresno SpPK(K)