Pre-Invasive Disease: Pathogenesis and Clinical Management
There are many books written on cancer, but this monograph focuses on pre-invasive disease. One of the prizes waiting to be won in cancer medicine is to thoroughly understand the processes by which a cell becomes invasive. This quest takes us into the wor
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Rebecca C. Fitzgerald Editor
Pre-Invasive Disease: Pathogenesis and Clinical Management
Editor Rebecca C. Fitzgerald Programme Leader, MRC Cancer Cell Unit Hutchison-MRC Research Centre Hills Road Cambridge CB2 0XZ UK [email protected]
ISBN 978-1-4419-6693-3 e-ISBN 978-1-4419-6694-0 DOI 10.1007/978-1-4419-6694-0 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2010936286 © Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Cover illustration: Biopsy of Barrett’s oesophagus (metaplastic oesophageal epithelium which predisposes to adenocarcinoma) stained with Alexa 555-labelled lectin called wheat germ agglutinin (WGA). Non-dysplastic areas within the biopsy demonstrate strong WGA staining of both the apical epithelial membrane and the superficial epithelial mucous globules. The superficial epithelial mucous globule staining is lost in areas of low grade dysplasia and in high grade dysplasia, this as well as the apical membrane staining is almost entirely lost. (Picture provided by Dr. Elizabeth Bird-Lieberman) Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface
On a weekly basis, as we discuss new oesophago-gastric cancer cases within a multidisciplinary team, I am reminded of how dismal cancer is for the majority of patients. The lucky ones in whom we can achieve a cure are, generally speaking, those who present with early-stage disease. It has been recognized for almost two centuries that pre-cancerous conditions exist, and indeed it is now known that most cancers develop over a period of years through a series of pre-invasive stages. This being the case there should be ample opportunity to intervene early in the natural history of cancer in order to improve outcomes. To do this effectively requires an understanding of the molecular and cellular basis for the disease. 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 programme
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