1. KNH Research Symposium Current Trends and Innovations in management of Cancer Topic: Overview of Cancer Past, Present, Future Presenter : Dr. Opiyo, Anselmy Head, Cancer Treatment Centre – KNH Date: 13 th April, 2012

2. KNH Research Symposium  What is cancer? What is cancer?  Renaissance period Renaissance period  Nineteenth century Nineteenth century  Cancer causes: Theories throughout history Cancer causes: Theories throughout history  Modern knowledge and cancer cause Modern knowledge and cancer cause  Viral and chemical carcinogens Viral and chemical carcinogens  Cancer epidemiology Cancer epidemiology  Cancer screening and early detection Cancer screening and early detection  Evolution of cancer treatments Evolution of cancer treatments  Hormone therapy Hormone therapy  Radiation Radiation  Chemotherapy Chemotherapy  Immunotherapy Immunotherapy  Targeted therapy Targeted therapy  Cancer survivorship Cancer survivorship  The twenty-first century and beyond The twenty-first century and beyond

3. Principles of Oncology  - Epidemiology of Cancer: Tobacco - Epidemiology of Tobacco and Cancer - Tumour Induction in Laboratory Animals by Tobacco products - Carcinogens in Tobacco Products

4. - Relationship of Carcinogens to Specific Cancers caused by Tobacco Products - Overview of Mechanisms of Tumour Induction by Tobacco Products - Tobacco Carcinogen Biomarkers

5. Etiology of Cancer: Cancer Susceptibility Syndromes  - Principles of Cancer Susceptibility - Genetic Testing - Cancer Susceptibility syndromes - Future Directions

6. Etiology of Cancer: Cancer Susceptibility Syndromes  - Principles of Cancer Susceptibility - Genetic Testing - Cancer Susceptibility syndromes - Future Directions

7. Etiology of Cancer: Viruses - RNA Viruses - Retroviruses: Background, Replication Cycle and Molecular Genetics - Mechanisms of Retroviral Oncogenesis - Human T-Lymphotropic Virus Type 1 - Human T-Lymphotropic Virus Type 2 - Human Immunodeficiency Virus - Hepatitis C Virus

8. DNA Viruses - Hepadnaviruses and Hepatocellular Carcinoma - Papillomaviruses and Human Cancer - Epstein-Barr Virus - Kaposi’s Sarcoma- Associated Herpesvirus - Polyomaviruses

9. Etiology of Cancer: Inflammation - Tumour Immune Surveillance - Inflammation and Tumorigenesis - Inflammatory Cells and Stromal Cells in the Initiation of Neoplasia and in the Tumour Microenvironment - Cellular Receptors Involved in the Modulation of Inflammation Etiology of Cancer: Chemical Factors - The Nature of Chemical Carcinogens: Chemistry and Metabolism - Animal Model Systems and Chemical Carcinogenesis - DNA Repair Protects the Host from Chemical Carcinogens - Genetic Susceptability to Chemical Carcinogenesis - Molecular Epidemiology, Chemical Carcinogenesis, and Cancer Risk in Human Populations - Benzene as a Model for Gene-Environment Interaction

10. Etiology of Cancer: Physical Factors - Interactions of Radiation with Cells and Tissues - Ultra-violet Light - Asbestos Etiology of Cancer: Dietary Factors - Methodologic Challenges - Energy - Alcohol - Dietary Fat - Fruits and Vegetables - Fiber - Other Foods and Nutrients - Dietary Patterns - Diet during Early Phases of Life

11. Etiology of Cancer:Obesity and Physical Activity - Breast Cancer - Colon Cancer - Endometrial Cancer - Adenocarcinomas of the Esophagus - Kidney/Renal Cell Cancer - Pancreatic Cancer - Gallbladder Cancer - Non-Hodgkin Lymphoma - Prostate Cancer - Lung Cancer - Ovarian Cancer

12. Epidemiology of Cancer - Epidemiology Methods - Descriptive Studies - Analytical Studies - Interpretation of Epidemiologic Findings - Molecular Epidemiology - Global Cancer Incidence (Surveillance, Epidemiology and End Results Database) - Data Sources and Measurements - Overall Cancer Risk - Incidence and Mortality Patterns for Common Cancers - Issues in Interpretating Temporal Trends

13. Changes in Cancer Mortality - Cancer Surveillance Systems - Making Sense of Cancer Trends - Trends in Cancer Risk Factors - Cancer Trends - Predicting Future Cancer Trends Principles of Surgical Oncology - General Issues - Historical Perspective - Anesthesia for Oncologic Surgery - Determination of Operative Risk - Roles of Surgery - Surgical Oncologist

14. - Laparoscopic Surgery - Physiology of Laparoscopy - Laparoscopy in the Diagnosis of Malignancy - Laparoscopy in the Staging of Malignancy - Laparoscopy in the Treatment of Malignancy - Laparoscopy in the Palliation of Malignancy

15. Principles of Radiation Oncology - Biologic Aspects of Radiation Oncology - Factors That Effect the Response of Tumours to Radiation - Tumour Oxygenation - Hypoxic Cell Sensitizers and Cytotoxins - Role of Hypoxia Imaging in Clinical Oncology - Radiation Physics - Treatment Planning - Clinical Applications of Radiation Therapy

16. Principles of Medical Oncology - Basic Principles - Historical Perspective - Clinical Application of Chemotherapy - Principles of Cancer Cells Kinetic - Principles Governing the Use of Chemotherapy - Dose Intensity and Combination Chemotherapy

17. - Biology of Drug Resistance - Mediator of Chemosensitivity - Role of Bcl-2 Family Members in - Mediating Chemosensitivity - Signalling Pathway - Assessment of Clinical Response - Signal Endpoints Used to Assess Response to Different Uses of Chemotherapy

18. Principles of Immunotherapy - Categories of Tumour Antigens Can be Defined by Expression Patterns - Cancer Therapies - Influence of Immune System on Tumour Development Principles of Health Services Research - Studies of Health Service - Patient-Reported Outcomes Assessment - The Economics of Cancer Care

19. Pharmacology of Cancer Chemotherapy - Drug Development - Preclinical Development - Clinical Development - Alkylating Agents - Cisplatin and Its Analogs - Antimetabolites - Topoisomerase-Interacting Agents - Antimicrotubule Agents

20. Pharmacology of Cancer Biotherapeutics - Antiangiogenesis Agents - Monoclonal Antibodies - Preventive Cancer Vaccines

21. Pharmacology of Endocrine Manipulation - Selective Estrogen Receptor Modulators - Aromatase Inhibitors - Antiandrogens

22. Genetic Counseling Cancer Screening - Principles of Cancer Screening - Gastrointestinal Cancers - Gynecologic Cancers - Breast Cancer

23. Specialized Techniques in Cancer Management - Vascular Techniques in Cancer Management - Isolation Perfusion - Interventional Radiology - Cardiopulmonary- Vascular System - Liver Metastasis - Cholangiocarcinoma - Genitourinary - Musculoskeletal Cancer - Functional Imaging - Molecular Imaging

24. Role of Endoscopy in Cancer Management - Gastrointestinal Endoscopy - Respiratory Endoscopy

25.  THANK YOU