The Role of Genetic Predisposition and Environmental Factors in the Occurrence of Multiple Different Solid Tumors. The Experience of the University Hospital of Sienna
Radiotherapy and/or chemotherapy, or a combination of both, are increasingly used at the highest doses. Powerful antimetabolic, antiblastic, antibiotic drugs, together with immunosuppression and immunomodulation facilitate the occurrence of second tumors, sometimes within the first decade after treatment.
Environmental pollution or inappropriate waste treatment has increased our exposure to carcinogens and other toxic agents. This has lead to increased frequencies of some cancers, particularly in subjects genetically more sensitive to these agents. Polycyclic aromatic hydrocarbons, nitrosamines, aromatic amines are known carcinogens found in cigarette smoke and in air pollution. Transitional metals (Fe, Cr, Cu, Pb, Cd, V), fibers such as asbestos, pollutants from metropolitan areas, as well as long-term and long-distance side-effects of nuclear accidents (such as Chernobyl or similar nuclear disasters) are certainly responsible for an increased number of tumors, i.e., in addition to those usually occurring in the natural history of each individual.
Patients undergoing organ transplantation, such as liver transplantation, in the treatment of malignant disease require immunosuppression. In these patients, in addition to recurrence of the primary tumor, new tumors, related to chronic immunosuppression, may develop.
KeywordsPapillary Thyroid Carcinoma Germline Mutation Familial Adenomatous Polyposis Adenomatous Polyposis Coli Familial Adenomatous Polypo Patient
Unable to display preview. Download preview PDF.
- 20.Cetta F, Dhamo A, Malagnino G, Barellini L (2007) Germ-line and somatic mutations of the APC gene and/or beta-catenin gene in the occurrence of FAP associated thyroid carcinoma. World J Surg 3:1366–1367Google Scholar
- 24.Paraf F, Jothy S, Van Meir EG (1997) Brain tumor polyposis syndrome: two genetic diseases? J Clin Oncol15:2744–2758Google Scholar
- 45.Li SF, Hursting SD, Davis BJ et al (2003) Environmental exposure, DNA methylation, and gene regulation-lessons from diethylstilbesterol-induced cancers. In: Epigenetics in cancer prevention: Early detection and risk assessment. New York Academy of Sciences, New York, pp 161–169Google Scholar
- 56.Cetta F, Della Patrona S, Azzarà A et al (2008) Airway abnormalities induced by ozone exposure in the sheep. EAG Conference, Thessaloniki 2008. Abstract TO9A018PGoogle Scholar