What are pancreas and what is its function?
Pancreas is a large organ that is located behind the stomach.

The function of the pancreas is to synthesize and release the enzymes into the lumen of the intestine for the absorption of food, mainly fats.

Pancreas releases some hormones by its specialized cells like alpha and beta cells.
Alpha cells of pancreas release glucagon and beta cells of the islets of langerhans of the pancreas release insulin.

These hormones are very essential for maintaining the blood glucose levels. Insulin and glucagon have opposite effects on the receptors.

Incidence and Causes of Pancreatic Cancer:
Tumors may also occur in these specialized islet cells, such type of cancer is called islet cell tumors.
The main cause of pancreatic cancer is not well known but it is thought to be caused commonly in the:

• Diabetic patients
• People with Chronic pancreatitis (long term inflammation of the pancreas)
• People with smoking habits
• Advanced age

Women seems to be affected more with pancreatic cancer than men and this risk increases with age.

Some of the cases of pancreatic cancer are related to genetic syndromes that pass down through generations of families.

Symptoms of the Pancreatic Cancer:
Pancreatic cancer develops without any symptoms in the early stages. It is only in the advanced stage that pancreatic cancer in a person gets detected.
Some of the symptoms of the pancreatic cancer:

• Dark colored urine
• Stools in clay color
• Fatigue
• Weakness
• Jaundice with yellow coloration of the skin, mucous membrane and eyes
• Weight loss
• Loss of appetite
• Nausea and vomiting
• Pain and discomfort in the abdomen mainly in the upper part of the belly
• Back pain
• Diarrhea
• Indigestion
• Blood clots
• Bloating

Tests to detect the Pancreatic Cancer:
Some of the tests performed to detect the pancreatic cancer include
• Pancreatic biopsy
• CT scan of the abdomen
• MRI of the abdomen
• Endoscopic ultrasound
• ERCP (Endoscopic retrograde cholangiopancreatography)
• CBC (Complete Blood Count)
• Liver function tests
• Serum bilirubin

Treatment for Pancreatic Cancer:
As pancreatic cancer is detected only in the advanced stages, very few cases of the pancreatic tumors can be removed by surgery.

The standard surgical procedure to remove pancreatic tumors is known as “pancreaticoduodenectomy”, which is also known as “Whipple procedure”.

Radiation therapy and chemotherapy can be employed in the patients with tumors that cannot be removed surgically even though they have not spread outside the pancreas.

When the tumors get metastasized to other organs like liver, chemotherapy alone is employed. The main chemotherapeutic drug used in the treatment of the pancreatic cancer is ‘gemcitabine’ that helps around 25% of the patients.

The persons facing blockage in the biliary tubes that transport bile should be relieved of this obstruction by the application of the surgery or by placing biliary stent during ERCP.

The important thing in the treatment of advanced pancreatic cancer is to manage the pain and other symptoms. Palliative care tams and hospice can be employed to manage pain and other symptoms. These provide psychological support for patients and their families during the illness.

Prevention of the Pancreatic Cancer:
Pancreatic cancer can be prevented by

• Quit smoking
• Eat more amount of fruits, vegetables and whole grains
• Regular exercise

Some of the marine cytotoxic compounds are Ara-C, Crassin acetate etc.

1. Ara-C:
Chemical Nature:
Ara-C is chemically 1-a-D-arabinofuranosyl cytosine. It is also known as cytosine arabinoside.

Source and Synthesis:
Ara-C is a synthetic compound and is synthesized from the naturally occurring moieties that are present in the Caribbean sponges like spongosine and spongouridine.

Uses:

• Ara-C is helpful in the treatment of acute myelogenous leukemia.
• Ara-C helps in the treatment of Human acute leukemia.
• Ara-C is active against Erlich carcinoma.
• Ara-C is active against Sarcoma-180.
• Ara-C also helps in the treatment of L-1210 leukemia in mice.

2. Crassin Acetate:
Chemical Nature:
Chemically crassin acetate belongs to cyclic diterpenes and it is a member of cembranoids.

Source and Synthesis:
Crassin acetate is obtained generally from soft corals. It is obtained from Caribbean gorgonian, Pseudoplexaura porosa.

Uses:
This compound is cytotoxic to Human Leukemia and the cells like HeLa cells in vitro.

3. Simularin, Dihydrosimularin and Simulariolide
From among the various cembranoids, Sinularia flexibilis is a soft coral that gives cytotoxic compounds like simularin, dihydrosimularin and simulariolide.

4. Asperidol:
Asperidol is also a cembranoid but it is chemically non-lactonic. Asperidol is obtained from gorgonian coral and it has cytotoxic properties.

Many chemical compounds with anti-tumour and immuno-suppressant effects are discussed below:

5. Geranyl Hydroquinone:
Geranyl hydroquinone is extracted by using chloroform extract of Aplidium species and is cytotoxic to leukemia and mammary carcinoma.

6. Aplysistatin:
Aplysistatin is a chemical compund that is extracted from the sea hare Aplysia angasi. Aplysistatin has antileukemic activity.

7. Halitoxin:
Halitoxin is extracted from a sponge known as Haliclona viridis. Halitoxin has antitumour properties.

8. Didemnins A, B and C:
Didemnins A, B and C are extracted from Caribbean tunicate Trididemnum species.
Didemnins are the potent inhibitors of L-1210 leukemic cells in vitro and also inhibit P-388 leukemia and B-16 melanoma in vivo.

9. Majusculamine-C:
Majusculamine-C is extracted from algae, Lyngbya majuscula and it is an inhibitor of X-5563 myeloma.

The other compounds with antitumour properties are extracted and purified from the fractions of sea sqirt, Ecteinascidia turbinata.

A monthly self-examination, an annual check up by physician and periodic mammograms helps in early detection of the breast cancer. If breast cancer is detected in the early stages, it will increase the chance of successful treatment. If early signs are not spotted, the disease creeps up without our notice and can be diagnosed only when we feel the painful changes. Be vigilant.

Some of the warning signs during self-examination include:

• Dimpling
• Puckering of skin
• Bulging of skin
• Inverted nipples
• Discharge from the nipples
• Redness
• Soreness
• Rashes
• Swelling

When to consult a doctor?
If any of the above signs are observed, it may indicate some abnormality like presence of cancerous cells and it requires immediate attention for screening and treatment. So consult a doctor if you find the above signs. The warning signs not only suggest us to take immediate action but also shows the presence of some risk factors.

The National Institute of Health gives some list of risk factors for the breast cancer:

• Family history of breast cancer if present
• If there is onset of menstruation before 12 years
• Onset of menopause after 55 years
• If not given birth to children
• If first child is born after 30 years
• Fewer pregnancies
• Low breast feeding (if less time spent in breast feeding)
• Birth control pills (oral contraceptives)
• Hormone replacement therapy

Now, the option of genetic testing has become available (but only to a few) to assess the risk of breast cancer. But before taking this option, it has to be discussed with the physician to understand its implications.

Mammogram has to be scheduled during the first 2 weeks of the menstrual cycle to avoid a hormonal shift that makes the breasts more sensitive in the case of pre-menopausal women. Caffeine also should be stopped for a week before the test as caffeine increases the tenderness of breasts.

Understanding of the condition:
If you are at low risk, screening can be done annually from 40 years of age. The previous reports have to be taken whenever you are consulting a physician. The doctor compares the earlier images with the new ones and tracks the changes over time.
A healthy lifestyle should be maintained. Avoid some addicting habits like smoking, drinking that elevates the risk of cancer. So healthy diet has to be taken. Taking of anti-oxidants reduces the risk of cancer and they are present from turmeric to tea as anti-oxidants are ubiquitous. Moderate eating helps in maintaining a healthy weight. Obesity is not associated with breast cancer.
If you are at a high risk, the screening has to be done annually from 30 years onwards. The screening includes mammogram and an MRI.

Treatment by the Physician:
If there is an establishment of cancer, the physician suggests the ‘Tamoxifen Therapy’.
There may be preventive surgery also. The removal of breasts may be possible.
But the treatment should be done after considering everything and should be done with great care.
Women who have experienced non-invasive cancerous growths can reduce the future risk by undergoing lumpectomies. It means removal of the cancerous lumps and the margin of non-cancerous tissue.
Therapies should be taken well in time.

Some of the steps that can be followed to stay safe against breast cancer by early detection.
Keep an eye on your lifestyle: The changes in lifestyle can reduce the risk of incidence of breast cancer. Breast-feeding helps in preventing the breast cancer. But breast-feeding alone is not sufficient and you are advised to take a healthy diet.
The diet rich in fat and obesity are the major risk factors for the development of breast cancer. This kind of diet also gives rise to the development of many other cancers like gall bladder, pancreas, uterus and colon cancers, mostly on the post-menopausal women.
So to prevent the attack of breast cancer the diet rich in fibers (whole grains, fresh fruits and vegetables) have to be taken along with regular exercise and weight reduction, which are the important steps that have to be followed.
Avoid the consumption of alcohol and don’t take the pills containing estrogen.

Diagnosis and Stages:
The average age at which the breast cancer is diagnosed is 48 years in India where as in other industrialized nations it is 58 years.
In less than 20% of women, the breast cancer manifests in the early stages (stages I & II). The remaining will have a locally advanced disease (advanced and limited to regions of breast and lymph glands in the armpit) It may be around 60% in stage III. The stage IV is characterized by the spreading of the cancer to other regions of the body like bones, other breast, lung, liver etc.
The survival rate is more for the patients of stage I – 90%, stage II – 65 to 80%, stage III – 50% and stage IV – 14%.
It means that early diagnosis is very essential for the survival. Mammography is considered as the gold standard test for the screening of the breast cancer. But the organized screening test has not been performed. This is due to the lack of the infrastructure like trained radiologists and technicians and due to the high cost involved to carry out the procedure for such a large population.
Physical examination of the breast can be carried out for the early detection of the breast cancer. A trained health worker can perform the breast examination to detect the breast cancer at the earliest.

Self-examination by a woman:
A woman need to self examine herself once a month to detect any kind of irregularity in the shape of the nipple, appearance of the breasts and to feel any nodules in the armpits for any glands. A woman has to go for check up once in a year after 45 years of age. If there is any kind of suspicion, the physician may perform mammography for both the breasts and it is essential if any of the family members had that problem.

Treatment:
A number of therapies are available today and it is customized for a woman. The therapies may include surgeries like lumpectomy or mastectomy, chemotherapy, radiation therapy and hormone therapy.

Advantages of Nanoparticles in Cancer Treatment:
The nanoparticles that are employed in the treatment of cancer are tubular shaped, nano sized structures and provide triple advantages.
The main advantage of these nanoparticles are they are non toxic in nature.

They do not accumulate in the body.

They help in monitering the distribution to various organs of the body due to their fluorescent nature.

How was the research conducted?
The studies were carried out initially by orally feeding the live Drosophila larvae. The result was that there was no impairment in the normal development of Drosophila, or in its egg laying capacity. The particles of the drug also have total clearance after a certain period of time from the living organism.

The preliminary results of the ongoing studies on mice have shown that 80% of the targeted cancer related genes have been silenced as said by the scientists of IICT.

The studies on mice have almost came to an end within a few months and the researchers are planning to conduct the pre-clinical trials.

Different types of nanoparticles are being synthesized all over the world for drug delivery ranging from biological substances like albumin to various chemicals. The chemical substances include various polymers and soild metal containing nano-materials. But most of the present structures like carbon nano tubes and polymers get accumulated in the body and cause high toxicity. This project is being funded by the Department of Biotechnology and will be extended for the next three years.

What is pleura? What is their role in the functioning of the lungs?
Pleura is the lining of the lungs and are present as two layers. The outer layer is called as the parietal pleura and the inner lining is called as the visceral pleura. Both these layers are separated by a little amount of the fluid that keeps the pleural membrane moist and serves for protection. The pleura are thin and are helpful in the contraction and expansion of the lungs.

When the person gets affected with the mesothelioma, the pleura becomes thickened or hard and he feels the difficulty in breathing due to inability of the lungs to expand and contract properly.

What are the causes of Mesothelioma?
Mesothelioma is caused mainly due to the exposure of the person to the asbestos. Another cause is found to be linked with the virus SV50 which helps in the development of the mesothelioma. The activity of the virus is yet to be proved. Exposure of the person to some other dusts may also cause this cancer.

What are the symptoms of Mesothelioma?
The symptoms of the mesothelioma are generally non-specific and cannot be identified at the early stages. They usually develop after 20 to 50 years after the person is initially exposed to the asbestos. This leads to the delay in the diagnosis of the disease. The symptoms may resemble the symptoms of pneumonia.
Some of the symptoms are:

• Shortness of breath
• Chest pain
• Persistent cough
• Pleural effusion
• Fever
• Sweats in the night time
• Loss of weight
• Bowel obstruction
• Pain in the abdomen
• Swelling in the abdomen
• Nausea
• Anaemia
• Swelling of the feet

What is meant by pleural effusion?
Pleural effusion is the main symptom of the mesothelioma. It is due to the accumulation of the fluid between the parietal pleura and the visceral pleura. Mesothelial cells cover these membranes and secrete a small amount of fluid that acts as lubricant between the chest cavity and the lungs. The excess of the fluid is absorbed into the blood and lymph to maintain the balance. When excess is secreted it results in effusion.

What are the types of Mesothelioma?
There are five different types of mesothelioma namely

1. Pleural Mesothelioma: It is the commonest of the disease. It affects the pleural membrane of the lungs.
2. Peritoneal Mesothelioma: It affects the peritoneal membrane of the abdomen.
3. Pericardial Mesothelioma: It affects the pericardial membrane of the heart.
4. Testicular Mesothelioma: It affects the lining of the testicles.
5. Histological types of mesothelioma.

How can we treat Mesothelioma?
Mesothelioma can be treated by surgery, chemotherapy or radiation. Some other types of treatment which are still under experimental phase include photodynamic therapy, gene therapy, immuno therapy, hormonal therapy, ozone therapy and anti-angiogenesis therapy.

What are carcinogens that cause mutation of DNA?
Carcinogens are the agents which can induce the formation of Cancer. The agents may be physical, chemical or biologic agents and are capable of inducing Cancer. These agents can damage the cellular DNA, either directly or by producing toxic intermediates such as free radicals. Certain viruses also act as oncogens. These viruses induce mutations in the host cell DNA or they may alter the rates of cellular transcription. Mutations of cellular DNA leads to the formation of cells with abnormal growth and differentiation characteristics.

List of Carcinogens:
Chemicals – Many chemicals like vinyl chloride, benzene, cigarette smoke, aromatic hydrocarbons etc.,
Radiation, radon gas, radioactive materials, ultraviolet radiation
Occupational exposure to certain metals in the industries – Asbestos, coal dust, uranium, solvents
Oncogenic viruses
Dietary factors- high fat diet, excessive intake of alcohol, nitrosamine preservatives, grilled or charred foods
Hormones – estrogens, progesterone

Oncogenic viruses in humans
Both the DNA and RNA viruses are found to be oncogenic in nature, which are capable of producing Cancer in human hosts, they infect.
Human Papillomavirus cause cervical carcinoma
Hepatitis B virus cause liver Cancer
Epstein-Barr virus cause Burkitt’s lymphoma and nasopharyngeal Cancer
HIV virus cause Kaposi’s sarcoma

Hereditary factors:
Some Cancers like colon Cancer, breast Cancer, retinoblastoma, leukemia and lymphoma are predisposed genetically. The present research is focused to identify certain genetic markers in individuals that are basis for development of certain types of Cancer.

Key factor in cachexia is the production of cytokines like tumor necrosis factor and interleukins in response to presence of Cancer. Many cells produce these substances within the body and are protective against bacterial infections, viral infections and malignant cells. Although these substances are useful, they also produce effects of cachexia including anorexia and lean body wasting.

How does a normal cell turn into a Cancer cell?
Genesis of Cancer cell:
A normal cell turns into a Cancer cell due to one or more mutations in the DNA, which may be inherited or acquired.

e.g. Breast Cancer: If a woman has a defective copy of either of the tumor suppressor genes BRCA1 and BRCA2, they have risk of developing breast Cancer.