Berek & Hacker’s Gynecologic Oncology Sixth Edition

Berek & Hacker’s Gynecologic  Oncology Sixth Edition

Berek & Hacker’s Gynecologic Oncology Sixth Edition  Cancer is a complex disease that arises because of genetic and epigenetic alterations that
disrupt cellular proliferation, senescence, and death The alterations that underlie m the development of cancers have a diverse etiology, and the loss of DNA repair mechanisms often  plays a role in allowing mutations to accumulate. Specific molecular changes that cause a normal  cell to become malignant have been identified, but their spectrum varies considerably between
cancer types.

The malignant phenotype is characterized by the ability to invade surrounding tissues and  metastasize. The development of a cancer elicits a considerable molecular response in the local  microenvironment that is characterized by recruitment of stromal elements such as new blood vessels and by an active immunologic response.

These secondary events play a critical role in the evolution and progression of cancers. Although the molecular pathogenesis of gynecologic cancers  has been only partially elucidated, advances in the understanding of these diseases are providing  the opportunity for improvements in diagnosis, treatment, and prevention.

The initial sections of this chapter will outline what is known regarding the basic molecular  mechanisms involved in the development of cancers and the evolution of the malignant phenotype. The molecular alterations characteristic of gynecologic cancers will be outlined in the later  sections.

Berek & Hacker’s Gynecologic Oncology Sixth Edition