Figure:

Prevention: The main cause of the gastric cancer is the mutation of the gastric cells. So if we can prevent the mutation of the gastric cells, then we can easily prevent the gastric carcinoma. But it is very difficult to prevent the mutation. Mutation is permanent change in the DNA of the cells, which leads to the loss of normal criteria of the cells. But it has been suggested by doctors and the scientists that avoiding the radiant energy such as excessive x-ray, gamma radiation can decrease the frequency of the mutation of the gastric cells.
Diet can play a vital role in the development of gastric carcinoma. From a survey done in Japan we can know that the people who take fish in each meal are more susceptible to develop gastric carcinoma than the normal people. The people of Japan love to eat fish. And the rate of gastric carcinoma is highest in Japan. This statistics do not mean that we must not take fish in our meal. It only means the taking excessive amount of fish can be a cause of gastric carcinoma.
Some foods have been proved helpful to prevent gastric carcinoma. Mainly the dietary fibers are very helpful to prevent the gastric carcinoma. The fibers act as a stomach washer. Dietary fibers are some polymer of plant origin which is not digested by the human enzyme. It also prevents the development of the colon cancer.
Taking foods, which have low cholesterol, can decrease the risk of development of gastric carcinoma. Low density lipoproteins (LDL) can increase the risk of development of gastric carcinoma.
Treatment of gastric carcinoma: Gastric carcinoma cannot be totally cured if diagnosed in the advanced stage. Most of the gastric carcinoma is diagnosed at an advanced stage when they doctors have nothing to do. Cutting and poisoning of the cells of the gastric cancer can be effective. The surgical removal of the gastric cancer cell mass followed by the chemotherapy can prolong the life of the patient.

Most of the epithelial cancers are chemo sensitive. That means the cyto toxic drugs that are used in the chemotherapy can kill the cells of most of the epithelial cancer except the basal cell carcinoma (Rodent ulcer)
Mechanism by which the chemotherapeutic drugs kill the epithelial cancer cells:
The cyto toxic drugs which are used in the chemotherapy stimulate the apoptosis of the cancer cells. Apoptosis is a pathway of cell death, in which the cells die by its own enzyme without eliciting any inflammatory reaction. The drugs differentiate the cancer cells from the normal cells by their rate of proliferation. The cancer cells are rapidly proliferating cells. They have no control on the rate of their proliferation. The chemotherapeutic drugs activate some apoptotic proteins in the cancer cells that start to damage the DNA and the essential proteins of the cancer cells and thus kill the cancer cells.
Some side effect of using the chemotherapeutic drugs in a epithelial cancer: As I mentioned earlier that the cyto toxic drugs differentiate the cancer cells from the normal cells from their rate of proliferation. There are some normal cells in human body which are also rapidly proliferating. The cells of the scalp (Covering of the skull), cells of the mouth cavity and the cells of the hair follicle are rapidly proliferating normal cells of human body. The chemotherapeutic drugs can damage these cells. So ulceration in the mouth cavity, loss of hair and muscular weakness are some common side effect of the use of the chemotherapeutic drugs.

DEFINITION :

Epithelial cancer or in other words ( carcinoma ) is a malignancy that derive from that ectoderm and endoderm .

EPIDIMIOLOGY :

Carcinoma is the 2nd leading cause of death in the United states of America , accounting for about twenty percent of deaths compared to thirty eight percent from cardiac conditions , ten percent from cerebrovascular disease , and five percent from accidents of various types .

RISK FACTORS :

Four important factors said to increase the incidence of cancer are age , diet , environment and genetic makeup .

AGE : with the population increasing in age , carcinoma have more time to exert their effects ; additionally , the immunologic defenses of the elderly may be less effective than those of young .

DIET : Geographic differences in carcinoma rates partially reflect dietary differences . Alcoholic beverages affect carcinoma when they are consumed frequently and excessively over long periods .

ENVIROMENT : The environmental agents associated with a high incidence of cancer include radiation and chemical pollution . Industrialization and development , along with the conquest of infection and malnutrition , bring an increase in carcinoma incidence .

GENETIC MAKEUP : In some families predisposition to cancer appears to be hereditary . Non hereditary chromosomal abnormalities also increase the risk of certain cancers .

CHARACTERISTICS OF EPITHELIAL CANCER :
Groups of abnormally proliferating cells can arise in any part of the body . These neoplasms share certain characteristics , both in vitro and in vivo . Besides the major components found in all neoplasms , important properties inculed clonality , autonomy , a blood supply , and , in malignant neoplasms , the capacity to metastasize .

IMMUNE HOST RESPONSES TO MALIGNANT NEOPLASMS :
At least in animal studies , autoimmune reactions to cancer cells are common , the ability of  cancer cells to stimulate the immune mechanism in humans is usually quite small & is probably inconsequential as a defense mechanism .

Tumer antigens : some antigens on the surface of cancer cells are much the smae as those on   normal cells ( example : organ specific antigen & histocompatibility antigen . ) . Most cancer cells also appears yo possess antigenic specificities that are nonexistent in normal cells . Some of  these , such as carcinoembryonic antigen ( CEA ) & alpha fetoprotien ( AFP ) , may result from  derepression of the parts of the genome that normally function only in embryonic life .

A – Identification of malignancy : once a lesion has been identified as neoplastic , a prime duty of the pathologist is to determine whether the neoplasm is benign or malignant .

1 – The gross appearance of a lesion may suggest its degree of malignancy .
a – benign lesions : tend to grow by expansion , compress surrounding structures , and often produce a well defined capsule .
b – malignant lesions : by contrast , tend to infiltrate the surrounding tissues so that the borders of the lesions are not discrete , and no capsule is formed .

2 – The histological appearance is of major diagnostic importance.
a – the edges of malignant lesions are usually poorly demarcated , and individual neoplastic cells infiltrate the surrounding normal tissue .
b – lesions invade lymphatic channels and blood vessels .
c – Anaplasia , or lack of differentiation , is a major indicator of malignancy .

B – Identification of precancerous lesions :
1 – In many if not all systems ( as cervix , lung and colon ) , clinicopathologic studies have demonstrated that initial neoplastic change can be recognised in a preinvasive stage . Such changes can progress over a prolonged time span .

2 – The morphological alterations of cancer allow the trained pathologist to recognize not only the invasive malignant process , but also the preinvasive lesions ( carcinoma in situ ) .

C – Grading & staging of malignancies : These prognostic measures attempt to express the degree of malignancy & aggressiveness of a tumor , as a guide to its clinical behavior & the probable outcome of therapy .

D – Tumor markers : which can be used to screen the cancer and to monitor cancer patients for recurrences .

CLINICAL MANIFESTATIONS OF EPITHELIAL CANCER :

A – Both benign & malignant neoplasms can produce the following manifestation :
1 – they can be asymptomatic .
2 – they can produce a lump .
3 – they can cause obstruction .
4 – they can cause bleeding .
5 – they can produce abnormal function .
6 – they can interfere with function .

B – Problems more likely to occur with malignancies : includes :
1 – Anemia .
2 – malnutrition .
3 – loss of function .
4 – paraneoplastic syndromes  ( a – ectopic hormone production . / b – hypercoagulability . ) .
5 – Infections ( could be obstructive or altered host resistance as serologic factors , cellular factors and cytotoxic chemotherapy or due to malnutrition and associated disorders . ) .
6 – Associated disorders .

1. Laparotomy

In this test, the doctors cut the abdomen to check the organs where they also perform biopsy in which small pieces of tissues are cut to observe under microscope to check for cancer. During this checking, the doctors remove the cancerous organs.

2. Thoracentesis

In this process, a fluid is removed from the space between chest and ling with the help of needle. The fluid is then checked by the pathologist for cancerous cells.

Stages of Ovarian Epithelial Cancer

Following stages are used for ovarian epithelial cancer:

1. Stage I

The stage I is further divided into 3 categories as IA, IB and IC.

• Stage IA: In this stage, cancer is present in one of the ovary.
• Stage IB: In this stage, cancer is found in both of the ovaries.
• Stage IC: In this stage, following conditions can take place.
  • Cancer is present on the external surface of one or both ovaries.
  • The outer covering or the capsule of the ovary has been broken.
  • The cancer cells are present in peritoneal cavity fluid.

2. Stage II

The stage II is also divided into 3 categories as IIA, IIB and IIC.

• Stage IIA: In this stage, the cancer has spread to the fallopian tubes through which the eggs pass from ovaries to the uterus or the cancer has spread to the uterus.
• Stage IIB: In this stage, the cancer has spread to other tissues present in pelvis.
• Stage IIC: In this stage, following conditions can take place.
  • Cancer is present on the outside surface of one or both ovaries.
  • The outer covering or the capsule of the ovary has been broken.
  • The cancer cells are present in peritoneal cavity fluid.

3. Stage III

The stage III is also divided in three categories as IIIA, IIIB and IIIC:

• Stage IIIA: In this stage, though the tumor is found in the pelvis area only but these cancer cells may have spread to the small intestines and to the surface of peritoneum, the tissues that line the abdominal wall. And these cells can only be seen with the help of a microscope.
• Stage IIIB: In this stage, cancer is found to be present in one or both ovaries and also it has spread to the other tissues in the abdomen as well as to the peritoneum. At this stage it is 2 centimeter in diameter.
• Stage IIIC: In this stage, the cancer has reached the peritoneum but it is larger than 2 centimeter and it has also spread to the lymph nodes (tissues in the abdomen that are surrounded by the connective tissues and they also stores the white blood cells) in abdomen.

4. Stage IV

In stage IV, the cancerous cells have spread beyond the abdomen to the various other parts of the body such as lungs, bines, tissues etc. The cancer cells that are present around the lungs is also included in stage IV.

These are the four stages of epithelial cancer and the diagnosis of the cancer takes place according to the stage of epithelial cancer.

Epithelial cells are found all over our body. Since it can be easily attacked by foreign substances, there is a possibility of developing cancers and since it has the ability to replicate quickly, the cancerous cells can spread easily to the adjoining cells. Dr. Ralph W. Moss, Ph.D (also cancer advisor) once quoted that ‘Epithelial cancer is another name for carcinoma, the kind of cancer that affects any tissue covering bodily surfaces and cavities. This category includes not just stomach cancer, but breast, pancreas, colon, etc. – in other words, about 90 percent of all cancers.’

Carcinoma is cancerous tumors that can occur anywhere in our body. It is also known as epithelial carcinoma since it affects the epithelial tissue that lines all the organs of our body. It is one of the most persistent cancers and it has the ability to spread from one organ to the other. Since epithelial cells are present all throughout our body, epithelial cancer can happen in various places like reproductive system, urinary tract, digestive system and so on.

Epithelial carcinoma can be of various types. Here are they:

• Basal cell carcinoma
  When the cells in the uppermost layer of the skin (epidermis) is damaged through continuous exposure to UV rays emitted from the sun, the cells can start growing abnormally and uncontrollably. It is the most widespread form of skin cancer.
• Squamous cell carcinoma
  It is considered to be the second most common type of skin cancer. It also affects the upper layer of the skin and the most common reason for its occurrence is the UV radiation emitted from the sun. If this type of cancer is detected earlier, it can be treated and it is seldom fatal.
• Adenocarcinoma
  It usually occurs in the glandular epithelial cells which lines the inner organs. This kind of carcinoma has the ability to produce own secretions and works like a gland. If such a tumor is detected, it should be treated quickly otherwise the patient can die as the tumor can multiply very speedily.

When carcinoma is found, medical professionals usually make efforts to stop the tumor from metastasizing thereby stopping it from spreading to other organs. Even epithelial carcinoma may sound lethal, through surgery, chemotherapy, and drug treatment the cancer can be controlled and recovery can be achieved if and only when the tumor is detected early.

Many women fail to realize that there is suffering from ovarian cancer until the cancer reaches its final stage. The main reason is that it is difficult to determine on your own whether you are suffering from ovarian cancer or not. Some women may have undergone screening tests but such tests do not produce accurate results because of which sometimes the cancer can go undetected. The easiest way to find out that you are suffering from this type of cancer or not is to lookout for symptoms such as feeling of pressure or uneasiness in your abdomen or pelvic area, weariness, backache, bloating, abnormal bowel movement, frequent passing of urine, gastrointestinal issues, nausea, disinterest in having food, abnormal vaginal bleeding and so on.

When ovarian cancer is detected, depending on the stage of the cancer, the surgeon can suggest following kinds of treatment, surgery, chemotherapy and radiotherapy.

Surgery
The surgeon will perform surgery to remove the cancerous epithelial tissues that are proliferating quickly. This form of treatment can also be combined with other forms of treatment that are mentioned above. By doing surgery, the doctor will be able to remove the cancerous tumors so that the cancer does not spread to adjoining areas of the body. The idea is to completely remove residual tumor masses.

What the doctor will do is that he will make an incision in the abdomen area through laparoscopy. This technique allows the doctor to view the images of the surgical areas on a TV. He will cut a small piece of the tumor and perform tests to confirm ovarian cancer.  Once the tests show the occurrence of ovarian cancer, he may do hysterectomy (full or partial removal of the uterus), or bilateral salpingoophorectomy (removal of an ovary and its uterine tube), or omentectomy (removal of omentum), or lymphadenectomy (removal of lymph nodes)

Chemotherapy
This treatment involves eliminating the cancer by administering drugs. The drugs are very effective and produce good results but it can also affect the normal cells of our body and cause problems like anemia, temporary hair loss, etc. Doctors may even prescribe other drugs that can help in lowering such side effects. One can receive chemotherapy intravenously, intraperitonally, orally and intramuscularly. The period of the treatment can vary depending on the stage of the cancer.

Radiotherapy
Radiotherapy involves using ionizing radiation to exterminate cancer causing cells. This treatment can be done through radiotherapy devices or by using an injection.

Even when the treatment shows positive results, the patients will be required to visit the doctor for follow-up. Even after the cancerous cells are successfully removed, the cancer can reoccur within a time period to two to twenty years. Hence, patients must visit the doctor regularly.

Here are some things you can do to protect your skin from cancer.

1. Apply sunscreens
Skin cancer usually occurs because of skin damage. The very first thing you must do is to protect your skin from getting damaged from the harmful UV rays that are emitted from the sun. Protecting your skin by applying sunscreen is very important. If you spend a lot of time outside for a long duration, you should use sunscreen. The type of the sunscreen depends on the type of the skin you have. However, you can use a sunscreen that is SPF 15 or higher to prevent your skin from getting damaged from sun. If you are unsure about the sunscreen you should buy, you should consult with a dermatologist.

2. Avoid direct exposure to sun
UV rays coming out of the sun can cause a lot of problems to your skin. Hence, it will be very good for you to avoid going out during 10am to 4pm. During these hours, the sun’s rays are very bright and if you go out, there is a high chance of getting your skin damaged. Hence, if you are to go out during these hours, you should apply good amount of sunscreen.

3. Stay under the shade
Stay as much as you can under the shade. This will help you keep cool when the sun is hot. This will keep you away from the risk of contracting skin cancer. The more you remain under the shade, the safer you will be. Still you should use sunscreen to stay protected.

4.  Protect your children’s skin from sun
It is a fact that people who are vulnerable to sunburns and other such conditions during their childhood, have higher risk of contracting skin cancer. Hence, children should not be allowed to play or spend their time out under the hot sun. When they go out, always ensure that they are protected from sun by using sunblock and proper clothing.

5. Protect skin with proper clothing
Use caps, hats and proper clothing that can fully cover your skin so that your skin is not exposed to hot sun. You can also protect your eyes from sun damage by wear sunglasses that are specially designed to protect from UV rays.

• People who have got freckles
• People with fair skin
• People whose skin burns easily because of sun damage
• People with blonde hair
• People with light eyes that are green, blue or light colored.
• People who spend most of their time outdoors.
• People whose family history shows cases of skin cancer

It does not mean that only the people with fairer skin have higher risk of getting skin cancer, even people with darker complexions but the risk is higher among fair skinned people. Because of their fair skin, they can easily contract the most dangerous form of skin cancer called melanoma.

Melanoma cannot be detected easily through tests but it can proliferate very quickly. Melanoma first starts at the skin but it can spread throughout the body. Even though this disease quite prevalent all over the world, health experts haven’t yet found out its exact cause. The risk factors of melanoma can be same as mentioned above and one of the major risk factors is regular exposure to harmful UV rays emitted from sun and artificial sources.

here are various symptoms through which you can whether you have contracted the dreadful disease or not. One of the first signs of melanoma is the change in the appearance of an existing mole. Also, the occurrence of new mole can be a sign of the beginning of the lethal disease. The abnormal mole can be easily identified by self-examining. Usually, the moles are symmetrical in appearance but abnormal ones are asymmetrical in nature. The edges of the mole appear blurry. Even the color of the mole will abnormal shade and should be evaluated by your physician. Also the diameters of the mole will around 6mm or more.

Symptoms
When you suspect the appearance of new abnormal moles or change in the existing moles, you should meet a skin-care specialist to get the condition examined. If the doctor suspects that you may be suffering from melanoma, a biopsy must be done to confirm it. After this you will have to go through further tests to find out how far the disease has spread.

Treatment
For skin cancer including melanoma, there are four types of treatment, namely surgery, chemotherapy, radiotherapy and immunotherapy. The treatment can vary depending on the severity of the cancer, age and health of the patient. If detected early, patient can be cured from melanoma by surgically removing the area that has been infected. Chemotherapy and other types can be used if the condition is more advanced.

Preventive measures
The only and best thing you can do to prevent melanoma is to protect your skin from sun exposure. You can do this by using sunscreen and wearing clothes that can protect you completely from the sun and its harmful UV rays.