Synopsis

Neoplastic disease

In most cases, the cause of cancer is multifactorial. About 75% of cancers are due to environmental factors, some of which are within the control of the individual, e.g. tobacco smoking, exposure to sunlight. Growing understanding of cancer genetics and inherited disease suggests that fewer than 10% of cancers are familial.The different systemic modalities used to treat cancer patients are discussed. Immunosuppressive drugs are described here as they share many characteristics with cytotoxics.

• Cancer treatments and outcomes

• Rationale for cytotoxic chemotherapy1

• Classes of cytotoxic chemotherapy drugs

• Chemotherapy in clinical practice

• Endocrine therapy

Immunotherapy and biological therapies

• Emerging anticancer treatments

• Immunosuppression and immunosuppressive drugs

1 Although not in strict accord with the definition of Chapter

11, the word 'chemotherapy' is in general use in this connection and it would be pedantic to avoid it. It arose because some malignant cells can be cultured and the disease transmitted by inoculation, as with bacteria. The more precise term 'cytotoxic chemotherapy' is adopted here.

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