Gene activity associated with cancers treated by surgical oncologists

A significant component of the general surgeon's practice is treatment of cancer that most commonly involves breast, colorectal, pancreas, and hepatic surgeries. The prognosis for these patients is largely dependent upon the stage of the disease at the time of diagnosis. There is convincing evidence that the induction and progression of cancer occurs when the function of genes that regulate cell proliferation, cell death and DNA repair becomes altered. These molecular disturbances result from ongoing, tumor-promoting activity long before symptoms of the disease become apparent. The role of many genes and the extent of their involvement in this deleterious, molecular process is unique to the organ. However, the tumor suppressor genes p53 and p16, the oncogene c-myc, and the inflammation-associated enzyme COX-2 are implicated in all four of the tumors. The roles of the oncogenes ras and HER-2/erbB-2/neu are significant in all of the tumors except hepatocellular carcinoma. The systematic establishment of a comprehensive data base relating gene expression activity to the initiation and development of cancer will provide molecular markers for detection and targets for treatment. This overview presents the current status of information associating gene expression activity with cancers typically encountered by general surgeons.