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Recent studies have used as a reference group women who had no exposure to tobacco smoke - that is, they have never actively or passively smoked. These studies in most cases have reported increases in breast cancer risk for women who smoked or were passively exposed to tobacco smoke compared to reference women who were never exposed. Critics of this approach cite studies that indicate the reference women who have never been exposed to tobacco smoke are healthier, in general. They argue that the difference in risk is due to the better health of these women used as references for risk. Older studies used as a reference. | December 2003 Kuwait Medical Journal 253 Review Article Impact of Molecular Biology on Cancer Treatment I Therapeutic Targets Christopher HJ Ford Department of Surgery Faculty of Medicine Kuwait University Kuwait Kuwait Medical Journal 2003 35 4 253-262 ABSTRACT -----------------------------.--------------------------------------------- The study of cancer at the molecular level over the last two decades has led to the identification of major groups of genes which when disrupted or mutated can lead to the development of malignancy. Together with other molecules these genes their RNA transcripts and their protein products are providing a wide range of targets for therapeutic intervention. key WORDS cancer molecular targets therapy INTRODUCTION The need for better cancer treatment is evident. In the developed world approximately one in three persons contracts cancer and around one in four of these dies from the disease. The worldwide incidence of cancer is predicted to double from 10 to 20 million over the next two decades and the death rate will increase from 6 to 10 million. Advances in treatment with surgery radiotherapy and chemotherapy have had a limited impact on mortality. Cures can be achieved in childhood cancers testicular cancer and lymphoma and improvements in survival rates have been made as a result of the adjuvant drug treatment of breast and colorectal cancer. However the majority of human cancers are difficult to treat especially in their advanced metastatic forms. The need for new and effective forms of systemic therapy is pressing and the discovery of novel mechanismbased agents directed against the molecular pathology of cancer is of enormous potential 1 . it has been known for many years that cancer has a genetic component and it is clear that there is a multistage progression to malignancy. The application of modern molecular techniques to study cancer over the last 2 decades has led to the identification of 4 major groups of genes which are .
