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The major scientific advancements in the study of nutrition and
cancer in the last six years derive from the extensive use of
molecular approaches to perform research in the nutritional field.
Moreover, the fundamental observation of R. Doll and R. Peto
(1981), which suggested that at least 35% of all cancers (with
large differences among different tumors) might be prevented by
dietary regimens, has been definitively confirmed by
epidemiological studies. The molecular studies reported in this
volume include all of the major aspects of investigation on human
nutrition and malignant transformation. In the last decade a large
number of compounds responsible for the biological activity of
human foods has been identified and characterized. These molecules
not only include important and well-known risk factors but, most
promising, compounds, which might exert chemopreventive activity.
Among them, antioxidants (such as vitamins, phenols, and lycopene)
seem to play a critical role in reducing the risk of cancer at
different anatomical sites, including colon, breast, and prostate
malignancies. Other molecules, derived from fiber bacterial
intestinal degradation (short fatty acids), are of interest, even
if their importance has not been completely unraveled and is still
the subject of debate.
The 20th century has finished, the century when surgery took huge
steps forward thanks to progress in technology. Now we have entered
the "century of biotechnologies", which will not only generate
progress in surgery, but also lead to a real "cultural revolution"
that will completely change approaches to solving different
problems in medicine. The aim of this book is to bring surgeons
closer to biotechnologies and to overcome the cultural gap dividing
them from these new approaches. Biotechnologies are already
proposed and used at different levels in surgical practice: in
diagnostic technique, enabling practitioners to identify diseases
at an early stage and follow their molecular modification over
time; and in tissue engineering, where the use of "smart scaffolds"
offers a possible answer to increasing demand for biocompatible
tissues and organs in transplantation surgery. This volume focuses
on the emerging field of stem cells, analyzing both their role as
possible players in originating and perpetuating cancer - "cancer
stem cells" - and, conversely, their extraordinary therapeutical
potential. An additional section is dedicated to the evaluation and
application of derived molecular factors that can enhance the
physiological processes that are fundamentally important in
surgery, such as hemostasis and wound healing. Surgeons have always
been technologists, in the sense that since surgery began they have
always needed technology, beginning with a scalpel and surgical
instruments. They have always cooperated with technologists.
However, in the new century, the first one of the millennium, a
rapid increase in knowledge that is outside the realm of the
surgeon's traditional technological training is imposing itself -
hence the aim of this book. It is now urgent to encourage surgeons
to embrace this knowledge (biotechnology) with confidence. By its
very nature, biotechnology is completely different from the
technologies used so far, because it escapes the senses of sight
and touch, which up to now have been the essence of the surgeon's
work. The cellular and molecular dimensions of biotechnologies are
still far removed from most of the recent advances in modern
surgical techniques. A common language between surgeons and
biotechnologists will create further, revolutionary, progress in
surgical sciences in the twenty-first century.
This volume includes contributions presented at the Second
International Sym posium on Nutrition and Cancer, held in Naples,
Italy, in October 1998 at the National Tumor Institute "Fondazione
Pascale." During the Conference, experts from different disciplines
discussed pivotal and timely subjects on the interactions between
human nutrition and the development of malignancies. Comparing the
themes of this Meeting with those discussed at the First Sympo sium
in 1992, the major scientific advancements certainly derive from
the extensive use of molecular approaches to perform research in
nutrition. Moreover, the fundamental observation of R. Doll and R.
Peto (1981), which suggested that at least 35% of all cancers (with
large differences among different tumors) might be prevented by
dietary regimens, has been definitively confirmed by
epidemiological studies. On the other hand, the relationships
between diet and cancer are quite intricate and complex; it is
difficult, and at the same time not methodologically correct, to
reduce them to simple terms. Metabolic and hormonal factors,
contaminants and biological agents, and deficiency of specific
protective nutrients are all pieces of the same puzzle."
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