Cancer

There is a lot of conceptual engineering going on in medical research. I substantiate this claim with two examples, the medical debate about cancer classification and about obesity as a disease I also argue that the proper target of conceptual engineering in medical research are experts’ conceptions. These are explicitly written down in documents and guidelines, and they bear on research and policies. In the second part of the chapter, I propose an externalist framework in which conceptions have both the (...) explanatory power of psychological concepts and that of semantic concepts. It is likely, however, that human activities and practices distinct from medical research, and regulated by different practices and epistemic rules, call for different targets for conceptual engineering. I conclude with indicating an open agenda of problems for philosophers of medicine interested in conceptual engineering. (shrink)

Cancer biologists ascribe normal functions to parts of cancer. Normal functions are activities that parts of systems are in some minimal sense supposed to perform. Cancer biologists’ finding normality within the abnormality of cancer pose difficulties for two main approaches to normal function. One approach claims that normal functions are activities that parts are selected for. However, some parts of cancers that have normal functions aren’t selected to perform them. The other approach claims that normal functions are part-activities typical for (...) the system and that contribute to survival/reproduction. However, cancers are too heterogeneous to establish what’s typical across a type. (shrink)

Cancer biology features the ascription of normal functions to parts of cancers. At least some ascriptions of function in cancer biology track local normality of parts within the global abnormality of the aberration to which those parts belong. That is, cancer biologists identify as functions activities that, in some sense, parts of cancers are supposed to perform, despite cancers themselves having no purpose. The present paper provides a theory to accommodate these normal function ascriptions—I call it the Modeling Account of (...) Normal Function (MA). MA comprises two claims. First, normal functions are activities whose performance by the function-bearing part contributes to the self-maintenance of the whole system and, thereby, results in the continued presence of that part. Second, MA holds that models of system-level activities that are (partly) constitutive of self-maintenance are improved by including a representation of the relevant function-bearing part and by making reference to the activity/activities that part performs which contribute(s) to those system-level activities. I contrast MA with two other accounts that seek to explicate the ascription of normal functions in biology, namely, the organizational account and the selected effects account. Both struggle to extend to cancer biology. However, I offer ecumenical readings which allow them to recover some ascriptions of normal function to parts of cancers. So, though I contend that MA excels in this respect, the purpose of this paper is served if it provides materials for bridging the gap between cancer biology, philosophy of cancer, and the literature on function. (shrink)

Since its initial publication in 2018, Professor Anya Plutynski’s Explaining Cancer: Finding Order in Disorder has garnered a great deal of accolades.1 In 2021, The London School of Economics and Political Science conferred Professor Plutynski the Lakatos Award, recognizing the book’s significant contribution to the philosophy of science. On the heels of its recent reissuing as a paperback, it is an ideal time to revisit this remarkable work.

Lung cancer is a serious and deadly disease that affects the lungs, which are responsible for taking in oxygen and expelling carbon dioxide from the body. The disease can develop in any part of the lungs and is usually caused by smoking or exposure to certain chemicals. The main Objective: of this expert system is to provide an accurate diagnosis of lung cancer and the appropriate treatment options. In this paper, Methods: we present the design and implementation of an expert (...) system that can assist physicians in diagnosing lung cancer and determining the best course of treatment. The system provides an overview of the disease, its causes, symptoms, diagnosis, and treatment, along with relevant medical information. Results: The system was developed using the Clips expert system language and evaluated by medical professionals who found it to be an effective tool for diagnosing and treating lung cancer. Conclusion: The proposed expert system has the potential to improve patient outcomes and reduce healthcare costs associated with the treatment of lung cancer. (shrink)

Built-in decision thresholds for AI diagnostics are ethically problematic, as patients may differ in their attitudes about the risk of false-positive and false-negative results, which will require that clinicians assess patient values.

Objective: Hashimoto’s thyroiditis is the most common autoimmune thyroid disease. Papillary thyroid cancer is the most common thyroid cancer. Whether Hashimoto’s thyroiditis is a predisposing factor for papillary thyroid cancer remains unclear. In this study, the frequency of papillary thyroid cancer was investigated in patients with Hashimoto’s thyroiditis who underwent total thyroidectomy. -/- Methods: In this study, 534 patients were screened retrospectively. Preoperative thyroid function tests, anti-thyroid antibodies, ultrasonography findings, fine-needle aspiration biopsies, and thyroidectomy pathology results were examined. According to (...) the pathology, 139 patients had Hashimoto’s thyroiditis. Patients with Hashimoto’s thyroiditis (group 1) and non-Hashimoto’s thyroiditis (group 2) were compared. -/- Results: Papillary thyroid cancer was found in 70 patients (50.4%) in group 1 and 156 patients (39.5%) in group 2 (P=.026). The odds ratio was 1.59 (95% CI; 1.07-2.34). There was no difference for sex, age, tumor size, microcarcinoma–macrocarcinoma distribution, subtype, number of tumor focus, lymph node metastasis, vessel invasion, and extrathyroidal spread. -/- Conclusion: We found more papillary thyroid cancer and less capsular invasion in patients with Hashimoto’s thyroiditis, but we did not find any differences between groups in terms of age, gender, tumor size, vascular invasion, and metastasis. According to these findings, Hashimoto’s thyroiditis may be a risk factor for papillary thyroid cancer. (shrink)

In this paper, we developed an Artificial Neural Network (ANN) for detect the absence or presence of lung cancer in human body. Symptoms were used to diagnose the lung cancer, these symptoms such as Yellow fingers, Anxiety, Chronic Disease, Fatigue, Allergy, Wheezing, Coughing, Shortness of Breath, Swallowing Difficulty and Chest pain. They were used and other information about the person as input variables for our ANN. Our ANN established, trained, and validated using data set, which its title is “survey lung (...) cancer”. Model evaluation showed that the ANN model is able to detect the absence or presence of lung cancer with 96.67 % accuracy. -/- . (shrink)

Background: Chronic myeloid leukemia (CML) is a hematopoietic stem cell disease, associated with a reciprocal translocation between chromosomes 9 and chromosome 22, lead to the formation of the BCRABL fusion gene (Philadelphia chromosome). This fusion gene is believed to play golden role in the initial development of CML with constitutive tyrosine kinase activation. Successful use of tyrosine kinase inhibiters (TKIs) play a role in improve survival and increase prevalence of CML, but un fortunately mutations in the BCR-ABL kinase domain may (...) cause, or contribute to increase, resistance to TKIs in CML patients. . Objective: This study was designed to assess the association of five most common BCR-ABL kinase domain mutations (T315I, M351T, E255K, M244V and E255V) with resistance state of CML patients on TKIs in Iraqi Middle Euphrates region. Patients and methods: A retrospective case-control study in which 85 patients with chronic myeloid leukemia in chronic phase (45 patients as cases group and 40 patient as control group) were selected from three hemato-oncology centers in middle Euphrates in Iraq during the period from January 2016 till October 2016 out of a total of 240 CML patients (108 male and 132 female) who were registered during this period in these three centers and all patients on TKI (Imatinib and Nilotinib). Venous blood sampling done for BCRABL kinase domain mutations screening. Results: four patients from cases group (4/45) were carriers of one of five selected ABL kinase domain mutations and no one of control group. T315I mutation was detected in 3/45 (6.6 %) of resistant patients, with a significant risk association to develop resistance to TKI therapy (odd ratio and C. I.) (6.67, 0.3340 - 133.2255). E255V was detected in 1/45 (2.2 %) and also had significant risk association to develop resistance to TKIs (odd ratio, C.I.) (2.73, 0.1081 -68.9424). No one of these mutations had significance correlation with demographic or hematological features. M351T, E255K and M244V were not detected in any one of our study groups CML patients. Conclusions: T315I and E255V among five ABL kinas domain mutations were detected in our CML patients with resistance to TKIs. All of them may play a role in development variable degree of resistance to first and second generation TKIs weather primary or secondary.T315I mutation is most common mutation within BCR-ABL domain kinase gene. (shrink)

We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is particularly apparent in this (...) case. We also identify three practical reasons why RCTs do not qualify as the best option for PET validation, which have to do with specific characteristics of nuclear diagnostic imaging, and of radiopharmaceuticals. The paper is meant to contribute both to the philosophical discussion on the EBM hierarchy of evidence, and on the specific debate on radiopharmaceuticals in nuclear medicine. (shrink)

In this paper, we developed an Artificial Neural Network (ANN) for detect the absence or presence of lung cancer in human body. Symptoms were used to diagnose the lung cancer, these symptoms such as Yellow fingers, Anxiety, Chronic Disease, Fatigue, Allergy, Wheezing, Coughing, Shortness of Breath, Swallowing Difficulty and Chest pain. They were used and other information about the person as input variables for our ANN. Our ANN established, trained, and validated using data set, which its title is “survey lung (...) cancer”. Model evaluation showed that the ANN model is able to detect the absence or presence of lung cancer with 96.67 % accuracy. (shrink)

According to the biomedical model of medicine, the subject of the illness event is the pathology rather than the person diagnosed with the disease. In this view, a body-self becomes a ‘patient’ body-object that can be enrolled in a therapeutic protocol, investigated, assessed, and transformed. How can it be possible for cancer patients to make sense of the opposite dimensions of their body-self and their body-diseased-object? Could a creative embodied approach enable the coping with trauma tied to the experience of (...) illness? By applying a phenomenological approach and auto-ethnographic analysis to the experience of cancer, this visual exploration provides support for rethinking the cancer event through a performative perspective. This work previews images and video material collected over ten years of haematological treatments, video dance performances and physical explorations. This work displays how processes of healing can be set in motion by creative embodied practices, physical explorations and unexpected journeys. By resisting the biomedical model and allowing the emergence of new meanings, it illustrates how dance and performative practices offer ground for transformation. (shrink)

The “Expert System for Diagnosing Breast Cancer" is used to assist medical students to improve their education on diagnosis and counseling the process of analyzing the biopsy image of the microscope, determining the type of tumor and the treatment method for each case and identifying the disease related questions. According to the Ministry of Health in its annual report in Gaza, between 2009 and 2014 there are 7069 cases of breast cancer, and in 2014 there are 1502 cases of breast (...) cancer . We are now in the age of visual information where 65% of the populations are visual learners; the expert system is the easiest way to ensure students remember the information in the long term, using visual and textual information. The expert system has an easy-to-use interface to help students diagnose the disease and enhance their information about the disease; the system can be used on smart phones. This expert system can be divided into three main parts: The first part is specific questions for the patient, to help student to know questions type. The second part is the process of analyzing the biopsy sample image, to see if the biopsy image is intact or infected. The last part is the video shows ways to treat breast cancer in the form of animation. (shrink)

The Knowledge Based System for Diagnosing Breast Cancer is used to assist medical students to improve their education on diagnosis and counseling the process of analyzing the biopsy image of the microscope, determining the type of tumor and the treatment method for each case and identifying the disease related questions. According to the Ministry of Health in its annual report in Gaza, between 2009 and 2014 there are 7069 cases of breast cancer, and in 2014 there are 1502 cases of (...) breast cancer . We are now in the age of visual information where 65% of the populations are visual learners; the Knowledge Based System is the easiest way to ensure students remember the information in the long term, using visual and textual information. The Knowledge Based System has an easy-to-use interface to help students diagnose the disease and enhance their information about the disease; the system can be used on smart phones. This Knowledge Based System can be divided into three main parts: The first part is specific questions for the patient, to help student to know questions type. The second part is the process of analyzing the biopsy sample image, to see if the biopsy image is intact or infected. The last part is the video shows ways to treat breast cancer in the form of animation. (shrink)

Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predomi- nantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase ‘paradigm shift’ in (...) his groundbreaking book The Structure of Scientific Revolutions. He argued that the arrival of the new and often incompatible idea forms the core of a new paradigm, the birth of an entirely new way of thinking. This article discusses whether Steiner and col- leagues truly brought about a paradigm shift in oncological surgery. By rejecting the principle of en block resection and by replacing it with the belief that not only is it oncologically safe to cut through the substance of the tumour but in doing so one can actually achieve better results, Steiner was able to truly revolutionise the man- agement of laryngeal cancer. Even though within this article the repercussions of his insight are limited to the upper aerodigestive tract oncological surgery, his willingness to question other peoples’ dogma makes his contribution truly a genuine paradigm shift. (shrink)

I argue that ductal carcinoma in situ (DCIS), the tumor most commonly diagnosed by breast mammography, cannot be confidently classified as cancer, that is, as pathological. This is because there may not be dysfunction present in DCIS—as I argue based on its high prevalence and the small amount of risk it conveys—and thus DCIS may not count as a disease by dysfunction-requiring approaches, such as Boorse’s biostatistical theory and Wakefield’s harmful dysfunction account. Patients should decide about treatment for DCIS based (...) on the risks it poses and the risks and benefits of treatment, not on its disease status. (shrink)

In accordance with the critical women’s health literature recounting the ways that women are encouraged to submit themselves to various sorts of health “imperatives”, I investigate the messages tacitly conveyed to women in “campaigns for the cure” and breast cancer awareness efforts, which, I argue, overemphasizes a “positive attitude”, healthy lifestyle, and cure rather than prevention of this life-threatening disease. I challenge that the message of hope pervading breast cancer discourse silences the despair felt by many women, furthers a tacit (...) blaming for disease infliction via a rhetoric of personal responsibility, underemphasizes other cogent health determinants like environmental toxicity, and undermines legitimate critiques of current biomedical practices like widespread mammography. While finding a cure for breast cancer is a laudable and worthwhile healthcare goal that can understandably be shared by women’s health activists, corporate sponsors, and the medical community, this paper resists the current formation of campaigns for the cure and “pink ribbon activism” in general. (shrink)

In this paper we present applications of the ACGT Master Ontology (MO) which is a new terminology resource for a transnational network providing data exchange in oncology, emphasizing the integration of both clinical and molecular data. The development of a new ontology was necessary due to problems with existing biomedical ontologies in oncology. The ACGT MO is a test case for the application of best practices in ontology development. This paper provides an overview of the application of the ontology within (...) the ACGT project thus far. (shrink)

Ontological principles are needed in order to bridge the gap between medical and biological information in a robust and computable fashion. This is essential in order to draw inferences across the levels of granularity which span medicine and biology, an example of which include the understanding of the roles of tumor markers in the development and progress of carcinoma. Such information integration is also important for the integration of genomics information with the information contained in the electronic patient records in (...) such a way that real time conclusions can be drawn. In this paper we describe a large multi-granular datasource built by using ontological principles and focusing on the case of colon carcinoma. (shrink)

This article, based on a case study, examines issues of confidentiality and family impact in a diagnosis of Huntington's disease. Genetic-based illness transcends individualistic models of patient autonomy because it also involves other family members, requiring a new approach to patient confidentiality.

This chapter considers ethical issues involved in genetic testing and screening for susceptibility to various forms of cancer.