Cancer

C a n c e r
Normal cells grow, divide, and eventually die. Cancer occurs when cell growth continues unchecked; cancer cells
continue to grow and divide and eventually overrun the healthy cells. When cancer cells enter the bloodstream or the
lymphatic system they have the potential to travel to other parts of the body and take over the tissues in other organs.
This process is called metastasis. This ability—and proclivity—of cancer to crowd out healthy cells is why the disease is
so deadly.
Where the cancer begins determines what kind of cancer the person has, even after metastasis, which may
cause several different cancers throughout the body. For example, a stomach cancer cell that migrates and forms a
tumor in the lung would still be considered a stomach cancer.
The cause of cancer is usual y a mutation to the genetic information (DNA) of a cel . These mutations can be due
to many causes, with certain cancer-causing chemicals (carcinogens), radiation (UV rays in sunlight), and viruses (like the
Human Papil omavirus (HPV)) acting as possible triggers.
Cancers often start out as tumors, which are simply the abnormal growths of rapidly dividing cells. Not all
tumors are malignant (cancerous), however; many are benign (non cancerous) and remain that way. Cancers may
also begin as a few individual abnormal cells that travel throughout the rest of the body. Leukemia is an example of
such a cancer.
Because cancers are formed differently and affect various tissues and organs, they each respond differently to
treatments. Chemotherapy uses chemicals to try to kil the cancer cel s. Radiation therapy aims to destroy the cancer by
irradiating it (subjecting it to severe radiation). Monoclonal antibody therapy takes advantage of antibodies that are used
natural y by the body to destroy infections and other foreign invasions. These monoclonal antibodies draw the attention
of the immune system onto the cancer cel s with the goal of attacking and kil ing the rogue cel s. Some of monoclonal
antibodies are combined with drugs, toxins, or other radioactive atoms to make them more powerful.
An unfortunate consequence of chemotherapy and radiation is that these treatments are not able to specifical y
target cancer cel s. Healthy cel s are damaged in the process of treatment, creating many unwanted complications.
Monoclonal antibody therapy, however, is able to target cancer cel s, leaving normal cel s unharmed. Cancers each
respond differently to each treatment and the correct combination of therapies is the subject of much research.

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Adenocarcinoma
Adenocarcinoma is a form of carcinoma that originates in glandular tissue. To be classified
as adenocarcinoma, cells need to have secretory properties. It is frequently associated with
cancers such as breast cancer, lung cancer, pancreatic cancer, and stomach cancer.
COMPANY
PRODUCT
PHASE
Adenocarcinoma
PDL BioPharma Inc
M200 (volociximab) in combination
II
with gemcitabine
SuperGen Inc
Mitomycin for Injection
M
Acute Lymphoblastic Leukemia
Acute lymphoblastic leukemia (ALL) is the most commonly diagnosed malignancy in children
and it represents nearly one-third of all pediatric cancers. In this form of cancer, a lymphoid
(white blood) cell divides uncontrollably, thus crowding the bone marrow and affecting the
body’s ability to produce healthy blood cells. The cancerous cells run the risk of spreading
throughout the body, causing further cancers and damage. The locations of the blasts
(lymphoid clusters) vary, but they are most commonly found in bone marrow, thymus, liver,
spleen, lymph nodes, testes, and CNS. According to the NIH, 6 in every 100,000 people develop
ALL, accounting for 80 percent of childhood leukemias and 20 percent of adult leukemias.
COMPANY
PRODUCT
PHASE
Acute Lymphoblastic
Leukemia
Hana Biosciences, Inc.
Marqibo with Dexamethasone
II
Hana Biosciences, Inc.
Talvesta (talotrexin) for Injection
II
Acute Myelogenous Leukemia
Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow characterized by
the growth of immature white blood cells. These abnormal leukemia cells quickly multiply and
replace normal cells. Patients with AML have difficulty fighting infection and microorganisms.
This form of cancer can occur at any age but generally affects adults and children younger than
1 year. Genetic abnormalities as well as environmental toxins are thought to contribute to the
onset of the disease.
COMPANY
PRODUCT
PHASE
Acute Myelogenous
Leukemia
Cell Genesys, Inc.
GVAX Leukemia Vaccine
II
Novartis AG
Proleukin (aldesleukin)
II
Exelixis, Inc.
XL999
II
SuperGen, Inc.
Dacogen (decitabine)
III
Berlex
Leukine (sargramostim)
M
Bladder Cancer
Bladder cancer usually takes the form of a cancerous tumor within the bladder. In the U.S.,
these cancers often start from the cells that line the bladder (transitional cells). The exact cause
of this cancer is unknown, but several risk factors have been identified. Smoking cigarettes
increases the risk five-fold and the NIH estimates that over 50 percent of bladder cancers can

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CANCER
43
be linked to cigarette smoke. Additionally, 25 percent of bladder cancers are thought to be due
to carcinogen exposure (especially arylamines) in the workplace. Dye workers, rubber workers,
aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest
risk. Also, women who have received radiation for the treatment of cervical cancer have an
increased risk of developing cancer of the bladder. Treatments focus on limiting the growth of
cancerous tumors.
COMPANY
PRODUCT
PHASE
Titan Pharmaceuticals, Inc.
Gallium Maltolate
II
Bladder Cancer
Bone Metastases
Cancer cells that metastasize for a tumor somewhere in the body most commonly end up in
bone cells and start growing. Metastases can occur in bones anywhere in the body but are
mostly found near the center of the body. Bone metastasis is one of the most frequent causes
of pain for people with cancer and can cause bones to break, high levels of cancer in the blood
and other complications. Bone metastases are not the same as cancers that start in the bone,
called primary bone cancers. Most people with cancer will develop bone metastases during the
course of their disease.
COMPANY
PRODUCT
PHASE
Berlex
Bonefos (clodronate)
PA
Bone Metastases
In 1989, as a scientist at Genentech in South San Francisco, Dr. Napoleone
Ferrara identified and cloned vascular endothelial growth factor (VEGF), the
most potent angiogenic factor known to date.
Angiogenesis is the process by which new blood vessels form. In people
with cancer, this process helps to feed tumors with blood and vital nutrients. For
more than 100 years scientists have been looking for a way to block the process,
and hopefully starve the tumor. The discovery of VEGF, which was made during
Dr. Ferrera’s discretionary lab time, added greatly to our understanding of the
biology and treatment of cancer and other diseases that involve angiogenesis.
In 1993, Dr. Ferrera demonstrated that an antibody directed at VEGF
could suppress angiogenesis and tumor growth in preclinical models, providing
compelling evidence that VEGF may play a critical role in tumor growth.
Working with other scientists at Genentech, he developed a humanized anti-
VEGF monoclonal antibody now known as Avastin® (bevacizumab). Clinical
trials of Avastin began in 1997.
In May 2003, results from a pivotal Phase III trial showed that Avastin
significantly increased survival in metastatic colorectal cancer patients. In
February 2004, Avastin was approved for the first-line treatment of metastatic
colorectal cancer in combination with intravenous 5-FU-based chemotherapy,
becoming the first anti-angiogenic therapy approved by the U.S. Food and Drug
Administration for cancer. Currently, Avastin is being studied in more than
100 clinical trials across numerous tumor types, including non-small cell lung,
breast, kidney, prostate, and pancreatic cancer.
Dr. Ferrera’s contribution to bringing anti-angiogenesis from bench to
bedside will greatly impact the lives of patients worldwide for years to come.

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44
Brain Tumor
Primary brain tumors start in the brain and may be confined to a small area of the brain, spread
to nearby areas (invasive). They may cancerous (malignant) or not cancerous (benign),. Brain
metastases are cancerous tumors that form in the brain that originated from a cancer in other
parts of the body. Brain tumors generally destroy brain cells and damage those around them.
The tumor presses against the brain, causing the brain to swell thus increasing the pressure in
the skull. The cause of these tumors is unknown and, because there are many different types,
many different risk factors may play a role. Tumors can happen at any age, though gliomas,
metastases, and meningiomas are more common in adults.
COMPANY
PRODUCT
PHASE
Brain Tumor
Genentech, Inc.
Avastin (bevacizumab)
II
Direct Therapeutics, Inc.
DTI-015 (carmustine)
II
Genentech, Inc.
INO-1001
II
Genentech, Inc.
Tarceva (erlotinib)
II
Pharmacyclics, Inc.
Xcytrin (motexafin gadolinium) and Radiation
II
Pharmacyclics, Inc.
Xcytrin (motexafin gadolinium) and
II
Temodar (Temozolomide)
Brain Metastases
Pharmacyclics, Inc.
Xcytrin with Stereotactic radiosurgery
II
Pharmacyclics, Inc.
Xcytrin (motexafin gadolinium) and Radiation
III
Brain Tumor
Neurobiological
Xerecept
III
Technologies, Inc.
Genomic Health, Inc., a life science company located in Redwood City, California,
conducts sophisticated genomic research to develop clinically validated molecular
diagnostics, which provide individualized information on the likelihood of
disease recurrence and response to certain types of therapy. These diagnostic
technologies generate information that physicians and patients can use in making
treatment decisions.
The first diagnostic test developed by Genomic Health, Oncotype DX™, is
the first breast cancer test that uses the unique gene expression profile of a patient’s
tumor to quantify the likelihood that her cancer wil recur. Oncotype DX can provide
doctors with a better understanding of the aggressiveness of individual tumors, and
can also assess a patient’s likely benefit from certain types of chemotherapy.
Oncotype DX works by analyzing a specific set of genes within a tumor to
determine a Recurrence Score™. The Recurrence Score is a number between 0 and
100 that corresponds to a specific likelihood of breast cancer recurrence within 10
years of the initial diagnosis. This information may provide an added measure of
confidence that the treatment plan is tailored to the patient’s individual disease.
By integrating Oncotype DX into the clinical decision-making process,
healthcare professionals may be able to make more informed treatment decisions.

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CANCER
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Breast Cancer
Breast cancer is a cancer of the breast tissue. The American Cancer Society estimates that in
2006, 212,920 new cases of breast cancer will be diagnosed in the United States alone. Women
are most commonly affected by the disease, with one out of every 8 women developing
the cancer at some point in their lives. After lung cancer, breast cancer is the second most
fatal cancer to women. Men also are occasionally diagnosed with breast cancer because the
tissues are the same as in women. Nobody knows for sure what causes this common cancer,
but research studies show that age, alcohol intake, obesity, and hormonal fluctuations may
contribute to the development of the disease.
The American Cancer Society recommends that women over the age of 40 get annual
mammograms from their health care providers, in addition to regular monthly breast self-
exams. These tests can help detect a lump if cancer is present. Other symptoms may include
breast discharge, nipple inversion, and surface changes to the skin of the breast. Through
routine examinations and subsequent early detection, there is a high survival rate for those with
breast cancer.
COMPANY
PRODUCT
PHASE
Kosan Biosciences, Inc.
17-AAG
II
Breast Cancer
Threshold Pharmaceuticals, Inc.
Glufosfamide
II
Cytokinetics, Inc.
Ispinesib / SB-715992
II
Kosan Biosciences, Inc.
KOS-862 (epothilone D)
II
Kosan Biosciences, Inc.
KOS-862 (epothilone D) and Herceptin
II
Onyx Pharmaceuticals, Inc.
Nexavar (sorafenib)
II
Genentech, Inc.
Omnitarg (pertuzumab) / R1273
II
Kosan Biosciences, Inc.
Tanespimycin (KOS-953) with Herceptin
II
Genentech, Inc.
Tarceva (erlotinib)
II
Telik, Inc.
Telcyta / TLK286
II
Exelixis, Inc.
XL 119 (Rebeccamycin Analogue)
II
Intarcia Therapeutics, Inc.
Atamestane
III
Genentech, Inc.
Herceptin (trastuzumab) plus Chemotherapy
III
Genentech, Inc.
Herceptin combination with hormonal therapy
III
Genentech, Inc.
Avastin (bevacizumab) with Chemotherapy
PA
Genentech, Inc.
Herceptin (trastuzumab)
PA
Genentech, Inc.
Herceptin (trastuzumab)
M

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46
Cancer
A cancer is generally defined as the uncontrollable growth and replication of cells. This can
occur virtually anywhere in the body, in any tissue or organ. When the cancer is detected early
there is a good chance that chemotherapy and radiation treatments will be able to eradicate
the cancer cells from the body. Therapies are currently in development to increase the body’s
own immune response to cancer cells, thus reducing pain and the need for chemotherapy.
COMPANY
PRODUCT
PHASE
Cancer Pain
Jazz Pharmaceuticals
Butamben (butyl-p-amino benzoate)
II
Cancer
Cellerant Therapeutics, Inc.
CLT-001
II
VaxGen, Inc.
IGN311/ HuABL364
II
Cancer Chemotherapy
Pharmagenesis, Inc.
Xuebao / PG2
II
Pharmagenesis, Inc.
Injectable Astragalus Polysaccharide / PG2
M
Cancer
SciClone Pharmaceuticals, Inc.
Zadaxin (thymalfasin)
M
Chemotherapy Induced Side Effects
Cancer is often treated with a combination of medications, radiation, and chemotherapy.
Radiation and chemotherapy, unfortunately, bring with them a variety of side effects ranging
from hair loss and appetite changes to decreased general immune function. Current treatments
attempt to lessen the severity and occurrences of these effects, making the lives of the patients
easier and more hopeful.
COMPANY
PRODUCT
PHASE
Chemotherapy-induced
Intarcia Therapeutics, Inc.
Biomed 101
II
Side Effects
Planet Biotechnology Inc.
DoxoRx
II
AP Pharma, Inc.
APF530
III
Hana Biosciences, Inc.
Zensana (ondansetron hydrochloride)
PA
Oral Spray
I am a patient diagnosed with chronic lymphocytic leukemia in 1994. Although asymptomatic
for the first five years, I required oral chemotherapy in the form of Chlorambucil beginning
in 1999. This treatment was effective until 2004, when I began infusion chemotherapy of a
combination of three medications: Rituxan, Cytoxan and Fludarabine. Five months of this
regimen was extremely successful in returning blood chemistry to near normal levels, which
has been sustained without medication for over one year.
Prior to beginning infusion chemotherapy for the first time, I was fortunate to
become associated with one of the patient services provided by The Leukemia & Lymphoma
Society (www.lls.org) entitled “First Connection.” This national program matches current
and veteran blood cancer patients of similar ages, diagnoses and treatments in order to help
lower anxiety and provide realistic feedback and peer support. My experience as a recipient
of this service was so helpful, I subsequently became part of the First Connection volunteer
corps and have engaged in many fulfilling interactions with leukemia and lymphoma
patients. Patients and caregivers in the greater Bay Area can learn more
about First Connection, and other services provided by The Leukemia & Lymphoma
Society, by contacting Shirley McGrath, Patient Services Manager, at (415) 625-1105
(Shirley.McGrath@lls.org).

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Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia (CLL) results from an injury to the DNA of a single cell in the
bone marrow, a lymphocyte. This injury occurs later in life and scientists do not know what
the cause of the damage to the DNA is. Because of the altered cell DNA, CLL cells are able to
grow uncontrollably in the bone marrow, causing an increased concentration of those cells
in the blood. The CLL cells do not affect normal blood cell production as is the cause in acute
lymphocytic leukemia, lessening the symptoms in the early stages of the disease. According
to the Leukemia & Lymphoma Society, nearly 10,020 people are diagnosed with chronic
lymphocytic leukemia in the United States each year, most of whom are over 50 years old at the
time of diagnosis.
COMPANY
PRODUCT
PHASE
Novacea, Inc.
Banoxantrone / AQ4N
II
Chronic
Lymphocytic Leukemia
Geron Corporation
GRN163L
II
Genitope Corp.
MyVax / GTOP-99
II
SuperGen, Inc.
Nipent plus Cyclophosphamide, Rituximab
II
SuperGen, Inc.
Orathecin (rubitecan)
II
Pharmacyclics, Inc.
Xcytrin (motexafin gadolinium)
II
Genentech, Inc.
Rituxan (rituximab)
III
Berlex
Campath (alemtuzumab)
M
Berlex
Fludara (fludarabine phosphate)
M
SuperGen, Inc.
Nipent (pentostatin for injection)
PM
Chronic Myelogenous Leukemia
Chronic myelogenous leukemia (CML) results from an injury to the DNA of a stem cell,
specifically to the Philadelphia chromosome, in the bone marrow. This causes white blood
cells to grow uncontrollably and can lead to their massive increase in the blood. Though there
is an excess of white blood cells, they generally function normally, allowing the early course
of the disease to be less severe than other forms of leukemia. The Leukemia & Lymphoma
Society estimates that approximately 4,500 new cases are diagnosed each year in the United
States. CML typically occurs in adults, with only 2.6 percent of child leukemias classified as CML.
Treatments involve stem cell transplantation and medications.
COMPANY
PRODUCT
PHASE
SuperGen, Inc.
Dacogen (decitabine) and Gleevec (imatinib)
II
Chronic
Myelogenous Leukemia
Cell Genesys, Inc.
GVAX Leukemia Vaccine
II
PDL BioPharma, Inc.
IV Busulfex injection (busulfan)
M

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Amgen, a biotechnology pioneer, discovers, develops and delivers innovative
human therapeutics. Our medicines have helped millions of patients in the fight
against cancer, kidney disease, rheumatoid arthritis and other serious illnesses.
With a deep and broad pipeline of potential new medicines, we continue to
advance science to serve patients.
In October 2006, Amgen introduced Amgen™ Oncology Assistance
(AOA), a comprehensive, multi-faceted financial assistance program for cancer
patients in the United States. Through AOA, patients who are uninsured,
underinsured, or unable to afford their insurance co-payments will receive help
obtaining financial support for Amgen’s cancer medicines.
AOA expands and consolidates the company’s existing financial
assistance programs into a simplified package with a single gateway:
• The new Vectibix Cap limits total out-of-pocket patient
co-payments for Vectibix in the United States, regardless of
income or insurance status. Once a patient reaches the cap
(5 percent of their adjusted gross income), he or she will
become eligible for the SAFETY NET® Foundation.
• The SAFETY NET® Foundation is a well-established patient
assistance program that provides Amgen oncology medicines at
no cost to qualifying uninsured patients. Available to patients
with household adjusted gross incomes of up to $75,000 per
year, The SAFETY NET® Foundation is one of the most generous
oncology product donation programs in the industry.
• Amgen also donates millions of dollars to independent third-
party administered patient assistance programs to help reduce
the financial burden for uninsured or low-income patients.
For more information about Amgen™ Oncology Assistance, please visit
www.amgenoncologyassistance.com or call 1-800-272-9376.
Colon Cancer/Colorectal Cancer
Colorectal cancer starts either in the large intestine (colon) or in the rectum (end of the
colon), most commonly in the lining of the large intestine. Like many other cancers, there is
no single cause for colorectal cancer. Research shows that most colorectal cancers begin as
benign polyps, which over a period of many years, develop into cancers. Other factors that can
contribute are ulcerative colitis, a family history of colon cancer and a high-meat, high-fat, low-
fiber diet. The National Institute of Health estimates that there are over 130,000 new diagnosed
cases of colorectal cancer in the United States each year, and over 50,000 deaths. Early detection
through colonoscopy is the key to surviving this disease.

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COMPANY
PRODUCT
PHASE
SuperGen, Inc.
Avicine
II
Colorectal Cancer
Threshold Pharmaceuticals, Inc.
Glufosfamide
II
Colon Cancer
Receptor BioLogix
Insegia (G17DT immunogen) / Gastrimmune
II
Colorectal Cancer
Cytokinetics, Inc.
Ispinesib / SB-715992
II
Onyx Pharmaceuticals, Inc.
Nexavar (sorafenib)
II
Amgen, Inc.
Panitumumab / AB-EGF with chemotherapy
II
Telik, Inc.
Telcyta / TLK286
II
Exelixis, Inc.
XL999
II
Genentech, Inc.
Avastin (bevacizumab)
III
Genentech, Inc.
Tarceva (erlotinib)
III
Amgen, Inc.
Panitumumab / ABX-EGF
III
Amgen, Inc.
Panitumumab / ABX-EGF with chemotherapy
III
Berlex
PTK/ZK
III
Amgen, Inc.
Panitumumab / ABX-EGF
PA
Genentech, Inc.
Avastin (bevacizumab) with
M
chemotherapy (First-Line)
Genentech, Inc.
Avastin (bevacizumab) with
M
chemotherapy (Second-Line)
Esophageal Cancer
Esophageal cancer is one of several various malignancies of the esophagus. Symptoms
generally include difficulty swallowing hard or bulky foods and localized pain. A biopsy is the
best way to determine whether or not cancer is present. Due to the difficulty of swallowing,
many patients experience substantial weight loss as a result of inadequate nutrition. Early
detection is paramount to surviving this form of cancer.
COMPANY
PRODUCT
PHASE
Receptor BioLogix
Insegia (G17DT immunogen) / Gastrimmune
II
Esophageal Cancer
Gastrointestinal Cancer
Gastrointestinal (GI) cancer refers to cancer that forms within the gastrointestinal tract,
somewhere in the esophagus, stomach, liver, biliary system, pancreas, bowels, or anus. Due
to the central location of the cancer there is a somewhat higher possibility that the damaged
cells will travel to other parts of the body. Doctors and scientists have not come to a consensus
as what causes cancer to form in the gastrointestinal tract but they have identified several
risk factors. Most patients with the disease are 72 years of age or older and they tend to
be men. Persons of Asian, Pacific Islander, Hispanic and African American descent have a
statistically higher chance of developing GI cancer compared to non-Hispanic white Americans.

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Additionally, eating smoked, salted or pickled foods may lead to an increased risk, whereas
eating fresh fruits and vegetables lowers the risk. Also, as with several other cancers, cigarette
smokers tend to see increased rates of stomach cancers.
COMPANY
PRODUCT
PHASE
Gastrointestinal
Receptor BioLogix
Insegia (G17DT immunogen) / Gastrimmune
II
(Stomach) Cancer
SuperGen, Inc.
Orathecin (rubitecan)
II
Amgen, Inc.
T607
III
Hairy Cell Leukemia
Hairy cell leukemia (HCL) is a cancer of white blood cells that leads to low counts of normal
blood cells. The disease is named after abnormally developed white blood cells that look “hairy”
under the microscope due to fine projections coming from their surface. Symptoms can include
weakness, fatigue, weight loss, easy bruising, and swollen lymph glands. The causes for the
disease are unknown. The National Institutes of Health estimate that the disease affects men
5 times more often than women, with 55 being the average age of onset. HCL is rare and only
accounts for 2 percent of diagnosed leukemias each year.
COMPANY
PRODUCT
PHASE
Hairy Cell Leukemia
SuperGen Inc

Nipent (pentostatin for injection)
M
Head and Neck Cancer
Head and neck cancers typically begin in the mucous linings in the head and neck, such as
the sinuses, mouth, and larynx. Symptoms of such a cancer usually include a lump or sore that
does not heal, a persistent sore throat, difficulty swallowing, and a change or hoarseness in the
voice. The most common cause of this form of cancer is prolonged tobacco use. The American
Academy of Otolaryngology estimates that 55,000 Americans will develop this form of cancer
this year in 2006, with 13,000 dying as a result of the disease. Refraining from smoking is the
best way to prevent onset of this disease. Early detection is key to effective treatment and
improved survival.
COMPANY
PRODUCT
PHASE
Head and Neck Cancer
Cytokinetics, Inc.
Ispinesib / SB-715992
II
Genentech, Inc.
Tarceva (erlotinib)
II
Genentech, Inc.
Tarceva (erlotinib) and Docetaxel with Cisplatin
II
Kidney Cancer
The kidneys are a pair of bean-shaped organs attached to the upper back wall of the abdominal
cavity and protected by the lower ribcage. The main job of the kidneys is to filter excess water,
salt and waste products out of the body and blood. These filtered products are concentrated
into urine and passed out of the body. Though the kidneys perform a vital function, less than
one full kidney is actually needed by the body. When both kidneys cease to function properly,
patients must be connected to an external dialysis machine to filter their blood.
The most common of kidney cancers, renal cell carcinoma, usually begins as a small
tumor within the kidney and grows and spreads throughout the organ. As with other cancers,
when the tumors are found early they can be removed and the patient can be treated with
chemotherapy to rid the body of cancer cells. Once the cancer has metastasized (spread),
however, it becomes much more difficult to treat. Treatments are being developed to prevent or
slow tumor growth and metastasis.

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