Anatomical, histopathological and neuropathological consequences of spinal cord injury have been reviewed previously. The present review concentrates on literature published since then, and is particularly concerned with the molecular events following spinal cord injury, with the emphasis on such events that relate to genotoxicity. Modern theories relating to oncogenes, to initiation and promotion, and to co-carcinogens are dealt with. There is overwhelming evidence in the literature for the role of hormones in the etiology of cancer.
As co-carcinogens, or agents of promotion, hormones have a prominent role in tumorigenesis through their influence on cellular environment and on the expression of growth capacity. In addition, some writers have suggested that hormones may also be important as initiators of neoplasia as well as being promoters of neoplasia initiated by other agents.
Because of the chronic nature of the results of many spinal injuries, to whatever degree of debilitation, the impact of stress on the human organism must be considered. Hormonal changes elicited by physical and psychological stress are summarized. While pain is included in the general context of stress, it is also treated from other viewpoints: recent literature on pain perception, on endogenous opiates, and on pain control are included in the review. In addition, attention is drawn to the side effects of some drugs, including analgesics as it is clear that some drugs are closely connected with carcinogenesis.
Author keywords: chiropractic, subluxation, adjustment, manipulation, oncogenes, stress, immunity, cancer, mutageneis, neuropathophysiology
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