mkdir -p /home/daytona/workspace/cancer-ppt && ls /home/daytona/workspace/cancer…

~/cancer-ppt/create_cancer_ppt.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Understanding Cancer";
pres.author = "Orris Medical";

// ── COLOR PALETTE ──────────────────────────────────────────────
const DARK_BG  = "0D1B2A";   // deep navy  (dominant)
const MID_BG   = "1B2A3E";   // slightly lighter navy
const ACCENT   = "E63946";   // vivid red
const ACCENT2  = "F4A261";   // warm amber
const WHITE    = "FFFFFF";
const LIGHT    = "CBD5E1";   // soft blue-grey text
const TEAL     = "2EC4B6";   // teal highlight

// ── HELPER: add a full-bleed background rect ──────────────────
function bg(slide, color) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color } });
}

// ── HELPER: bottom accent bar ─────────────────────────────────
function bottomBar(slide, color) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 5.325, w: "100%", h: 0.3, fill: { color } });
}

// ── HELPER: section label pill ────────────────────────────────
function sectionPill(slide, text, x, y) {
  slide.addShape(pres.ShapeType.roundRect, { x, y, w: 2.8, h: 0.35, fill: { color: ACCENT }, rectRadius: 0.15 });
  slide.addText(text, { x, y, w: 2.8, h: 0.35, fontSize: 10, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
}

// ── HELPER: left accent stripe ────────────────────────────────
function leftStripe(slide, color) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.12, h: "100%", fill: { color } });
}

// ── HELPER: icon circle ───────────────────────────────────────
function iconCircle(slide, emoji, x, y, size, fillColor) {
  slide.addShape(pres.ShapeType.ellipse, { x, y, w: size, h: size, fill: { color: fillColor } });
  slide.addText(emoji, { x, y, w: size, h: size, fontSize: size * 18, align: "center", valign: "middle", margin: 0 });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, DARK_BG);

  // Large diagonal accent shape
  s.addShape(pres.ShapeType.rect, { x: 6.5, y: 0, w: 3.5, h: 5.625, fill: { color: ACCENT }, rotate: 0 });
  // Soften with a semi-transparent overlay strip
  s.addShape(pres.ShapeType.rect, { x: 6.5, y: 0, w: 0.3, h: 5.625, fill: { color: MID_BG } });

  // Red cell / cancer cell motif (decorative circles)
  const circleData = [
    { x: 7.1, y: 0.3, w: 0.8, h: 0.8, c: "C1121F" },
    { x: 8.2, y: 0.9, w: 1.1, h: 1.1, c: "E63946" },
    { x: 7.4, y: 1.6, w: 0.6, h: 0.6, c: "FF6B6B" },
    { x: 8.5, y: 2.2, w: 0.9, h: 0.9, c: "C1121F" },
    { x: 7.0, y: 2.8, w: 1.2, h: 1.2, c: "E63946" },
    { x: 8.1, y: 3.8, w: 0.7, h: 0.7, c: "FF6B6B" },
    { x: 7.5, y: 4.5, w: 0.9, h: 0.9, c: "C1121F" },
  ];
  circleData.forEach(d => {
    s.addShape(pres.ShapeType.ellipse, { x: d.x, y: d.y, w: d.w, h: d.h, fill: { color: d.c }, line: { color: WHITE, width: 0.5, transparency: 60 } });
  });

  // Title
  s.addText("UNDERSTANDING", { x: 0.5, y: 1.0, w: 6.0, h: 0.7, fontSize: 28, bold: true, color: LIGHT, charSpacing: 8, align: "left", valign: "middle", margin: 0 });
  s.addText("CANCER", { x: 0.5, y: 1.7, w: 6.0, h: 1.2, fontSize: 72, bold: true, color: WHITE, charSpacing: 4, align: "left", valign: "middle", margin: 0 });

  // Red underline bar
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 3.0, w: 4.0, h: 0.06, fill: { color: ACCENT } });

  s.addText("Etiology · Pathogenesis · Classification\nDiagnosis · Treatment · Prevention", {
    x: 0.5, y: 3.2, w: 6.0, h: 0.9, fontSize: 16, color: LIGHT, align: "left", valign: "top", margin: 0
  });

  s.addText("For Medical Students & Professionals", {
    x: 0.5, y: 4.6, w: 5.5, h: 0.5, fontSize: 13, italic: true, color: TEAL, align: "left", valign: "middle", margin: 0
  });

  s.addText("Sources: Robbins Pathology · Goldman-Cecil Medicine · Schwartz's Surgery · Katzung Pharmacology", {
    x: 0.5, y: 5.25, w: 9.0, h: 0.3, fontSize: 8, color: "607080", align: "left", valign: "middle", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 2 — WHAT IS CANCER? (Definition)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, DARK_BG);
  leftStripe(s, ACCENT);

  // Top header band
  s.addShape(pres.ShapeType.rect, { x: 0.12, y: 0, w: "100%", h: 1.0, fill: { color: MID_BG } });

  sectionPill(s, "DEFINITION", 0.3, 0.32);
  s.addText("What is Cancer?", { x: 3.3, y: 0.1, w: 6.5, h: 0.8, fontSize: 32, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  // Core definition box
  s.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.1, w: 9.4, h: 1.1, fill: { color: "1C3A55" }, rectRadius: 0.1, line: { color: ACCENT, width: 1.5 } });
  s.addText("Cancer is a group of diseases characterized by uncontrolled cell growth and proliferation, resulting from accumulation of genetic mutations in oncogenes and tumor suppressor genes, with capacity for local invasion and distant metastasis.", {
    x: 0.5, y: 1.15, w: 9.0, h: 1.0, fontSize: 14, color: WHITE, align: "left", valign: "middle", margin: 0
  });

  // Key facts row
  const facts = [
    { icon: "🧬", label: ">100 types", sub: "of cancer exist" },
    { icon: "📊", label: "#2 cause", sub: "of death worldwide" },
    { icon: "🔬", label: "Clonal origin", sub: "arises from single cell" },
    { icon: "⚠️",  label: "Genetic disease", sub: "somatic mutations" },
  ];
  facts.forEach((f, i) => {
    const x = 0.3 + i * 2.4;
    s.addShape(pres.ShapeType.roundRect, { x, y: 2.4, w: 2.2, h: 1.6, fill: { color: "162840" }, rectRadius: 0.12, line: { color: TEAL, width: 1 } });
    s.addText(f.icon, { x, y: 2.45, w: 2.2, h: 0.55, fontSize: 24, align: "center", margin: 0 });
    s.addText(f.label, { x, y: 2.98, w: 2.2, h: 0.4, fontSize: 14, bold: true, color: ACCENT2, align: "center", margin: 0 });
    s.addText(f.sub,   { x, y: 3.35, w: 2.2, h: 0.35, fontSize: 11, color: LIGHT, align: "center", margin: 0 });
  });

  // Benign vs Malignant
  s.addText("Benign vs. Malignant Tumors", { x: 0.3, y: 4.15, w: 9.4, h: 0.35, fontSize: 13, bold: true, color: TEAL, margin: 0 });
  const cols = [
    { h: "Feature", c1: "Benign", c2: "Malignant" },
    { h: "Growth rate", c1: "Slow", c2: "Rapid / uncontrolled" },
    { h: "Capsule", c1: "Usually present", c2: "Absent" },
    { h: "Invasion", c1: "No", c2: "Yes" },
    { h: "Metastasis", c1: "No", c2: "Yes" },
  ];
  const rows = cols.map(r => [
    { text: r.h,  options: { bold: true, color: WHITE,  fill: { color: "1C3A55" }, align: "left"   } },
    { text: r.c1, options: { color: TEAL,   fill: { color: "14304A" }, align: "center" } },
    { text: r.c2, options: { color: ACCENT, fill: { color: "14304A" }, align: "center" } },
  ]);
  s.addTable(rows, {
    x: 0.3, y: 4.55, w: 9.4, h: 0.95,
    fontSize: 11, border: { pt: 0.5, color: "2A4A6A" },
    rowH: 0.19,
  });

  bottomBar(s, ACCENT);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 3 — CLASSIFICATION OF CANCERS
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, DARK_BG);
  leftStripe(s, TEAL);

  s.addShape(pres.ShapeType.rect, { x: 0.12, y: 0, w: "100%", h: 1.0, fill: { color: MID_BG } });
  sectionPill(s, "CLASSIFICATION", 0.3, 0.32);
  s.addText("Types of Cancer", { x: 3.4, y: 0.1, w: 6.3, h: 0.8, fontSize: 32, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  const categories = [
    {
      name: "Carcinomas",
      pct: "~85%",
      color: ACCENT,
      desc: "Arise from epithelial cells",
      examples: "Lung, Breast, Colon, Prostate, Pancreatic"
    },
    {
      name: "Sarcomas",
      pct: "~1%",
      color: ACCENT2,
      desc: "Arise from mesenchymal (connective) tissue",
      examples: "Osteosarcoma, Liposarcoma, Rhabdomyosarcoma"
    },
    {
      name: "Lymphomas",
      pct: "~5%",
      color: TEAL,
      desc: "Arise from lymphoid tissue",
      examples: "Hodgkin lymphoma, Non-Hodgkin lymphoma"
    },
    {
      name: "Leukemias",
      pct: "~3%",
      color: "9B59B6",
      desc: "Malignancy of hematopoietic cells",
      examples: "AML, CML, ALL, CLL"
    },
    {
      name: "CNS Tumors",
      pct: "~2%",
      color: "27AE60",
      desc: "Brain and spinal cord tumors",
      examples: "Glioblastoma, Meningioma, Medulloblastoma"
    },
    {
      name: "Germ Cell",
      pct: "<1%",
      color: "E67E22",
      desc: "From germ cells (gonadal/extragonadal)",
      examples: "Testicular (seminoma), Ovarian (dysgerminoma)"
    },
  ];

  categories.forEach((c, i) => {
    const col = i % 3;
    const row = Math.floor(i / 3);
    const x = 0.3 + col * 3.2;
    const y = 1.15 + row * 2.2;
    s.addShape(pres.ShapeType.roundRect, { x, y, w: 3.0, h: 2.0, fill: { color: "12253A" }, rectRadius: 0.14, line: { color: c.color, width: 1.5 } });
    // top colored bar
    s.addShape(pres.ShapeType.roundRect, { x, y, w: 3.0, h: 0.42, fill: { color: c.color }, rectRadius: 0.14 });
    s.addShape(pres.ShapeType.rect, { x, y: 0.28 + y, w: 3.0, h: 0.14, fill: { color: c.color } });
    s.addText(c.name, { x: x + 0.08, y, w: 1.8, h: 0.42, fontSize: 14, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });
    s.addText(c.pct,  { x: x + 1.8, y, w: 1.1, h: 0.42, fontSize: 14, bold: true, color: WHITE, align: "right", valign: "middle", margin: 0 });
    s.addText(c.desc, { x: x + 0.1, y: y + 0.50, w: 2.8, h: 0.45, fontSize: 11, color: LIGHT, align: "left", valign: "top", margin: 0 });
    s.addText("e.g. " + c.examples, { x: x + 0.1, y: y + 0.98, w: 2.8, h: 0.55, fontSize: 10, italic: true, color: ACCENT2, align: "left", valign: "top", margin: 0 });
  });

  s.addText("Carcinomas are by far the most common, accounting for ~85% of all cancers   |   Robbins & Kumar Basic Pathology", {
    x: 0.3, y: 5.3, w: 9.4, h: 0.25, fontSize: 8.5, italic: true, color: "5A7A9A", align: "center", margin: 0
  });
  bottomBar(s, TEAL);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 4 — ETIOLOGY & RISK FACTORS
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, DARK_BG);
  leftStripe(s, ACCENT2);

  s.addShape(pres.ShapeType.rect, { x: 0.12, y: 0, w: "100%", h: 1.0, fill: { color: MID_BG } });
  sectionPill(s, "ETIOLOGY", 0.3, 0.32);
  s.addText("Risk Factors & Carcinogens", { x: 3.4, y: 0.1, w: 6.3, h: 0.8, fontSize: 32, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  const groups = [
    {
      icon: "🧪", title: "Chemical Carcinogens", color: "C0392B",
      items: ["Tobacco smoke (BPDE → TP53 mutation)", "Aflatoxin B1 (liver cancer)", "Vinyl chloride (angiosarcoma)", "Benzene (leukemia)", "Aromatic amines (bladder cancer)"]
    },
    {
      icon: "☢️", title: "Physical Carcinogens", color: "8E44AD",
      items: ["UV radiation (melanoma, SCC)", "Ionizing radiation (leukemia, thyroid)", "Asbestos (mesothelioma, lung)", "X-ray exposure (breast cancer)"]
    },
    {
      icon: "🦠", title: "Biological / Infectious", color: "16A085",
      items: ["HPV 16/18 → cervical, oropharyngeal", "HBV/HCV → hepatocellular carcinoma", "H. pylori → gastric cancer/MALT", "EBV → Burkitt lymphoma, NPC", "HTLV-1 → adult T-cell leukemia"]
    },
    {
      icon: "🧬", title: "Genetic & Hereditary", color: "D35400",
      items: ["BRCA1/2 → breast & ovarian", "APC → familial adenomatous polyposis", "TP53 → Li-Fraumeni syndrome", "HNPCC (Lynch) → colorectal/endometrial", "RB1 → retinoblastoma"]
    },
  ];

  groups.forEach((g, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = 0.3 + col * 4.85;
    const y = 1.1 + row * 2.2;
    s.addShape(pres.ShapeType.roundRect, { x, y, w: 4.55, h: 2.0, fill: { color: "12253A" }, rectRadius: 0.12, line: { color: g.color, width: 1.2 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 4.55, h: 0.45, fill: { color: g.color } });
    s.addShape(pres.ShapeType.rect, { x, y: y + 0.31, w: 4.55, h: 0.14, fill: { color: g.color } });
    s.addText(g.icon + "  " + g.title, { x: x + 0.1, y, w: 4.3, h: 0.45, fontSize: 13, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });
    g.items.forEach((item, j) => {
      s.addText("▸  " + item, { x: x + 0.15, y: y + 0.52 + j * 0.27, w: 4.25, h: 0.27, fontSize: 10.5, color: LIGHT, align: "left", valign: "middle", margin: 0 });
    });
  });

  s.addText("Source: Robbins, Cotran & Kumar Pathologic Basis of Disease", {
    x: 0.3, y: 5.3, w: 9.4, h: 0.25, fontSize: 8.5, italic: true, color: "5A7A9A", align: "center", margin: 0
  });
  bottomBar(s, ACCENT2);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 5 — HALLMARKS OF CANCER
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, DARK_BG);
  leftStripe(s, ACCENT);

  s.addShape(pres.ShapeType.rect, { x: 0.12, y: 0, w: "100%", h: 1.0, fill: { color: MID_BG } });
  sectionPill(s, "PATHOGENESIS", 0.3, 0.32);
  s.addText("Hallmarks of Cancer", { x: 3.4, y: 0.1, w: 6.3, h: 0.8, fontSize: 32, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  // Attribution
  s.addText("Hanahan & Weinberg (2000, updated 2011) — Cell", { x: 0.3, y: 1.05, w: 9.4, h: 0.3, fontSize: 11, italic: true, color: TEAL, align: "center", margin: 0 });

  const hallmarks = [
    { n: "1", title: "Self-sufficiency in growth signals", icon: "📈", color: "C0392B", sub: "Constitutively active RAS, EGFR mutations" },
    { n: "2", title: "Insensitivity to growth-inhibitory signals", icon: "🚫", color: "8E44AD", sub: "Loss of RB, p16/INK4a inactivation" },
    { n: "3", title: "Evasion of apoptosis", icon: "🛡️", color: "16A085", sub: "BCL-2 overexpression, TP53 mutation" },
    { n: "4", title: "Limitless replicative potential", icon: "♾️", color: "D35400", sub: "Telomerase (hTERT) reactivation" },
    { n: "5", title: "Sustained angiogenesis", icon: "🩸", color: "C0392B", sub: "VEGF upregulation, HIF-1α pathway" },
    { n: "6", title: "Tissue invasion & metastasis", icon: "🔀", color: "2980B9", sub: "E-cadherin loss, MMP activation, EMT" },
    { n: "7", title: "Reprogramming energy metabolism", icon: "⚡", color: "F39C12", sub: "Warburg effect — aerobic glycolysis" },
    { n: "8", title: "Evading immune destruction", icon: "🎭", color: "27AE60", sub: "PD-L1 upregulation, CTLA-4 signaling" },
  ];

  hallmarks.forEach((h, i) => {
    const col = i % 4;
    const row = Math.floor(i / 4);
    const x = 0.28 + col * 2.42;
    const y = 1.45 + row * 2.0;
    s.addShape(pres.ShapeType.roundRect, { x, y, w: 2.26, h: 1.82, fill: { color: "12253A" }, rectRadius: 0.14, line: { color: h.color, width: 1.2 } });
    s.addShape(pres.ShapeType.ellipse, { x: x + 0.02, y, w: 0.45, h: 0.45, fill: { color: h.color } });
    s.addText(h.n, { x: x + 0.02, y, w: 0.45, h: 0.45, fontSize: 13, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    s.addText(h.icon, { x: x + 0.55, y: y + 0.02, w: 1.6, h: 0.42, fontSize: 20, align: "right", margin: 0 });
    s.addText(h.title, { x: x + 0.1, y: y + 0.48, w: 2.08, h: 0.72, fontSize: 11, bold: true, color: WHITE, align: "left", valign: "top", margin: 0 });
    s.addText(h.sub,  { x: x + 0.1, y: y + 1.22, w: 2.08, h: 0.52, fontSize: 9.5, italic: true, color: ACCENT2, align: "left", valign: "top", margin: 0 });
  });

  s.addText("Two additional enabling characteristics: Genome instability & Tumor-promoting inflammation", {
    x: 0.3, y: 5.3, w: 9.4, h: 0.25, fontSize: 8.5, italic: true, color: "5A7A9A", align: "center", margin: 0
  });
  bottomBar(s, ACCENT);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 6 — MOLECULAR PATHOGENESIS (Oncogenes & TSGs)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, DARK_BG);
  leftStripe(s, TEAL);

  s.addShape(pres.ShapeType.rect, { x: 0.12, y: 0, w: "100%", h: 1.0, fill: { color: MID_BG } });
  sectionPill(s, "MOLECULAR BASIS", 0.3, 0.32);
  s.addText("Oncogenes & Tumor Suppressor Genes", { x: 3.4, y: 0.1, w: 6.5, h: 0.8, fontSize: 28, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  // Two column layout
  // LEFT: Oncogenes
  s.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.1, w: 4.5, h: 4.35, fill: { color: "1A0A0A" }, rectRadius: 0.14, line: { color: ACCENT, width: 1.5 } });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.1, w: 4.5, h: 0.5, fill: { color: ACCENT } });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.45, w: 4.5, h: 0.15, fill: { color: ACCENT } });
  s.addText("🔴  ONCOGENES  (Gain of function)", { x: 0.4, y: 1.12, w: 4.3, h: 0.48, fontSize: 14, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  const onco = [
    { gene: "RAS (KRAS)", role: "GTPase signaling — mutated in >30% of all cancers" },
    { gene: "MYC",        role: "Transcription factor — amplified in many cancers" },
    { gene: "HER2/ERBB2", role: "Receptor tyrosine kinase — breast, gastric" },
    { gene: "BCL-2",      role: "Anti-apoptotic — follicular lymphoma t(14;18)" },
    { gene: "EGFR",       role: "RTK — lung adenocarcinoma target for erlotinib" },
    { gene: "ALK",        role: "Fusion gene (EML4-ALK) — lung, ALCL" },
    { gene: "ABL (BCR-ABL)", role: "Kinase fusion — CML; target of imatinib" },
  ];
  onco.forEach((o, i) => {
    s.addText(o.gene, { x: 0.45, y: 1.7 + i * 0.36, w: 1.5, h: 0.34, fontSize: 11, bold: true, color: ACCENT2, align: "left", valign: "middle", margin: 0 });
    s.addText(o.role, { x: 2.0,  y: 1.7 + i * 0.36, w: 2.65, h: 0.34, fontSize: 10.5, color: LIGHT, align: "left", valign: "middle", margin: 0 });
  });

  // RIGHT: TSGs
  s.addShape(pres.ShapeType.roundRect, { x: 5.1, y: 1.1, w: 4.5, h: 4.35, fill: { color: "0A1A0A" }, rectRadius: 0.14, line: { color: TEAL, width: 1.5 } });
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.1, w: 4.5, h: 0.5, fill: { color: TEAL } });
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.45, w: 4.5, h: 0.15, fill: { color: TEAL } });
  s.addText("🟢  TUMOR SUPPRESSOR GENES (Loss of function)", { x: 5.2, y: 1.12, w: 4.3, h: 0.48, fontSize: 13, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  const tsg = [
    { gene: "TP53",   role: "\"Guardian of the genome\" — G1 arrest / apoptosis" },
    { gene: "RB1",    role: "Cell cycle brake — G1→S checkpoint" },
    { gene: "BRCA1/2", role: "DNA repair (HR) — breast, ovarian cancer" },
    { gene: "APC",    role: "WNT pathway inhibitor — FAP, CRC" },
    { gene: "PTEN",   role: "PI3K/AKT inhibitor — many solid tumors" },
    { gene: "CDKN2A", role: "p16/INK4a — CDK4/6 inhibitor; pancreatic, melanoma" },
    { gene: "VHL",    role: "HIF regulator — clear cell renal carcinoma" },
  ];
  tsg.forEach((t, i) => {
    s.addText(t.gene, { x: 5.25, y: 1.7 + i * 0.36, w: 1.5, h: 0.34, fontSize: 11, bold: true, color: TEAL, align: "left", valign: "middle", margin: 0 });
    s.addText(t.role, { x: 6.75, y: 1.7 + i * 0.36, w: 2.75, h: 0.34, fontSize: 10.5, color: LIGHT, align: "left", valign: "middle", margin: 0 });
  });

  s.addText("Two-hit hypothesis (Knudson): both alleles of a TSG must be inactivated for tumor development   |   Emery's Medical Genetics & Genomics", {
    x: 0.3, y: 5.3, w: 9.4, h: 0.25, fontSize: 8.5, italic: true, color: "5A7A9A", align: "center", margin: 0
  });
  bottomBar(s, TEAL);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 7 — CANCER STAGING
// ═══════════════════════════════════════════════════════════════
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  leftStripe(s, ACCENT2);

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    { letter: "T", title: "Tumor", color: ACCENT, desc: "Size and extent of the primary tumor", rows: ["Tx — Cannot be assessed", "T0 — No evidence of primary tumor", "Tis — Carcinoma in situ", "T1–T4 — Increasing size/extent"] },
    { letter: "N", title: "Node", color: ACCENT2, desc: "Regional lymph node involvement", rows: ["Nx — Cannot be assessed", "N0 — No regional LN metastasis", "N1 — Regional LN metastasis", "N2–N3 — More extensive LN involvement"] },
    { letter: "M", title: "Metastasis", color: TEAL, desc: "Presence of distant metastasis", rows: ["Mx — Cannot be assessed", "M0 — No distant metastasis", "M1 — Distant metastasis present", "M1a/b/c — Organ specific (varies)"] },
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// ═══════════════════════════════════════════════════════════════
// SLIDE 8 — DIAGNOSIS
// ═══════════════════════════════════════════════════════════════
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      items: ["History & physical exam", "Performance status (ECOG/KPS)", "Red flag symptoms"]
    },
    {
      step: "2", title: "Laboratory Tests", icon: "🧪", color: "27AE60",
      items: ["CBC, LFT, RFT, LDH", "Tumor markers (PSA, AFP, CEA, CA-125, CA 19-9, β-hCG)", "Genomic/liquid biopsy (ctDNA)"]
    },
    {
      step: "3", title: "Imaging", icon: "📷", color: "F39C12",
      items: ["CT scan (chest/abdomen/pelvis)", "MRI (brain, soft tissue, spine)", "PET-CT (staging, metastasis)", "Ultrasound, mammography, bone scan"]
    },
    {
      step: "4", title: "Biopsy & Pathology", icon: "🔬", color: "9B59B6",
      items: ["Core needle / excisional biopsy", "Histology + IHC (ER/PR, HER2, Ki-67)", "Molecular profiling (NGS)", "Cytogenetics / FISH"]
    },
  ];

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    });
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  s.addText("Multidisciplinary Tumor Board (MDT) review is essential for treatment planning", {
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// ═══════════════════════════════════════════════════════════════
// SLIDE 9 — TREATMENT MODALITIES
// ═══════════════════════════════════════════════════════════════
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      intent: "Curative, debulking, palliative",
      mech: "Physical removal of tumor",
      ex: "Mastectomy, colectomy, lobectomy, orchiectomy",
      note: "1st-line for most solid tumors; adjuvant chemo/RT often follow"
    },
    {
      name: "Radiation Therapy", icon: "☢️", color: "8E44AD",
      intent: "Curative, adjuvant, palliative",
      mech: "DNA double-strand breaks → cell death",
      ex: "EBRT, IMRT, SBRT, brachytherapy, SRS",
      note: "Local control; combined with surgery or chemo"
    },
    {
      name: "Chemotherapy", icon: "💊", color: "2980B9",
      intent: "Curative, neoadjuvant, adjuvant, palliative",
      mech: "Alkylation, antimetabolites, topoisomerase inhibitors",
      ex: "Cisplatin, doxorubicin, 5-FU, paclitaxel, cyclophosphamide",
      note: "Systemic — targets rapidly dividing cells (+ toxicity)"
    },
    {
      name: "Targeted Therapy", icon: "🎯", color: TEAL,
      intent: "Advanced/metastatic; biomarker-selected patients",
      mech: "Inhibit specific oncoproteins (TKIs, mAbs)",
      ex: "Imatinib (BCR-ABL), trastuzumab (HER2), erlotinib (EGFR)",
      note: "Requires molecular testing; resistance develops"
    },
    {
      name: "Immunotherapy", icon: "🛡️", color: "27AE60",
      intent: "Advanced; often after other lines",
      mech: "Checkpoint inhibition restores anti-tumor immunity",
      ex: "Pembrolizumab (PD-1), ipilimumab (CTLA-4), CAR-T cells",
      note: "Durable responses; immune-related adverse events"
    },
    {
      name: "Hormone Therapy", icon: "⚗️", color: "F39C12",
      intent: "Hormone receptor-positive tumors",
      mech: "Deprive tumor of hormonal growth signals",
      ex: "Tamoxifen, aromatase inhibitors, ADT (leuprolide)",
      note: "Breast (ER+) and prostate cancer cornerstone"
    },
  ];

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  s.addText("Source: Katzung's Basic & Clinical Pharmacology 16e  |  Sabiston Textbook of Surgery  |  Schwartz's Principles of Surgery", {
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  });
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// ═══════════════════════════════════════════════════════════════
// SLIDE 10 — METASTASIS
// ═══════════════════════════════════════════════════════════════
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    { n: "2", title: "Intravasation", icon: "🩸", desc: "Entry into blood/lymph vessels\nTumor cell migration" },
    { n: "3", title: "Survival in Circulation", icon: "🔄", desc: "Evade immune surveillance\nPlatelets protect CTCs" },
    { n: "4", title: "Extravasation", icon: "⬆️", desc: "Exit from vessel at distant site\nAdhesion molecule interaction" },
    { n: "5", title: "Colonization", icon: "🏠", desc: "Pre-metastatic niche formation\nOrgan-specific tropism" },
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    s.addText(st.n, { x: x + 0.25, y: 1.9, w: 0.7, h: 0.7, fontSize: 18, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    s.addText(st.icon, { x: x + 0.1, y: 2.65, w: 1.0, h: 0.5, fontSize: 20, align: "center", margin: 0 });
    s.addText(st.title, { x: x - 0.05, y: 3.18, w: 1.5, h: 0.38, fontSize: 10.5, bold: true, color: ACCENT2, align: "center", margin: 0 });
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  s.addText("Common Metastasis Sites:", { x: 0.45, y: 4.48, w: 2.2, h: 0.4, fontSize: 11, bold: true, color: TEAL, align: "left", valign: "middle", margin: 0 });
  s.addText("Lung → brain, liver, bone, adrenal  |  Breast → bone, liver, lung, brain  |  Prostate → bone (osteoblastic)  |  Colon → liver (portal circulation first)  |  Renal cell → lung, bone, liver, brain", {
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  s.addText("Metastatic disease accounts for >90% of cancer-related mortality   |   Goldman-Cecil Medicine", {
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  });
  bottomBar(s, "E67E22");
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// ═══════════════════════════════════════════════════════════════
// SLIDE 11 — CANCER PREVENTION & SCREENING
// ═══════════════════════════════════════════════════════════════
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  s.addText("🛡️  Primary Prevention", { x: 0.4, y: 1.12, w: 4.3, h: 0.48, fontSize: 14, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  const prev = [
    "Tobacco cessation — eliminates #1 preventable cause",
    "HPV vaccination (Gardasil 9) — cervical, oropharyngeal CA",
    "HBV vaccination — hepatocellular carcinoma prevention",
    "Healthy diet (Mediterranean), maintain BMI < 25",
    "Regular physical activity (≥150 min/week moderate)",
    "Limit alcohol consumption",
    "Sun protection (SPF, protective clothing)",
    "Occupational carcinogen reduction (asbestos, benzene)",
    "Chemoprevention: Tamoxifen (breast), aspirin (CRC)",
  ];
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    s.addText("✓  " + p, { x: 0.45, y: 1.7 + i * 0.35, w: 4.25, h: 0.34, fontSize: 10.5, color: LIGHT, align: "left", valign: "middle", margin: 0 });
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  s.addText("🔍  Screening Guidelines (Key)", { x: 5.27, y: 1.12, w: 4.3, h: 0.48, fontSize: 14, bold: true, color: WHITE, align: "left", valign: "middle", margin: 0 });

  const screen = [
    { cancer: "Breast",   test: "Mammography annually from age 40–45 (ACOG)" },
    { cancer: "Cervical",  test: "Pap smear ± HPV co-test every 3–5 years" },
    { cancer: "Colorectal", test: "Colonoscopy every 10 yrs from age 45 (ACS)" },
    { cancer: "Lung",      test: "Low-dose CT: age 50–80, ≥20 pack-yr smokers" },
    { cancer: "Prostate",  test: "PSA screening — discuss with patient, age ≥50" },
    { cancer: "Liver",     test: "US + AFP q6mo in cirrhosis / chronic HBV" },
    { cancer: "Skin",      test: "Annual skin exam for high-risk individuals" },
    { cancer: "Thyroid",   test: "Ultrasound if nodule palpated or incidentaloma" },
  ];
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    s.addText(sc.cancer, { x: 5.3, y: 1.7 + i * 0.33, w: 1.3, h: 0.31, fontSize: 10.5, bold: true, color: ACCENT2, align: "left", valign: "middle", margin: 0 });
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  s.addText("Early detection at Stage I vs Stage IV can improve 5-year survival from <20% to >90% for many cancers", {
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// ═══════════════════════════════════════════════════════════════
// SLIDE 12 — SUMMARY / CONCLUSION
// ═══════════════════════════════════════════════════════════════
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  });

  const points = [
    "Cancer is a genetic disease of uncontrolled clonal proliferation",
    "Hallmarks: 8 core biological capabilities (Hanahan & Weinberg)",
    ">100 types — carcinomas most common (~85%)",
    "Etiology: chemical, radiation, viral, hereditary",
    "TNM staging guides prognosis & treatment",
    "Biopsy + histopathology = gold standard diagnosis",
    "Treatment: surgery, RT, chemo, targeted therapy, immunotherapy",
    "Prevention & early screening save lives",
  ];

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  s.addText("A Comprehensive Overview", { x: 0.3, y: 1.5, w: 6.2, h: 0.45, fontSize: 18, color: LIGHT, align: "left", valign: "middle", margin: 0 });

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  s.addText("Sources consulted:", { x: 0.3, y: 2.15, w: 6.2, h: 0.3, fontSize: 11, bold: true, color: TEAL, align: "left", margin: 0 });
  const sources = [
    "Robbins & Kumar Basic Pathology  |  Robbins, Cotran & Kumar Pathologic Basis of Disease",
    "Goldman-Cecil Medicine  |  Schwartz's Principles of Surgery",
    "Katzung's Basic & Clinical Pharmacology 16e  |  Sabiston Textbook of Surgery",
    "Emery's Elements of Medical Genetics and Genomics  |  Harper's Illustrated Biochemistry 32e",
  ];
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  s.addText("\"Cancer is, in essence, a genetic disease\" — Bert Vogelstein, MD", {
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  });

  s.addText("Prepared with Orris Medical AI  ·  orris.care", {
    x: 0, y: 5.35, w: 6.8, h: 0.28, fontSize: 9, color: "405060", align: "center", margin: 0
  });
}

// ═══ WRITE FILE ═══
pres.writeFile({ fileName: "/home/daytona/workspace/cancer-ppt/Cancer_Overview.pptx" })
  .then(() => console.log("✅ Cancer_Overview.pptx saved successfully!"))
  .catch(err => console.error("❌ Error:", err));

cp /dev/stdin /home/daytona/workspace/cancer-ppt/create_cancer_ppt.js << 'ENDOFS…

cd /home/daytona/workspace/cancer-ppt && node create_cancer_ppt.js 2>&1

ls -lh /home/daytona/workspace/cancer-ppt/Cancer_Overview.pptx