CANCER
• result from
abnormal
proliferation
of any of the
different
kinds of cells
in the body
• there are
more than a
hundred
distinct types
of cancer
CHARACTERISTICS
• Uncontrolled proliferation—Cancer cells can grow
out of control and form new tissue.
•Abnormal differentiation— Cancer cells do not
mature normally; therefore, they are not able to
carry out their functions.
•Loss of apoptosis— Cancer cells do not follow the
typical cell cycle that leads to programmed cell
death.
•Loss of contact inhibition— lose the ability to respond to
inhibition of proliferation that results from cell to cell contact.
• Loss of cohesiveness and adhesiveness— Cancer
cells can break away from the mass of cells,
circulate through blood and lymphatic vessels, and
spread to distant sites.
•Impaired cellular communication— Cancer cells
do not wait for signals from the body to form new
tissue.
•Tumor markers— Cancer cells can express (or
overexpress) proteins, called antigens, on the cell
surface, which makes them different from normal,
healthy cells.
• Tumours can be non cancerous (benign) or cancerous
(malignant)
• Benign tumour, such as a common skin wart,
remains confined to its original location, neither
invading surrounding normal tissue nor spreading
to distant body sites
• Malignant tumour, however, is capable of both
invading surrounding normal tissue and spreading
throughout the body via the circulatory or lymphatic
systems (metastasis)
• Metastasis: the tumor cells induce secondary tumors.
Types of cancer
• Carcinoma: Cancer that begins in the skin or in tissues
that line or cover internal organs -- "skin, lung, colon,
pancreatic, ovarian cancers," epithelial, squamous
and basal cell carcinomas, melanomas, papillomas,
and adenomas.
• Sarcoma: Cancer that begins in bone, cartilage, fat,
muscle, blood vessels, or other connective or
supportive tissue -- "bone, soft tissue cancers,"
osteosarcoma, synovial sarcoma, liposarcoma,
angiosarcoma, rhabdosarcoma, and fibrosarcoma
• Leukemia: Cancer that starts in blood-forming tissue
such as the bone marrow and causes large numbers
of abnormal blood cells to be produced and enter the
blood --"leukemia”.
• Lymphoma and myeloma: Cancers that begin in the
cells of the immune system --"lymphoma," T-cell
lymphomas
Development of Cancer(Pathogenesis)
Carcinogenesis is a multistage process.
1. Initiation
2. Promotion
3. Progression
4. Metastasis
INITIATION
• Three classes of defects can contribute to the
development of cancer:
(1) Oncogenes- activation of cellular (DNA) that
regulates normal cell growth and repair. Proto-
oncogenes are the normal genes.
(2) mutated tumor suppressor genes- components of DNA
that stop, inhibit, or suppress cell division
* Mutations in oncogenes and tumor suppressor genes
allow cells to grow beyond normal body needs
(3) mutated stability genes, with the defect leading to
unrepaired damage to the cell’s replication machinery
Causes of cancer
1. Ionizing radiation- Electromagnetic (X-rays, gamma rays) and
particulate (- particles, - particles, protons, neutrons)
radiations are all carcinogenic
2. Chemical substances- . Compounds that bind to DNA are
genotoxic, whereas compounds that are carcinogenic,
but have no evidence of DNA binding are termed
epigenetic. Some of the major chemical carcinogens are
Aflatoxin B1, vinyl chloride, nickel, chromium insecticide
and fungicide are also some of the chemical carcinogens.
Tobacco, smoking, drug abuse are also known to cause
cancers
3. Heredity - Some cancers are programmed by genes to
develop. Gene mutations result from one or more regulatory
genes in the cell nucleus. It might be an inherited one
but environmental factors also contribute to its expression
4. Dietary factors – Meat, energy balance, fat, protein,
alcohol, nitrates -Obesity has been associated with an
increased risk for many types of cancer, including breast,
colorectal, endometrial, esophageal, kidney, pancreatic,
and gallbladder
[Link]
6. Viruses- Some viruses can cause cancer. Human
papillomavirus (commonly known as HPV) can cause
cervical cancer; Epstein-Barr virus can cause non-
Hodgkin lymphoma; hepatitis B virus can cause liver
cancer; and human T-cell leukemia virus can cause
leukemia
• 7. Stress- Clinicians and researchers have reported
that psychic trauma, seems to carry strong
correlations with cancer.
- One is damage to the thymus gland and the immune
system.
- Second is the neuroendocrine effects mediated
through the hypothalamus, pituitary and adrenal
cortex. Specific studies need to be carried out in this
area to confirm the association between stress
factors and cancer
• 8. Age- Cancer has long been associated with increasing
age. While no age group is immune to cancer, evidence
has shown that cancers are found more frequently in
people aged 50 and older
Promotion
• Promotion is the second stage where the
transformed (or initiated) cells are stimulated to
divide.
• The environment within (intracellular) and
outside (extracellular) the cell influences cancer
development.
• Malignant transformation may involve more than one
step and requires repeated exposures to promoting
agents. For example, one tumor promoter is
estrogen, a naturally occurring hormone that by
itself will not “initiate” cancer. However, estrogen
can drive the growth of a mutated breast cell.
Progression
• During progression, tumor cells compete with
one another to survive, leading to more
mutations that make the cells more
aggressive.
• As the tumor increases in size, the cells
undergo further mutations, leading to
increased heterogeneity within the tumor.
• Heterogeneity refers to multiple genetic
variants of the mutated or transformed cell.
With increased heterogeneity, the cancer cells
found in one lump or mass can look and act
differently, making diagnosis and treatment
increasingly harder
METASTASIS
• Cancer cells are distinct in that they have lost
important features of normal cells, one of which is
adhesiveness. Molecules on a normal cell surface
allow them to bind to other cells with similar
molecules.
• As a result, cancer cells can easily break away from
their neighbors and invade other tissues, which is
known as metastasis.
• Additionally, rogue cells can also enter the blood and
lymphatic vessels and be transported to more distant
sites within the body.
Symptoms
• Symptoms and signs of cancer depend on the type
of cancer, where it is located, and/or where the
cancer cells have spread.
• For example, breast cancer may present as a lump in
the breast or as nipple discharge while metastatic
breast cancer may present with symptoms of pain
(if spread to bones), extreme fatigue (lungs), or
seizures (brain).
• A few patients show no signs or symptoms until
the cancer is far advanced
Diagnosis
• CT scan
• MRI
• Bone scan
• Ultrasound
• PET scan
• Biopsy
• *Reading assignment
Types of Cancer Treatment
• SURGERY- is a procedure in which a surgeon removes
cancer from the body.
• RADIATION THERAPY- is a type of cancer treatment that
uses high doses of radiation to kill cancer cells and
shrink tumors.
• CHEMOTHERAPY- uses drugs to kill cancer cells.
• TARGETED THERAPY- Targeted therapy is a type of
cancer treatment that targets the changes in cancer
cells that help them grow, divide, and spread.
• HORMONE THERAPY - Hormone therapy is a
treatment that slows or stops the growth of
breast and prostate cancers that use hormones
to grow.
• STEM CELL TRANSPLANT- are procedures that
restore blood-forming stem cells in cancer
patients who have had theirs destroyed by very
high doses of chemotherapy or radiation
therapy.