CANCER

Contents:

 INTRODUCTION

 CANCEROUS CELLS

 FACTORS CAUSING
CANCER

 DIAGNOSIS OF CANCER

 TREATING CANCER

 SIDE EFFECTS OF CANCER

THERAPY

 CANCER VACCINES
Introduction
Cancer is the abnormal and unregulated growth
of cells. This growth destroys surrounding body
tissues and may spread to other parts of the body
in a process that is known as metastasis.
"Cancer" is actually a group of more than one
hundred separate diseases.
The different types of cancer:
 Skin cancer (squamous cell carcinoma and
basal cell carcinoma being the most common)
 Lung cancer
 Brain cancer
 Breast cancer
 Prostate cancer
 Colon cancer
 Ovarian cancer
 Leukemia
 Lymphoma
There are many others as well.
Cancer can develop anywhere in the body, and at
any age. Unlike infectious diseases such as AIDS,
the flu (influenza), or tuberculosis, cancer is not
contagious - cancer is usually caused by genetic
damage that happens inside an individual cell.
Cancerous Cells

Cells affected by cancer are called malignant

cells. Malignant cells are different from normal cells
in the body in that they divide much more rapidly
than they should.
When cells divide at an accelerated rate, they
often begin to form a mass of tissue called a tumor.
The tumor is fed by nutrients that diffuse through
neighboring blood vessels and can also grow by
forming a substance called tumor angiogenesis
(vessel forming) factor. This factor stimulates the
growth of an independent blood supply to the
tumor. Tumors can cause destruction in three
common ways:
• Tumors put pressure on nearby tissues and/or
organs.
• Tumors invade tissues and organs directly
(direct extension), often damaging or disabling
them in the process.
• Tumors make invaded tissues and/or organs
susceptible to infection.
Tumors can also release substances that destroy
tissues in close proximity to them.

One of the frightening things about cancer is the

possibility of metastasis. This is the process where
millions of malignant cells are released from the
tumor (the primary) into the bloodstream.
Fortunately, most of these cells are killed by
trauma produced while traveling within the blood
vessel walls, or by circulating cells from the
immune system, like the Natural Killer (NK) cells
and other T lymphocytes.
Other immune cells that battle malignant cells
are macrophages, antigen-presenting cells, and
substances produced by immune cells called
lymphokines. One common lymphokine is called
interleukin-2 (IL-2) or interferon.

In some cases, the circulating malignant cells

survive and adhere to the inner muscular lining of
the blood vessel walls. Here the process of tumor
formation can begin in a different area of the body
(the secondary), causing further destruction.

It is important to note that not all tumors are

cancerous. Tumors can be either malignant or
benign.A malignant tumor is cancer, and a benign
tumor is not.

One main difference between a benign tumor

and a malignant tumor is that a benign tumor will
not spread (metastasize) to distant parts of the
body, and usually it will not grow back once
removed.

A benign tumor is either surgically removed, or it

may be left in place and simply observed to see
what it does. The decision to remove or observe
depends on the tumor's size, type and location.

Factors Causing Cancer

Cancer is caused by a number of factors, some of

which we can control, and some we cannot.
1) FACTOR WHICH WE CANNOT CONTROL :
♦GENE MUTATIONS
One of the uncontrollable factors is the presence
of gene mutations.
One type of gene that plays a role in normal cell
growth -- an oncogene -- can be altered to
contribute to the uncontrolled growth of a tumor.
Oncogenes affect the way cells use energy and
multiply. For example, in some cancers, the ras
gene (an oncogene) is mutated, and produces a
protein that stimulates cells to divide prematurely.
Other oncogenes, such as C-myc and C-erb B-2,
when amplified, are implicated in small cell lung
cancer and breast cancer, respectively.
♦TUMOR SUPPRESSOR GENES
 Mutations in tumor suppressor genes are
another common cause of cancer.
A tumor suppressor gene is supposed to prevent
tumors. But when these genes are damaged, they
can allow cancer to develop instead of preventing
it.
One of these genes, p53, normally prevents cells
with abnormal DNA from surviving. When p53 is
defective, these cells with abnormal DNA survive
and can multiply, increasing the probability of
developing cancer.
♦CHROMOSOMAL ABNORMALITIES
Certain cancers are associated with
chromosomal abnormalities. Chromosomes are
located within the nucleus of our cells, and contain
our genes. When genes are missing, duplicated, or
rearranged, a predisposition to develop a tumor is
increased. Certain leukemias, sarcomas,
lymphomas, and others tumors are associated with
chromosomal abnormalities.
♦VIRUS
There are also viruses associated with cancer.
The human papillomavirus (HPV) that causes
genital warts is associated with carcinoma of the
cervix.
The Epstein-Barr virus that causes infectious
mononucleosis is associated with Burkitt's
lymphoma.
♦OTHER DISEASES OR DRUGS
Diseases or drugs that affect the immune system
can also increase the risk for certain cancers. The
disease AIDS, for instance, is associated with a high
risk of two types of cancer, namely, Kaposi's
sarcoma and lymphoma.
♦RADIATION
Exposure to ionizing radiation can increase the
risk of certain cancers. X-rays used to treat
disorders such as acne or adenoid enlargement can
increase the risk of certain types of leukemias and
lymphomas.
Cancer is caused by a number of factors, some of
which we can control, and some we cannot.

2) FACTOR WHICH WE CAN CONTROL :

Fortunately, there are also factors under our

control that can increase the risk of getting cancer,
and can therefore be avoided.
♦CARCINOGENS
There are substances called carcinogens (cancer-
forming agents) that can increase the risk of
getting cancer.
Some common carcinogens include:
∗Arsenic, asbestos, and nickel - cause lung and
other cancer
∗Benzene - cause leukemia
 ∗Formaldehyde - cause nasal and
nasopharyngeal cancer
Carcinogens that are associated with a person's
lifestyle include:
∗Alcohol - increases the risk of oral, esophageal,
and oropharyngeal cancer
∗Tobacco - causes lung, head and neck,
esophageal, and bladder cancer.
∗Smokeless or chewing tobacco - can also
increase the risk of oral cancer.
♦ULTRAVIOLET RADIATION
Unprotected exposure to sunlight (ultraviolet
radiation) is associated with skin cancer.The main
cancers caused by sunlight are basal cell
carcinoma, squamous cell carcinoma, and malignant
melanoma.

Diagnosis of Cancer

Diagnosis of cancer involves taking a detailed

history, physical examination, imaging studies and
laboratory tests.
The person is required to answer questions
about his general health, medications he may be
taking, family history, and his work history
(environmental exposure to carcinogens, etc.).

 Symptoms that may lead to a diagnosis of

cancer:
∗Fatigue
∗Unexplained weight loss
∗Night sweats
∗Cough
∗Blood found in vomit
∗Urine or after bowel movements
∗Persistent pain
∗Painless ulcer in the mouth or on the skin that
does not heal

♦PHYSICAL EXAMINATION
A complete physical examination is done, with
special attention paid to the lymph nodes (in the
neck, under the arms, etc.), skin, lungs, breasts,
genitals, and prostate (in men).

♦BIOPSY
Suspicious growths that may be potential tumors
are often removed (using and excisional or
incisional biopsy) or sampled (using a fine needle
aspiration biopsy) and sent to a laboratory to be
identified.
A biopsy can also be obtained with the aid of a
procedure known as endoscopy, where a tiny
camera is used to view a suspicious lesion.

♦BLOOD TESTS
Blood tests can help determine the extent or
stage of certain cancers, and other abnormal
findings correlated with different types of cancer.

♦IMAGING STUDIES
Imaging studies like x-rays, MRI, bone scans, or
ultrasound can often determine the location and
other characteristics of a tumor.

♦SCREENING
The American Cancer Society recommends
screenings for certain types of cancer.

∗For Women:
Breast cancer should be tested for by self-
examination every month for women over 18.
Examination of the breasts by your doctor should
be completed every three years for women between
the ages of 18 and 40, then every year after age 40.
A mammogram should be taken between the age of
35 and 40 as a baseline, then every 1 to 2 years
between ages 40 to 49, and then annually after age
50.
Women should also receive a Papanicolaou (Pap)
smear to screen for cervical cancer annually
between the ages of 18 and 65.
An evaluation of the pelvis to screen for cervical,
uterine, and ovarian cancer should be preformed
every 1-3 years between the ages of 18-40, then
annually.

∗For Men:
For men, screening for prostate cancer should be
completed yearly after age 50 (45 for high risk
individuals), which includes rectal examination and
a blood test for prostate specific antigen (PSA).
Screening for rectal and colon cancer should be
done with a rectal examination annually after age
40, with stool examination annually after age 50,
and with sigmoidoscopy every 3 to 5 years after
age 50.
Treating Cancer

Cancer is treated in a variety of ways depending

on the size of the tumor, its location, the type of
cancer, and a host of other factors.
Three common ways to treat cancer include:
• Surgery
• Radiation
• Chemotherapy (drug therapy).
In many cases, these methods are combined to
get the most effective results.

♦SURGERY
Surgery is the oldest way to treat cancer. If the
tumor is relatively localized, it can be surgically
removed. Often, a border of healthy tissue
surrounding the tumor is also taken to ensure that
all of the malignant cells have been removed.
Surgery is commonly used for cancer of the
breast, colon, mouth, head and neck, kidney, testes
and other parts of the body.
Surgery can also be used to remove tissue that
may become cancerous if left untreated
(precancerous) and also to relieve symptoms
caused by the cancer.
Surgery is often combined with chemotherapy
and/or radiation to improve results.
♦RADIATION THERAPY
Radiation therapy, also know as radiotherapy, x-
ray therapy, cobalt therapy, or irradiation, is useful
in fighting cancer because it destroys cancer cells
more easily than normal cells.
Radiotherapy is commonly delivered with an
external beam of x-rays, gamma rays or alpha and
beta particles directed at the tumor.
Radioactive pellets or wires can also be used
internally if they are put in a tiny container and
then implanted into the body near the tumor.
In some cases, both internal and external
radiation is used.
Radiation therapy is used for early Hodgkin's
lymphoma, certain cancers of the lung, prostate,
bladder, and other tumors.
Radiation therapy is commonly used in
conjunction with other therapies, including surgery
and chemotherapy.For instance, radiation therapy
may shrink a tumor to facilitate surgery, or be used
as an adjunct after surgery to prevent the tumor
from reforming.
In some cases, radiation therapy is used alone,
especially when the tumor is very susceptible to
radiation, or when surgery to the area is too risky.
 Radiation can be used to shrink a tumor to
provide relief from symptoms associated with
tumor growth, even when a cure is highly unlikely.

♦CHEMOTHERAPY
Chemotherapy or drug therapy is used to kill
cancer cells, while attempting to limit the damage
to normal cells.
Chemotherapy is useful in fighting cancer that
has spread to other parts of the body and cannot be
easily detected or treated with surgery or radiation
therapy.
Chemotherapy has been successful in treating
acute leukemia, Hodgkin's and malignant
lymphoma, small cell lung cancer, bladder and
testicular cancer, and other forms of cancer.
Chemotherapy can cure cancer in some cases, limit
the spread of cancer, and help alleviate symptoms
in some types of cancer.
Chemotherapy can be used in combination with
surgery and/or radiation, often with improved
results.
♦HORMONE THERAPY
Hormone therapy involves anything that deals
with manipulating the body's hormones to treat the
cancer, including administering hormones and
drugs. Doctors may also remove hormone glands to
kill cancer cells or prevent further cancerous
growth.
♦IMMUNOTHERAPY
During immunotherapy, patients are given
medication to stimulate the body's immune system
to fight cancerous cells.

Side Effects of Cancer

Therapy

Side effects from cancer treatment vary widely

from person to person, and are also dependent on
which type of therapy is used.

♦Side effects from chemotherapy:

∗Nausea and vomiting
∗Hair loss
∗Fatigue
∗Increased chance of bleeding or infection
∗Anemia

♦Side effects from radiation:

∗Loss of appetite
∗Skin changes
∗Fatigue

♦Side effects from cancer surgery:

∗Pain during recovery
∗Temporary nausea from drugs used during
anesthesia
∗Potential for bleeding or infection after the
surgery

There are medications, nutritional tips, and other

ways available to greatly reduce the impact of side
effects from cancer treatment.

Cancer Vaccines

Scientists are on the verge of developing a

cancer vaccine that will save millions of lives
annually when it's discovered.
There are two major categories that cancer
vaccines fit into:
♦Specific Cancer Vaccines - treat specific types of
cancers.
♦Universal Cancer Vaccine - fight cancer cells
regardless of cancer type.
In these two categories, there are more specific
types of cancer vaccines. Each type of cancer
vaccine works on the same basic idea: “The
vaccine, which contains tumor cells or antigens,
stimulates the patient's immune system, which
produces special cells that kill cancer cells and
prevent relapses of the cancer.”
Here is a list of five kinds of cancer vaccines
being developed:
∗Antigen vaccines
Antigen vaccines use tumor-specific antigens to
stimulate the immune system, which will produce
an increased amount of antibodies or T cells, to
attack cancer cells that carry that specific antigen.
Multiple antigens can be used in this type of
vaccine to vary the immune system response.

∗Anti-idiotype vaccines
Antibodies, called idiotype antibodies, act as
antigens, triggering immune system which will
produce anti-idiotype antibodies to attack the
idiotypes.
∗Dendritic cell vaccines
Dendritic cells break the antigens on the cancer
cell surfaces into smaller pieces and then act as
most-wanted posters for the immune system,
displaying those antigen pieces to the killer T cells.
To make a dendritic cell vaccine, scientists extract
use the patient's dendritic cells.
∗DNA vaccines
Bits of DNA from the patient's cells are injected
into the patient, which instructs the other cells to
continuously produce certain antigens which force
the immune system to respond by producing more T
cells.
∗Tumor cell vaccines
Tumor cell vaccines can be produced using
cancer cells from the patient or another patient.
These cells are killed and injected into the patient.
While the cells are dead, the antigens are still
recognized by the immune system, which responds
by attacking the dead cells. The immune system
will also attack the live cancer cells carrying the
antigen that was displayed on the dead cells.

While scientists have had some success with

each of these cancer vaccines, it is still much too
early to predict when a true cancer vaccine will be
developed.