CHAPTER ONE: INTRODUCTION TO CANCER
Cancer is a complex group of diseases characterized by uncontrolled cell proliferation
and the ability to invade or spread to distant sites in the body. It arises primarily due to
genetic alterations that affect key regulatory pathways in cells, particularly those
controlling growth, division, and programmed cell death (Hanahan, 2022). These genetic
mutations may be inherited or acquired through environmental exposures to carcinogens
such as tobacco smoke, ultraviolet radiation, certain chemicals, and viral infections
(WHO, 2022). Such disruptions lead to the breakdown of normal cellular regulation,
resulting in tumor formation and, in severe cases, metastasis.
The biological mechanisms underlying cancer have been categorized into several
hallmark features, including sustained proliferative signaling, evasion of growth
suppressors, resistance to cell death, replicative immortality, angiogenesis, and the
capacity to invade and metastasize (Hanahan, 2022). These hallmarks provide a
framework for understanding cancer development at the molecular level and have been
pivotal in shaping modern research and therapeutic interventions. Globally, cancer
remains a major health challenge. According to the World Health Organization (2022),
cancer accounted for nearly 10 million deaths in 2020, with breast, lung, colorectal, and
prostate cancers being among the most prevalent types.
Cancer can be broadly classified into five major types based on the tissue or cell type of
origin. Carcinomas, which arise from epithelial cells, constitute the most common
category and include malignancies of the breast, lung, colon, and prostate (NCI, 2023).
Sarcomas develop in connective tissues such as bone, muscle, and fat. Leukemias
originate from hematopoietic tissues and typically involve abnormal proliferation of
white blood cells. Lymphomas affect the lymphatic system and are divided into Hodgkin
and non-Hodgkin types. Cancers of the central nervous system, including brain and spinal
cord tumors, form a distinct category with unique challenges in treatment and prognosis.
Each type of cancer demonstrates variability in progression, metastasis potential, and
response to therapy.
Significant advancements in molecular biology and genetic sequencing have
revolutionized the classification and understanding of cancers. Tumors are now
increasingly identified based on specific genetic mutations or expression profiles,
enabling clinicians to tailor treatments to individual patients — a practice known as
precision medicine (Topalian et al., 2022). This approach enhances the effectiveness of
interventions and minimizes adverse effects, particularly for cancers that were previously
resistant to standard therapies. For example, targeting HER2 in breast cancer or EGFR in
lung cancer has yielded substantial clinical benefits. Such molecular profiling also
provides valuable prognostic information and aids in monitoring disease progression.
Treatment modalities for cancer are multifaceted and depend on the type, stage, and
location of the tumor, as well as the overall health of the patient. Surgery is often
employed to physically remove localized tumors and can be curative when the disease
has not spread (DeVita et al., 2021). Chemotherapy involves the administration of
cytotoxic agents to kill rapidly dividing cells, although it frequently affects healthy cells,
leading to side effects such as fatigue, nausea, and hair loss. Radiation therapy utilizes
ionizing radiation to destroy cancer cells and is commonly used in conjunction with
surgery or chemotherapy.
In addition to traditional treatments, newer modalities have transformed cancer care.
Immunotherapy, which includes immune checkpoint inhibitors and CAR-T cell therapy,
empowers the immune system to recognize and eliminate cancer cells (Topalian et al.,
2022). Targeted therapy involves drugs that specifically attack cancer-associated
molecules, limiting damage to normal cells. Hormone therapy is effective for cancers
driven by hormonal signaling, such as breast and prostate cancers. These treatments are
often combined in multimodal regimens to increase therapeutic success.
Supportive care is integral to comprehensive cancer treatment. It includes interventions
aimed at relieving symptoms, managing treatment side effects, and improving quality of
life. Palliative care may be provided alongside curative treatment or as the main focus in
advanced stages of cancer. Strategies such as pain management, nutritional support,
psychological counseling, and rehabilitative services help patients cope with the physical
and emotional burden of the disease (DeVita et al., 2021). Collectively, these therapeutic
and supportive approaches represent a shift from a one-size-fits-all model to a more
individualized, patient-centered paradigm in oncology.
References
1. DeVita, V. T., Lawrence, T. S., & Rosenberg, S. A. (2021). Cancer: Principles and
practice of oncology (11th ed.). Lippincott Williams & Wilkins.
2. Hanahan, D. (2022). Hallmarks of cancer: New dimensions. Cell, 185(2), 215–232.
[Link]
3. National Cancer Institute. (2023). Cancer treatment. [Link]
cancer/treatment
4. Topalian, S. L., Taube, J. M., & Pardoll, D. M. (2022). Immune checkpoint blockade:
A common denominator approach to cancer therapy. Cancer Cell, 40(5), 470–481.
[Link]
5. World Health Organization. (2022). Cancer. [Link]
sheets/detail/cancer
