Cancer
Cancer is one of the most common diseases
in the developed world:
1 in 4 deaths are due to cancer
1 in 17 deaths are due to lung cancer
Lung cancer is the most common cancer in
men
Breast cancer is the most common cancer in
women
There are over 100 different forms of cancer
Cancer
Normal cells stay in the G1 stage of
the cell cycle until they are given a
specific signal to enter the S phase,
in which the DNA replicates and the
cell prepares for division. Cancer
cells enter the S phase without
waiting for a signal.
Cancer
Normal cells are mortal. This means
that they can divide about 50 times
and then they lose the ability to divide,
and eventually die. This “clock” gets
re-set during the formation of the
gametes. Cancer cells escape this
process of mortality: they are immortal
and can divide endlessly.
Cancer
Normal cells that suffer significant
chromosome damage destroy
themselves due to the action of a
gene called “p53”. Cancer cells
either lose the p53 gene or ignore its
message and fail to kill themselves.
Cancer
The division of normal cells is precisely
controlled. New cells are only formed for
growth or to replace dead ones.
Cancerous cells divide repeatedly out of
control even though they are not needed,
they crowd out other normal cells and
function abnormally. They can also
destroy the correct functioning of major
organs.
What causes cancer?
Cancer arises from the mutation of a
normal gene.
Mutated genes that cause cancer are
called oncogenes.
It is thought that several mutations
need to occur to give rise to cancer
Cells that are old or not functioning
properly normally self destruct and are
replaced by new cells.
However, cancerous cells do not self
destruct and continue to divide rapidly
producing millions of new cancerous
cells.
A factor which brings about a
mutation is called a mutagen.
A mutagen is mutagenic.
Any agent that causes cancer is
called a carcinogen and is described
as carcinogenic.
So some mutagens are carcinogenic.
Carcinogens
Ionizing radiation – X Rays, UV light
Chemicals – tar from cigarettes
Virus infection – papilloma virus can be
responsible for cervical cancer.
Hereditary predisposition – Some families
are more susceptible to getting certain
cancers. Remember you can’t inherit
cancer its just that you maybe more
susceptible to getting it.
Benign or malignant?
Benign tumours do not spread from their site of
origin, but can crowd out (squash) surrounding
cells eg brain tumour, warts.
Malignant tumours can spread from the original
site and cause secondary tumours. This is called
metastasis. They interfere with neighbouring
cells and can block blood vessels, the gut,
glands, lungs etc.
Why are secondary tumours so bad?
Both types of tumour can tire the body out as
they both need a huge amount of nutrients to
sustain the rapid growth and division of the cells.
The Development of Cancer
Within every nucleus of every one of
the human body's 30 trillion cells
exists DNA, the substance that
contains the information needed to
make and control every cell within
the body. Here is a close-up view of a
tiny fragment of DNA.
1. DNA of a normal cell
This piece of DNA is an exact copy of the DNA
from which it came. When the parent cell divided
to create two cells, the cell's DNA also divided,
creating two identical copies of the original DNA.
2. Mutation of DNA
Here is the same section of DNA but from another cell.
If you can imagine that DNA is a twisted ladder, then
each rung of the ladder is a pair of joined molecules, or
a base pair. With this section of DNA, one of the base
pairs is different from the original.
This DNA has suffered a mutation, either through mis-
copying (when its parent cell divided), or through the
damaging effects of exposure to radiation or a chemical
carcinogen.
3. Genetically altered cell
Body cells replicate through mitosis, they respond
to their surrounding cells and replicate only to
replace other cells. Sometimes a genetic mutation
will cause a cell and its descendants to reproduce
even though replacement cells are not needed.
The DNA of the cell highlighted above has a
mutation that causes the cell to replicate even
though this tissue doesn't need replacement cells
at this time or at this place.
4. Spread and second mutation
The genetically altered cells have, over time, reproduced
unchecked, crowding out the surrounding normal cells. The
growth may contain one million cells and be the size of a
pinhead. At this point the cells continue to look the same as
the surrounding healthy cells.
After about a million divisions, there's a good chance that
one of the new cells will have mutated further. This cell,
now carrying two mutant genes, could have an altered
appearance and be even more prone to reproduce
unchecked.
5. Third mutation
Not all mutations that lead to cancerous cells result in the
cells reproducing at a faster, more uncontrolled rate. For
example, a mutation may simply cause a cell to keep from
self-destructing. All normal cells have surveillance
mechanisms that look for damage or for problems with their
own control systems. If such problems are found, the cell
destroys itself.
Over time and after many cell divisions, a third mutation
may arise. If the mutation gives the cell some further
advantage, that cell will grow more vigorously than its
predecessors and thus speed up the growth of the tumour.
6. Fourth mutation
The new type of cells grow rapidly, allowing
for more opportunities for mutations. The
next mutation paves the way for the
development of an even more aggressive
cancer.
At this point the tumour is still contained.
7. Breaking through the
membrane
The newer, wilder cells created by another
mutation are able to push their way through the
epithelial tissue's basement membrane, which is a
meshwork of protein that normally creates a
barrier. The invasive cells in this tumour are no
longer contained.
At this point the cancer is still too small to be
detected.
8. Angiogenesis
Often during the development of earlier stages of the
tumour, or perhaps by the time the tumour has broken
through the basement membrane (as pictured above),
angiogenesis takes place. Angiogenesis is the recruitment
of blood vessels from the network of neighbouring
vessels.
Without blood and the nutrients it carries, a tumour would
be unable to continue growing. With the new blood
supply, however, the growth of the tumour accelerates; it
soon contains thousand million cells and, now the size of
a small grape, is large enough to be detected as a lump
9.Invasion and dispersal
The tumour has now invaded the tissue beyond the
basement membrane.
Individual cells from the tumour enter into the
network of newly formed blood vessels , using these
vessels as highways by which they can move to
other parts of the body. A tumour as small as a
gram can send out a million tumour cells into blood
vessels a day.
10. Tumour What makes most
tumours so lethal is
cells travel - their ability to
metastasize -- that
metastasis is, establish new
tumour sites at other
locations throughout
the body.
Secondary tumours.
Metastasis is now
underway, as tumour
cells from the
original cancer
growth travel
throughout the body.
Most of these cells
will die soon after
entering the blood or
lymph circulation.
11. Metastasis
To form a secondary tumour, a tumour cell needs
to leave the vessel system and invade tissue. The
cell must attach itself to a vessel's wall. Once this
is done, it can work its way through the vessel and
enter the tissue.
Although perhaps less than one in 10,000 tumour
cells will survive long enough to establish a new
tumour site, a few survivors can escape and
initiate new colonies of the cancer.
