tumor cancer

8/13/2019 Tumor Cancer

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Tumor

From Wikipedia, the free encyclopedia

A tumoror tumouris the name for a neoplasmor a solid lesion formed by an abnormal growth

of cells (termedneoplastic) which looks like a swelling. Tumoris not synonymous with cancer.

A tumor can bebenign,pre-malignantormalignant, whereas cancer is by definition malignant.

Etymology

he term tumour!tumor is deri"ed from the #atinword for $swelling$ tumorand has come to the

%nglish language "ia the &ld French tumour (contemporary French' tumeur). n the

ommonwealth the spelling $tumour$ is commonly used, whereas in the *.+. it is usually spelled

$tumor$.n its medical sense it originally meant an abnormal swelling of the flesh. elsus (ca

/ 0 A1) described four cardinal signs of acute inflammationas tumor,dolor, calorand

rubor(swelling, pain, increased heat and redness).

ut in contemporary %nglish, tumor is synonymous with solid neoplasm, all other forms of

swelling being called swelling.23his usage is common also in medical literature, where the

nouns tumefaction and tumescence, deri"ed from the ad4ecti"e tumefied, are the current

medical terms for non-neoplastic swelling. +welling is most often caused by inflammation

caused by trauma, infection, etc.

Cause

A. 5ormal pathway. .

1aughter cell fails to

proliferate causing a tumor.

. +tem cell fails to create a

daughter cell and keeps

de"iding causing a tumor.A neoplasm is an abnormal

proliferation of tissues,

usually caused by genetic

mutations. 6ost neoplasms

cause a tumor, with a few

e7ceptions like leukemia or

carcinoma in situ.

he nature of the tumor is

determined by apathologistafter e7amination of the tumor tissues from a biopsyor a surgical

e7cisionspecimen and is then 8ualified asbenign, pre-malignant or malignant.
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his page was last modified on 9: 1ecember ;9 at 99'


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intrudes upon and destroys ad4acent tissues, and sometimes metastasis, which spreads the cells to

other locations in the body "ia lymph or blood. hese three malignant properties of cancers

differentiate them frombenign tumors, which are self-limited, and do not in"ade or metastasi>e.

6ost cancers form a tumorbut some, likeleukemia, do not. he branch of medicine concerned

with the study, diagnosis, treatment, and pre"ention of cancer is oncology.ancer can affect people at all ages with the risk for most types increasing with age.t caused

about 9? of all human deathsin ;=(=.@ million). ancers are primarily an en"ironmental

disease with :-:? of cases due to lifestyle and en"ironmental factors and -9? due to

genetics. ommon en"ironmental factors leading to cancer death include' tobacco(;-?), diet

and obesity (-?), infections (9-;?), radiation, stress, lack of physical acti"ity, and

en"ironmental pollutants. hese en"ironmental factors cause abnormalities in the genetic

materialof cells.

Benetic abnormalities found in cancer typically affect two general classes of genes. ancer-

promoting oncogenesare typically acti"ated in cancer cells, gi"ing those cells new properties,

such as hyperacti"e growth and di"ision, protection against programmed cell death, loss of

respect for normal tissue boundaries, and the ability to become established in di"erse tissue

en"ironments. umor suppressor genesare then inacti"ated in cancer cells, resulting in the loss

of normal functions in those cells, such as accurate 15A replication, control o"er the cell cycle,

orientation and adhesion within tissues, and interaction with protecti"e cells of the immune

system.

1efiniti"e diagnosis re8uires the histologice7amination of a biopsyspecimen, although the

initial indication of malignancy can be symptomatic or radiographicimaging abnormalities. 6ost

cancers can be treated and some forced into remission, depending on the specific type, location,

and stage. &nce diagnosed, cancer is usually treated with a combination of surgery,chemotherapyand radiotherapy. As research de"elops, treatments are becoming more specific

for different "arieties of cancer. here has been significant progress in the de"elopment of targeted

therapydrugs that act specifically on detectable molecular abnormalities in certain tumors, and

which minimi>e damage to normal cells. he prognosis of cancer patients is most influenced by

the type of cancer, as well as the stage, or e7tent of the disease. n addition, histologicgrading

and the presence of specific molecular markers can also be useful in establishing prognosis, as

well as in determining indi"idual treatments.

Classification

ancers are classified by the type of cell that resembles the tumor and, therefore, the tissue

presumed to be the origin of the tumor. hese are the histology and the location, respecti"ely.

%7amples of general categories include'

arcinoma:6alignant tumors deri"ed from epithelialcells. his group represents the

most common cancers, including the common forms ofbreast, prostate, lung and colon

cancer.

+arcoma:6alignant tumors deri"ed from connecti"e tissue, or mesenchymalcells.

#ymphomaand leukemia:6alignancies deri"ed from hematopoietic (blood-forming)

cells
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Berm cell tumor:umors deri"ed fromtotipotentcells. n adults most often found in

the testicleand o"aryC in fetuses, babies, and young children most often found on the body

midline, particularly at the tip of the tailboneC in horses most often found at the poll (base of

the skull).

Blastic tumor orblastoma:A tumor (usually malignant) which resembles an immatureor embryonic tissue. 6any of these tumors are most common in children.

6alignant tumors (cancers) are usually named using -carcinoma, -sarcoma or -blastomaas a

suffi7, with the #atin or Breek word for the organ of origin as the root. For instance, a cancer of

the li"er is called hepatocarcinomaC a cancer of the fat cells is called liposarcoma. For common

cancers, the %nglish organ name is used. For instance, the most common type of breast canceris

called ductal carcinoma of the breast or mammary ductal carcinoma. Dere, the ad4ecti"e ductal

refers to the appearance of the cancer under the microscope, resembling normal breast ducts.

enign tumors(which are not cancers) are named using -omaas a suffi7 with the organ name as

the root. For instance, a benign tumor of the smooth muscle of the uterus is called leiomyoma(the

common name of this fre8uent tumor isfibroid). *nfortunately, some cancers also use the -oma

suffi7, e7amples being melanomaand seminoma.

Signs and symptoms
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+ymptoms of cancer

metastasis depend on the

location of the tumor.Eoughly, cancer symptoms

can be di"ided into three

groups'

Local symptoms'

unusual lumps or

swelling (tumor),

hemorrhage (bleeding),

pain and!orulceration.

ompression of

surrounding tissues may cause symptoms such as4aundice(yellowing the eyes and skin).

+ymptoms of metastasis (spreading)' enlargedlymph nodes, coughandhemoptysis,

hepatomegaly (enlarged li"er), bone pain, fractureof affected bones and neurological

symptoms. Although ad"anced cancer may causepain, it is often not the first symptom.

Systemic symptoms' weight loss, poor appetite, fatigue and cache7ia (wasting),

e7cessi"e sweating (night sweats), anemia and specificparaneoplastic phenomena, i.e.

specific conditions that are due to an acti"e cancer, such as thrombosisor hormonal changes.

%"ery symptom in the abo"e list can be caused by a "ariety of conditions (a list of which is

referred to as the differential diagnosis). ancer may be a common or uncommon cause of each

item.

Causes

ancers are primarily an en"ironmental disease with :-:? of cases due to lifestyle and

en"ironmental factors and -9? due to genetics. ommon en"ironmental factors that lead to

cancer death include' tobacco (;-?), diet and obesity (-?), infections (9-;?),

radiation, radone7posure, stress, lack ofphysical acti"ity, anden"ironmental pollutants

Chemicals

he incidence of lung cancer

is highly correlated with

smoking. +ource'5D.

ancer pathogenesis is
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traceable back to 15A mutationsthat impact cell growth and metastasis. +ubstances that cause

15A mutations are known as mutagens, and mutagens that cause cancers are known as

carcinogens. articular substances ha"e been linked to specific types of cancer. obacco smoking

is associated with many forms of cancer, and causes :? oflung cancer. rolonged e7posure to

asbestosfibers is associated with mesothelioma.6any mutagensare also carcinogens, but some carcinogens are not mutagens. Alcoholis an

e7ample of a chemical carcinogen that is not a mutagen. +uch chemicals may promote cancers

through stimulating the rate of cell di"ision. Faster rates of replication lea"es less time for repair

en>ymes to repair damaged 15A during 15A replication, increasing the likelihood of a

mutation.

1ecades of research has demonstrated the link between tobaccouse and cancer in the lung,

laryn7, head, neck, stomach, bladder, kidney, oesophagus and pancreas.obacco smoke

contains o"er fifty known carcinogens, including nitrosamines and polycyclic aromatic

hydrocarbons. obacco is responsible for about one in three of all cancer deaths in the de"eloped

world, and about one in fi"e worldwide. ndeed, lung cancerdeath rates in the *nited +tates ha"e

mirrored smokingpatterns, with increases in smoking followed by dramatic increases in lung

cancer death rates and, more recently, decreases in smoking followed by decreases in lung cancer

death rates in men. Dowe"er, the numbers of smokers worldwide is still rising, leading to what

some organi>ations ha"e described as the tobacco epidemic.

ancer related to ones occupation is belie"ed to represent between ;-;? of all cases

Ionizing radiation

+ources of ioni>ing radiation, such as radon gas, can cause cancer. rolonged e7posure to

ultra"iolet radiation from the suncan lead to melanomaand other skin malignancies. &nereport estimates that appro7imately ;: future cancers could be related to the appro7imately =

million scansperformed in the *+ in ;=. t is estimated that .


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%7perimental and epidemiological data imply a causati"e role for "iruses and they appear to be the

second most important risk factor for cancer de"elopment in humans, e7ceeded only by tobacco

usage. he mode of "irally induced tumors can be di"ided into two, acutely transforming or

slowly transforming. n acutely transforming "iruses, the "irus carries an o"eracti"e oncogene

called "iral-oncogene ("-onc), and the infected cell is transformed as soon as "-onc is e7pressed.n contrast, in slowly transforming "iruses, the "irus genome is inserted near a proto-oncogene in

the host genome. he "iral promoter or other transcription regulation elements then cause

o"ere7pression of that proto-oncogene. his induces uncontrolled cell di"ision. ecause the site of

insertion is not specific to proto-oncogenes and the chance of insertion near any proto-oncogene is

low, slowly transforming "iruses will cause tumors much longer after infection than the acutely

transforming "iruses.

Depatitis "iruses, including hepatitis andhepatitis , can induce a chronic "iral infection that

leads to li"er cancer in .


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6ost forms of cancer aresporadic, meaning that there is no inherited cause of the cancer. here

are, howe"er, a number of recognised syndromeswhere there is an inherited predisposition to

cancer, often due to a defect in a gene that protects against tumor formation. Famous e7amples

are'

certain inherited mutations in the genes EA9 and EA;are associated with anele"ated risk ofbreast cancerand o"arian cancer

tumors of "arious endocrine organs in multiple endocrine neoplasia(6%5 types 9, ;a,

;b)

#i-Fraumeni syndrome("arious tumors such as osteosarcoma, breast cancer,soft tissue

sarcoma,brain tumors) due to mutations ofp

urcot syndrome(brain tumorsand colonic polyposis)

Familial adenomatous polyposisan inherited mutation of the APCgene that leads to

early onset of colon carcinoma.

Dereditary nonpolyposis colorectal cancer(D5, also known as #ynch syndrome)

can include familial cases ofcolon cancer, uterine cancer, gastric cancer, and o"arian

cancer, without a preponderance of colon polyps.

Eetinoblastoma, when occurring in young children, is due to a hereditary mutation in the

retinoblastoma gene.

1own syndromepatients, who ha"e an e7tra chromosome ;9, are known to de"elop

malignancies such as leukemiaand testicular cancer, though the reasons for this difference

are not well understood.

Other causes

%7cepting the rare transmissions that occur with pregnancies and only a marginal few organdonors, cancer is generally not a transmissible disease. he main reason for this is tissue graft

re4ection caused by 6D incompatibility.2;=3 n humans and other "ertebrates, the immune

system uses 6D antigens to differentiate between $self$ and $non-self$ cells because these

antigens are different from person to person. When non-self antigens are encountered, the immune

system reacts against the appropriate cell. +uch reactions may protect against tumour cell

engraftment by eliminating implanted cells. n the *nited +tates, appro7imately , pregnant

women ha"e a malignancy annually, and transplacental transmission of acute leukaemia,

lymphoma, melanoma and carcinoma from mother to fetus has been obser"ed.2;=3 he

de"elopment of donor-deri"ed tumors from organ transplants is e7ceedingly rare. he main causeof organ transplant associated tumors seems to be malignant melanoma, that was undetected at the

time of organ har"est.though other cases e7ist. n fact, cancer from one organism will usually

grow in another organism of that species, as long as they share the same histocompatibility

genes, pro"en using miceC howe"er this would ne"er happen in a real-world setting e7cept as

described abo"e.

n non-humans, a few types oftransmissible cancerha"e been described, wherein the cancer

spreads between animals by transmission of the tumor cells themsel"es. his phenomenon is seen

in dogs with +tickerHs sarcoma, also known as canine transmissible "enereal tumor, as well as

1e"il facial tumour diseasein asmanian de"ils.
http://en.wikipedia.org/wiki/Syndromehttp://en.wikipedia.org/wiki/Tumor_suppressorhttp://en.wikipedia.org/wiki/BRCA1http://en.wikipedia.org/wiki/Lung_cancer#Non-small_cell_lung_carcinoma_.28NSCLC.29http://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Ovarian_cancerhttp://en.wikipedia.org/wiki/Multiple_endocrine_neoplasiahttp://en.wikipedia.org/wiki/Li-Fraumeni_syndromehttp://en.wikipedia.org/wiki/Li-Fraumeni_syndromehttp://en.wikipedia.org/wiki/Osteosarcomahttp://en.wikipedia.org/wiki/Soft_tissue_sarcomahttp://en.wikipedia.org/wiki/Soft_tissue_sarcomahttp://en.wikipedia.org/wiki/Soft_tissue_sarcomahttp://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/P53http://en.wikipedia.org/wiki/Turcot_syndromehttp://en.wikipedia.org/wiki/Turcot_syndromehttp://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/Familial_adenomatous_polyposishttp://en.wikipedia.org/wiki/Familial_adenomatous_polyposishttp://en.wikipedia.org/wiki/Colon_carcinomahttp://en.wikipedia.org/wiki/Hereditary_nonpolyposis_colorectal_cancerhttp://en.wikipedia.org/wiki/Hereditary_nonpolyposis_colorectal_cancerhttp://en.wikipedia.org/wiki/Colorectal_cancerhttp://en.wikipedia.org/wiki/Colorectal_cancerhttp://en.wikipedia.org/wiki/Gastric_cancerhttp://en.wikipedia.org/wiki/Ovarian_cancerhttp://en.wikipedia.org/wiki/Ovarian_cancerhttp://en.wikipedia.org/wiki/Polyp_(medicine)http://en.wikipedia.org/wiki/Retinoblastomahttp://en.wikipedia.org/wiki/Retinoblastomahttp://en.wikipedia.org/wiki/Down_syndromehttp://en.wikipedia.org/wiki/Down_syndromehttp://en.wikipedia.org/wiki/Chromosome_21http://en.wikipedia.org/wiki/Leukemiahttp://en.wikipedia.org/wiki/Testicular_cancerhttp://en.wikipedia.org/wiki/Transmission_(medicine)http://en.wikipedia.org/wiki/Major_histocompatibility_complexhttp://en.wikipedia.org/wiki/Major_histocompatibility_complexhttp://en.wikipedia.org/wiki/Histocompatibilityhttp://en.wikipedia.org/wiki/Cancer#cite_note-Tolar-26http://en.wikipedia.org/wiki/Cancer#cite_note-Tolar-26http://en.wikipedia.org/wiki/Acute_leukaemiahttp://en.wikipedia.org/wiki/Lymphomahttp://en.wikipedia.org/wiki/Melanomahttp://en.wikipedia.org/wiki/Melanomahttp://en.wikipedia.org/wiki/Carcinomahttp://en.wikipedia.org/wiki/Cancer#cite_note-Tolar-26http://en.wikipedia.org/wiki/Cancer#cite_note-Tolar-26http://en.wikipedia.org/wiki/Histocompatibilityhttp://en.wikipedia.org/wiki/Transmissible_cancerhttp://en.wikipedia.org/wiki/Transmissible_cancerhttp://en.wikipedia.org/wiki/Sticker's_sarcomahttp://en.wikipedia.org/wiki/Sticker's_sarcomahttp://en.wikipedia.org/wiki/Devil_facial_tumour_diseasehttp://en.wikipedia.org/wiki/Tasmanian_Devilhttp://en.wikipedia.org/wiki/Syndromehttp://en.wikipedia.org/wiki/Tumor_suppressorhttp://en.wikipedia.org/wiki/BRCA1http://en.wikipedia.org/wiki/Lung_cancer#Non-small_cell_lung_carcinoma_.28NSCLC.29http://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Ovarian_cancerhttp://en.wikipedia.org/wiki/Multiple_endocrine_neoplasiahttp://en.wikipedia.org/wiki/Li-Fraumeni_syndromehttp://en.wikipedia.org/wiki/Osteosarcomahttp://en.wikipedia.org/wiki/Soft_tissue_sarcomahttp://en.wikipedia.org/wiki/Soft_tissue_sarcomahttp://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/P53http://en.wikipedia.org/wiki/Turcot_syndromehttp://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/Familial_adenomatous_polyposishttp://en.wikipedia.org/wiki/Colon_carcinomahttp://en.wikipedia.org/wiki/Hereditary_nonpolyposis_colorectal_cancerhttp://en.wikipedia.org/wiki/Colorectal_cancerhttp://en.wikipedia.org/wiki/Gastric_cancerhttp://en.wikipedia.org/wiki/Ovarian_cancerhttp://en.wikipedia.org/wiki/Ovarian_cancerhttp://en.wikipedia.org/wiki/Polyp_(medicine)http://en.wikipedia.org/wiki/Retinoblastomahttp://en.wikipedia.org/wiki/Down_syndromehttp://en.wikipedia.org/wiki/Chromosome_21http://en.wikipedia.org/wiki/Leukemiahttp://en.wikipedia.org/wiki/Testicular_cancerhttp://en.wikipedia.org/wiki/Transmission_(medicine)http://en.wikipedia.org/wiki/Major_histocompatibility_complexhttp://en.wikipedia.org/wiki/Histocompatibilityhttp://en.wikipedia.org/wiki/Cancer#cite_note-Tolar-26http://en.wikipedia.org/wiki/Acute_leukaemiahttp://en.wikipedia.org/wiki/Lymphomahttp://en.wikipedia.org/wiki/Melanomahttp://en.wikipedia.org/wiki/Carcinomahttp://en.wikipedia.org/wiki/Cancer#cite_note-Tolar-26http://en.wikipedia.org/wiki/Histocompatibilityhttp://en.wikipedia.org/wiki/Transmissible_cancerhttp://en.wikipedia.org/wiki/Sticker's_sarcomahttp://en.wikipedia.org/wiki/Devil_facial_tumour_diseasehttp://en.wikipedia.org/wiki/Tasmanian_Devil


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athophysiology

ancers are caused by a

series of mutations. %ach

mutation alters the beha"ior

of the cell somewhat.

ancer is fundamentally a

disease of regulation of tissue

growth. n order for a normal

cell to transform into a

cancer cell, genes which

regulate cell growth anddifferentiation must be

altered. Benetic changes can

occur at many le"els, from

gain or loss of entire

chromosomes to a mutation

affecting a single 15A

nucleotide. here are two

broad categories of genes

which are affected by these

changes. &ncogenesmay be

normal genes which are

e7pressed at inappropriately

high le"els, or altered genes

which ha"e no"el properties.

n either case, e7pression of

these genes promotes the

malignant phenotype of

cancer cells. umor

suppressor genesare genes which inhibit cell di"ision, sur"i"al, or other properties of cancercells. umor suppressor genes are often disabled by cancer-promoting genetic changes. ypically,

changes in many genes are re8uired to transform a normal cell into a cancer cell.

here is a di"erse classification scheme for the "arious genomic changes which may contribute to

the generation of cancer cells. 6ost of these changes are mutations, or changes in the nucleotide

se8uence of genomic 15A. Aneuploidy, the presence of an abnormal number of chromosomes,

is one genomic change which is not a mutation, and may in"ol"e either gain or loss of one or more

chromosomesthrough errors inmitosis.

#arge-scale mutations in"ol"e the deletion or gain of a portion of a chromosome. Benomic

amplificationoccurs when a cell gains many copies (often ; or more) of a small chromosomal

locus, usually containing one or more oncogenes and ad4acent genetic material. ranslocation
http://en.wikipedia.org/wiki/Malignant_transformationhttp://en.wikipedia.org/wiki/Geneshttp://en.wikipedia.org/wiki/Single_nucleotide_polymorphismhttp://en.wikipedia.org/wiki/Single_nucleotide_polymorphismhttp://en.wikipedia.org/wiki/Single_nucleotide_polymorphismhttp://en.wikipedia.org/wiki/Oncogenehttp://en.wikipedia.org/wiki/Tumor_suppressor_genehttp://en.wikipedia.org/wiki/Tumor_suppressor_genehttp://en.wikipedia.org/wiki/Tumor_suppressor_genehttp://en.wikipedia.org/wiki/Mutationhttp://en.wikipedia.org/wiki/Nucleotidehttp://en.wikipedia.org/wiki/Aneuploidyhttp://en.wikipedia.org/wiki/Chromosomeshttp://en.wikipedia.org/wiki/Mitosishttp://en.wikipedia.org/wiki/Mitosishttp://en.wikipedia.org/wiki/Gene_amplificationhttp://en.wikipedia.org/wiki/Gene_amplificationhttp://en.wikipedia.org/wiki/Chromosomal_translocationhttp://en.wikipedia.org/wiki/Malignant_transformationhttp://en.wikipedia.org/wiki/Geneshttp://en.wikipedia.org/wiki/Single_nucleotide_polymorphismhttp://en.wikipedia.org/wiki/Single_nucleotide_polymorphismhttp://en.wikipedia.org/wiki/Single_nucleotide_polymorphismhttp://en.wikipedia.org/wiki/Oncogenehttp://en.wikipedia.org/wiki/Tumor_suppressor_genehttp://en.wikipedia.org/wiki/Tumor_suppressor_genehttp://en.wikipedia.org/wiki/Tumor_suppressor_genehttp://en.wikipedia.org/wiki/Tumor_suppressor_genehttp://en.wikipedia.org/wiki/Mutationhttp://en.wikipedia.org/wiki/Nucleotidehttp://en.wikipedia.org/wiki/Aneuploidyhttp://en.wikipedia.org/wiki/Chromosomeshttp://en.wikipedia.org/wiki/Mitosishttp://en.wikipedia.org/wiki/Gene_amplificationhttp://en.wikipedia.org/wiki/Gene_amplificationhttp://en.wikipedia.org/wiki/Chromosomal_translocation


10/21

occurs when two separate chromosomal regions become abnormally fused, often at a

characteristic location. A well-known e7ample of this is the hiladelphia chromosome, or

translocation of chromosomes : and ;;, which occurs in chronic myelogenous leukemia, and

results in production of the E-ablfusion protein, an oncogenic tyrosine kinase.

+mall-scale mutations include point mutations, deletions, and insertions, which may occur in thepromoterof a gene and affect its e7pression, or may occur in the geneHs coding se8uenceand

alter the function or stability of itsproteinproduct. 1isruption of a single gene may also result

from integration of genomic materialfrom a 15A "irusor retro"irus, and such an e"ent may

also result in the e7pression of "iral oncogenes in the affected cell and its descendants.

Anything which replicates (li"ing cells) will probabilisticallysuffer from errors (mutations).

*nless error correction and pre"ention is properly carried out, the errors will sur"i"e, and might

be passed along to daughter cells. 5ormally, the body safeguards against cancer "ia numerous

methods, such as' apoptosis, helper molecules (some 15A polymerases), possibly senescence,

etc. Dowe"er these error-correction methods often fail in small ways, especially in en"ironments

that make errors more likely to arise and propagate. For e7ample, such en"ironments can include

the presence of disrupti"e substances called carcinogens, or periodic in4ury (physical, heat, etc.),

or en"ironments that cells did not e"ol"e to withstand, such as hypo7ia(see subsections). ancer

is thus aprogressivedisease, and these progressi"e errors slowly accumulate until a cell begins to

act contrary to its function in the organism.

he errors which cause cancer are often selfamplifying, e"entually compounding at an

e7ponential rate. For e7ample'

A mutation in the error-correcting machinery of a cell might cause that cell and its

children to accumulate errors more rapidly

A mutation in signaling (endocrine) machinery of the cell can send error-causing signalsto nearby cells

A mutation might cause cells to become neoplastic, causing them to migrate and disrupt

more healthy cells

A mutation may cause the cell to become immortal (see telomeres), causing them to

disrupt healthy cells fore"er

hus cancer often e7plodes in something akin to a chain reactioncaused by a few errors, which

compound into more se"ere errors. %rrors which produce more errors are effecti"ely the root cause

of cancer, and also the reason that cancer is so hard to treat' e"en if there were 9,,,

cancerous cells and one killed all but 9 of those cells, those cells (and other error-prone

precancerous cells) could still self-replicate or send error-causing signals to other cells, starting the

process o"er again. his rebellion-like scenario is an undesirable sur"i"al of the fittest, where the

dri"ing forces of e"olutionwork against the bodyHs design and enforcement of order. n fact, once

cancer has begun to de"elop, this same force continues to dri"e the progression of cancer towards

more in"asi"e stages, and is called clonal e"olution.

Eesearch about cancercauses often falls into the following categories'

Agents (e.g. "iruses) and e"ents (e.g. mutations) which cause or facilitate genetic changes

in cells destined to become cancer.

he precise nature of the genetic damage, and the genes which are affected by it.

he conse8uences of those genetic changes on the biology of the cell, both in generatingthe defining properties of a cancer cell, and in facilitating additional genetic e"ents which lead
http://en.wikipedia.org/wiki/Philadelphia_chromosomehttp://en.wikipedia.org/wiki/Chronic_myelogenous_leukemiahttp://en.wikipedia.org/wiki/BCR_genehttp://en.wikipedia.org/wiki/Abl_genehttp://en.wikipedia.org/wiki/Fusion_proteinhttp://en.wikipedia.org/wiki/Fusion_proteinhttp://en.wikipedia.org/wiki/Tyrosine_kinasehttp://en.wikipedia.org/wiki/Promoter_(biology)http://en.wikipedia.org/wiki/Gene_expressionhttp://en.wikipedia.org/wiki/Coding_sequencehttp://en.wikipedia.org/wiki/Proteinhttp://en.wikipedia.org/wiki/Provirushttp://en.wikipedia.org/wiki/DNA_virushttp://en.wikipedia.org/wiki/Retrovirushttp://en.wikipedia.org/wiki/Probabilityhttp://en.wikipedia.org/wiki/Cell_divisionhttp://en.wikipedia.org/wiki/Apoptosishttp://en.wikipedia.org/wiki/Senescencehttp://en.wikipedia.org/wiki/Carcinogenshttp://en.wikipedia.org/wiki/Hypoxia_(medical)http://en.wikipedia.org/wiki/Endocrinehttp://en.wikipedia.org/wiki/Neoplastichttp://en.wikipedia.org/wiki/Telomereshttp://en.wikipedia.org/wiki/Chain_reactionhttp://en.wikipedia.org/wiki/Survival_of_the_fittesthttp://en.wikipedia.org/wiki/Evolutionhttp://en.wikipedia.org/wiki/Cancer#Clonal_evolutionhttp://en.wikipedia.org/wiki/Cancer_researchhttp://en.wikipedia.org/wiki/Philadelphia_chromosomehttp://en.wikipedia.org/wiki/Chronic_myelogenous_leukemiahttp://en.wikipedia.org/wiki/BCR_genehttp://en.wikipedia.org/wiki/Abl_genehttp://en.wikipedia.org/wiki/Fusion_proteinhttp://en.wikipedia.org/wiki/Tyrosine_kinasehttp://en.wikipedia.org/wiki/Promoter_(biology)http://en.wikipedia.org/wiki/Gene_expressionhttp://en.wikipedia.org/wiki/Coding_sequencehttp://en.wikipedia.org/wiki/Proteinhttp://en.wikipedia.org/wiki/Provirushttp://en.wikipedia.org/wiki/DNA_virushttp://en.wikipedia.org/wiki/Retrovirushttp://en.wikipedia.org/wiki/Probabilityhttp://en.wikipedia.org/wiki/Cell_divisionhttp://en.wikipedia.org/wiki/Apoptosishttp://en.wikipedia.org/wiki/Senescencehttp://en.wikipedia.org/wiki/Carcinogenshttp://en.wikipedia.org/wiki/Hypoxia_(medical)http://en.wikipedia.org/wiki/Endocrinehttp://en.wikipedia.org/wiki/Neoplastichttp://en.wikipedia.org/wiki/Telomereshttp://en.wikipedia.org/wiki/Chain_reactionhttp://en.wikipedia.org/wiki/Survival_of_the_fittesthttp://en.wikipedia.org/wiki/Evolutionhttp://en.wikipedia.org/wiki/Cancer#Clonal_evolutionhttp://en.wikipedia.org/wiki/Cancer_research


11/21

to further progression of the cancer.

re!ention

ancer pre"ention is defined as acti"e measures to decrease the incidence of cancer. Breater than? of cancer is pre"entable "ia a"oiding risk factors including' tobacco, o"erweight or

obesity, low fruit and "egetable intake, physical inacti"ity, alcohol, se7ually transmitted

infection, air pollution. his can be accomplished by a"oiding carcinogensor altering their

metabolism, pursuing a lifestyle or diet that modifies cancer-causing factors and!or medical

inter"ention (chemopre"ention, treatment of pre-malignant lesions). he epidemiological

concept of $pre"ention$ is usually defined as eitherprimary pre"ention, for people who ha"e not

been diagnosed with a particular disease, or secondary pre"ention, aimed at reducing recurrence

or complications of a pre"iously diagnosed illness.

ut the % study published in ;9, tracking the eating habits of eneat their

workplaces.urrently, most cancer deaths caused by occupational risk factors occur in the

de"eloped world. t is estimated that appro7imately ;, cancer deaths and


12/21

+tates. n this e7ample the preceding consideration of Daplogroupsare e7cluded). +tudies ha"e

shown that immigrants de"elop the risk of their new country, often within one generation,

suggesting a substantial link between diet and cancer. Whether reducing obesity in a population

also reduces cancer incidence is unknown.

1espite fre8uent reports of particular substances (including foods) ha"ing a beneficial ordetrimental effect on cancer risk, few of these ha"e an established link to cancer. hese reports are

often based on studies in cultured cell media or animals. ublic health recommendations cannot be

made based on these studies until they ha"e been "alidated in an obser"ational (or occasionally a

prospecti"e inter"entional) trial in humans.

roposed dietary inter"entions for primary cancer risk reduction generally gain support from

epidemiological association studies. %7amples of such studies include reports that reduced meat

consumption is associated with decreased risk of colon cancer, and reports that consumption of

coffee is associated with a reduced risk of li"er cancer. +tudies ha"e linked consumption of grilled

meat to an increased risk of stomach cancer, colon cancer, breast cancer, and pancreatic

cancer, a phenomenon which could be due to the presence of carcinogens such as ben>opyrene

in foods cooked at high temperatures.

A recent study analysed the correlation between many factors and cancer and concluded that the

ma4or contributory dietary factor was animal protein, whereas plant protein did not ha"e an effect.

Animal studies confirmed the mechanism by showing that reducing the proportion of animal

protein switched off both the initiation and promotion stages.

A ; secondary pre"entionstudy showed that consumption of a plant-based diet and lifestyle

changes resulted in a reduction in cancer markers in a group of men with prostate cancer who

were using no con"entional treatments at the time. hese results were amplified by a ;@ study.

&"er ;,ations ha"e in fact begun to recommend

reducing intake of refined sugars and starches as part of their cancer pre"ention regimens.

n 5o"ember ;=, the American nstitute for ancer Eesearch(AE), in con4unction with the

World ancer Eesearch Fund (WEF), published Food, 5utrition, hysical Acti"ity and the

re"ention of ancer' a Blobal erspecti"e, $the most current and comprehensi"e analysis of the

literature on diet, physical acti"ity and cancer$. he WEF!AE %7pert Eeport lists 9

recommendations that people can follow to help reduce their risk of de"eloping cancer, including

the following dietary guidelines' (9) reducing intake of foods and drinks that promote weight gain,

namely energy-dense foods and sugary drinks, (;) eating mostly foods of plant origin, () limiting

intake of red meat and a"oiding processed meat, (ei, 6aitake, and rametes "ersicolor. Eesearch suggests the compounds in medicinal

mushroomsmost responsible for up-regulating the immune system and pro"iding an anti-cancereffect, are a di"erse collection ofpolysaccharidecompounds, particularlybeta-glucans. eta-
http://en.wikipedia.org/wiki/Haplogroupshttp://en.wikipedia.org/wiki/Stomach_cancerhttp://en.wikipedia.org/wiki/Colorectal_cancerhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Pancreatic_cancerhttp://en.wikipedia.org/wiki/Pancreatic_cancerhttp://en.wikipedia.org/wiki/Benzopyrenehttp://en.wikipedia.org/wiki/Secondary_preventionhttp://en.wikipedia.org/wiki/American_Institute_for_Cancer_Researchhttp://en.wikipedia.org/wiki/World_Cancer_Research_Fundhttp://en.wikipedia.org/wiki/Food,_Nutrition,_Physical_Activity_and_the_Prevention_of_Cancer:_a_Global_Perspectivehttp://en.wikipedia.org/wiki/Food,_Nutrition,_Physical_Activity_and_the_Prevention_of_Cancer:_a_Global_Perspectivehttp://en.wikipedia.org/wiki/Reishihttp://en.wikipedia.org/wiki/Agaricus_blazeihttp://en.wikipedia.org/wiki/Agaricus_blazeihttp://en.wikipedia.org/wiki/Agaricus_blazeihttp://en.wikipedia.org/wiki/Maitakehttp://en.wikipedia.org/wiki/Trametes_versicolorhttp://en.wikipedia.org/wiki/Medicinal_mushroomshttp://en.wikipedia.org/wiki/Medicinal_mushroomshttp://en.wikipedia.org/wiki/Polysaccharidehttp://en.wikipedia.org/wiki/Beta-glucanshttp://en.wikipedia.org/wiki/Haplogroupshttp://en.wikipedia.org/wiki/Stomach_cancerhttp://en.wikipedia.org/wiki/Colorectal_cancerhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Pancreatic_cancerhttp://en.wikipedia.org/wiki/Pancreatic_cancerhttp://en.wikipedia.org/wiki/Benzopyrenehttp://en.wikipedia.org/wiki/Secondary_preventionhttp://en.wikipedia.org/wiki/American_Institute_for_Cancer_Researchhttp://en.wikipedia.org/wiki/World_Cancer_Research_Fundhttp://en.wikipedia.org/wiki/Food,_Nutrition,_Physical_Activity_and_the_Prevention_of_Cancer:_a_Global_Perspectivehttp://en.wikipedia.org/wiki/Food,_Nutrition,_Physical_Activity_and_the_Prevention_of_Cancer:_a_Global_Perspectivehttp://en.wikipedia.org/wiki/Reishihttp://en.wikipedia.org/wiki/Agaricus_blazeihttp://en.wikipedia.org/wiki/Agaricus_blazeihttp://en.wikipedia.org/wiki/Maitakehttp://en.wikipedia.org/wiki/Trametes_versicolorhttp://en.wikipedia.org/wiki/Medicinal_mushroomshttp://en.wikipedia.org/wiki/Medicinal_mushroomshttp://en.wikipedia.org/wiki/Polysaccharidehttp://en.wikipedia.org/wiki/Beta-glucans


13/21

glucans are known as $biological response modifiers$, and their ability to acti"ate the immune

system is well documented. +pecifically, beta-glucans stimulate the innatebranch of the immune

system. Eesearch has shown beta-glucans ha"e the ability to stimulate macrophage,5G cells,

cells, and immune system cytokines. he mechanisms in which beta-glucans stimulate the

immune system is only partially understood. &ne mechanism in which beta-glucans are able toacti"ate the immune system, is by interacting with the 6acrophage-9 antigen(190) receptor

on immune cells.

$itamins

As of ;9"itaminsha"e not been found to be effecti"e at pre"enting cancer, while low le"els of

"itamin 1 is correlated with increased cancer risk. Whether this relationship is causal and

"itamin 1 supplementation is protecti"e is yet to be determined. eta-carotenesupplementation

has been found to increase slightly, but not significantly risks of lung cancer. Folic acid

supplementation has not been found effecti"e in pre"enting colon cancer and may increase colonpolyps.

Chemopre!ention

he concept that medications could be used to pre"ent cancer is an attracti"e one, and many high-

8uality clinical trials support the use of such chemopre"ention in defined circumstances.

1aily use of tamo7ifen, aselecti"e estrogen receptor modulator(+%E6), typically for K years,

has been demonstrated to reduce the risk of de"elopingbreast cancerin high-risk women by

about ?. A recent study reported that the selecti"e estrogen receptor modulatorralo7ifenehas

similar benefits to tamo7ifen in pre"enting breast cancer in high-risk women, with a more

fa"orable side effect profile.

Ealo7ifeneis a +%E6 like tamo7ifenC it has been shown (in the +AE trial) to reduce the risk

of breast cancer in high-risk women e8ually as well as tamo7ifen. n this trial, which studied

almost ;, women, ralo7ifenehad fewer side effects than tamo7ifen, though it did permit

more 1+to form.

Finasteride, a -alpha-reductase inhibitor, has been shown to lower the risk of prostate cancer,

though it seems to mostly pre"ent low-grade tumors. he effect of &L-; inhibitors such as

rofeco7ib and celeco7ib upon the risk of colon polyps ha"e been studied in familial

adenomatous polyposis patients and in the general population. n both groups, there were

significant reductions in colon polyp incidence, but this came at the price of increasedcardio"ascular to7icity.

%enetic testing

Benetic testingfor high-risk indi"iduals is already a"ailable for certain cancer-related genetic

mutations. arriers of genetic mutations that increase risk for cancer incidence can undergo

enhanced sur"eillance, chemopre"ention, or risk-reducing surgery. %arly identification of inherited

genetic risk for cancer, along with cancer-pre"enting inter"entions such as surgery or enhanced

sur"eillance, can be lifesa"ing for high-risk indi"iduals.

%ene Cancer types &!ailability
http://en.wikipedia.org/wiki/Innate_immune_systemhttp://en.wikipedia.org/wiki/Macrophagehttp://en.wikipedia.org/wiki/NK_cellshttp://en.wikipedia.org/wiki/T_cellshttp://en.wikipedia.org/wiki/T_cellshttp://en.wikipedia.org/wiki/Cytokineshttp://en.wikipedia.org/wiki/Complement_Receptor_3http://en.wikipedia.org/wiki/CD18http://en.wikipedia.org/wiki/Cell_receptorhttp://en.wikipedia.org/wiki/Vitaminhttp://en.wikipedia.org/wiki/Vitaminhttp://en.wikipedia.org/wiki/Vitamin_Dhttp://en.wikipedia.org/wiki/Beta-carotenehttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Folic_acidhttp://en.wikipedia.org/wiki/Folic_acidhttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Selective_estrogen_receptor_modulatorhttp://en.wikipedia.org/wiki/Selective_estrogen_receptor_modulatorhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Selective_estrogen_receptor_modulatorhttp://en.wikipedia.org/wiki/Raloxifenehttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Raloxifenehttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Raloxifenehttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Ductal_carcinomahttp://en.wikipedia.org/wiki/Finasteridehttp://en.wikipedia.org/wiki/5-alpha-reductase_inhibitorhttp://en.wikipedia.org/wiki/COX-2_selective_inhibitorhttp://en.wikipedia.org/wiki/Rofecoxibhttp://en.wikipedia.org/wiki/Celecoxibhttp://en.wikipedia.org/wiki/Celecoxibhttp://en.wikipedia.org/wiki/Familial_adenomatous_polyposishttp://en.wikipedia.org/wiki/Familial_adenomatous_polyposishttp://en.wikipedia.org/wiki/Colon_polyphttp://en.wikipedia.org/wiki/Incidence_(epidemiology)http://en.wikipedia.org/wiki/Genetic_testinghttp://en.wikipedia.org/wiki/Innate_immune_systemhttp://en.wikipedia.org/wiki/Macrophagehttp://en.wikipedia.org/wiki/NK_cellshttp://en.wikipedia.org/wiki/T_cellshttp://en.wikipedia.org/wiki/T_cellshttp://en.wikipedia.org/wiki/Cytokineshttp://en.wikipedia.org/wiki/Complement_Receptor_3http://en.wikipedia.org/wiki/CD18http://en.wikipedia.org/wiki/Cell_receptorhttp://en.wikipedia.org/wiki/Vitaminhttp://en.wikipedia.org/wiki/Vitamin_Dhttp://en.wikipedia.org/wiki/Beta-carotenehttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Folic_acidhttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Selective_estrogen_receptor_modulatorhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Selective_estrogen_receptor_modulatorhttp://en.wikipedia.org/wiki/Raloxifenehttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Raloxifenehttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Raloxifenehttp://en.wikipedia.org/wiki/Tamoxifenhttp://en.wikipedia.org/wiki/Ductal_carcinomahttp://en.wikipedia.org/wiki/Finasteridehttp://en.wikipedia.org/wiki/5-alpha-reductase_inhibitorhttp://en.wikipedia.org/wiki/COX-2_selective_inhibitorhttp://en.wikipedia.org/wiki/Rofecoxibhttp://en.wikipedia.org/wiki/Celecoxibhttp://en.wikipedia.org/wiki/Familial_adenomatous_polyposishttp://en.wikipedia.org/wiki/Familial_adenomatous_polyposishttp://en.wikipedia.org/wiki/Colon_polyphttp://en.wikipedia.org/wiki/Incidence_(epidemiology)http://en.wikipedia.org/wiki/Genetic_testing


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EA9,EA; reast, o"arian, pancreatic ommercially a"ailable for

clinical specimens

6#D9, 6+D;,

6+D@,6+9,6+;

olon, uterine, small bowel,

stomach, urinary tract

ommercially a"ailable for

clinical specimens

$accination

rophylactic"accinesha"e been de"eloped to pre"ent infection by oncogenic infectious agents

such as "iruses, and therapeutic "accines are in de"elopment to stimulate an immune response

against cancer-specificepitopes.

As reported abo"e, a pre"enti"e human papilloma"irus "accinee7ists that targets certain se7ually

transmitted strains of human papilloma"irusthat are associated with the de"elopment of cer"ical

cancer and genital warts. he only two DI "accines on the market as of &ctober ;= are

Bardasiland er"ari7.20


15/21

li"es. he contro"ersy arises when it is not clear if the benefits of screening outweigh the risks of

follow-up diagnostic tests and cancer treatments. For e7ample' when screening for prostate

cancer, the +Atest may detect small cancers that would ne"er become life threatening, but

once detected will lead to treatment. his situation, called o"erdiagnosis, puts men at risk for

complications from unnecessary treatment such as surgery or radiation. Follow up procedures usedto diagnose prostate cancer (prostate biopsy) may cause side effects, including bleeding and

infection. rostate cancer treatment may cause incontinence(inability to control urine flow) and

erectile dysfunction(erections inade8uate for intercourse). his situation was summarised in an

editorial commenting on recent randomised controlled trials. +imilarly, for breast cancer, there

ha"e recently2whenM3been criticisms that breast screening programs in some countries cause more

problems than they sol"e. his is because screening of women in the general population will result

in a large number of women with false positi"e results which re8uire e7tensi"e follow-up

in"estigations to e7clude cancer, leading to ha"ing a high number-to-treat (or number-to-screen) to

pre"ent or catch a single case of breast cancer early.

&ne difficulty with demonstrating the benefits of mammography screening is that proof of benefit

re8uires not only a reduction in breast cancer mortality among women offered screening compared

with those in the control group in randomised controlled trials, but also a reduction in deaths from

all causes. n most screening trials the obser"ed reduction in deaths from the particular cancer was

accompanied by a comparable increase in deaths from other causes, presumably as a result of

harm caused by post-screening treatments, gi"ing no significant reduction in deaths from all

causes. %"en in the large breast and prostate cancer screening trials the power of the trials is

inade8uate to confirm the significance of the lack of reduction in o"erall deaths. 1espite the

reduction in harm caused by post-screening treatments in recent years there is still a significant

number of deaths due to treatment.er"ical cancer screening "ia the ap smearhas the best cost-benefit profile of all the forms of

cancer screening from a public health perspecti"e as, largely caused by a "irus, it has clear risk

factors (se7ual contact), and the natural progression of cer"ical cancer is that it normally spreads

slowly o"er a number of years therefore gi"ing more time for the screening program to catch it

early. 6oreo"er, the test is easy to perform and relati"ely cheap.

For these reasons, it is important that the benefits and risks of diagnostic procedures and treatment

be taken into account when considering whether to undertake cancer screening.

*se ofmedical imaging to search for cancer in people without clear symptoms is similarly

marred with problems. here is a significant risk of detection of what has been recently 2called an

incidentaloma- a benign lesion that may be interpreted as a malignancy and be sub4ected to

potentially dangerous in"estigations. Eecent2studies of scan-based screening forlung cancer

in smokers ha"e had e8ui"ocal results, and systematic screening is not recommended as of July

;=.Eandomi>ed clinical trialsof plain-film chest L-raysto screen for lung cancer in smokers

ha"e shown no benefit for this approach.

anine cancer detectionhas shown promise, but is still in the early stages of research.
http://en.wikipedia.org/wiki/Prostate_cancerhttp://en.wikipedia.org/wiki/Prostate_cancerhttp://en.wikipedia.org/wiki/Prostate_specific_antigenhttp://en.wikipedia.org/wiki/Prostate_biopsyhttp://en.wikipedia.org/wiki/Urinary_incontinencehttp://en.wikipedia.org/wiki/Erectile_dysfunctionhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style_(dates_and_numbers)#Chronological_itemshttp://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style_(dates_and_numbers)#Chronological_itemshttp://en.wikipedia.org/wiki/Pap_smearhttp://en.wikipedia.org/wiki/Medical_imaginghttp://en.wikipedia.org/wiki/Medical_imaginghttp://en.wikipedia.org/wiki/Incidentalomahttp://en.wikipedia.org/wiki/CT_scanhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Randomized_clinical_trialshttp://en.wikipedia.org/wiki/Randomized_clinical_trialshttp://en.wikipedia.org/wiki/Chest_X-rayshttp://en.wikipedia.org/wiki/Canine_cancer_detectionhttp://en.wikipedia.org/wiki/Prostate_cancerhttp://en.wikipedia.org/wiki/Prostate_cancerhttp://en.wikipedia.org/wiki/Prostate_specific_antigenhttp://en.wikipedia.org/wiki/Prostate_biopsyhttp://en.wikipedia.org/wiki/Urinary_incontinencehttp://en.wikipedia.org/wiki/Erectile_dysfunctionhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style_(dates_and_numbers)#Chronological_itemshttp://en.wikipedia.org/wiki/Pap_smearhttp://en.wikipedia.org/wiki/Medical_imaginghttp://en.wikipedia.org/wiki/Incidentalomahttp://en.wikipedia.org/wiki/CT_scanhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Randomized_clinical_trialshttp://en.wikipedia.org/wiki/Chest_X-rayshttp://en.wikipedia.org/wiki/Canine_cancer_detection


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#iagnosis

hest 7-ray showing lung

cancer in the left lung.

6ost cancers are initially

recogni>ed either because

signs or symptoms appear or

through screening. 5either of

these lead to a definiti"e

diagnosis, which usually

re8uires the opinion of a

pathologist, a type of

physician (medical doctor) who speciali>es in the diagnosis of cancer and other diseases. eople

with suspected cancer are in"estigated with medical tests. hese commonly includeblood tests,

L-rays, scansandendoscopy.

athology

A cancer may be suspected for a "ariety of reasons, but the definiti"e diagnosis of most

malignancies must be confirmed by histological e7amination of the cancerous cells by a

pathologist. issue can be obtained from abiopsyorsurgery. 6any biopsies (such as those of

the skin, breast or li"er) can be done in a doctorHs office. iopsies of other organs are performed

underanesthesiaand re8uire surgeryin anoperating room.

he tissue diagnosisgi"en by the pathologist indicates the type of cell that is proliferating, its

histological grade, genetic abnormalities, and other features of the tumor. ogether, this

information is useful to e"aluate theprognosisof the patient and to choose the best treatment.

ytogenetics and immunohistochemistry are other types of testing that the pathologist may

perform on the tissue specimen. hese tests may pro"ide information about the molecular changes

(such as mutations, fusion genes, and numerical chromosomechanges) that has happened in

the cancer cells, and may thus also indicate the future beha"ior of the cancer (prognosis) and besttreatment.

ypical macroscopic

appearance of cancer. his

in"asi"e ductal carcinomaof

the breast (pale area at the

center) shows an o"al tumor

An in"asi"e

A large
http://en.wikipedia.org/wiki/Anatomical_pathologyhttp://en.wikipedia.org/wiki/Medical_testhttp://en.wikipedia.org/wiki/Blood_testhttp://en.wikipedia.org/wiki/X-rayhttp://en.wikipedia.org/wiki/CT_scanhttp://en.wikipedia.org/wiki/Endoscopyhttp://en.wikipedia.org/wiki/Endoscopyhttp://en.wikipedia.org/wiki/Histologyhttp://en.wikipedia.org/wiki/Anatomical_pathologyhttp://en.wikipedia.org/wiki/Biopsyhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Anesthesiahttp://en.wikipedia.org/wiki/Anesthesiahttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Operating_roomhttp://en.wikipedia.org/wiki/Operating_roomhttp://en.wikipedia.org/wiki/Medical_diagnosishttp://en.wikipedia.org/wiki/Histological_gradehttp://en.wikipedia.org/wiki/Prognosishttp://en.wikipedia.org/wiki/Cytogeneticshttp://en.wikipedia.org/wiki/Immunohistochemistryhttp://en.wikipedia.org/wiki/Immunohistochemistryhttp://en.wikipedia.org/wiki/Mutationhttp://en.wikipedia.org/wiki/Fusion_genehttp://en.wikipedia.org/wiki/Chromosomehttp://en.wikipedia.org/wiki/Ductal_carcinomahttp://en.wikipedia.org/wiki/Anatomical_pathologyhttp://en.wikipedia.org/wiki/Medical_testhttp://en.wikipedia.org/wiki/Blood_testhttp://en.wikipedia.org/wiki/X-rayhttp://en.wikipedia.org/wiki/CT_scanhttp://en.wikipedia.org/wiki/Endoscopyhttp://en.wikipedia.org/wiki/Histologyhttp://en.wikipedia.org/wiki/Anatomical_pathologyhttp://en.wikipedia.org/wiki/Biopsyhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Anesthesiahttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Operating_roomhttp://en.wikipedia.org/wiki/Medical_diagnosishttp://en.wikipedia.org/wiki/Histological_gradehttp://en.wikipedia.org/wiki/Prognosishttp://en.wikipedia.org/wiki/Cytogeneticshttp://en.wikipedia.org/wiki/Immunohistochemistryhttp://en.wikipedia.org/wiki/Mutationhttp://en.wikipedia.org/wiki/Fusion_genehttp://en.wikipedia.org/wiki/Chromosomehttp://en.wikipedia.org/wiki/Ductal_carcinoma


17/21

surrounded by spikes of

whitish scar tissue in the

surrounding yellow fatty

tissue. he silhouette "aguely

resembles a crab.

colorectal

carcinoma (top

center) in a

colectomy

specimen.

A s8uamous cell

carcinoma (the whitish

tumor) near thebronchi

in a lung specimen.

in"asi"e ductal

carcinomain a

mastectomy

spec

"anagement

9:0 poster identifying surgery, 7-rays and radium as the proper treatments for cancer

6any management options for cancer e7ist including' chemotherapy, radiation therapy,

surgery, immunotherapy, monoclonal antibody therapyand other methods. Which are used

depends upon the location and grade of the tumor and the stageof the disease, as well as the

general state of a personHs health.%7perimental cancer treatmentsare also under de"elopment.

omplete remo"al of the cancer without damage to the rest of the body is the goal of treatment.

+ometimes this can be accomplished by surgery, but the propensity of cancers to in"ade ad4acent

tissue or to spread to distant sites by microscopic metastasis often limits its effecti"eness. +urgery

often re8uired the remo"al of a wide surgical marginor a free margin. he width of the free

margin depends on the type of the cancer, the method of remo"al (16A,6ohs surgery,

&6A, etc.). he margin can be as little as 9K mm forbasal cell cancerusing16Aor

6ohs surgery, to se"eral centimeters for aggressi"e cancers. he effecti"eness of chemotherapy

is often limited by to7icity to other tissues in the body. Eadiation can also cause damage to normal

tissue.ecause $cancer$ refers to a class of diseases, it is unlikely that there will e"er be a single $cure

for cancer$ any more than there will be a single treatment for all infectious

diseases.Angiogenesis inhibitors were once thought to ha"e potential as a $ sil"er bullet$

treatment applicable to many types of cancer, but this has not been the case in practice.

rognosis

ancer has a reputation as a deadly disease. While this certainly applies to certain particular types,

the truths behind the historical connotations of cancer are increasingly o"erturned by ad"ances in

medical care. +ome types of cancer ha"e a prognosis that is substantially better than nonmalignant

diseases such asheart failureand stroke.

rogressi"e and disseminated malignant disease has a substantial impact on a cancer patientHs

8uality of life, and many cancer treatments (such as chemotherapy) may ha"e se"ere side-effects.

n the ad"anced stages of cancer, many patients need e7tensi"e care, affecting family members

and friends. alliati"e caresolutions may include permanent or $respite$ hospice nursing.
http://en.wikipedia.org/wiki/Colorectal_carcinomahttp://en.wikipedia.org/wiki/Colorectal_carcinomahttp://en.wikipedia.org/wiki/Colectomyhttp://en.wikipedia.org/wiki/Squamous_cell_carcinomahttp://en.wikipedia.org/wiki/Squamous_cell_carcinomahttp://en.wikipedia.org/wiki/Bronchihttp://en.wikipedia.org/wiki/Bronchihttp://en.wikipedia.org/wiki/Mammary_ductal_carcinomahttp://en.wikipedia.org/wiki/Mammary_ductal_carcinomahttp://en.wikipedia.org/wiki/Mastectomyhttp://en.wikipedia.org/wiki/Chemotherapyhttp://en.wikipedia.org/wiki/Radiation_therapyhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Immunotherapyhttp://en.wikipedia.org/wiki/Immunotherapyhttp://en.wikipedia.org/wiki/Monoclonal_antibody_therapyhttp://en.wikipedia.org/wiki/Monoclonal_antibody_therapyhttp://en.wikipedia.org/wiki/Cancer_staginghttp://en.wikipedia.org/wiki/Experimental_cancer_treatmenthttp://en.wikipedia.org/wiki/Experimental_cancer_treatmenthttp://en.wikipedia.org/wiki/Surgical_marginhttp://en.wikipedia.org/wiki/Free_marginhttp://en.wikipedia.org/wiki/CCPDMAhttp://en.wikipedia.org/wiki/Mohs_surgeryhttp://en.wikipedia.org/wiki/Mohs_surgeryhttp://en.wikipedia.org/wiki/Basal_cell_cancerhttp://en.wikipedia.org/wiki/CCPDMAhttp://en.wikipedia.org/wiki/CCPDMAhttp://en.wikipedia.org/wiki/Mohs_surgeryhttp://en.wikipedia.org/wiki/Cure_for_cancerhttp://en.wikipedia.org/wiki/Cure_for_cancerhttp://en.wikipedia.org/wiki/Infectious_diseasehttp://en.wikipedia.org/wiki/Infectious_diseasehttp://en.wikipedia.org/wiki/Angiogenesis_inhibitorshttp://en.wikipedia.org/wiki/Angiogenesis_inhibitorshttp://en.wikipedia.org/wiki/Silver_bullethttp://en.wikipedia.org/wiki/Heart_failurehttp://en.wikipedia.org/wiki/Heart_failurehttp://en.wikipedia.org/wiki/Strokehttp://en.wikipedia.org/wiki/Chemotherapyhttp://en.wikipedia.org/wiki/Palliative_carehttp://en.wikipedia.org/wiki/Colorectal_carcinomahttp://en.wikipedia.org/wiki/Colorectal_carcinomahttp://en.wikipedia.org/wiki/Colectomyhttp://en.wikipedia.org/wiki/Squamous_cell_carcinomahttp://en.wikipedia.org/wiki/Squamous_cell_carcinomahttp://en.wikipedia.org/wiki/Bronchihttp://en.wikipedia.org/wiki/Mammary_ductal_carcinomahttp://en.wikipedia.org/wiki/Mammary_ductal_carcinomahttp://en.wikipedia.org/wiki/Mastectomyhttp://en.wikipedia.org/wiki/Chemotherapyhttp://en.wikipedia.org/wiki/Radiation_therapyhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Immunotherapyhttp://en.wikipedia.org/wiki/Monoclonal_antibody_therapyhttp://en.wikipedia.org/wiki/Cancer_staginghttp://en.wikipedia.org/wiki/Experimental_cancer_treatmenthttp://en.wikipedia.org/wiki/Surgical_marginhttp://en.wikipedia.org/wiki/Free_marginhttp://en.wikipedia.org/wiki/CCPDMAhttp://en.wikipedia.org/wiki/Mohs_surgeryhttp://en.wikipedia.org/wiki/Basal_cell_cancerhttp://en.wikipedia.org/wiki/CCPDMAhttp://en.wikipedia.org/wiki/Mohs_surgeryhttp://en.wikipedia.org/wiki/Cure_for_cancerhttp://en.wikipedia.org/wiki/Cure_for_cancerhttp://en.wikipedia.org/wiki/Infectious_diseasehttp://en.wikipedia.org/wiki/Infectious_diseasehttp://en.wikipedia.org/wiki/Angiogenesis_inhibitorshttp://en.wikipedia.org/wiki/Silver_bullethttp://en.wikipedia.org/wiki/Heart_failurehttp://en.wikipedia.org/wiki/Strokehttp://en.wikipedia.org/wiki/Chemotherapyhttp://en.wikipedia.org/wiki/Palliative_care


18/21

Emotional impact

6any local organi>ations offer a "ariety of practical and support ser"ices to people with cancer.

+upport can take the form of support groups, counseling, ad"ice, financial assistance,

transportation to and from treatment, films or information about cancer. 5eighborhoodorgani>ations, local health care pro"iders, or area hospitals may ha"e resources or ser"ices

a"ailable.

ounseling can pro"ide emotional support to cancer patients and help them better understand their

illness. 1ifferent types of counseling include indi"idual, group, family, peer counseling,

berea"ement, patient-to-patient, and se7uality.

6any go"ernmental and charitable organi>ations ha"e been established to help patients cope with

cancer. hese organi>ations are often in"ol"ed in cancer pre"ention, cancer treatment, and cancer

research.

Epidemiology

1eath rate from malignant

cancer per 9,

inhabitants in ;


19/21

n the first year of life the incidenceis about ; cases per million in the *.+., with the most

common beingneuroblastoma.

n the de"eloped world, one in three people will de"elop cancer during their lifetimes. f allcancer

patients sur"i"ed and cancer occurred randomly, the lifetime odds of de"eloping a second primary

cancer would be one in nine. Dowe"er, cancer sur"i"ors ha"e an increased risk of de"eloping asecond primary cancer, and the odds are about two in nine. About half of these second primaries

can be attributed to the normal one-in-nine risk associated with random chance. he increased risk

is belie"ed to be primarily due to the same risk factors that produced the first cancer (such as the

personHs genetic profile, alcohol and tobacco use, obesity, and en"ironmental e7posures), and

partly due to the treatment for the first cancer, which typically includes mutagenic

chemotherapeutic drugs or radiation. ancer sur"i"ors may also be more likely to comply with

recommended screening, and thus may be more likely than a"erage to detect cancers.

6ost common cancers in males, by

occurrence

in females, by

occurrence

in males, by

mortality

in females, by

mortality

'esearch

ancer research is the intense scientific effort to understand disease processes and disco"erpossible therapies. he impro"ed understanding of molecular biologyandcellular biologydue

to cancer research has led to a number of new, effecti"e treatments for cancer since resident

5i7on declared $War on ancer$ in 9:=9. +ince 9:=9 the *nited +tateshas in"ested o"er P;

billion on cancer researchC that total includes money in"ested by public and pri"ate sectors and

foundations. 1espite this substantial in"estment, the country has seen a fi"e percent decrease in

the cancer death rate (ad4usting for si>e and age of the population) between 9: and ;.

#eading cancer research organi>ations and pro4ects include the American Association for ancer

Eesearch, the American ancer +ociety(A+), the American +ociety of linical &ncology,

the%uropean &rganisation for Eesearch and reatment of ancer, the5ational ancer nstitute,the5ational omprehensi"e ancer 5etwork, and he ancer Benome Atlaspro4ect at the

5.

%lossary

he following closely related terms may be used to designate abnormal growths'

umoror tumour:originally, it meant any abnormal swelling, lump or mass. n current

%nglish, howe"er, the word tumor has become synonymous with malignant neoplasm,

specifically solid neoplasm. 5ote that some neoplasms, such as leukemia, do not form
http://en.wikipedia.org/wiki/Incidence_(epidemiology)http://en.wikipedia.org/wiki/Neuroblastomahttp://en.wikipedia.org/wiki/Neuroblastomahttp://en.wikipedia.org/wiki/Molecular_biologyhttp://en.wikipedia.org/wiki/Cellular_biologyhttp://en.wikipedia.org/wiki/Cellular_biologyhttp://en.wikipedia.org/wiki/War_on_Cancerhttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/American_Association_for_Cancer_Researchhttp://en.wikipedia.org/wiki/American_Association_for_Cancer_Researchhttp://en.wikipedia.org/wiki/American_Cancer_Societyhttp://en.wikipedia.org/wiki/American_Society_of_Clinical_Oncologyhttp://en.wikipedia.org/wiki/European_Organisation_for_Research_and_Treatment_of_Cancerhttp://en.wikipedia.org/wiki/European_Organisation_for_Research_and_Treatment_of_Cancerhttp://en.wikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/National_Comprehensive_Cancer_Networkhttp://en.wikipedia.org/wiki/The_Cancer_Genome_Atlashttp://en.wikipedia.org/wiki/Tumorhttp://en.wikipedia.org/wiki/Tumorhttp://en.wikipedia.org/wiki/Leukemiahttp://en.wikipedia.org/wiki/Incidence_(epidemiology)http://en.wikipedia.org/wiki/Neuroblastomahttp://en.wikipedia.org/wiki/Molecular_biologyhttp://en.wikipedia.org/wiki/Cellular_biologyhttp://en.wikipedia.org/wiki/War_on_Cancerhttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/American_Association_for_Cancer_Researchhttp://en.wikipedia.org/wiki/American_Association_for_Cancer_Researchhttp://en.wikipedia.org/wiki/American_Cancer_Societyhttp://en.wikipedia.org/wiki/American_Society_of_Clinical_Oncologyhttp://en.wikipedia.org/wiki/European_Organisation_for_Research_and_Treatment_of_Cancerhttp://en.wikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/National_Comprehensive_Cancer_Networkhttp://en.wikipedia.org/wiki/The_Cancer_Genome_Atlashttp://en.wikipedia.org/wiki/Tumorhttp://en.wikipedia.org/wiki/Leukemia


20/21

tumors.

5eoplasm:the scientific term to describe an abnormal proliferation of genetically altered

cells. 5eoplasms can be benign or malignant'

o "alignant neoplasmor malignant tumor' synonymous with cancer in

e"eryday speech.o Benign neoplasmor benign tumor' a tumor (solid neoplasm) that stops

growing, does not in"ade other tissues and does not form metastases.

In!asi!etumor is another synonym of cancer. he name refers to in"asion of surrounding

tissues.

re-malignancy, pre-canceror non-in!asi!etumor' A neoplasm that is not in"asi"e but

has the potential to progress to cancer (become in"asi"e) if left untreated. hese lesions are, in

order of increasing potential for cancer,atypia,dysplasiaandcarcinoma in situ.

he following terms can be used to describe a cancer'

Screening' a test done on healthy people to detect tumors before they become apparent. A

mammogramis a screening test.

#iagnosis' the confirmation of the cancerous nature of a lump. his usually re8uires a

biopsyor remo"al of the tumor by surgery, followed by e7amination by apathologist.

Surgical e(cision' the remo"al of a tumor by a surgeon.

o Surgical margins' the e"aluation by a pathologistof the edges of the tissue

remo"ed by the surgeon to determine if the tumor was remo"ed completely

($negati"e margins$) or if tumor was left behind ($positi"e margins$).

%rade' a number (usually on a scale of ) established by a pathologistto describe the

degree of resemblance of the tumor to the surrounding benign tissue.

Stage' a number (usually on a scale of


21/21

:? of treated patients li"e after the date of their diagnosis of cancer. his period "aries

among different types of cancerC for e7ample, in the case of DodgkinHs disease this period is

9 years, whereas for urkittHs lymphoma this period would be 9 year. he phrase $cure$ used

in oncology is based upon the statistical concept of a median sur"i"al time and disease-free

median sur"i"al time.his page was last modified on ; 1ecember ;9 at ;'.

tumor cancer

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