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INTRODUCTION

TO

CANCER

INDRANIL MODAK

OVERVIEW
The body's system is composed of

trillions of cells. Even though we stop


growing when we become adults, many
of our cells continue to grow and
divide.
Our

bodies constantly replace the


worn-out cells with new cells to stay
healthy.

To do

this , Cells must enter a


"highway" called the cell cycle.

CELL CYCLE
A

cell divides into two identical


daughter cells.
When enough cells have been made to
replace the worn out cells, the cell
leaves the cell cycle and stops dividing.
The cell depends on signals to decide
when to stay in or exit the cell cycle.

Cell cycle is the series of events that takes place in


a cell leading to its division and duplication

Stop and go
The cell's machinery, are two

signals:
The "go" signal to stay in the
cycle and keep dividing
The "stop" signal to stop
dividing and exit the cell
cycle.
"stop" and "go" signals maintain

the correct balance of healthy,


functioning cells in the body.

go
signal

All

these information are


contained in small units
called genes.
Genes are written in a DNA
code which must first be
transcribed and translated
into another language to make
proteins.
These proteins then serve as
signals in the cell to carry out
the work of the genes.

The characteristics of normal cells


They can

Reproduce themselves exactly


Stop reproducing at the right time
Stick together in the right place
Self destruct if they are damaged
Become specialised or 'mature'

How cancer cells are different


They don't die if they move to another part of the body and

Cancer cells don't stop reproducing


Cancer cells don't obey signals from other cells
Cancer cells don't stick together
Cancer cells don't specialise, but stay immature

Cancer cells don't stop reproducing


Unlike normal cells, cancer cells do

not stop reproducing. This


means that a cancer cell will go on
and on and on doubling.
Cancer cells may be able to stop

themselves self destructing. Or they


may self destruct more slowly than
they reproduce, so that their
numbers continue to increase.
Eventually a tumour is formed.

Cancer cells as being


'immortal'

LOSS OF NORMAL GROWTH CONTROL


Cancer arises from a loss of normal growth control.
In normal tissues, the rates of new cell growth and old cell death

are kept in balance.


In cancer, this balance is disrupted.
This disruption can result from uncontrolled cell growth or loss of a

cell's ability to undergo cell suicide by a process called "APOPTOSIS."


Apoptosis, or "cell suicide," is the mechanism by which old or
damaged cells normally self-destruct.

EXAMPLE OF NORMAL GROWTH


Consider the skin: outermost layer

of normal skin -> epidermis.


Cells in the bottom row -> basal

layer, divide just fast enough to


replenish cells that are continuously
being shed from the surface of the
skin.
1 parent cell -> 2 daughter cells
One remains in the basal layer and
retains the capacity to divide.

The other migrates out of the basal layer and loses the capacity to divide.
The number of dividing cells in the basal layer, therefore, stays the same.

BEGINNING OF CANCEROUS GROWTH


During the development of skin

cancer, the normal balance


between cell division and cell loss
is disrupted.
The basal cells now divide faster

than is needed to replenish the


cells being shed from the surface
of the skin.
1

basal cells divides -> 2


newly formed cells will often
retain the capacity to divide,
leading to increase in the total
number of dividing cells.

Cancer cells don't obey signals from other cells


Something in the cancer cells overrides the normal signalling system
This may be because the genes that tell the cell to reproduce keep on

and on sending signals. Or because the genes that normally tell the cell
to stop reproducing have been damaged or lost.
So the cancer cell keeps on doubling, regardless of the damage the extra

cells cause to the part of the body where the cancer is growing.

Cancer cells don't stick together


Cancer cells can lose the molecules on their surface that keep normal

cells in the right place. So they can become detached from their
neighbours.

INVASION & METASTASIS


Invasion refers to the direct migration and penetration by cancer cells

into neighboring tissues.


Metastasis refers to the ability of cancer cells to penetrate into
lymphatic and blood vessels, circulate through the bloodstream, and then
invade normal tissues elsewhere in the body

Cancer cells don't specialise, but stay immature

Unlike normal cells, cancer cells do not carry on maturing once they

have been made. In fact, the cells in a cancer can become even less
mature over time.
With all the reproducing, it is not surprising that more of the genetic

information in the cell can become lost.


So the cells become more and more primitive and tend to reproduce

more quickly and even more haphazardly.

Normal Cells vs. Cancer Cells

Neoplasm or tumor
An abnormal mass of tissue as a result of abnormal growth or division

of cells
Prior to abnormal growth (known as neoplasia), cells often undergo an
abnormal pattern of growth, such as metaplasia or dysplasia
The growth of neoplastic cells exceeds, and usually causes a lump or tumor.
Neoplasms may be
benign,
pre-malignant (carcinoma in situ)
malignant (cancer).
Dysplasia is an abnormal type of
excessive cell proliferation characterized
by loss of normal tissue arrangement
and cell structure.

MALIGNANT vs. BENIGN TUMORS


Depending on invasion and

metastasis, tumors are classified:


(1) benign, (2) malignant.
Benign tumors are tumors that

cannot spread by invasion or


metastasis; hence, they only
grow locally.
Malignant tumors are tumors

that are capable of spreading by


invasion and metastasis. By
definition, the term "cancer"
applies only to malignant
tumors.

CARCINOMA IN SITU
The most severe cases of dysplasia ->

"carcinoma in situ.
Carcinoma in situ refers to an
uncontrolled growth of cells that
remains in the original location.
Carcinoma in situ (CIS) is defined by
the absence of invasion of tumor cells
into the surrounding tissue, usually
before
penetration
through
the basement membrane.
However, carcinoma in situ may develop
into an invasive, metastatic malignancy
and, therefore, is usually removed
surgically, if possible.

TUMOR GRADING
doctors assign a numerical "grade" to most cancers
In this grading system, a low number grade (grade I or II) refers

to cancers with fewer cell abnormalities than those with higher


numbers (grade III, IV)

Some interesting facts


The word Cancer derives from Greek word carkinos which

means a crab.
Three most common childhood cancers are leukemia (34%), brain
tumors (23%), and lymphomas (12%)
Most doctors will refer to CIS as "pre-cancer", not cancer.
Some neoplasms do not form a tumor. These include leukemia.
In origin, metastasis is a Greek word meaning "displacement.
Metastatic cancer has the same name and same type of cancer cells as
the original cancer.
The most common sites of cancer metastasis are, in alphabetical order,
the bone, liver, and lung.

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