Into to cancer

• Cancer

  Disease in which a group of abnormal cells grow uncontrollably by disregarding the normal rules of cell division

  
• Cancer

  • Normal cells subject to signals that dictate growth, division, differentiation or death – cancer cells lose these signals
  • Results in uncontrolled growth and proliferation
  • If allowed to continue and spread, it can be fatal
  • Almost 90% cancer deaths due to spreading – termed "metastasis"

  
• Hallmarks of Cancer

  • Sustaining proliferative signaling
  • Evading growth suppressors
  • Resisting cell death
  • Enabling replicative immortality
  • Inducing angiogenesis
  • Activating invasion and metastasis
  • Deregulating cellular energetics
  • Avoiding immune destruction
  • Genome instability and mutation
  • Tumor-promoting inflammation

  
• Staging

  Process of determining the extent of cancer in the body

  
• T2 N1 M0 would be Stage 3b
• Common cancers in the UK

  • Lung, breast, colon, prostate

  
• Leukemia, brain and intracranial tumors and lymphomas account for more than 2/3 of cancers in children, with leukemia the most common

  
• Leukemia

  Blood cancers that originate in the bone marrow with high numbers of abnormal and undifferentiated blood cells

  
• Types of leukemia

  • Acute myeloid leukemia (AML)
  • Chronic myeloid leukemia (CML)
  • Acute lymphocytic leukemia (ALL)
  • Chronic lymphocytic leukemia (CLL)
  • Hairy cell leukemia
• Lung, breast, colorectal, prostate, stomach, liver, cervical, melanoma, and leukemias have well-established risk factors
• Eating sugar, antiperspirants/deodorants, living near power lines, and family history do not directly cause cancer
• Risk factors for cancer

  • Genetics - Family history
  • Age
  • Alcohol
  • Cancer-causing substances
  • Chronic inflammation
  • Diet
  • Hormones
  • Immunosuppression
  • Infectious agents
  • Obesity
  • Radiation
  • Sunlight
  • Tobacco
• Genetics and cancer

  • Cancer is a genetic disease with mutations in DNA
  • Cancer cells generally have more genetic changes than normal cells
  • Even within same tumor, can have different genetic changes

  
• Hereditary cancers

  • 5-10% of all cancers
  • Over 50 hereditary cancer syndromes with genetic tests available
  • Also cancers that "run in families" but not inherited genetic mutation
  • Pre-disposing mutation doesn't always lead to cancer
  • Common mutated genes – TP53, BRCA1/2, PTEN

  
• Tobacco is linked to lung, bladder, larynx/throat/mouth, oesophagus, kidney, liver, pancreas, colorectal, cervix, and acute myeloid leukemia
• Chronic inflammation and infectious agents

  • Underlying infections/inflammation are linked to up to 20% of all cancer deaths
  • Sustained use of non-steroidal anti-inflammatory drugs reduce the risk of many cancers
• Chronic inflammation and cancer

  • Ulcerative colitis and colon cancer
  • H pylori and gastritis and gastric cancer
  • HBV/HCV and hepatitis and hepatocellular cancer

  
• Immunosuppression

  • Initially, immune system can attack tumor as foreign and therefore immunosuppressed patient cannot use immune system to fight back
  • Over time, tumor environment becomes immunosuppressed through M2 macrophage activation

  
• 38-67% of cancers are preventable through healthy lifestyle changes like not smoking, moderate alcohol, healthy diet, and physical activity

  
• Ways to prevent cancer

  • Don't smoke or vape
  • Moderate alcohol intake
  • Healthy diet
  • Physically active
  • Reduce exposure to toxins
  • Health and safety in working environment
  • Reduce exposure in water and monitor waste
  • Reduce air pollution
  • Care with exposure to sunlight
• Cancer diagnosis

  • Early diagnosis correlates with prognosis
  • Includes family history, genetic testing, lab tests, imaging, and biopsy

  
• Common cancer symptoms

  • Cough
  • Tired
  • Blood in stool or sputum
  • Weight loss
  • Headaches

  
• Cancer treatments

  • Surgery
  • Radiotherapy
  • Laser therapy
  • Photodynamic therapy
  • Thermal ablation (Heat)
  • Chemotherapy
  • Immunotherapy
• Drug resistance

  Tumor cells can develop resistance to cancer drugs over time

  
• There is no evidence that herbal products can cure cancer

  
• Attitude (positive or negative) does not determine cancer risk or recovery

  
• Even with no family history, individuals are still at risk of cancer

  
• Metastasis


  Spread of cancer cells to other parts of the body
• Cancer deaths


  Almost 90% due to metastasis
• Unrestricted division


  Excessive cell division due to loss of normal cell signals
• Uncontrolled growth


  Excessive cell growth due to loss of normal cell signals
• Cancer cell signals


  Loss of signals that control cell growth, division, differentiation, and death
• Sustaining proliferative signaling


  Abnormal signaling pathways that promote cell growth and division in cancer cells
• Evading growth suppressors


  Inactivation of tumor suppressor genes, which normally prevent cells from dividing too rapidly or in an uncontrolled way
• Resisting cell death


  Resistance to programmed cell death (apoptosis), allowing cancer cells to continue growing and dividing
• Enabling replicative immortality


  Activation of telomerase, which extends the length of telomeres and allows cancer cells to divide indefinitely
• Inducing angiogenesis


  Stimulation of the growth of new blood vessels, providing cancer cells with the nutrients and oxygen they need to grow and spread
• Activating invasion and metastasis


  Invasion of surrounding tissues and spread to other parts of the body through the bloodstream or lymphatic system
• Deregulating cellular energetics


  Abnormal metabolism, allowing cancer cells to generate the energy they need to grow and divide rapidly
• Avoiding immune destruction


  Evasion of the immune system, which would normally recognize and destroy abnormal cells