Cancer /knsr/ ( listen) (medical term: malignant neoplasm) is a large, heterogeneous class of diseases in which a group of cells display

uncontrolled growth, invasion that intrudes upon and destroys adjacent tissues, and often metastasizes, wherein the tumor cells spread to other locations in the body via the lymphatic system or through the bloodstream. These three malignant properties of cancer differentiate malignant tumors from benign tumors, which do not grow uncontrollably, directly invade locally, or metastasize to regional lymph nodes or distant body sites like brain, bone, liver, or other organs. Researchers divide the causes of cancer into two groups: those with an environmental cause, and those with a hereditary genetic cause. Cancer is primarily an environmental disease, though genetics influence the risk of some cancers.[1] Common environmental factors leading to cancer include tobacco use, poor diet and obesity, infection, radiation, lack of physical activity, and environmental pollutants.[1] These environmental factors cause or enhance abnormalities in the genetic material of cells.[2] Cell reproduction is an extremely complex process that is normally tightly regulated by several classes of genes, including oncogenes and tumor suppressor genes. Hereditary or acquired abnormalities in these regulatory genes can lead to the development of cancer. A small percentage of cancers, approximately five to ten percent, are entirely hereditary. The presence of cancer can be suspected on the basis of clinical signs and symptoms, or findings after medical imaging. Definitive diagnosis of cancer, however, requires the microscopic examination of a biopsy specimen. Most cancers can be treated, with the most important modalities being chemotherapy, radiotherapy and surgery. The prognosis in cancer cases can be greatly influenced by the type and location of the cancer and the extent of disease. While cancer can affect people of all ages, and a few types of cancer are more common in children than in adults, the overall risk of developing cancer generally increases with age, at least up to age 80-85 yr. In 2007, cancer caused about 13% of all human deaths worldwide (7.9 million). Rates are rising as more people live to an old age and as mass lifestyle changes occur in the developing world.[3] Worldwide approximately 18% of cancers are related to infectious diseases.[1] This proportion varies in different regions of the world from a high of 25% in Africa to less than 10% in the developed world.[1] Viruses are usual infectious agents that cause cancer but bacteria and parasites may also have an effect. A virus that can cause cancer is called an oncovirus. These include human papillomavirus (cervical carcinoma), Epstein-Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), Kaposi's sarcoma herpesvirus (Kaposi's Sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma), and Human T-cell leukemia virus1 (T-cell leukemias). Bacterial infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced gastric carcinoma.[19] Parasitic infections strongly associated with cancer include Schistosoma haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis viverrini and Clonorchis sinensis (cholangiocarcinoma).[20]

Cancer symptoms can be divided into three groups:

Local symptoms: are restricted to the site of the primary cancer. They can include lumps or swelling (tumor), hemorrhage (bleeding from the skin, mouth or anus), ulceration and pain. Although local pain commonly occurs in advanced cancer, the initial swelling is often painless. Metastatic symptoms: are due to the spread of cancer to other locations in the body. They can include enlarged lymph nodes (which can be felt or sometimes seen under the skin), hepatomegaly (enlarged liver) or splenomegaly (enlarged spleen) which can be felt in the abdomen, pain or fracture of affected bones, and neurological symptoms. Systemic symptoms: occur due to distant effects of the cancer that are not related to direct or metastatic spread. Some of these effects can include weight loss (poor appetite and cachexia), fatigue, excessive sweating (especially night sweats), anemia (low red blood cell count) and other specific conditions termed paraneoplastic phenomena. These may be mediated by immunological or hormonal signals from the cancer cells.

None of these non-specific symptoms are helpful in determining if a patient has cancer, as many of these symptoms commonly occur in individuals who do not have cancer.

Causes
It is almost always impossible to prove exactly what caused a cancer in any individual, because most cancers have multiple possible causes. For example, if a person who uses tobacco heavily develops lung cancer, then it was very probably caused by the tobacco use, but since everyone has a small chance of developing lung cancer as a result of air pollution or radiation, then there is a tiny chance that the smoker's lung cancer actually developed because of air pollution or radiation. Cancers are primarily an environmental disease with 90-95% of cases attributed to environmental factors and 5-10% due to genetics.[1] Environmental, as used by cancer researchers, means any cause that is not genetic, not merely pollution. Common environmental factors that contribute to cancer death include tobacco (25-30%), diet and obesity (30-35%), infections (15-20%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity, and environmental pollutants.[1]