Carakerja/pengaruh pd DNA

How does radiation damage DNA?

-A middle school student from California

March 30, 2011
That's a great question because radiation can damage anyone's DNA. Radiation is really just high-
powered particles or energy. When something like that smashes into your DNA (or most anything),
it is definitely going to do some damage. Luckily, our cells are very good at repairing the damage
so it takes a lot of radiation to do permanent harm.

Damaged DNA matters because your DNA has the instructions for making and running you. If
these instructions get damaged, it can sometimes affect how well you run.

Like any good instructions, the ones in DNA are written up with letters. The high energy of
radiation can mess up the instructions by changing a letter. It can also tear the DNA removing
one, some, or even millions (!!) of these letters. This would be like ripping out anything from part
of a page to a whole chapter of your personal instruction manual.

These changes can have a real impact on a cell or a person if the cell can't fix it in time. But not
always.

Like any instructions, some mistakes can be tolerated. And luckily for us, our DNA has a lot of
white space where a bit of damage is fine. When these parts get hit, our instructions are hardly
affected at all.

But when critical DNA gets hit and doesn't get fixed, problems like cancers can happen. Or
problems can be passed down to the next generation. As I said though, our cells are really good at
fixing these mistakes so it usually isn't a problem unless our cells get overwhelmed by too much
radiation.

That's what radiation does to DNA in general. To get at the specifics, I need to tell you more about
how DNA works. Then I can show you how radiation can affect it.

You Want to Learn a New Language?

Your DNA tells your cells what to do. These instructions are written in a language called the
genetic code. It's an easy language to learn because it has only four letters: A, C, G and T.

Each letter stands for the name of a different molecule:

A = adenine

C = cytosine

G = guanine

T = thymine

These molecules are called bases and certain ones stick together like puzzle pieces. So A pairs up
with T and C with G.

And just like other languages, the genetic code isn't a big old pile of letters…bases are stuck
together in a line just like words in a sentence. However, the "sentences" in this language are
made up of super long words (much longer than
supercalifragilisticexpialidocious!)

DNA reads just like words in a sentence.

In case you think a four-letter language is boring, here's a twist. A sentence of DNA has two
strings of letters with one stuck on top of the other. Remember how your bases pair up (A with T
and C with G)? Well, this makes a single strand of letters quickly find a partner to form a double
strand. This double stranded DNA holds the instructions for making a living thing.

DNA is made of two strings of letters one on top of the other.

Like any set of instructions, the ones in DNA have to have most of the letters in the right order.
Radiation can affect the instructions by removing letters, tearing out big chunks, or even whole
chapters. And it can do these things in a number of different ways.

Radiation Can Damage Your DNA in Multiple Ways

Now that we are DNA experts, I can show you how radiation affects your DNA. One way is by
actually breaking the long string of letters. This can happen to just one or both of the strands.

Your cells are pretty good at fixing one broken strand. So normally that damage is not too bad.
But cells have trouble fixing the double strand

breaks.

Radiation can break your DNA different ways.

If double strand breaks don't get fixed, then part of your DNA can be deleted, duplicated or stuck
some place it shouldn't (like to other DNA). Any of these problems can cause cancers and other
genetic disorders.
Double strand breaks can also be big problems for you and your future kids' chromosomes.
Chromosomes are how your DNA is stored in your cells. They are long pieces of DNA that each
have some of the instructions for making you. You can think of them as the chapters in the book
that is you.
A chromosome is actually a tightly bunched up string of DNA. We have two sets them, one from
mom and the other from dad. If a chromosome in a parent's egg or sperm is damaged by
radiation, they could pass it on with some parts missing or misplaced. This can cause disorders like
Cri-du-chat syndrome.

Another way radiation can cause problems is by changing the structure of your bases. It can
change a base just enough that your cells can mistake it for a different one. For example, a G
could look more like an A.

This tiny change can be a problem when your DNA duplicates itself, which has to occur every time
a cell divides. So, if your cell reads that G as an A, then it would put in the wrong base when
duplicating the DNA. This is because A's only pair with T's and C's only pair with G's. Now instead
of a GC pair, you made an AT one.

This small change might put a glitch into a key bit of the DNA, modifying your instruction manual.
This could cause cancer or other problems. Or it could also be completely harmless. Gray and grey
are spelled differently but mean the same thing. It's the same idea with your DNA. It all depends
where your code gets changed.

UV radiation in sunlight can damage your DNA by messing up the base pairing. UV light will often
make two T's that are next to each other stick together making something called a dimer. Our cells
have ways to fix this problem but if there if too many TT pairs, your cells can't deal very well with

it.

Sunlight can sometimes cause two T's to stick together.

Some cells with lots of thymine dimers will die. You've seen this happen if your skin ever peeled
after a sunburn. Cells that can't fix themselves and don't die could become cancerous. Melanoma
is a common UV-induced skin cancer. Your cells have amazing ways of repairing "damaged" DNA
but you can help them out by avoiding radiation when possible. Wear your sunscreen and try to
stay away from uranium mines

How radiation affects cells

Radiation
Ionizing radiation is energy transmitted via X rays, gamma rays, beta particles (high-speed electrons), alpha

particles (the nucleus of the helium atom), neutrons, protons, and other heavy ions such as the nuclei of argon,

nitrogen, carbon, and other elements. X rays and gamma rays are electromagnetic waves like light, but their

energy is much higher than that of light (their wavelengths are much shorter). Ultraviolet (UV) light is a

radiation of intermediate energy that can damage cells (the well known sunburn), but UV light differs from

the forms of electromagnetic radiation mentioned above in that it does not cause ionization (loss of an
electron) in atoms or molecules, but rather excitation (change in energy level of an electron). The other forms
of radiation--particles--are either negatively charged (electrons), positively charged (protons, alpha rays, and

other heavy ions), or electrically neutral (neutrons).

Ionization
As an example of ionization, beta rays are fast electrons that lose energy as they pass through cells and

interact with molecules. The transferred energy is high enough to disrupt chemical bonds, which results

inradical formation (or ionization). Ionization differs from the ion formation that occurs in ordinary chemical

reactions. The process that takes place when salt (sodium chloride, NaCl) is dissolved in water is a good

example of an ordinary reaction. Sodium and chloride bind together because, separately, each atom is

unstable. The sodium (Na) atom has only one electron in its outermost orbit, and loss of that electron makes it

more stable. In contrast, the chloride (Cl) atom has seven electrons in its outermost orbit and gaining one

electron to have a full complement of eight outer electrons makes it more stable. When the two atoms bind to

form NaCl, sodium shares its single outer electron with chloride, and so, both are stable. In ordinary chemical

reactions, such as the binding of Na to Cl, electrons that are lost or gained are always those on the outermost

orbit. When NaCl is dissolved in water, the two atoms separate, with chloride keeping the extra outer

electron; thus, the sodium has a net positive charge (hence Na+) and the chloride has a net negative charge

(hence Cl-), but the net charge (balance between positive and negative) remains neutral. These charged atoms

are called ions, and they are stable in water despite their electrical charges.

In contrast, when an electron passes through a cell, it releases its energy along its path (called a track) by

interacting with the electrons of nearby molecules. The released energy is absorbed by atoms near the track,

resulting in either excitation (a shift in the orbit of an electron to a higher energy level) or ionization (release

of an electron from the atom). What differs from an ordinary chemical reaction is that when radiation donates

energy to atoms or molecules, electrons other than those on the most outer orbit can be released, which makes

the atoms very unstable. Such unstable atoms are called radicals and are chemically very reactive. Some

radicals are so reactive that they exist only for as short a time as a microsecond.

X and gamma rays differ from beta particles in that they release high-speed electrons from atoms first.

Positively charged particles transfer energy to molecules in cells by essentially the same mechanisms.

Neutrons are somewhat different since they are electrically uncharged, and their main effect is to impact the

nuclei of hydrogen atoms, namely protons. Since the masses of a neutron and a proton are similar, the impact

results in an elastic scattering process like in billiards. The ejected protons behave as charged particles.

How ionizations affect cells

Radiation-induced ionizations may act directly on the cellular component molecules or indirectly on water

molecules, causing water-derived radicals. Radicals react with nearby molecules in a very short time,
resulting in breakage of chemical bonds or oxidation (addition of oxygen atoms) of the affected molecules.
The major effect in cells is DNA breaks. Since DNA consists of a pair of complementary double strands,

breaks of either a single strand or both strands can occur. However, the latter is believed to be much more

important biologically. Most single-strand breaks can be repaired normally thanks to the double-stranded

nature of the DNA molecule (the two strands complement each other, so that an intact strand can serve as a

template for repair of its damaged, opposite strand). In the case of double-strand breaks, however, repair is

more difficult and erroneous rejoining of broken ends may occur. These so-called misrepairs result in

induction of mutations, chromosome aberrations, or cell death.

Characteristics of DNA damage by radiation exposure

Deletion of DNA segments is the predominant form of radiation damage in cells that survive irradiation. It

may be caused by (1) misrepair of two separate double-strand breaks in a DNA molecule with joining of the

two outer ends and loss of the fragment between the breaks or (2) the process of cleaning (enzyme digestion

of nucleotides--the component molecules of DNA) of the broken ends before rejoining to repair one double-

strand break.

Biological effects differ by type of radiation

Radiations differ not only by their constituents (electrons, protons, neutrons, etc.) but also by their energy.

Radiations that cause dense ionization along their track (such as neutrons) are called high-linear-energy-

transfer (high-LET) radiation, a physical parameter to describe average energy released per unit length of the

track. (See the accompanying figure.) Low-LET radiations produce ionizations only sparsely along their track

and, hence, almost homogeneously within a cell. Radiation dose is the amount of energy per unit of biological

material (e.g., number of ionizations per cell). Thus, high-LET radiations are more destructive to biological

material than low-LET radiations--such as X and gamma rays--because at the same dose, the low-LET

radiations induce the same number of radicals more sparsely within a cell, whereas the high-LET radiations--

such as neutrons and alpha particles--transfer most of their energy to a small region of the cell. The localized

DNA damage caused by dense ionizations from high-LET radiations is more difficult to repair than the
diffuse DNA damage caused by the sparse ionizations from low-LET radiations.

Figure. Both examples produce the

same total number of ionizations, thus

represent the same dose.

http://www.rerf.jp/radefx/basickno_e/radcell.htm
http://genetics.thetech.org/ask/ask402
mengapa dipilih/cara kerja
Medical Uses
Hospitals, doctors, and dentists use a variety of nuclear materials and procedures to diagnose,
monitor, and treat a wide assortment of metabolic processes and medical conditions in humans. In
fact, diagnostic x-rays or radiation therapy have been administered to about 7 out of every 10
Americans. As a result, medical procedures using radiation have saved thousands of lives through
the detection and treatment of conditions ranging from hyperthyroidism to bone cancer.
The most common of these medical procedures involve the use of x-rays — a type of radiation that
can pass through our skin. When x-rayed, our bones and other structures cast shadows because
they are denser than our skin, and those shadows can be detected on photographic film. The effect
is similar to placing a pencil behind a piece of paper and holding the pencil and paper in front of a
light. The shadow of the pencil is revealed because most light has enough energy to pass through
the paper, but the denser pencil stops all the light. The difference is that x-rays are invisible, so
we need photographic film to "see" them for us. This allows doctors and dentists to spot broken
bones and dental problems.
X-rays and other forms of radiation also have a variety of therapeutic uses. When used in this
way, they are most often intended to kill cancerous tissue, reduce the size of a tumor, or reduce
pain. For example, radioactive iodine (specifically iodine-131) is frequently used to treat thyroid
cancer, a disease that strikes about 11,000 Americans every year.
X-ray machines have also been connected to computers in machines called computerized axial
tomography (CAT) or computed tomography (CT) scanners. These instruments provide doctors
with color images that show the shapes and details of internal organs. This helps physicians locate
and identify tumors, size anomalies, or other physiological or functional organ problems.
In addition, hospitals and radiology centers perform approximately 10 million nuclear
medicineprocedures in the United States each year. In such procedures, doctors administer slightly
radioactive substances to patients, which are attracted to certain internal organs such as the
pancreas, kidney, thyroid, liver, or brain, to diagnose clinical conditions.

http://www.nrc.gov/about-
nrc/radiation/around-us/uses-
radiation.html
Radiation therapy
By Mayo Clinic staff

Original Article: http://www.mayoclinic.com/health/radiation-

therapy/MY00299

Definition
 Radiation therapy

Radiation therapy is a type of cancer treatment that uses beams of intense energy to
kill cancer cells. Radiation therapy most often gets its power from X-rays, but the
power can also come from protons or other types of energy.

The term "radiation therapy" most often refers to external beam radiation therapy.
During this type of radiation, the high-energy beams come from a machine outside of
your body that aims the beams at a precise point on your body. During a different
type of radiation treatment called brachytherapy (brak-e-THER-uh-pee), radiation is
placed inside your body.

Radiation therapy damages cells by destroying the genetic material that controls how
cells grow and divide. While both healthy and cancerous cells are damaged by
radiation therapy, the goal of radiation therapy is to destroy as few normal, healthy
cells as possible.

Why it's done

About half of all people with cancer receive radiation therapy as part of their cancer
treatment. Doctors use radiation therapy to treat just about every type of cancer.
Radiation therapy is also useful in treating some noncancerous (benign) tumors.

How radiation therapy is used in people with cancer

Your doctor may suggest radiation therapy as an option at different times during your
cancer treatment and for different reasons, including:

 As the only (primary) treatment for cancer

 Before surgery, to shrink a cancerous tumor (neoadjuvant therapy)

 After surgery, to stop the growth of any remaining cancer cells (adjuvant therapy)

 In combination with other treatments, such as chemotherapy, to destroy cancer cells

 In advanced cancer to alleviate symptoms caused by the cancer

Risks
Side effects of radiation therapy greatly depend on which part of your body is being
exposed to radiation and how much radiation is used. You may experience no side
effects, or you may experience several. Most side effects are temporary, can be
controlled and generally disappear over time once treatment has ended.

Part of body
Common side effects
being treated

Any part Hair loss at treatment site (sometimes permanent), skin irritation at
 treatment site, fatigue

Head and neck Dry mouth, thickened saliva, difficulty swallowing, sore throat,
changes in the way food tastes, earaches, sore jaw, nausea

Chest Difficulty swallowing, cough, shortness of breath

Abdomen Nausea, vomiting, diarrhea

Pelvis Diarrhea, bladder irritation, frequent urination, sexual dysfunction

Source: National Cancer Institute, 2007

Some side effects may develop later. For example, in rare circumstances a new
cancer (second primary cancer) that's different from the first one treated with
radiation may develop years later. Ask your doctor about potential side effects, both
short and long term, that may occur after your treatment.

How you prepare

Before you undergo external beam radiation therapy, your health care team guides
you through a planning process to ensure that radiation reaches the precise spot in
your body where it's needed. Planning typically includes:

 Radiation simulation. During simulation, your radiation therapy team works with you to find
a comfortable position for you during treatment. It's imperative that you lie still during
treatment, so finding a comfortable position is vital. To do this, you'll lie on the same type of
table that's used during radiation therapy. Cushions and restraints are used to position you
in the right way and to help you hold still. Your radiation therapy team will mark the area of
your body that will receive the radiation. Depending on your situation, you may receive
temporary marking with a marker or you may receive permanent tattoos.

 Planning scans. Your radiation therapy team may have you undergo X-rays or
computerized tomography (CT) scans to determine the area of your body to be treated.
After the planning process, your radiation therapy team decides what type of
radiation and what dose you'll receive based on your type and stage of cancer, your
general health, and the goals for your treatment. The precise dose and focus of
radiation beams used in your treatment is carefully planned to maximize the radiation
to your cancer cells and minimize the harm to surrounding healthy tissue.

What you can expect

 External beam radiation therapy

External beam radiation therapy is conducted using a linear accelerator — a

machine that directs high-energy beams of radiation into your body. As you lie on a
table, the linear accelerator moves around you to deliver radiation from several
angles. The linear accelerator can be adjusted for your particular situation so that it
delivers the precise dose of radiation your doctor has ordered.

You typically receive external beam radiation on an outpatient basis five days a week
over a period of at least two to 10 weeks. Treatments are usually spread out over
several weeks to allow your healthy cells to recover in between radiation therapy
sessions. Expect each treatment session to last approximately 10 to 30 minutes. In
some cases, a single treatment may be used to help relieve pain or other symptoms
associated with more advanced cancers.

During a treatment session, you'll lie down in the position determined during your
radiation simulation session. You might be positioned with molds to hold you in
place, and shields may be placed to block radiation from reaching certain parts of
your body.

The linear accelerator machine may rotate around your body to reach the target from
different directions. The machine makes a buzzing sound. You'll lie still and breathe
normally during the treatment, which takes only a few minutes. Your radiation
therapy team stays nearby in a room with video and audio connections so that you
can talk to each other. You should speak up if you feel uncomfortable, but you
shouldn't feel any pain during your radiation therapy session.

Results
If you're receiving radiation to a tumor, your doctor may have you undergo periodic
scans after your treatment to see how your cancer has responded to radiation
therapy. In some cases, your cancer may respond to treatment right away. In other
cases, it may take weeks or months for your cancer to respond. Some people aren't
helped by radiation therapy.

Sources of Radiation Exposure

Explore an interactive, virtual community of houses, schools, laser light shows, construction equipment, flying planes,

and moving trains. Each place in RadTown helps you learn about radiation sources or radiation- treated items you

might find there.

Though you may have never been aware of it, radiation is, and always has been, all around us.
Natural, “background” radiation has been with us since the birth of the universe. Today modern
medical procedures utilize various types of radiation to save lives and heal patients. This page
provides information on the most common sources of radiation exposure.

On this page:

 Natural Radiation Sources

o Radon
o Cosmic Radiation
o Other Natural Resources
 Man made Radiation Exposure
o Medical Radiation Exposure
o Other Man made Sources of Radiation Exposure

Natural Radiation Sources

Radon

You cannot see it, smell it, or taste it, but radon is the leading source of natural radiation exposure
and the second leading cause of lung cancer. Where does it come from? Well, usually from soil,
but it is found everywhere. The ground that we all walk and build our homes upon contains varying
levels of naturally occurring radioactive elements that decay into radon gas, which can seep into
homes and become a health concern. To learn what you can do to protect yourself and your
family, please see www.epa.gov/radon.

Cosmic (Space) Radiation

Outer space is full of various types of radiation, such as heavily charged particles and gamma rays.
Fortunately, Earth has an atmosphere that helps absorb and filter them out, which protects us
from high doses of cosmic radiation. However, some radiation is able to make it through. The dose
of cosmic radiation that you receive varies depending on the altitude of the area in which you live.
Since air is thinner at higher elevations, less cosmic radiation is filtered out than it is at lower
altitudes with thicker air.

Top of page

Other Natural Radiation Sources

Other natural sources, such as radiation naturally present in our own bodies and radiation from
elements in the ground ("Terrestrial" in addition to radon gas), are also all around us. The
following chart from the National Council on Radiation Protection and Measurement (NCRP) shows
all sources of natural radiation exposure and the percentage of our annual dose that comes from
each source: http://www.ncrponline.org/images/160_pie_charts/Fig3-19.pdf

Man made Radiation Exposure

Medical Radiation Exposure

The National Council on Radiation Protection and Measurement (NCRP) published a
study in 2009 that found that nearly half of the radiation to which the US population is exposed
comes from medical sources such as CT scans, x-rays, and nuclear medicine. While individual
exposure from medical sources varies considerably depending on the number and types of
procedures that one undergoes, the NCRP has indicated that medical radiation exposure is much
more common now than ever before. Thanks to advancements in modern science and medicine,
doctors are now better able to diagnose ailments and save lives through the use of these
procedures. For more information on radiation emitting products and procedures, please see
the Food and Drug Administration’s Center for Devices and Radiological Health.

Other Man made Sources of Radiation Exposure

While the primary source of man made radiation exposure comes from medical sources, there are
various other sources that expose us to small amounts of radiation. Information on other sources
of radiation exposure can be found on our RadTown educational website. For a more technical
resource please see United Nations Scientific Committee on the Effects of Atomic Radiation:
SOURCES AND EFFECTS OF IONIZING RADIATION.

http://www.epa.gov/radiation/sources/
Cancer cells vs. normal cells: what's different?
To understand what cancer is, it is important to first understand how the body's cells normally work.

How does the body grow and maintain itself?

The body is made up of tiny cells - for example, skin cells, muscle cells, heart cells, nerve cells, and bone cells.
When a baby grows, the number of cells increases very quickly. A cell becomes a bit larger, then divides into 2
"daughter" cells (Figure 1). After a period of time, each of these cells divides, and so on.

Figure 1

Normal cell division. A cell grows a bit larger then divides into 2 cells.

Once a child grows to adulthood, the size of the body no longer increases. However, our bodies go through a lot
of wear and tear, both inside and outside. Worn-out cells constantly need to be replaced, so cell division still
takes place, but more slowly. An obvious "outside" change is the tiny bits of dead skin flaking off as the skin
constantly renews itself.

Although our bodies' cells continue to divide to replace worn-out cells, this happens in a very ordered, systematic
way. The reason is that each cell carries genetic instructions that regulate how fast the cell should grow and
divide and when the cell should die. A balance between cells growing and dying keeps our bodies functioning
normally.

When cell growth goes out of control

Cell growths can be classified as either benign or malignant.

Benign growths

Sometimes a cell starts to grow without regard for the normal balance between cell growth and death, and a
small, harmless (or benign), lump of cells will form. A benign growth can occur in any part of the body, including
the prostate, skin, or intestine.

Malignant growths

In other cases, a cell may grow and divide with complete disregard for the needs and limitations of the body.
Cells that have this aggressive behaviour are called malignant. They have the potential to grow into large masses
or spread to other areas of the body. More commonly, a mass of such cells is called a cancer. When clumps of
these cells spread to other parts of the body, they are metastases. A cancer that continues to grow can
eventually overwhelm and destroy the part of the body or particular organ where it is located.

There are many different types of cancer

Each type of cancer is distinguished by the cells in which it originates. For example, a cancer may arise from
cells of a gland, muscle cells, nerve cells, or fat cells. Each of these cancers behaves differently and has a
different name:

 adenocarcinoma (cancer of a gland)

 leiomyosarcoma( cancer of the muscle cells)
 neurosarcoma (cancer of the nerve cells)
 liposarcoma (cancer of the fat cells)

Cancer cells have the ability to spread

Most normal cells remain in the area where they belong and do not spread to other parts of the body. Cancer
cells disregard this principle and may spread through the body (metastasize) in several ways. These include
direct invasion and destruction of the organ of origin, or spread through the lymphatic system or bloodstream to
distant organs such as the bone, lung, and liver.

When a cancer spreads, it retains the properties of the original cancer. For example, prostate or breast
cancer that spreads to the bones is still a prostate or breast cancer. Under the microscope it looks different from
a cancer that started in the bones, and it responds to treatment like a prostate or breast cancer, not a bone
cancer.

The original cancer is called the primary cancer. A cancer that has spread to another site is called
a secondary or metastatic cancer.

Cancer cells can trick the immune system

The immune system consists of a group of cells called white blood cells that are specialized to recognize and
destroy "foreign" material in the body such as bacteria, viruses, and unfamiliar or abnormal cells. Cancer cells
somehow manage to slip through this detection system without triggering the immune system to start fighting,
either at the primary cancer site, in the blood vessels, or at the site of the distant spread.

Excerpt from the Intelligent Patient Guide to Prostate Cancer by S. Larry Goldenberg, MD
in association with the MediResource Clinical Team
 http://chealth.canoe.ca/channel_section_details.asp?text_id=1520&channel_id=136&relation
_id=2530

Healthy cells have a structure determined by their DNA. They need energy to exist and thrive, which
they derive from chemicals in the food you consume. Cells need a system to deliver nutrients such as
amino acids, carbohydrates, fats, vitamins, and minerals to them. This system is the body's network of
blood vessels. Growth factors take a cell from birth (mitosis and meiosis) to death (apoptosis), all the
while helping it to function normally.
The body and its cells are mostly made up of protein. The building blocks of proteins are substances
called amino acids that, in the form of enzymes and hormones, literally control every chemical
reaction within the cells. When these are modified, different messages are sent to a complex control
system that can alter their function. Twenty amino acids are necessary to sustain human life:
 Alanine  Leucine
 Arginine  Lysine
 Asparagine  Methionine
 Aspartic acid  Phenylalanine
 Cysteine  Proline
 Glutamic acid  Serine
 Glutamine  Threonine
 Glycine  Tryptophan
 Histidine  Tyrosine
 Isoleucine  Valine
The ten amino acids appearing in bold face above are called essential amino acids because the body
does not synthesize them and thus they must be supplied by the daily diet; the remaining ones are
called nonessential amino acids because they are synthesized in the body.

Structure
Normal Cells Cancer Cells
Have DNA in their genes and chromosomes that Develop an aberrant DNA or gene structure or
functions normally. acquire abnormal numbers of chromosomes.

Divide in an orderly way to produce more cells only Continue to be created without control or order.
when the body needs them. Excess cells form a mass of tissue called a tumor.

Energy
Normal Cells Cancer Cells
Derive 70% of their energy from a process called the Exhibit a defective Krebs cycle and derive little or no
Krebs cycle. energy from it.

Derive only 20% of their energy from a process

called glycolysis. Derive almost all their energy from glycolysis.

Derive most of their energy using oxygen. Derive most of their energy in the absence of
 oxygen.

Blood Vessels
Normal Cells Cancer Cells
Lack a built-in blood vessel system. They require
Have a built-in blood vessel system. more of certain amino acids to grow.

Growth Factors
Normal Cells Cancer Cells
Operate at a normal metabolic level and reproduce Are overactive and overproduce themselves, thus
themselves at a regulated pace. requiring more nutrients.

Functions
Normal Cells Cancer Cells
Have enzymes and hormones that behave in a Have either overactive or underactive enzymes and
balanced manner. hormones.

Differences between Tumor Types

Benign
Are not cancerous. Do not invade nearby tissues or
spread to other parts of the body. Can be removed
and are not a threat to life.
Malignant
Are cancerous. Can invade and damage nearby
tissues and organs and can break away and enter the
bloodstream to form new tumors in other parts of
the body, a process called metastasis.

https://www.apjohncancerinstitute.org/frequently-asked-questions/healthy-cells-vc-cancer-cells

Fetal Radiation Dose Estimates

A PERSPECTIVE ON RISK TO THE FETUS FROM IONIZING RADIATION

Ionizing radiation is known to cause harm in mammalian organisms. Deleterious

effects of radiation include carcinogenicity, mutagenicity and organ system
toxicity. As general rule, the sensitivity of a tissue to radiation is directly
proportional to its rate of proliferation. Therefore, one could infer that the human
fetus, because of its rapid progression from a single cell to a formed organism in
nine months, is more sensitive to radiation than the adult. This inference is
supported by the results of experiments in animal models, and experience with
human populations that have been exposed to very high doses of radiation (atomic
bombing victims). In humans, the major deleterious effects on the fetus include
fetal wastage (miscarriage), teratogenicity (birth defects), mental retardation,
intrauterine growth retardation and the induction of cancers (such as leukemia) that
appear in childhood. Birth defects and mental retardation are the adverse effects
which are of the most immediate concern for expectant mothers. Fortunately, not
all exposures to ionizing radiation result in these outcomes. The risk to the fetus is
a function of (a) gestational age at exposure and (b) the radiation dose.

At the level of most diagnostic procedures ( fetal dose < 10 rem), little data in
humans is available. However, some qualitative observations regarding fetal risk
can be made.

Risk Related to Gestational Age

Early Gestation / First Trimester -- At this point, the rate of fetal growth is very
rapid and the fetus, as an organism, is at its most radiation-sensitive stage if fetal
demise is taken as an end-point. The incidence of fetal wastage consequential to
radiation exposure at this stage of gestation is not known, since (a) many women
were never aware they were pregnant at the time of the exposure or miscarriage,
and (b) the "background" rate of miscarriage is believed to be high (25 - 50 percent
of conceptions). It is believed that radiation injury during early gestation is an "all-
or-nothing" effect.

Second Trimester -- During this period, the overall growth rate of the fetus has
slowed. However, the major organ systems are beginning to differentiate. From a
standpoint of future development, the fetus is in its most sensitive stage. The
incidence of gross congenital malformations and mental retardation are dose-
related and appear to have thresholds; i.e. doses below which the incidence above
"background" is not elevated.

Third Trimester -- Irradiation during this period may deplete cell populations at
very high doses (over 50 rem), but will not result in gross organ malformations.

Risk Related to Radiation Dose

The risk of deleterious effects increases with increasing dose. The nature of this
dependence, i.e. the shapes of the dose-response curves for humans in the low-dose
range (under 50 rem), is controversial. For some prenatal irradiation effects, there
is epidemiological basis for the existence of threshold doses. For others, such as
childhood cancer induction, the existence of a threshold is not clear-cut. Despite
these uncertainties in the dose-effect relationship, some broad generalizations
based on fetal dose ranges may be made.
Fetal Dose Less Than 1,000 millirem -- There is no evidence supporting the
increased incidence of any deleterious developmental effects on the fetus at
diagnostic doses within this range.

Fetal Dose between 1,000 millirem and 10,000 millirem -- The additional risk of
gross congenital malformations, mental retardation, intrauterine growth retardation
and childhood cancer is believed to be low compared to to the baseline risk.
However, the lower limits (in terms of statistical confidence intervals around the
mean) for threshold doses for some studies, especially those related to cancer
induction, fall within this range.

Fetal Dose Exceeding Than 10,000 millirem -- The lower limits (in terms of
statistical confidence intervals) for threshold doses for effects such as mental
retardation and diminished IQ and school performance fall within this range.
Overall, exposure at levels exceeding 10 rem could be expected to result in a dose-
related increased risk for deleterious effects. For example, the lower limit (95%
confidence interval) for the threshold for mental retardation is about 15 rem, which
an expectation value of about 30 rem.

Counseling the Pregnant Patient Exposed to Ionizing Radiation

Due to the complexity of the issues surrounding fetal irradiation, there is no

"standard" or predetermined advice that can be given to the expectant patient.
However, it is possible to assist the patient in assessing the implications of the
exposure if a systematic evaluation of the risk is performed. According to Dr.
Robert Brent, the following parameters should be considered in the evaluation:

1. Gestational age at the time of exposure

2. Menstrual history
3. History of previous pregnancies, including a history of congenital
malformations
4. Other potentially harmful environmental factors (malnutrition,
smoking, alcohol / drugs, etc.)
5. Maternal / paternal age
6. Calculation of fetal exposure using dose reconstruction techniques
7. Attitude of the mother toward the pregnancy.

In any event, it is important not to defer medically necessary studies with

anticipated fetal doses of less than 5,000 millirem based solely on a concern for
causing adverse fetal effects.

http://www.safety.duke.edu/radsafety/fdose/fdrisk.asp