CANCER

Around 300 cancer cells created in healthy body everyday, among the 30 trillion cells that comprise human body. Immune system able to eliminate them. In fact, healthy cellular defense system is able to hold cancer incidence down to 1 in 10/17 cell divisions. Purpose of cancer cell is to signal body to get rid of matter in the body that didn't replicate normally. Cancer disease probability based on "total body tumor burden" concept (sum of all factors suppressing immune system including cancer cells), hence even in healthy immune system, cancer disease may develop due to increased production of cancer cells or decreased removal of cancer cells due to clogged lymphatic drainage or weakened immunity.

Classification:
Carcinoma: Cancers derived from epithelial cells. This group includes many of the most common cancers, particularly in the aged, and include nearly all those developing in the breast, prostate, lung, pancreas, and colon. Sarcoma: Cancers arising from connective tissue (i.e. bone, cartilage, fat, nerve), each of which develop from cells originating in mesenchymal cells outside the bone marrow. Lymphoma and leukemia: These two classes of cancer arise from hematopoietic (blood-forming) cells that leave the marrow and tend to mature in the lymph nodes and blood, respectively. Germ cell tumor: Cancers derived from pluripotent cells, most often presenting in the testicle or the ovary (seminoma and dysgerminoma, respectively. Blastoma: Cancers derived from immature "precursor" cells or embryonic tissue. These are also most common in children.

Carcinogens
A mutated gene that causes cancer is an oncogene. A change in gene is called mutation. (Mutations are not usual events, and most mutated cells are either crippled in some way that results in their early death or are destroyed by the body immune system. Cancerous cell however manage to escape both possible fate. Although mutation occur only in one cell, it will passed on to all that cells descendants.) A factor which brings about any mutation is called mutagen. Any agent that case cancer is called carcinogen. Carcinogen is divided into 2 catagories: - Initiators (damage genes in single cell, mutation passed from generation to generation, form tumor) - Promoters (support/selectively enhance growth of tumor cells; may also reduce removal of cancer cells by immune system)

Factors increasing mutation rates

Ionising radiation Chemicals Virus infection Hereditary predisposition

Ionising radiation
It includes X-rays, gamma rays and particles from the decay of radioactive elements. Formation of damaging ions inside the cells which can breaks DNA strands. Whereas for ultraviolet light it will causes damage to the gene. Ultraviolet light penetrate to the earths surface will leads to skin cancer. It causes formation of damaging ions and free radicals.

Chemicals
Pesticides become significant through bioaccumulation. Eg. DDT (dichlorodiphenyltrichloroethane), an organochlorine which is an endocrine disruptor. Chlorinated H2O, chlorine added reacts with organic matter in water to form chloroform which is carcinogenic. Food content such as aspartame(may cause brain tumour), preservatives, and aflatoxins found in ground nuts. Tobacco and tar. Refined sugar reduce ability of neutrophils to engulf bacteria. Stress (during stress, brain signal adrenal glands to produce corticosteroids which weaken immune response).

Virus infection
Virus can cause genetic changes in cells that make them more likely to become cancerous. Virus that cause cancer usaully carry oncogenes, or regulatory genes that can become oncogenes. These cancers and viruses are linked: -Cervical cancer, and other cancers of the genital and anal area, and the human papilloma virus (HPV). This virus may leads tp oropharyngeal cancer and non melanoma skin cancers. -Primary liver cancer and the Hepatitis B and C viruses -Lymphomas and the Epstein-Barr Virus -T cell leukemia in adults and the Human T cell leukemia virus

Hereditary predisposition
Cancer tends to become more common in some families. For most people who develop cancer, the cancer-causing gene mutations happen over the course of a lifetime, leading to cancer later in life. Some people are born with a gene mutation that they inherited from their mother or father. This damaged gene puts them at higher risk for cancer than most people. For example : - the inherited form of retinoblastoma, which starts in one or both eyes during childhood and spreads to the brain causing blindness and then deth if untreated.

Benign or malignant
Benign tumours Do not spread from the site of origin, but can compress and displace surrounding tissues. Malignant tumours (cancerous) Spread throughout the body, invade other tissues and destroy them.

Malignant tumours
It interfere with the normal functioning area. They may block the intestines, lungs or bloods vessels. Cells can break off and spread through the blood and lymphatic system to other parts of the body to form secondary growth. The spread of cancer in this way is called metastasis.

Figure: Microscopic appearance of the lesion which is composed of epitheloid cells showing frequent mitoses. (H&E staining x 30 magnification)

Figure: Microscopic appearance of the lesion which is composed of spindle cells showing frequent mitoses. (H&E staining x 15 magnification)

Figure: Section of specimen studied by immunohistochemistry using anti S-100 human protein antibody. The figure shows strong staining of the tumour cells confirming that the lesion was a metastatic malignant melanoma (x15 magnification)

Prostate cancer
Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-sized structure that makes up part of a man's reproductive system. It wraps around the urethra, the tube that carries urine out of the body. Prostate cancer is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.

 People at risk include: - Men exposed to agent orange exposure - Men who abuse alcohol - Farmers - Men who eat a diet high in fat, especially animal fat - Tire plant workers - Painters - Men who have been exposed to cadmium

Symptoms
Delayed or slowed start of urinary stream Dribbling or leakage of urine, most often after urinating Slow urinary stream Straining when urinating, or not being able to empty out all of the urine Blood in the urine or semen Bone pain or tenderness, most often in the lower back and pelvic bones (only when the cancer has spread)

Colon cancer
Colon, or colorectal, cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). You have a higher risk for colon cancer if you: - Are older than 60 - Eat a diet high in red or processed meats - Have cancer elsewhere in the body - Have colorectal polyps - Have inflammatory bowel disease (Crohn's disease or ulcerative colitis) - Have a family history of colon cancer - Have a personal history of breast cancer Certain genetic syndromes also increase the risk of developing colon cancer. Two of the most common are: - Familial adenomatous polyposis (FAP) - Hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome

Symptoms
Abdominal pain and tenderness in the lower abdomen Blood in the stool Diarrhea, constipation, or other change in bowel habits Narrow stools Weight loss with no known reason