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CANCER (MEDICAL TERM:MALIGNANTNEOPLASM
Cancer
is a class of diseases in which a group of cells display
uncontrolled growth
(division beyond the normal limits),
invasion
(intrusion on and destruction of adjacenttissues), and sometimes
metastasis
(spread to other locations in the body via lymph or  blood). These three malignant properties of cancers differentiate them from benigntumors, which are self-limited, do not invade or metastasize. Most cancers form a tumor  but some, like leukemia, do not. The branch of medicine concerned with the study,diagnosis, treatment, and prevention of cancer is oncology.Cancer may affect people at all ages, even fetuses, but the risk for most varietiesincreases with age. Cancer causes about 13% of all deaths
.
According to the AmericanCancer Society, 7.6 million people died from cancer in the world during 2007. Cancerscan affect all animals. Nearly all cancers are caused by abnormalities in the genetic material of the transformedcells
.
These abnormalities may be due to the effects of carcinogens, such as tobaccosmoke, radiation, chemicals, or infectious agents. Other cancer-promoting geneticabnormalities may be randomly acquired through errors in DNA replication, or areinherited, and thus present in all cells from birth. The heritability of cancers are usuallyaffected by complex interactions between carcinogens and the host's genome. Newaspects of the genetics of cancer pathogenesis, such as DNA methylation, andmicroRNAs are increasingly recognized as important.Genetic abnormalities found in cancer typically affect two general classes of genes.Cancer-promoting
oncogenes
are typically activated in cancer cells, giving those cellsnew properties, such as hyperactive growth and division, protection against programmedcell death, loss of respect for normal tissue boundaries, and the ability to becomeestablished in diverse tissue environments.
Tumor suppressor genes
are then inactivatedin cancer cells, resulting in the loss of normal functions in those cells, such as accurateDNA replication, control over the cell cycle, orientation and adhesion within tissues, andinteraction with protective cells of the immune system.Diagnosis usually requires the histologic examination of a tissue biopsy specimen by a pathologist, although the initial indication of malignancy can be symptoms or radiographic imaging abnormalities. Most cancers can be treated and some cured,depending on the specific type, location, and stage. Once
 
diagnosed, cancer is usuallytreated with a combination of surgery. chemotherapy and radiotherapy. As
 
researchdevelops, treatments are becoming more specific for different varieties of cancer. There
 
has been significant progress in the development of targeted therapy drugs that actspecifically on detectable molecular abnormalities in certain tumors, and which minimizedamage to normal cells. The prognosis of cancer patients is most influenced by the typeof cancer, as well as the stage, or extent of the disease. In addition, histologic grading andthe presence of specific molecular markers can also be useful in establishing prognosis,as well as in determining individual treatments.
Classification
Cancers are classified by the type of cell that resembles the tumor and, therefore, thetissue presumed to be the origin of the tumor. These are the histology and the location,respectively. Examples of general categories include:
•
Carcinoma:
Malignant tumors derived from epithelial cells. This grouprepresents the most common cancers, including the common forms of breast, prostate, lung and colon cancer.
•
Sarcoma:
Malignant tumors derived from connective tissue, or mesenchymalcells.
•
Lymphoma
and
leukemia:
Malignancies derived from hematopoietic (blood-forming) cells
•
Germ cell tumor:
Tumors derived from totipotent cells. In adults most oftenfound in the testicle and ovary; in fetuses, babies, and young children most oftenfound on the body midline, particularly at the tip of the tailbone; in horses mostoften found at the poll (base of the skull).
•
Blastic tumor or blastoma:
A tumor (usually malignant) which resembles animmature or embryonic tissue. Many of these tumors are most common inchildren.Malignant tumors (cancers) are usually named using
-carcinoma
,
-sarcoma
or 
-blastoma
as a suffix, with the Latin or Greek word for the organ of origin as the root.For instance, a cancer of the liver is called
hepatocarcinoma
, a cancer of the fat cells iscalled
liposarcoma
. For common cancers, the English organ name is used. For instance,the most common type of breast cancer is called
ductal carcinoma of the breast 
or 
mammary ductal carcinoma
. Here, the adjective
ductal 
refers to the appearance of thecancer under the microscope, resembling normal breast ducts.Benign tumors (which are not cancers) are named using
-oma
as a suffix with the organname as the root. For instance, a benign tumor of the smooth muscle of the uterus iscalled
leiomyoma
(the common name of this frequent tumor is
 fibroid 
). Unfortunately,some cancers also use the
-oma
suffix, examples being melanoma and seminoma
Signs and symptoms
Roughly, cancer symptoms can be divided into three groups:
 
•
 Local symptoms
: unusual lumps or swelling (
tumor 
), hemorrhage (bleeding), painand/or ulceration. Compression of surrounding tissues may cause symptoms suchas jaundice (yellowing the eyes and skin).
•
Symptoms of metastasis (spreading)
: enlarged lymph nodes, cough andhemoptysis, hepatomegaly (enlarged liver), bone pain, fracture of affected bonesand neurological symptoms. Although advanced cancer may cause pain, it is oftennot the first symptom.
•
Systemic symptoms
: weight loss, poor appetite, fatigue and cachexia (wasting),excessive sweating (night sweats), anemia and specific paraneoplastic phenomena i.e. specific conditions that are due to an active cancer, such asthrombosis or hormonal changes.
Every symptom in the above list can be caused by a variety of conditions (a list of which is referred to as the differential diagnosis).Cancer may be a common or uncommon cause of each item.
Causes of cancer
Cancer is a diverse class of diseases which differ widely in their causes and biology. Anyorganism, even plants, can acquire cancer. Nearly all known cancers arise gradually, aserrors build up in the genetic material of the cancer cell and its progeny.Anything which replicates (our cells) will probabilistically suffer from errors (mutations).Unless error correction is properly carried out, the errors will survive, and might passedalong to daughter cells. Normally, the body tries to perform error correction via numerousmethods, such as: apoptosis, helper molecules (some DNA polymerases), possiblysenescence, etc. However these error-correction methods often fail in small ways,especially in environments that increase make errors more likely to arise and propagate.For example, such environments can include the presence of disruptive substances calledcarcinogens, or recovering from injury, or environments the cell was not designed for such as hypoxia. Cancer is thus a
 progressive
disease, and these progressive errors slowlyaccumulate until a cell slowly begins to act contrary to its intended purpose.The errors which cause cancer are often
 self-amplifying 
, eventually compounding (likemoney) at an exponential rate. For example:
•
A mutation in the error-correcting machinery of a cell might cause that cell and itschildren to accumulate errors more rapidly
•
A mutation in signaling (endocrine) machinery of the cell can send error-causingsignals to nearby cells
•
A mutation might cause cells to become neoplastic, causing them to migrate anddisrupt more healthy cells
•
A mutation may cause the cell to become immortal (see telomeres), causing themto disrupt healthy cells forever 
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