NOTES ON CANCER (2021-07-07 Biology – Human health and diseases(L-5) Cancer)

Cancer is an uncontrolled growth and proliferation of cells of the body.

- The cancerous cells divide repeatedly and endlessly by miotic divisions.
- The word cancer does not refer to a single disease but number of changes or malfunction of the body cells.
- These cells develop mainly due to transformation of normal cells in which the normal process of growth is changed.

How do cancer cells differ from normal cells?

1- Cell division in normal cells is a highly regulated process. There is a balance between the formation of new cells and
cell deaths in most tissues and organs.
Normal cells show a property of contact inhibition so contact with other cells inhibits further cell divisions.
But
In cancer, cells suddenly start multiplying uncontrollably and do not respond to normal growth mechanisms as there is
breakdown of these regulatory mechanisms.

2- Mature and differentiated cells have a finite life span. Old and worn out cells are replaced by new cells formed by cells
division and differentiation.
Production of new cells is regulated in a manner that the number of given cell type remains nearly constant at any
given time.
But
The cancerous cells proliferate in an unregulated manner and give rise to clones of cells that expand and give rise to
tumours.
Tumour is formed by an abnormal mass of tissue that results when cells divide more than they should. They then
increase in size and disrupt the normal cells. A tumour may or may not be cancerous.
Tumours are of two types: -
Benign or Non-Malignant Tumours Malignant Tumours
They are enclosed in a connective tissue. They are not enclosed in any specific tissue.
They remain confined to the site of their origins only. They are not confined to the original tissue,
They may grow in size but do not spread to other parts of The cancerous cells are carried by blood or lymph to other
the body. parts and they spread secondary cancers or metastasis.
A Benign tumour may turn malignant and that is the reason The cancerous grow rapidly and kill other cells. The spread
they are removed as soon as discovered. of secondary tumours is fatal.
Only malignant tumours are true cancers.

Types of Cancers:
(i) Carcinomas – Arise from epithelial tissues that cover or line the internal body organs. About 85% of all tumours
are carcinomas.
(ii) Melanomas – Arise from cancerous growth of melanocytes (a type of skin cells).
(iii) Sarcomas – Arise from mesodermal tissue. Rare – only 1% of all tumours.
(iv) Leukaemia or Lymphomas – are tumours of haemopoietic tissue. (Commonly referred as blood cancer)
People suffering from Leukaemia have high WBC count. Blood contains many abnormal immature WBC that are
incapable of fighting infection.

Causes of Cancer:
- Cancer is neither hereditary nor a contagious disease.
- Gene mutations or abnormalities in the chromosomes or cytoplasm result in cancer.
- The agents that produce cancer are known as carcinogens like radiations, chemicals and viruses.

Main causes of cancer are:

1. Over exposure to ionising radiations like X-Rays, UV Rays and Gamma Rays.
2. Chemicals like nicotine, caffeine, steroids and air pollutants may cause cancer.
3. Irritation of buccal epithelium by chewing betel leaves or tobacco or irritation to lung epithelium by smoking may
cause cancer of mouth and lung respectively.
4. Various types of viruses called oncogenic viruses have genes called viral oncogenes have been said to be associated
with cancer.
 5. Several genes called proto-oncogenes have been identified in normal cells which on activation under certain
conditions could lead to cancers.

Signs and symptoms:

1. Local Symptoms – Unusual lumps or swelling, bleeding, pair, ulceration.
2. Symptoms or Metastasis (Spreading of cancer cells) – Enlarged lymph nodes, cough, enlarge liver, borne pain.
Advanced cancer may cause pain, usually not the first symptom.
3. Systemic Symptoms – Weight loss, poor appetite, excessive sweating anaemia, specific conditions due to active
cancer.

Diagnosis:
1. Biopsy – Involves the histological examination of the suspected cells/ tissue by a pathologist. Tissue can be obtained
by surgery.
2. Imaging Techniques – Radiography, CT Scan (Computed Tomography), MRI (Magnetic Resonance Imaging) are useful
to detect cancers of internal organs.
They can give more precise info about location of tumours in the body.

Treatment of Cancer:
- Cancer can be treated by
(i) Surgery
(ii) Chemotherapy
(iii) Immunotherapy
(iv) Monoclonal antibody therapy, etc.

- The choice of therapy depends upon the

(i) Location and grade of the tumour and
(ii) The stage of the disease and the
(iii) Physical condition of the patient.

- Complete removal of the cancer without damage to the rest of the body is the goal of treatment.
(i) Radiotherapy – The basic principle here is to bombard the cancer cells with rays that damage or destroy the
cancer cells but cause minimum damage to the surrounding normal tissues in the vicinity.

(ii) Chemotherapy – A variety of anti-cancer drugs that can destroy cancer cells. These drugs interfere with the
cell division in various ways. Most forms of chemotherapy target all rapidly dividing cells and not very specific
to cancer cells only. Hence, chemotherapy has the potential to harm healthy tissue.
Chemotherapy may lead to hair loss or anaemia but both get corrected after the treatment is stopped.

(iii) Immunotherapy – (Monoclonal Antibody Therapy) Immunotherapy is the use of immune mechanisms against
tumours. The agents are monoclonal antibodies directed against proteins that are characteristic to the cells of
the cancer, or cytokines that modulate the immune system’s response.
Patients are given substances called biological response modifiers such as interferon to activate immune
system and help in to destroy tumour.

(iv) Hormonal Suppression – The growth of some cancers can be inhibited by providing or blocking certain
hormones in certain types of breast and prostate cancers.
Removing or blocking estrogen or testosterone is often an important additional treatment.