Lesson 6: Cancer

A disease of cell division and

differentiation
&
A Relentless Killer
 Cancer Facts
• 1 in 3 Americans will develop detectable cancer in their lifetime.
• 1 in 4 Americans die from cancer.
• Over 1,500 Americans die each day from cancer (more than 500,000
each year).
• Smoking is responsible for over 30% of all cancer deaths.

• About 50% of individuals diagnosed with cancer are cured of the disease.
• The cure rate varies with the type of cancer and the timing of detection
(the earlier the detection, the greater the cure rate).
 Case Study
• Background Information:
• Over 13 out of every 100 women in the US will develop breast cancer
during their lifetime.
• Over 40,000 women die from breast cancer each year (2nd leading cause
of death among US women).
• More than 200,000 women are diagnosed with breast cancer each year.
• Background Information:
• 5-10% of women diagnosed with breast cancer each year carry
mutations in “breast cancer susceptibility genes.”
 Case Study
BRCA1 and BRCA2 Background Information:
• Most women who carry BRCA1 or BRCA2
mutations will not develop breast cancer.
• However, women with an altered BRCA1 or
BRCA2 gene are 3 to 7 times more likely to
develop breast cancer than women without
alterations in those genes.
• Some women who carry BRCA1 or BRCA2
mutations and have family history of cancer choose
to undergo elective mastectomy.
• Only 11% indicate dissatisfaction with their
choice.
• A woman who undergoes elective mastectomy still
has ~10% chance of developing breast cancer. From National Library of Medicine, NCBI
• Women who choose breast reconstruction after
mastectomy face other potential complications.
• Question: Should insurance companies (meaning
us) pay for elective mastectomies for these women?
• Read about one woman who chose elective
mastectomy and the challenge she had making that
decision: Cancer Free at 33, but Weighing a
Mastectomy.
 Five Key Characteristics of
Normal Cells
• Are genetically stable.
• Have a rate of division that is highly regulated and controlled.
• Remain in one location throughout their lifetime (blood cells are
the exception).
• Are highly differentiated (specialized) so they can carry out specific
functions (stem cells are exceptions).
• Undergo apoptosis when their DNA is mutated and cannot be repaired.
 Five Key Characteristics of
Cancer Cells
• Are genetically unstable (subject to mutation).
• Have a high rate of division, and the rate is totally out of control.
• Can become highly mobile in the body.
• Usually lose specialization and acquire characteristics of
undifferentiated cells.
• Escape apoptotic mechanisms designed to induce cell death.
 Cancer Cell Formation
• Cancer cells form as mutations occur
in DNA:
• Mutations permit the cell to
escape from influence of signals
that regulate and control cell
division.
• Cell undergoes repeated
uncontrolled division.
• A tumor forms.
• Additional mutations occur:
• Cancer cell acquires ability to
invade into tissue. Photograph by Ed Uthman, MD

• It may enter lymph or blood

vessels and be transported to
distant sites.
• It leaves the vessel and forms
new tumor.
 Tumor Comparison
• Benign tumor:
• Cells divide more rapidly than normal.
• Cell function and structure are slightly abnormal.
• The tumor is usually single masses enclosed in a capsule.
• In-situ Tumor (Cancer)
• Cell division is rapid and out of control.
• Cell function and structure become increasingly abnormal.
• The tumor is a single mass, but disorganized and may not have a capsule.
• Malignant Tumor (Cancer)
• Cell division is rapid and out of control.
• Cell function and structure is very abnormal.
• Tumor metastasizes as cells break away and invade other tissues, blood, or
lymph, creating new tumors in other areas.

Photograph from the Armed Photograph from the Armed

Photograph by Ed Uthman, Forces Institute of Pathology Forces Institute of Pathology
MD
 How Do Cells Become Cancerous?
Possible triggers include:
• Viruses
• Heredity
• Chemical carcinogens
• Radiation
• Immune system breakdown
 Chemical Carcinogens
A carcinogen is Chemical/Compound Types of Cancer
any cancer- Arsenic Lung, skin
producing substance
Asbestos Lung, body-cavity epithelial
or organism. Some
chemicals seem to Benzene Leukemia
be linked to specific Chromium Lung
types of cancer.
Ether Lung
Hydrocarbons (soot, tar Skin, lung
smoke)
Nickel Lung, nasal epithelial
Radioisotopes Leukemia
Solvents Bladder, nasal epithelial
Vinyl chloride Liver, connective tissue

The American Cancer Society provides information about Environmental

Carcinogens.
 Watching for Cancer
7 Warning Signs of Cancer from the American Cancer Society:

1. Change in bowel or bladder habits or function.

2. A sore that does not heal.
3. Unusual bleeding or bloody discharge.
4. Thickening or lump.
5. Indigestion or difficulty swallowing.
6. Obvious change in a wart or mole.
7. Nagging cough or hoarseness.

Notice that the first letters of the signs spell the word CAUTION.

The American Cancer Society provides information about recommended cancer

screenings.

The National Cancer Institute provides information about cancer rates, sites, and
mortality statistics. They also provide summaries of cancer treatments.