Asubham Lalbabu Kumar

CANCER
INTRODUCTION
1.The De nition of Cancer:
Cancer is a disease in which some of the body’s cells grow
uncontrollably and spread to other parts of the body.

Cancer can start almost anywhere in the human body, which is

made up of trillions of cells. Normally, human cells grow and
multiply (through a process called cell division) to form new cells as
the body needs them. When cells grow old or become damaged,
they die, and new cells take their place.

Sometimes this orderly process breaks down, and abnormal or

damaged cells grow and multiply when they shouldn’t. These cells
may form tumors, which are lumps of tissue. Tumors can be
cancerous or not cancerous (benign).

Cancerous tumors spread into, or invade, nearby tissues and can

travel to distant places in the body to form new tumors (a process
called metastasis). Cancerous tumors may also be called malignant
tumors. Many cancers form solid tumors, but cancers of the blood,
such as leukemias, generally do not.

Benign tumors do not spread into, or invade, nearby tissues. When

removed, benign tumors usually don’t grow back, whereas
cancerous tumors sometimes do. Benign tumors can sometimes be
quite large, however. Some can cause serious symptoms or be life
threatening, such as benign tumors in the brain.
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2.Differences between Cancer Cells and
Normal Cells

Cancer cells differ from normal cells in many ways. For instance,
cancer cells:

• grow in the absence of signals telling them to grow. Normal

cells only grow when they receive such signals.
• ignore signals that normally tell cells to stop dividing or to die
(a process known as programmed cell death, or apoptosis).
• invade into nearby areas and spread to other areas of the
body. Normal cells stop growing when they encounter other
cells, and most normal cells do not move around the body.
• tell blood vessels to grow toward tumors. These blood vessels
supply tumors with oxygen and nutrients and remove waste
products from tumors.
• hide from the immune system. The immune system normally
eliminates damaged or abnormal cells.
• trick the immune system into helping cancer cells stay alive
and grow. For instance, some cancer cells convince immune
cells to protect the tumor instead of attacking it.
• accumulate multiple changes in their chromosomes, such as
duplications and deletions of chromosome parts. Some cancer
cells have double the normal number of chromosomes.
• rely on different kinds of nutrients than normal cells. In
addition, some cancer cells make energy from nutrients in a
 different way than most normal cells. This lets cancer cells
grow more quickly.
Many times, cancer cells rely so heavily on these abnormal
behaviors that they can’t survive without them. Researchers have
taken advantage of this fact, developing therapies that target the
abnormal features of cancer cells. For example, some cancer
therapies prevent blood vessels from growing toward tumors,
essentially starving the tumor of needed nutrients. Differences
between Cancer Cells and Normal Cells.

3.How Does Cancer Develop?

ENLARGE
Cancer is caused by certain changes to genes, the basic physical units of
inheritance. Genes are arranged in long strands of tightly packed DNA called
chromosomes.
Credit: © Terese Winslow
Cancer is a genetic disease—that is, it is caused by changes to
genes that control the way our cells function, especially how they
grow and divide.

Genetic changes that cause cancer can happen because:

• of errors that occur as cells divide.

• of damage to DNA caused by harmful substances in the
environment, such as the chemicals in tobacco smoke and
ultraviolet rays from the sun. (Our Cancer Causes and
Prevention section has more information.)
• they were inherited from our parents.
The body normally eliminates cells with damaged DNA before they
turn cancerous. But the body’s ability to do so goes down as we
age. This is part of the reason why there is a higher risk of cancer
later in life.

Each person’s cancer has a unique combination of genetic

changes. As the cancer continues to grow, additional changes will
occur. Even within the same tumor, different cells may have
different genetic changes.
4.Types of Genes that Cause Cancer
The genetic changes that contribute to cancer tend to affect three
main types of genes—proto-oncogenes, tumor suppressor genes,
and DNA repair genes. These changes are sometimes called
“drivers” of cancer.

Proto-oncogenes are involved in normal cell growth and division.

However, when these genes are altered in certain ways or are more
active than normal, they may become cancer-causing genes (or
oncogenes), allowing cells to grow and survive when they should
not.

Tumor suppressor genes are also involved in controlling cell growth

and division. Cells with certain alterations in tumor suppressor
genes may divide in an uncontrolled manner.

DNA repair genes are involved in xing damaged DNA. Cells with
mutations in these genes tend to develop additional mutations in
other genes and changes in their chromosomes, such as
duplications and deletions of chromosome parts. Together, these
mutations may cause the cells to become cancerous.

As scientists have learned more about the molecular changes that

lead to cancer, they have found that certain mutations commonly
occur in many types of cancer. Now there are many cancer
treatments available that target gene mutations found in cancer. A
few of these treatments can be used by anyone with a cancer that
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has the targeted mutation, no matter where the cancer started
growing.

When Cancer Spreads

ENLARGE
In metastasis, cancer cells break away from where they rst formed and form
new tumors in other parts of the body.
Credit: © Terese Winslow
A cancer that has spread from the place where it rst formed to
another place in the body is called metastatic cancer. The process
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by which cancer cells spread to other parts of the body is called
metastasis.

Metastatic cancer has the same name and the same type of cancer
cells as the original, or primary, cancer. For example, breast cancer
that forms a metastatic tumor in the lung is metastatic breast
cancer, not lung cancer.

Under a microscope, metastatic cancer cells generally look the

same as cells of the original cancer. Moreover, metastatic cancer
cells and cells of the original cancer usually have some molecular
features in common, such as the presence of speci c chromosome
changes.

In some cases, treatment may help prolong the lives of people with
metastatic cancer. In other cases, the primary goal of treatment for
metastatic cancer is to control the growth of the cancer or to relieve
symptoms it is causing. Metastatic tumors can cause severe
damage to how the body functions, and most people who die of
cancer die of metastatic disease.
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5.Tissue Changes that Are Not
Cancer
Not every change in the body’s tissues is cancer. Some tissue
changes may develop into cancer if they are not treated, however.
Here are some examples of tissue changes that are not cancer but,
in some cases, are monitored because they could become cancer:

• Hyperplasia occurs when cells within a tissue multiply faster

than normal and extra cells build up. However, the cells and
the way the tissue is organized still look normal under a
microscope. Hyperplasia can be caused by several factors or
conditions, including chronic irritation.
• Dysplasia is a more advanced condition than hyperplasia. In
dysplasia, there is also a buildup of extra cells. But the cells
look abnormal and there are changes in how the tissue is
organized. In general, the more abnormal the cells and tissue
look, the greater the chance that cancer will form. Some types
of dysplasia may need to be monitored or treated, but others
do not. An example of dysplasia is an abnormal mole (called a
dysplastic nevus) that forms on the skin. A dysplastic nevus
can turn into melanoma, although most do not.
• Carcinoma in situ is an even more advanced condition.
Although it is sometimes called stage 0 cancer, it is not cancer
because the abnormal cells do not invade nearby tissue the
way that cancer cells do. But because some carcinomas in situ
may become cancer, they are usually treated.
Normal cells may become cancer cells. Before cancer cells form in tissues of
the body, the cells go through abnormal changes called hyperplasia and
dysplasia. In hyperplasia, there is an increase in the number of cells in an
organ or tissue that appear normal under a microscope. In dysplasia, the cells
look abnormal under a microscope but are not cancer. Hyperplasia and
dysplasia may or may not become cancer.
6.Types of Cancer
There are more than 100 types of cancer. Types of cancer are
usually named for the organs or tissues where the cancers form.
For example, lung cancer starts in the lung, and brain cancer starts
in the brain. Cancers also may be described by the type of cell that
formed them, such as an epithelial cell or a squamous cell.

You can search NCI’s website for information on speci c types of

cancer based on the cancer’s location in the body or by using our A
to Z List of Cancers. We also have information on childhood
cancers and cancers in adolescents and young adults.

Here are some categories of cancers that begin in speci c types of

cells:

Carcinoma
Carcinomas are the most common type of cancer. They are formed
by epithelial cells, which are the cells that cover the inside and
outside surfaces of the body. There are many types of epithelial
cells, which often have a column-like shape when viewed under
a microscope.

Carcinomas that begin in different epithelial cell types have speci c

names:

Adenocarcinoma is a cancer that forms in epithelial cells that

produce uids or mucus. Tissues with this type of epithelial cell
are sometimes called glandular tissues. Most cancers of the
breast, colon, and prostate are adenocarcinomas.

Basal cell carcinoma is a cancer that begins in the lower or basal

(base) layer of the epidermis, which is a person’s outer layer of
skin.
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Squamous cell carcinoma is a cancer that forms in squamous cells,
which are epithelial cells that lie just beneath the outer surface of
the skin. Squamous cells also line many other organs, including
the stomach, intestines, lungs, bladder, and kidneys. Squamous
cells look at, like sh scales, when viewed under a microscope.
Squamous cell carcinomas are sometimes called epidermoid
carcinomas.

Transitional cell carcinoma is a cancer that forms in a type of

epithelial tissue called transitional epithelium, or urothelium. This
tissue, which is made up of many layers of epithelial cells that
can get bigger and smaller, is found in the linings of the bladder,
ureters, and part of the kidneys (renal pelvis), and a few other
organs. Some cancers of the bladder, ureters, and kidneys are
transitional cell carcinomas.
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 ENLARGE
Soft tissue sarcoma forms in soft tissues of the body, including muscle,
tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints.
Credit: © Terese Winslow
Sarcomas are cancers that form in bone and soft tissues, including
muscle, fat, blood vessels, lymph vessels, and brous tissue
(such as tendons and ligaments).
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Osteosarcoma is the most common cancer of bone. The most
common types of soft tissue sarcoma are leiomyosarcoma,
Kaposi sarcoma, malignant brous histiocytoma, liposarcoma,
and dermato brosarcoma protuberans.

Our page on soft tissue sarcoma has more information.

Leukemia
Cancers that begin in the blood-forming tissue of the bone marrow
are called leukemias. These cancers do not form solid tumors.
Instead, large numbers of abnormal white blood cells (leukemia
cells and leukemic blast cells) build up in the blood and bone
marrow, crowding out normal blood cells. The low level of normal
blood cells can make it harder for the body to get oxygen to its
tissues, control bleeding, or ght infections.

There are four common types of leukemia, which are grouped

based on how quickly the disease gets worse (acute or chronic)
and on the type of blood cell the cancer starts in (lymphoblastic
or myeloid). Acute forms of leukemia grow quickly and chronic
forms grow more slowly.

Our page on leukemia has more information.

Lymphoma
Lymphoma is cancer that begins in lymphocytes (T cells or B cells).
These are disease- ghting white blood cells that are part of the
immune system. In lymphoma, abnormal lymphocytes build up in
lymph nodes and lymph vessels, as well as in other organs of the
body.

There are two main types of lymphoma:

Hodgkin lymphoma – People with this disease have abnormal

lymphocytes that are called Reed-Sternberg cells. These cells
usually form from B cells.
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Non-Hodgkin lymphoma – This is a large group of cancers that start
in lymphocytes. The cancers can grow quickly or slowly and can
form from B cells or T cells.

Our page on lymphoma has more information.

Multiple Myeloma
Multiple myeloma is cancer that begins in plasma cells, another
type of immune cell. The abnormal plasma cells, called myeloma
cells, build up in the bone marrow and form tumors in bones all
through the body. Multiple myeloma is also called plasma cell
myeloma and Kahler disease.

Our page on multiple myeloma and other plasma cell neoplasms

has more information.

Melanoma
Melanoma is cancer that begins in cells that become melanocytes,
which are specialized cells that make melanin (the pigment that
gives skin its color). Most melanomas form on the skin, but
melanomas can also form in other pigmented tissues, such as
the eye.

Our pages on skin cancer and intraocular melanoma have more

information.

Brain and Spinal Cord Tumors

There are different types of brain and spinal cord tumors. These
tumors are named based on the type of cell in which they formed
and where the tumor rst formed in the central nervous system.
For example, an astrocytic tumor begins in star-shaped brain
cells called astrocytes, which help keep nerve cells healthy. Brain
tumors can be benign (not cancer) or malignant (cancer).

Our page on brain and spinal cord tumors has more information.
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 Other Types of Tumors
Germ Cell Tumors
Germ cell tumors are a type of tumor that begins in the cells that
give rise to sperm or eggs. These tumors can occur almost
anywhere in the body and can be either benign or malignant.

Our page of cancers by body location/system includes a list of germ

cell tumors with links to more information.

Neuroendocrine Tumors
Neuroendocrine tumors form from cells that release hormones into
the blood in response to a signal from the nervous system.
These tumors, which may make higher-than-normal amounts
of hormones, can cause many different symptoms.
Neuroendocrine tumors may be benign or malignant.

Our de nition of neuroendocrine tumors has more information.

Carcinoid Tumors
Carcinoid tumors are a type of neuroendocrine tumor. They are
slow-growing tumors that are usually found in the
gastrointestinal system (most often in the rectum and small
intestine). Carcinoid tumors may spread to the liver or other
sites in the body, and they may secrete substances such as
serotonin or prostaglandins, causing carcinoid syndrome.
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COLON CANCER ♋
Colon cancer is a growth of cells that begins in a part of the large
intestine called the colon. The colon is the rst and longest part of
the large intestine. The large intestine is the last part of the
digestive system. The digestive system breaks down food for the
body to use.

Colon cancer typically affects older adults, though it can happen at

any age. It usually begins as small clumps of cells called polyps that
form inside the colon. Polyps generally aren't cancerous, but some
can turn into colon cancers over time.

Polyps often don't cause symptoms. For this reason, doctors

recommend regular screening tests to look for polyps in the colon.
Finding and removing polyps helps prevent colon cancer.

If colon cancer develops, many treatments can help control it.

Treatments include surgery, radiation therapy and medicines, such
as chemotherapy, targeted therapy and immunotherapy.

Colon cancer is sometimes called colorectal cancer. This term

combines colon cancer and rectal cancer, which begins in the
rectum.
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Symptoms
Many people with colon cancer don't have symptoms at rst. When
symptoms appear, they'll likely depend on the cancer's size and
where it is in the large intestine.

Symptoms of colon cancer can include:

• A change in bowel habits, such as more frequent diarrhea or

constipation.
• Rectal bleeding or blood in the stool.
• Ongoing discomfort in the belly area, such as cramps, gas or
pain.
• A feeling that the bowel doesn't empty all the way during a
bowel movement.
• Weakness or tiredness.
• Losing weight without trying.
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 Risk factors
Factors that may increase the risk of colon cancer include:

• Older age. Colon cancer can happen at any age. But most
people with colon cancer are older than 50. The numbers of
people younger than 50 who have colon cancer has been
growing. Doctors don't know why.
• Black race. Black people in the United States have a greater
risk of colon cancer than do people of other races.
• A personal history of colorectal cancer or polyps. Having had
colon cancer or colon polyps increases the risk of colon cancer.
• In ammatory bowel diseases. Conditions that cause pain and
swelling of the intestines, called in ammatory bowel diseases,
can increase the risk of colon cancer. These conditions include
ulcerative colitis and Crohn's disease.
• Inherited syndromes that increase colon cancer risk. Some
DNA changes that increase the risk of colon cancer run in
families. The most common inherited syndromes that increase
colon cancer risk are familial adenomatous polyposis and Lynch
syndrome.
• Family history of colon cancer. Having a blood relative who has
colon cancer increases the risk of getting colon cancer. Having
more than one family member who has colon cancer or rectal
cancer increases the risk more.
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 • Low- ber, high-fat diet. Colon cancer and rectal cancer might
be linked with a typical Western diet. This type of diet tends to
be low in ber and high in fat and calories. Research in this
area has had mixed results. Some studies have found an
increased risk of colon cancer in people who eat a lot of red
meat and processed meat.
• Not exercising regularly. People who are not active are more
likely to develop colon cancer. Getting regular physical activity
might help lower the risk.
• Diabetes. People with diabetes or insulin resistance have an
increased risk of colon cancer.
• Obesity. People who are obese have an increased risk of colon
cancer. Obesity also increases the risk of dying of colon cancer.
• Smoking. People who smoke can have an increased risk of
colon cancer.
• Drinking alcohol. Drinking too much alcohol can increase the
risk of colon cancer.
• Radiation therapy for cancer. Radiation therapy directed at the
abdomen to treat previous cancers increases the risk of colon
cancer.
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Prevention
Screening for colon cancer

Doctors recommend that people with an average risk of colon

cancer consider starting colon cancer screening around age 45. But
people with an increased risk should think about starting screening
sooner. People with an increased risk include those with a family
history of colon cancer.

There are several different tests that are used for colon cancer
screening. Talk about your options with your health care team.

Lifestyle changes to reduce the risk of colon cancer

Making changes in everyday life can reduce the risk of colon

cancer. To lower the risk of colon cancer:

• Eat a variety of fruits, vegetables and whole grains. Fruits,

vegetables and whole grains have vitamins, minerals, ber and
antioxidants, which may help prevent cancer. Choose a variety
of fruits and vegetables so that you get a range of vitamins and
nutrients.
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• Drink alcohol in moderation, if at all. If you choose to drink
alcohol, limit the amount you drink to no more than one drink a
day for women and two for men.
• Stop smoking. Talk to your health care team about ways to quit.
• Exercise most days of the week. Try to get at least 30 minutes
of exercise on most days. If you've been inactive, start slowly
and build up gradually to 30 minutes. Also, talk with a health
care professional before starting an exercise program.
• Maintain a healthy weight. If you are at a healthy weight, work
to maintain your weight by combining a healthy diet with daily
exercise. If you need to lose weight, ask your health care team
about healthy ways to achieve your goal. Aim to lose weight
slowly by eating fewer calories and moving more.
Colon cancer prevention for people
with a high risk
Some medicines can reduce the risk of colon polyps or colon
cancer. For instance, some evidence links a reduced risk of polyps
and colon cancer to regular use of aspirin or aspirin-like medicines.
But it's not clear what dose and what length of time would be
needed to reduce the risk of colon cancer. Taking aspirin daily has
some risks, including ulcers and bleeding in the digestive system.

These options are generally reserved for people with a high risk of
colon cancer. There isn't enough evidence to recommend these
medicines to people who have an average risk of colon cancer.

If you have an increased risk of colon cancer, discuss your risk

factors with your health care team to see if preventive medicines
are safe for you.
BIBLIOGRAPHY

.cancer.gov.in

.safari

.wikipedia

. Cancer.net