CANCER, THE INTIMATE ENEMY Neoplasm (new growth) or tumor: An abnormal cell mass that develops when controls

of the cell cycle and cell division malfunction is called. Not all neoplasms are cancerous. Benign (kindly) neoplasms: tend to be surrounded by a capsule, grow slowly, and seldom kill their hosts if they are removed before they compress vital organs. Malignant (bad) neoplasms (cancers): are nonencapsulated masses that grow more relentlessly and may become killers. Their cells resemble immature cells, and they invade their surroundings rather than pushing them aside, as reflected in the name cancer, from the Latin word for crab. Metastasis: Capability of malignant cells to break away from the parent mass and spread via the blood to distant parts of the body, where they form new masses. What causes transformation? i.e., convert a normal cell into a cancerous one. Radiation, mechanical trauma, certain viral infections, and many chemicals (tobacco tars, saccharine) can act as carcinogens (cancer-causers). All factors cause mutationschanges in DNA that alter the expression of certain genes. However, most carcinogens are eliminated by peroxisomal or lysosomal enzymes or the immune system. Several genetic changes are needed to change a normal cell to a cancer cell (Figure a). Oncogenes (cancer-causing [onco = tumor] genes). Proto-oncogenes code for proteins that are needed for normal cell division and growth. However, many have fragile sites that break when they are exposed to carcinogens, and this event converts them into oncogenes. An example of a problem that might result from this conversion is the switching on of dormant genes that allow cells to become invasive. However, oncogenes have been discovered in only 15 to 20 percent of human cancers. Tumor suppressor genes which work to suppress or prevent cancer. The tumor suppressor genes help DNA repair, put the brakes on cell division, help to inactivate carcinogens, or enhance the ability of the immune system to destroy cancer cells. When the tumor suppressor genes are damaged or changed in some way, the oncogenes are free to do their thing. Example of cancers: One of the best-understood of human cancers, colon cancer, illustrates this principle (Figure b). The first sign of colon cancer is a polyp (benign tumor), due to an unusual increase in the division rate of apparently normal cells of the colon lining. In time, a malignant neoplasm makes its appearance at the site. In most cases, these changes parallel cellular changes at the DNA level and include activation of an oncogene and inactivation of two tumor suppressor genes. Early diagnosis: Cancer can arise from almost any cell type, but the most common cancers originate in the skin, lung, colon, breast, and male prostate gland. Screening procedures, such as self-examination of ones breasts or testicles for lumps and checking fecal samples for blood, aid in early detection of cancers. However, most cancers are diagnosed only after they have begun to cause symptoms (pain, bloody discharge, lump, etc.), and the diagnostic method most used is the biopsy. In a biopsy, a sample of the primary tumor

is removed surgically (or by scraping) and examined microscopically for structural changes typical of malignant cells. Treatment 1. The treatment of choice for either type of neoplasm is surgical removal. 2. If surgery is not possible as in cases where the cancer has spread widely or is inoperable radiation and drugs (chemotherapy) are used. Anticancer drugs have unpleasant side effects because most target all rapidly dividing cells, including normal ones. The side effects include nausea, vomiting, and loss of hair. X rays, even if highly localized, also have side effects because, in passing through the body, they kill healthy cells that lie in the path to the cancer cells. 3. Promising new methods focus on the following: Delivering anticancer drugs more precisely to the cancer (via monoclonal antibodies that respond to one type of protein on a cancer cell), Increasing the immune systems ability to fend off cancer, Starving tumors by cutting off their ability to attract a rich blood supply, and Destroying cancer cells with viruses.