Lecture 1: What is Cancer?

Reading: King Chapter 1

Outline:
1. Cancer defined
2. Multiple changes lead to cancer
3. Genes and environment
4. Common cancers
5. How does a normal cell become a cancer cell?
6. Cancer prognoses

Lecture:
1. What is cancer?
How would you define cancer?
• A collection of different diseases
• Cancers display uncontrolled growth
• Metastasis=Migration from the site of origin

Cancer=malignant growth
Malignant=ability of growth to migrate and invade surrounding tissues
Neoplasm=new growth
Tumor=benign (harmless) and malignant growths

2. Multiple changes lead to cancer

• Requires multiple exposures to chemicals or radiation, leading to changes
in DNA
• Cell can repair some damage
• Cell can commit suicide (programmed cell death) if badly damaged
• Cancers except leukemia associated with age (Fig. 1.1)

3. What influences cancer?

Environment/lifestyle
U.S. smoking
lung cancer
China smoked or pickled foods
stomach cancer
Fig. 1.2 Five most common cancers U.S. vs. China

Heredity
Certain cancers run in families
Breast cancer
Retinoblastoma (cancer affecting the eye)

4. Most common cancers

Carcinomas=cancers of the epithelial cells (cells that cover the body or line body
cavities)
• Epithelia are actively dividing

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 • Exposed to chemicals or radiation
Table 1.1
• Men vs. women differences in cancer incidence
• Death rates for the same kind of cancer can vary between men and women

5. How does a normal cell become a cancer cell?

• Organisms are made of cells
• Cells work together in tissues

Diagram of normal skin

How can a single cell from skin go on to form skin cancer?

Cancer cells
• divide when they shouldn’t
• don’t cooperate
• don’t respond to normal signals
• don’t do their specialized job
• migrate away from their original site
• enter the blood stream
• move to other parts of the body

Growth of a tumor depends on

• Nutrients
• Blood supply

Survival of cancer cells depends on

• Escaping detection
• Finding fertile ground to migrate to

6. Cancer prognoses
• Cancer wouldn’t be so bad if it didn’t kill people
• Prognoses vary for different cancer types

Heart disease
leading cause of death

Cancer
second leading cause of death

Pancreatic cancer: Poor prognosis; death in 5 years for 97%

Testicular cancer: Excellent prognosis; 91% survive 5 years or more

Prognosis depends on:

• Type of cancer
• Time of diagnosis
• Reliability of cancer testing

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• Treatment strategy
• Access to treatment