Cancer arises from mutations in genes that control cell growth and division. These genetic mutations cause cells to grow and divide uncontrollably. Most cancers develop through a multi-step process where a single cell acquires successive mutations that allow it to proliferate into a tumor mass. The mutations disrupt the normal cellular processes that regulate cell division, differentiation, and death. As a result, cancer cells ignore signals that would normally tell the cells to stop dividing or die and instead they continue to grow and divide in an uncontrolled manner.
Cancer arises from mutations in genes that control cell growth and division. These genetic mutations cause cells to grow and divide uncontrollably. Most cancers develop through a multi-step process where a single cell acquires successive mutations that allow it to proliferate into a tumor mass. The mutations disrupt the normal cellular processes that regulate cell division, differentiation, and death. As a result, cancer cells ignore signals that would normally tell the cells to stop dividing or die and instead they continue to grow and divide in an uncontrolled manner.
Cancer arises from mutations in genes that control cell growth and division. These genetic mutations cause cells to grow and divide uncontrollably. Most cancers develop through a multi-step process where a single cell acquires successive mutations that allow it to proliferate into a tumor mass. The mutations disrupt the normal cellular processes that regulate cell division, differentiation, and death. As a result, cancer cells ignore signals that would normally tell the cells to stop dividing or die and instead they continue to grow and divide in an uncontrolled manner.
Cancer arises from mutations in genes that control cell growth and division. These genetic mutations cause cells to grow and divide uncontrollably. Most cancers develop through a multi-step process where a single cell acquires successive mutations that allow it to proliferate into a tumor mass. The mutations disrupt the normal cellular processes that regulate cell division, differentiation, and death. As a result, cancer cells ignore signals that would normally tell the cells to stop dividing or die and instead they continue to grow and divide in an uncontrolled manner.
1.1 Defining cancer 7 1.2 Cancer is clonal in origin 7 1.3 Insights into cancer 9 1.4 Causes of cancer (aetiology of cancer) 10 1.5 Identification and histopathology of cancers 13 1.6 The 6 hallmarks of cancer 14 1.7 Bibliography 15 1.8 Further reading 16 2 Immortality: Continuous cell division 17 2.1 Further reading 19 3 Sustained growth signals (oncogenes*) 20 3.1 Bibliography 28 3.2 Further Reading 28 4 Bypass anti-growth signals (Tumour Suppressor Genes*) 29 4.1 Bibliography 33 4.2 Further reading 33 5 Avoidance of cell death (apoptosis) 34 5.1 When does apoptosis occur? 34 5.2 What triggers apoptosis? 35 5.3 How does apoptosis occur? 36 5.4 Bibliography 39 5.5 Further reading 39 6 Ensuring blood vessel growth (angiogenesis) 40 6.1 Bibliography 42 6.2 Further Reading 42
1 How cancer arises
1.1 Defining cancer Cancer can be defined as a disease in which a group of abnormal cells grow uncontrollably by disregarding the normal rules of cell division. Normal cells are constantly subject to signals that dictate whether the cell should divide, differentiate into another cell or die. Cancer cells develop a degree of autonomy from these signals, resulting in uncontrolled growth and proliferation. If this proliferation is allowed to continue and spread, it can be fatal. In fact, almost 90% of cancer-related deaths are due to tumour spreading a process called metastasis. The foundation of modern cancer biology rests on a simple principle virtually all mammalian cells share similar molecular networks that control cell proliferation, differentiation and cell death. The prevailing theory, which underpins research into the genesis and treatment of cancer, is that normal cells are transformed into cancers as a result of changes in these networks at the molecular, biochemical and cellular level, and for each cell there is a finite number of ways this disruption can occur. Phenomenal advances in cancer research in the past 50 years have given us an insight into how cancer cells develop this autonomy. We now define cancer as a disease that involves changes or mutations in the cell genome. These changes (DNA mutations) produce proteins that disrupt the delicate cellular balance between cell division and quiescence, resulting in cells that keep dividing to form cancers. 1.2 Cancer is clonal in origin Current dogma states that cancer is a multi-gene, multi-step disease originating from a single abnormal cell (clonal origin) with an altered DNA sequence (mutation). Uncontrolled proliferation of these abnormal cells is followed by a second mutation leading to the mildly aberrant stage. Successive rounds of mutation and selective expansion of these cells results in the formation of a tumour mass (FIG 1.1 a & b).