What is Cancer? What Causes Cancer?

Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100 different
types of cancer, and each is classified by the type of cell that is initially affected.

Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue
called tumors (except in the case of leukemia where cancer prohibits normal blood function by abnormal
cell division in the blood stream). Tumors can grow and interfere with the digestive, nervous, and
circulatory systems, and they can release hormones that alter body function. Tumors that stay in one spot
and demonstrate limited growth are generally considered to be benign.

More dangerous, or malignant, tumors form when two things occur:

1. a cancerous cell manages to move throughout the body using the blood or lymph systems,
destroying healthy tissue in a process called invasion
2. that cell manages to divide and grow, making new blood vessels to feed itself in a process called
angiogenesis.

When a tumor successfully spreads to other parts of the body and grows, invading and destroying other
healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a
serious condition that is very difficult to treat.

In 2007, cancer claimed the lives of about 7.6 million people in the world. Physicians and researchers
who specialize in the study, diagnosis, treatment, and prevention of cancer are called oncologists.

What causes cancer?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body
follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and
when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not
experience programmatic death and instead continue to grow and divide. This leads to a mass of
abnormal cells that grows out of control
efining Cancer

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells
can spread to other parts of the body through the blood and lymph systems.

Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for
the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer that begins
in basal cells of the skin is called basal cell carcinoma.

Cancer types can be grouped into broader categories. The main categories of cancer include:

 Carcinoma - cancer that begins in the skin or in tissues that line or cover internal organs.
 Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
 Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal
blood cells to be produced and enter the blood.
 Lymphoma and myeloma - cancers that begin in the cells of the immune system.
 Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.

(For definitions of other cancer-related terms, see NCI's Dictionary of Cancer Terms.)

Origins of Cancer

All cancers begin in cells, the body's basic unit of life. To understand cancer, it's helpful to know what happens when normal cells
become cancer cells.

The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are
needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.

However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed,
producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells
form when the body does not need them. The extra cells may form a mass of tissue called a tumor.
(Image from Understanding Cancer Series: Cancer.)

Not all tumors are cancerous; tumors can be benign or malignant.

 Benign tumors aren't cancerous. They can often be removed, and, in most cases, they do not come back. Cells in
benign tumors do not spread to other parts of the body.
 Malignant tumors are cancerous. Cells in these tumors can invade nearby tissues and spread to other parts of the body.
The spread of cancer from one part of the body to another is called metastasis.

Some cancers do not form tumors. For example, leukemia is a cancer of the bone marrow and blood.

Cancer Statistics

A report from the nation's leading cancer organizations shows that rates of new diagnoses and rates of death from all cancers
combined declined significantly in the most recent time period for men and women overall and for most racial and ethnic populations
in the United States. (Read more about theAnnual Report.)

Estimated new cases and deaths from cancer in the United States in 2010:

 New cases: 1,529,560 (does not include nonmelanoma skin cancers)

 Deaths: 569,490 

NCI's Cancer Stat Fact Sheets provide frequently requested cancer statistics for a number of cancer types.

Cancer appears to develop through a series of events, when a cell divides, its chromosomal material,
consisting largely of very complex molecules of deoxyribonucleic acid (DNA) also divides, providing each
daughter cell with chromosomal material identical to that of the original. Some of the daughter cells continue to
divide, while others differentiate to perform special functions. If chromosomal material is affected by a
carcinogen (cancer-promoting agents) or some other factor, the resulting abnormal chromosome will be passed
on to succeeding generations of cells, destroying the well-ordered system of cell division. Malignantly
transformed cells will fail to differentiate and will continue to reproduce, a process that marks the beginning of a
malignant tumor.

Classification of Cancer: Cancer are classified according to the type of tissue in which the cancer originates
and the location in the body where the cancer first developed.
 Carcinoma is a malignancy that arises in the skin, the lining of various organs, or glandular organs or
tissues. Most carcinomas affect organs or glands capable of secretion, such as the breasts, lungs colon,
prostate and bladder.
 Sarcoma is a malignancy arising in bone, muscle, or connective tissue. The most common sarcoma
often develops as a painful mass on the bone.
 Leukemia, a neoplastic disease of the white blood cells, arises in bone marrow. Leukemia is
commonly classified into acute and chronic forms. These are further broken down according to the type
of white blood cells affected by the disease.
  Lymphoma develops in the glands or nodes of the lymphatic system, a network of vessels, nodes,
and organs that purify bodily fluids and produce infection-fighting white blood cells or lymphocytes

Causes of Cancer
63

Chemicals. Some chemical substances has been proven to causetumors when applied to the skin of mice and
other animals, although it is not necessarily mean that it will produce a same reaction to humans. But in some
cases it appears to exist that an exposure to a carcinogen is linked to the development of human cancer.
Example of some chemical substances that can cause cancer:
 Certain industrial oils have been associated with a high incidence of skin cancer and there are
evidence that have confirmed the connection between smoking and lung cancer. Among the more than
250 compounds that have been isolated from cigarette tar, several are carcinogenic, and others to
enhance the effects of the carcinogens.
 Vinyl chloride an industrial gas that is used to make the plastic material polyvinyl chloride can cause
liver cancer.
 Asbestos which is used in many products can cause lung cancer when it is inhaled as asbestos dust,
and it can also lead to mesothelioma, a cancer of the membrane lining the lung.
 Some food additives such as artificial food coloring, nitrites and nitrates (often found in preserved
meat), sulfites, artificial flavoring and artificial sweeteners may contain carcinogenic substances.
  Drugs formerly thought to be harmless, also now appear to be capable of causing various cancers. For
example, there seems to be a linked between hormone use and cancer of the uterus, and there is
evidence that daughters born of women who used the hormone diethylstilbestrol (DES)
duringpregnancy have a high incidence of vaginal cancer.

Viruses there are also evidences to suggest that viruses can cause cancer. Studies for example suggest that
the bacterium Helicobacter pylori may be involved in as many as three out of five cases of stomach cancer. It
appears that in nonhumans, specific viruses may be incorporated into the genetic material of a cell, thus
causing a mutation that result in cancer.
Other Causes of Cancer:
 Excessive intake of alcoholic drinks may promote cancer of the larynx, especially if the person is also a
heavy smoker.
 Nutritional deficiencies are also another factor that can lead to cancer of the liver and the esophagus,
and syphilitic lesions of the tongue may lead to cancer of the tongue.
 There is also strong evidence that link skin cancer and prolonged exposure to the ultraviolet rays of
the sun.

Cancer facts: how do we get cancer?

Genes in our cells contain instructions that control the way cells behave. If certain genes are damaged or changed,

they can affect the way our cells grow and develop. Cancer is the disease caused by abnormal cells multiplying out

of control.

Some genetic changes leading to cancer are caused by behaviors such as smoking, eating an unbalanced diet, or

drinking too much alcohol. Other causes include factors in our environment, such as toxic chemicals, and viruses.

Many causes of cancer are still unknown.

Inherited genes may also increase the risk of developing certain types of cancer. For example, some women inherit

a gene that makes them more likely to develop breast cancer.

Cancer facts: cancer and the immune system
 The body has its own natural way of defending itself, called the immune system. This protects us from things that

are “foreign” to the body, such as bacteria or viruses. It can also protect against abnormalities arising in our own

bodies. When our cells change and start multiplying in an uncontrolled way, our immune system can intervene and

eliminate those abnormal cells. When abnormal cells manage to escape from our immune system’s checking

process, the result can be cancer.

Some cancer statistics

 Overall, cancer statistics show that more than 1 person in 3 will get cancer at some time in their life

 In the western world, the commonest cancers are breast, lung, bowel and prostate. Between them, they
account for over half of all cases of cancer

 Most cancers are caused by a gradual build-up of genetic damage in cells. This means that cancer is most
common in older people. In general, cancer statistics show that the older you are, the higher your risk

 According to the World Health Organization, at least one-third of cancer cases are preventable. The most
effective ways to protect yourself from cancer are not smoking, limiting how much alcohol you drink, eating at
least 5 portions of fruit and vegetables a day, keeping to a healthy weight, keeping physically active, and avoiding
over-exposure to the sun

Types of cancer

There are around 200 different types of cancer. Most are named after the organ or cell type that they start in.

Cancer types can behave very differently from one another, and have very different outcomes. They also have

different treatments. A treatment that works well for some types of cancer may not be effective for others.

Types of cancer that start in a specific organ are called “solid cancers”. Examples include lung cancer, breast

cancer and bowel cancer. As the cancer grows it forms a solid mass or lump, called a “tumor”. The skin is also

classed as one of our body’s organs. Skin cancer is the most common of all cancers. But because most skin cancers

are slow-growing and do not spread to the rest of the body, they are often not counted in cancer statistics. The

most serious type of skin cancer, called “melanoma”, is the exception to this. Melanoma can grow quickly and can

spread like other cancers.

The other main type of cancer is “non-solid cancers”. These start in the blood cells, or in the blood-forming tissues

in the bone marrow. They result in large numbers of abnormal blood cells. Examples of non-solid cancers include

leukemia, lymphoma and myeloma.

Cancer spread

Cancer cells may break away from the tumor and attack other parts of the body. Cancer spread from one part of

the body to another is called “metastasis”. Tumors that form in other organs as a result of cancer spread are

called “secondary” tumors.

Cancer cells often spread via the lymphatic system. This is a network of vessels that carry a clear fluid called

“lymph”, which bathes our body tissues. Lymph vessels open into small, bean-shaped structures called “lymph

nodes”. People often call these “glands”. They are found in the neck, the groin, and under the arms, and also in

the chest and abdomen.

When cancer cells break away from a tumor, they often settle in the lymph nodes first. Because of this, doctors

check the nearby lymph nodes to see whether a cancer has spread. If cancer cells are found, surgeons often

remove the affected lymph nodes at the same time as removing the tumor.

No change in cancer type

When cancer spreads to another organ, its type does not change. For example, if someone has breast cancer that

spreads to their lungs, they do not have lung cancer. The tumors in their lungs are still breast cancer tumors. The

treatment they receive will still be tailored for breast cancer, so will probably be different from the treatment

given to someone with lung cancer.

@@@@@@@@

What is Cancer?

Your body is composed of many millions of tiny cells, each a self-contained living unit. Normally, each cell
coordinates with the others that compose tissues and organs of your body. One way that this coordination
occurs is reflected in how your cells reproduce themselves. Normal cells in the body grow and divide for a
period of time and then stop growing and dividing. Thereafter, they only reproduce themselves as necessary
to replace defective or dying cells. Cancer occurs when this cellular reproduction process goes out of control.
In other words, cancer is a disease characterized by uncontrolled, uncoordinated and undesirable cell
division. Unlike normal cells, cancer cells continue to grow and divide for their whole lives, replicating into
more and more harmful cells.

The abnormal growth and division observed in cancer cells is caused by damage in these cells' DNA (genetic
material inside cells that determines cellular characteristics and functioning). There are a variety of ways
that cellular DNA can become damaged and defective. For example, environmental factors (such as
exposure to tobacco smoke) can initiate a chain of events that results in cellular DNA defects that lead to
cancer. Alternatively, defective DNA can be inherited from your parents.

As cancer cells divide and replicate themselves, they often form into a clump of cancer cells known as a
tumor. Tumors cause many of the symptoms of cancer by pressuring, crushing and destroying surrounding
non-cancerous cells and tissues.

Tumors come in two forms; benign and malignant. Benign tumors are not cancerous, thus they do not grow
and spread to the extent of cancerous tumors. Benign tumors are usually not life threatening. Malignant
tumors, on the other hand, grow and spread to other areas of the body. The process whereby cancer cells
travel from the initial tumor site to other parts of the body is known as metastasis.

Overview: Causes of Cancer

Jessica Evert, MD, edited by Benjamin McDonald, MD Updated: Jun 30th 2010

The causes of cancer are not fully understood, but years of research have brought to light risk factors that
increase people's chances of getting particular types of cancer. Some of these risk factors are inevitable,
while others can be avoided by choosing to live a healthy lifestyle. For example, smoking cigarettes is an
avoidable risk factor. Changing your lifestyle to get rid of unhealthy choices such as smoking can be difficult
to accomplish (tobacco is an addictive drug and stopping smoking means beating that addiction), but the
rewards are real. Stopping smoking and similar healthy lifestyle changes will not insure that you never get
cancer, but they will reduce your cancer risk. This is true whether you have never had cancer before, or if
you have previously beaten cancer and are wondering what you can do to reduce your chances of relapse.

advertisement

It is important to note that cancer is not a uniform illness, but rather has many forms. Each specific type of
cancer is different and consequently has a different set of associated risk factors. Detailed information on
specific risk factors for specific types of cancer are found in our cancer subtype documents.

Overview: Cancer Symptoms and Diagnosis

Jessica Evert, MD, edited by Benjamin McDonald, MD Updated: Jun 30th 2010
Every type of cancer is different, and has a unique set of symptoms associated with it. Some cancer
symptoms are manifest outwardly, and are relatively easy to notice and identify (such as a lump in the
breast for breast cancer, or blood in the stool corresponding to colorectal cancer). Other symptoms are
observable, but harder to decipher. For instance, two of the major symptoms for lung cancer are a
bronchitis-like deep cough and excessive shortness of breath. Few people would assume these symptoms
were serious and fewer would associate them with cancer. Still other forms of cancer produce no observable
symptoms until they are at a very advanced (and therefore hard to treat) stage. Specific symptom detail for
cancer subtypes is provided in our cancer subtype documents.

advertisement

A physician who suspects a patient may have a specific form of cancer will perform a series of tests and
procedures to diagnose (or rule-out) a cancer. Commonly, doctors will collect a sample of tissue or fluid
from the area believed to contain a cancerous tumor so that it may be analyzed in the laboratory under a
microscope. This collection and observation procedure is known as a biopsy. Often, performing a biopsy and
analyzing the resulting samples is the only way that doctors can accurately determine a diagnosis of cancer.
Specific detail concerning diagnostic methods is provided in our cancer subtype documents.

Overview: Stages of Cancer

Jessica Evert, MD, edited by Benjamin McDonald, MD Updated: Jun 30th 2010

Following a positive identification of cancer, doctors will try to establish the stage of the cancer. Cancers are
ranked into stages depending on the specific characteristics that they possess; stages correspond with
severity. Determining the stage of a given cancer helps doctors to make treatment recommendations, to
form a likely outcome scenario for what will happen to the patient (prognosis), and to communicate
effectively with other doctors.

There are multiple staging scales in use. One of the most common ranks cancers into five progressively
more severe stages: 0, I, II, III, and IV. Stage 0 cancer is cancer that is just beginning, involving just a few
cells. Stages I, II, III, and IV represent progressively more advanced cancers, characterized by larger tumor
sizes, more tumors, the aggressiveness with which the cancer grows and spreads, and the extent to which
the cancer has spread to infect adjacent tissues and body organs. Another popular staging system is known
as the TNM system, a three dimensional rating of cancer extensiveness. Using the TNM system, doctors rate
the cancers they find on each of three scales, where T stands for tumor size, N stands for lymph node
involvement, and M stands for metastasis (the degree to which cancer has spread beyond its original
locations). Larger scores on each of the three scales indicate more advanced cancer. For example, a large
tumor that has not spread to other body parts might be rated T3, N0, M0, while a smaller but more
aggressive cancer might be rated T2, N2, M1 suggesting a medium sized tumor that has spread to local
lymph nodes and has just gotten started in a new organ location.

advertisement

Still another staging system, called summary staging, is in use by the National Cancer Institute for its SEER
program. Summary stages include: "In situ" or early cancer (stage 0 cancer), "localized" cancer which has
not yet begun to spread, "regional" cancer which has spread to local lymph nodes but not yet to distant
organs, "distant" cancer which has spread to distant organs, and finally, "unknown" cancer to describe
anything not fitting elsewhere

Overview: Cancer Treatments

Jessica Evert, MD, edited by Benjamin McDonald, MD Updated: Jun 30th 2010

Doctors prescribe cancer treatment regimens based on a variety of factors specific to patients' individual
circumstance. These factors often include the cancer's stage (type, location, and size of the cancer being
treated), as well as patients' age, medical history, and overall health. The doctor may also ask patients to
specify their treatment preferences before determining an optimal treatment plan. So long as their condition
does not require emergency intervention, patients should feel free to ask questions about various treatment
options so as to become comfortable with the plan they will ultimately follow. In general, it is not a good
idea to rush into a treatment plan merely as a way to reduce the understandable anxiety of having a cancer
diagnosis.

Each form of cancer is different and calls for a different set of treatment approaches. This being true, there
are two common approaches used to treat almost all types of cancer. These two treatments are
chemotherapy and radiation therapy. Chemotherapy and radiation therapy are covered here in some detail
to avoid having to restate the information at length in later sections covering specific cancer subtypes.

 Chemotherapy. Chemotherapy is one of the most commonly used methods to treat cancer patients. It is

commonly prescribed for patients whose cancer is not localized but instead has possibly metastasized, or spread, to

various locations in the body. Chemotherapy can be used to reduce the symptoms and pain associated with cancer as

well as to slow the growth of cancerous tumors. In some circumstances chemotherapy may even kill spreading

cancerous cells.
 Chemotherapy utilizes a powerful combination of drugs that are either taken by mouth or injected directly into the

bloodstream. Drug doses are commonly given in a repeating pattern over a set amount of time. Treatment frequency and

duration depend on the type of cancer each patient has, and the manner in which the patient tolerates and responds to the

drugs. Chemotherapy drugs target cells in the body that divide and grow quickly and are usually able to destroy these cells.

Unfortunately cancer cells are not the only cells in the body which divide and replicate quickly. In addition to cancerous cells,

chemotherapy drugs also kill some regular healthy cells, causing side effects such as the fatigue, nausea, and hair loss. To

some extent, side effects can be controlled or alleviated with other medications or by altering the schedule of chemotherapy

treatments. It is important to alert your doctor immediately if you experience side effects so that the doctor can adjust

treatment to make you more comfortable. Chemotherapy can be a long and arduous process, but it does not last forever and

negative side effects generally disappear upon completion of the treatment.

 Radiation Therapy. Radiation therapy is a method of treating cancer that utilizes radiation energy. Radiation is

most commonly used to treat localized cancers as opposed to cancer that has spread throughout the body. The goal of

radiation therapy is to kill cancer cells or at least limit their ability to grow and divide by damaging their genetic

material. Like chemotherapy, radiation therapy is not perfectly precise in its targeting of cancer cells, and some

normal, healthy cells can also become damaged. Patients should not become too concerned about damage to healthy

cells, however. Doctors generally do a good job shielding and protecting healthy cells surrounding cancer areas from

radiation damage. Also, healthy cells that do sustain damage during radiation treatment are usually able to repair

their genetic material when treatment ends.