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Understanding Cancer

Developed by:Lewis J. Kleinsmith, Ph.D.Donna Kerrigan, M.S.Jeanne KellyBrian Hollen

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A) What is cancer?

Cancer is the uncontrolled rapid growth and spread of invasive, abnormal cells.

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Cell Cycle

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Normal Cell Growth

Cancer cell division

Fourth orlater mutation

Third mutation

Second mutation

First mutation

Uncontrolled growth

Cell Suicide or Apoptosis

Normal cell division

Cell damage—no repair

Damaged cells are programmed to initiate apoptosis.

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Repeated genetic cell mutations may lead to loss of apoptosis ability.

Cancer cell division

Fourth orlater mutation

Third mutation

Second mutation

First mutation

Uncontrolled growth

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B) Characteristics of cancer cellsWhat differences do you observe?

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Normal Growth: uniform, organized

Cell migration

Dermis

Dividing cells in basal layer

Dead cells shed from

outer surface

Epidermis

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Tumors (Neoplasms)

Underlying tissue

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Find: •the lung cancer•the normal fibrous tissue

For the hotshots , find:•The largest cancer cell (dead), with its nucleus fragmented•a blood vessel

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Kansas City University of Medicine and Bioscienceshttp://www.bing.com/images/search?q=cancer+cells+vs+normal+cells&view=detail&id=B3EB6D27D608538D9EE4978F8343588428C479E4&first=60&FORM=IDFRIR

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Kansas City University of Medicine and Bioscienceshttp://www.bing.com/images/search?q=cancer+cells+vs+normal+cells&view=detail&id=B3EB6D27D608538D9EE4978F8343588428C479E4&first=60&FORM=IDFRIR

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Basal cell carcinoma (epidermis)

MDBloggerhttp://www.bing.com/images/search?q=cancer+cells+vs+normal+cells&view=detail&id=E5A26D97EAC8D6530CD998A7993BD7C6F8B29305&first=120&FORM=IDFRIR

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Basal cell carcinoma

MDBloggerhttp://www.bing.com/images/search?q=cancer+cells+vs+normal+cells&view=detail&id=E5A26D97EAC8D6530CD998A7993BD7C6F8B29305&first=120&FORM=IDFRIR

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Normal liver

Liver cancer

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C) Malignant vs.Benign TumorsMalignant (cancer) cells invade neighboring tissues, metastasize to different sites

Time

Benign (not cancer) tumor cells only grow locally

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Melanoma cells travel through bloodstream

Melanoma(initial tumor)

Brain

Liver

D) Metastasis

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E) Kinds of Cancer

Lung

Breast (women)

Colon

BladderProstate (men)

common sarcomas:Fat

Bone

Muscle

Lymphomas:Lymph nodes

Leukemias:Bloodstream

common carcinomas:

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F) Cancer Detection

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Early Stages of Cancer May NOT Have Any Symptoms!

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Tumor StagesFive-Year Survival Rates for

Patients with Melanoma (by stage)

Stage at Time of Initial Diagnosis

100%

50%

I II III

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Biopsy

Patient’stissue sample or

blood sample Genomic profile

Proteomic profile

Pathology

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F) Causes of Cancer

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1. Tobacco Use and CancerSome Cancer-Causing Chemicals in Tobacco Smoke

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4000

3000

2000

1000

20-Year Lag Time Between Smoking and Lung Cancer

CigarettesSmoked

per Personper Year

Lung Cancer Deaths (per 100,000 people)

Year

Lung cancer (men)

Cigarette consumption (men)

1900 1920 1940 1960 1980

150

100

50

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2. Radiation

Annual Sunshine(UV radiation)

SkinCancer

Incidence

Most

Dallas

Pittsburgh

High

Detroit

LowLeast

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3. Viruses

Virus inserts and changes genes forcell growth

Cancer-linked virus

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Examples of Human Cancer Viruses

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4. Cancer Risk and Aging

400

300

200

100

Cancer Risk and Aging

Number of Cancer Cases

(per 100,000 people)

Age of Person (in years)

Colon

Breast

0 20 40 60 80

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5. Heredity and Cancer

Inherited factors (1 in 20 breast cancer patients)

All Breast Cancer Patients

Other factor(s)

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6. Environmental carcinogens

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viruses or bacteria

HeredityDiet

Hormones

Radiationchemicals

(carcinogens)

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G) Cancer: Treatment

1. surgery2. chemotherapy3. radiation

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4. hormone therapy 5. biologic therapy (antibody)6. targeted therapy (block blood vessels to tumor)

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H) Cancer: Prevention

cancer

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Cancer Prevention

Cancer viruses or bacteria

Carcinogenic radiation

Carcinogenic chemicals

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1. Avoid Tobacco

15x

10x

5x

Non-smokerCigarettes Smoked per Day

Lung Cancer Risk Increases with Cigarette Consumption

Lung Cancer

Risk

0 15 30

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2. Protect Yourself From Excessive Sunlight

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3. Limit Alcohol and Tobacco Intake

40x

30x

20x

10x

Alcoholic Drinks Consumed per Day

Packs of Cigarettes Consumed per Day

Combination of Alcohol and Cigarettes Increases Risk for Cancer of the Esophagus

Risk Increase

AND

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4a. Limit Fats and Calories

0

Number of Cases (per 100,000

people)

Grams (per person per day)

Correlation Between Meat Consumption and Colon Cancer Rates in Different Countries

40

30

20

10

30020010080

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4b. Eat Fruits and Vegetables

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5. Exercise & maintain healthy body weight

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6. Avoid Cancer Viruses

Noninfected women

HPV Infection Increases Risk for Cervical Cancer

Cervical Cancer

Risk

Low

High

Women infected with HPV

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7. Physical exams & screenings

e.g. mammograms, biopsy

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8. Reduce exposures to environmental carcinogens

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What percentage of people survive cancer?

* The 5 year survival rate for all cancers diagnosed between 1996-2002 is 66%, up from 51% in 1975-1977. * The improvement reflects progress in diagnosing cancers at an earlier stage and improvements in treatment.

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The remaining are extra slides, not part of the outlined notes

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How Cancer Starts: Genes & Cancer

Chromosomes are DNA molecules

Heredity

RadiationChemicals

Viruses

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DNA Mutation

Additions

Deletions

Normal gene

Single base change

DNA

CT

A G C G A A C TAC

A G G C G C T AAC A C T

A G C T A A C TAC

A G A A C TAC

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Cancer Genes: Oncogenes

Mutated/damaged oncogene

Oncogenes accelerate cell growth and division

Cancer cell

Normal cell Normal genes regulate cell growth

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Tumor Suppressor Genes

Normal genes prevent cancer

Remove or inactivate tumor suppressor genes

Mutated/inactivated tumor suppressor genes

Damage to both genes leads to cancer

Cancer cell

Normal cell

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p53 Tumor Suppressor ProteinTriggers Cell Suicide

Normal cell Cell suicide(Apoptosis)

p53 protein

Excessive DNA damage

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DNA Repair Genes

Cancer

No cancer

No DNA repair

Normal DNA repair

Base pair mismatch

T CATC

A GTCG

T CAGC

A GTCG

A GTG A GTAG

T CATCT CATC

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Microscopic Appearance of Cancer

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Carcinoma in Situ

Milddysplasia

Carcinoma in situ (severe dysplasia) Cancer

(invasive)

Normal Hyperplasia

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Sources

National Cancer Institute (NCI)

American Cancer Society (ACS)