Cancer
Cancer is caused in all or almost all instances by muta-tion or by some other abnormal activation of cellulargenes
that control cell growth and cell mitosis. The abnormal genes are called oncogenes. As many as 100 different
oncogenes have been discovered.
Also present in all cells are antioncogenes,
which suppress the activation of specific oncogenes. There-fore, loss of or
inactivation of antioncogenes can allow activation of oncogenes that lead to
cancer.
Only a minute fraction of the cells that mutate in the body ever
lead to cancer. There are several reasons for this. First, most mutated cells
have less survival capa-bility than normal cells and simply die. Second, only a
few of the mutated cells that do survive become cancerous, because even most
mutated cells still have normal feedback controls that prevent excessive
growth.
Third, those cells that are potentially cancerous are often, if not
usually, destroyed by the body’s immune system before they grow into a cancer.
This occurs in the following way: Most mutated cells form abnormal proteins
within their cell bodies because of their altered genes, and these proteins
activate the body’s immune system, causing it to form antibodies or sen-sitized
lymphocytes that react against the cancerous cells, destroying them. In support
of this is the fact that in people whose immune systems have been sup-pressed,
such as in those taking immunosuppressant drugs after kidney or heart
transplantation, the prob-ability of a cancer’s developing is multiplied as
much as fivefold.
Fourth, usually several different activated onco-genes are required
simultaneously to cause a cancer. For instance, one such gene might promote
rapid reproduction of a cell line, but no cancer occurs because there is not a
simultaneous mutant gene to form the needed blood vessels.
But what is it that causes the altered genes? Con-sidering that
many trillions of new cells are formed each year in humans, a better question
might be, Why is it that all of us do not develop millions or billions of
mutant cancerous cells? The answer is the incredible precision with which DNA
chromosomal strands are replicated in each cell before mitosis can take place,
and also the proofreading process that cuts and repairs any abnormal DNA strand
before the mitotic process is allowed to proceed. Yet, despite all these
inherited cellular precautions, probably one newly formed cell in every few
million still has significant mutant characteristics.
Thus, chance alone is all that is required for muta-tions to take
place, so we can suppose that a large number of cancers are merely the result
of an unlucky occurrence.
However, the probability of mutations can be increased manyfold
when a person is exposed to certain chemical, physical, or biological factors,
includ-ing the following:
1. It is well known that ionizing
radiation, such as x-rays, gamma rays, and particle radiation from
radioactive substances, and even ultraviolet light can predispose individuals
to cancer. Ions formed in tissue cells under the influence of such radiation
are highly reactive and can rupture DNA strands, thus causing many mutations.
2. Chemical substances of certain types also have
ahigh propensity for causing mutations. It was discovered long ago that various
aniline dye derivatives are likely to cause cancer, so that workers in chemical
plants producing such substances, if unprotected, have a special predisposition
to cancer. Chemical substances that can cause mutation are called carcinogens. The carcinogens that
currently cause the greatest number of deaths are those in cigarette smoke.
They cause about one quarter of all cancer deaths.
3. Physical irritants also can lead to cancer, such
ascontinued abrasion of the linings of the intestinal tract by some types of
food. The damage to the tissues leads to rapid mitotic replacement of the
cells. The more rapid the mitosis, the greater the chance for mutation.
4. In many families, there is a strong hereditarytendency to cancer. This results from the fact thatmost
cancers require not one mutation but two or more mutations before cancer
occurs. In those families that are particularly predisposed to cancer, it is
presumed that one or more cancerous genes are already mutated in the inherited
genome. Therefore, far fewer additional mutations must take place in such
family members before a cancer begins to grow.
5. In laboratory animals, certain types of viruses can cause some
kinds of cancer, including leukemia. This usually results in one of two ways.
In the case of DNA viruses, the DNA strand of the virus can insert itself
directly into one of the chromosomes and thereby cause a mutation that leads to
cancer. In the case of RNA viruses, some of these carry with them an enzyme
called reversetranscriptase that
causes DNA to be transcribedfrom the RNA. The transcribed DNA then inserts
itself into the animal cell genome, leading to cancer.
Invasive
Characteristic of the Cancer Cell. The major dif-ferences between the cancer cell
and the normal cell are the following: (1) The cancer cell does not respect
usual cellular growth limits; the reason for this is that these cells
presumably do not require all the same growth factors that are necessary to
cause growth of normal cells. (2) Cancer cells often are far less adhe-sive to
one another than are normal cells. Therefore, they have a tendency to wander
through the tissues, to enter the blood stream, and to be transported all
through the body, where they form nidi for numerous new cancerous growths. (3) Some
cancers also produce angiogenic factors that
cause many new blood vesselsto grow into the cancer, thus supplying the
nutrients required for cancer growth.
Why Do
Cancer Cells Kill? The answer to this questionusually is simple. Cancer tissue
competes with normal tissues for nutrients. Because cancer cells continue to
proliferate indefinitely, their number multiplying day by day, cancer cells
soon demand essentially all the nutrition available to the body or to an
essential part of the body. As a result, normal tissues gradually suffer
nutritive death.
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