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In summaryHow cancer develops

1. DNA damage leads to dysplasia. 2. Damaged cells form a carcinoma in situ. 3. The carcinoma in situ recruits blood supply and grows to become a large benign tumor. 4. The benign tumor metastasizes and becomes a malignant tumor.

Cancer Uncontrolled Cell Division Why does it develop? How can it be prevented / treated?

Cell Replication

How can mutation be avoided?

Tumor Suppressor Genes coordinate several actions that prevent gene mutation:

Proto-Oncogenes stimulate cell division

If mutated, a proto-oncogene can become an oncogene that speeds up cell division.

Screen the DNA ______________________________ Repair Cell ______________________________ Initiate apoptosas if _______________________________ _______________________________ damage can't be corrected

In summary
Two types of genes regulate cell division:
1. Tumor Suppressor Genes prevent and/or correct accumulating DNA damage. 2. Proto-Oncogenes promote cell division.

What factors make DNA damage more likely?

Viral Infec,on Carcinogens
Chemicals Radia,on

Known Causes of Cancer - Viruses

Viruses Cause about 5% of cancers in U.S. Some ways in which viruses cause cancer:
Viral DNA can be inserted into the host DNA and lead to a reordering of the host DNA. Viruses can interfere with immune system

Known Causes of Cancer - Carcinogens

The chemical carcinogens
1. May cause DNA mutations Chemicals in tobacco smoke Alcohol in excess Formaldehyde, benzene, certain pesticides 2. May stimulate cell division Estrogen stimulates cell division in breast and endometrial tissues.

Known Causes of Cancer - Carcinogens

Causes DNA muta,ons Cosmic rays Radon Uranium UV light from sun

Reducing the risk of cancer

Limit the exposure to carcinogens. Regular screening Early detection Warning Signs (CAUTION)
Change in bowel or bladder function A sore throat that does not heal Unusual bleeding or bloody discharge Thickening or lump in breast or elsewhere Indigestion or difficulty swallowing Obvious change in wart or mole Nagging cough or hoarseness

From DNA damage to Cancer

DNA damage can lead to:
1. 2. 3. 4. Further DNA damage Too much Cell Division Too much growth of blood vessels Metastasis

Development of Cancer Regula9ng Division

Telomeres are located on each DNA segment and limit the number of ,me a cell can divide. In cancer cells the gene for telomerase is turned on, and cells can con,nually divide.

Development of Cancer Blood Vessels

When the p53 gene is mutated, cancer cells secrete a chemical that aNracts blood vessels. Blood vessels supply to tumor with nutrients, and removes waste, allowing it to grow.

Development of Cancer Metastasis

In most ,ssues, cells are anchored together by CAMs (cellular adhesion molecules). In cancer, a DNA muta,on leads to the produc,on of enzymes that breakdown CAMs. Cancer cells can then detach from the tumor and travel to other sites in the body.

Development of Cancer
Mul,ple muta,ons are needed for a healthy cell to become a cancerous cell. These muta,ons build up over ,me.

Trea9ng Cancer
Removing the primary tumor Destroying cells that divide rapidly Boos,ng the immune system Inhibi,ng angiogenesis Gene therapy

Treating Cancer - Surgery

Performed when the tumor can be removed without damaging vital ,ssues. Can completely prevent cancer if the tumor has not yet metastasized.

Treating Cancer - Radiation

Typically follows surgery. Eects a local area. Damages DNA and leads to apoptosis. Greatest damage is to rapidly dividing cells:
Cancer cells Skin Hair Diges,ve tract Blood stem cells

Treating Cancer - Chemotherapy

Typically follows surgery. Eects whole body. Damages DNA and leads to apoptosis. Greatest damage is to rapidly dividing cells:
Cancer cells Skin Hair Diges,ve tract Blood stem cells

Treating Cancer - Immunotherapy

White blood cells of the immune system con,nually search for abnormal cells, including cancer cells, and destroy them. Goal: boost the natural immune responses against cancer cells Vaccina,on can prevent viral infec,on (HPV)

Treating Cancer Gene Therapy

Numerous clinical trials using gene therapy to treat cancer are underway. Treatment strategies
Insert normal tumor-suppressor genes into cancerous cells Insert other genes into the cancer cell in order to counter the eects of oncogenes.

In Summary
As we age cells acquire DNA damage, and this damage can eventually lead to cancer. None of the treatments or preventa,ve measures are 100% eec,ve at elimina,ng cancer. The most eec,ve strategies are reducing risk, and early detec9on.