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Frequently Asked Questions About Cancer

What is cancer?

The human body has approximately 3 trillion cells. These cells divide at different paces according to the tissue/organ of origin. For example, Skin cells are replaced once in 28 days, the Intestine once in 4 days, liver cells only when damaged, and brain cells never. Cell division is a highly controlled mechanism, and when this goes out of control, the proliferation of cells occurs and turns into tumors.

No. In general, a tumor means an abnormal growth of tissue. It can be divided into:

Benign tumor

  • Abnormal cell growth
  • Well-defined edges
  • Doesn’t spread to surrounding tissues
  • Doesn’t spread to other areas

Malignant tumor

  • Abnormal cell growth
  • Poorly-defined edges
  • Infiltrates surrounding tissues
  • Spreads to other areas
Malignant tumors are synonymous with cancers.

Cancer is a genetically originated disease. As we know from above, uncontrolled cell division causes cancer. Cell division is controlled by the genes in the nucleus of the cells. There are close to 40,000 genes in a single cell, which has many functions. 2 sets of genes are of interest concerning cancer. Once genes vs. tumor suppressor genes regulate the cell division. An imbalance in these gene functions produces cancer. A mutation in any of the genes can cause cancer. Overstimulation of oncogenes or underfunction of TSG.

Now, we know the fundamental mechanism behind the development of cancer. So, to form cancer, mutation of the genes governing cell growth has to happen. Genes are made up of DNA, the basic blueprint of cellular function. When these DNA get damaged /altered, their corresponding genes as well as their functions get altered, causing cancer.

They can be broadly divided into:

  • Physical causes - Radiation, UV light, solar radiation
  • Chemical causes - various chemicals – explained later
  • Biological cause - virus, bacteria, parasites, aging, hereditary.
Cancer formation is multi-factorial. The cellular mechanism in cancer prevention by nature is vast. But when the damage to the DNA occurs more than what the cell can handle, genetic changes occur, and cancer forms. The first mutational damage is called initiation, and subsequent damage is called promoter mutation. Multiple mutations have to arise to form a full-blown cancer, which can take a few months to sometimes many years. For example, cervical cancer is 5-7 years.
Cancers are formed by mutations in DNA causing genetic modification, resulting in cell proliferation. All cancers will have modifications in genes associated with cancer formation. Hereditary is defective genes in the parents that are transmitted to the offspring, and these flawed genes cause cancers.
No. Only 5-10% of cancers are genetically transmitted from parents to offspring. Commonly transmitted hereditary cancers are Breast cancers, Intestinal cancers, and Thyroid cancers (Medullary thyroid cancer).

Physical: Radiation is the significant physical cause of cancer. Gamma, x-rays, UV rays, and natural radiation from solar and naturally present radioactive materials cause DNA damage. Prolonged trauma to the same site can cause tongue cancer due to a sharp tooth. Chemical: The list of chemicals causing cancers is massive, and we must have an enormous book to mention. Any chemical that can integrate into the genes/DNA has the potential to cause mutations.
Tobacco: More than 400 chemicals are present in tobacco and close to 70 are proven to cause cancer.
Other causatives include preservatives, coloring agents, alkaline dyes, repeated reheating of oil and food materials, toxic fumes, etc.,

Biological: viruses
  • HPV - Cervical cancer, oral cancer, skin cancer.
  • EBV - Lymphoma
  • HBV - Liver
  • HIV - Immuno HIV-compromised cancer
  • Bacteria - Poor Dental Hygiene, H-pylori
  • Parasites - Schistosomiasis
Cancer is divided basically into two major subgroups:
  • Solid organ cancers and Hematological cancers.
  • Solid organ cancers arise from tissue cells.
  • Hematological cancers arise from blood cells.
Solid organ cancers are again divided into two subgroups.
  • Epithelial cancer - Carcinoma. For example, breast cancer, cervical cancer, and stomach cancer.
  • Stromal cancers(connective tissues) - Sarcomas: Bone and Soft tissue sarcomas.
Cancer cures can be achieved to their maximum when treated by a multidisciplinary team, which includes surgical oncologists, medical oncologists, radiation oncologists, and psycho oncologists. Cancer treatment planning is imperative to achieve the best cure rates and should be planned once the cancer is diagnosed. The tumor board-based team approach decides to sequence the therapy modalities based on the stage, type, and other prognostic and patient-related factors.
In women, breast cancer and cervical cancer are the most common. Other common cancers are uterine and ovarian cancers. In men, lung, stomach, esophageal, and prostate cancers are common.
Cancer diagnosis is based on cellular and tissue architectural changes. Cancer confirmation can be done with either a biopsy from the tumor or pathological examination post-surgery.
Tumor markers are the chemicals in blood in excess amounts when certain cancers are present, but not always. Abnormally raised values may indicate cancer, but it is not confirmatory. They aid in diagnosing, prognostication, and surveillance of cancer.

For example,

  • Cancino Embryonic Antigen(CEA) - Colon cancer.
  • CA 125 - Ovary
  • AFP - Liver
  • BHCH, LDH, AFP - Germ cell tumor
  • CA19.9 - Liver – Bile duct, Pancreas