Biology Project By SHIVANI TYAGI XII C Roll no.

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Cancer

Recent years have seen a major revolution in molecular biology, genetics, cytology and medicine. Many novel treatment strategies have emerged for treatment of cancer. There have been obvious triumphs, for instance in cure of acute lymphocytic leukemia and other childhood cancers, Hodgkin's disease, and testicular cancer. However, substantial advances in molecular oncology have yet to substantially alter the mortality statistics. What is Cancer? Cancer is a group of many related diseases. All cancers begin in cells inside the body. Cells are the body's basic unit of life. All the tissues and organs inside body are made up of cells. Under normal conditions, cells grow and divide to form new cells as the body needs them. When a cell grows old it dies and new cells take their place. If this orderly process goes wrong, then new cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor. Tumors can be benign or malignant. Malignant tumors are cancer. Cancer cells can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or the lymphatic system. That is how cancer cells spread from the original (primary) tumor to form new tumors in other organs. The spread of cancer is called metastasis. Tumors are overgrowths, clones within clones, of cells bearing cumulative genetic injuries which each confer growth advantages over their neighbors ("NOWELL'S LAW"). Tumor cells typically have failure of division control, failure of senescence ("immortalization"), and failure of proper apoptosis (programmed cell death). By the time a tumor is visible, the changes have been underway for a long time (at least months, usually years).

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. Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens.

Inherited Cancer:
Features of Inherited Cancer What is sporadic cancer?

The word sporadic means "to occur by chance." Families who have a single person with cancer at an older age are usually classified as "sporadic." In other words, there is not an inherited pattern of cancer present, and often only one or two individuals in the family have cancer at a typical age of onset. Relatives are usually not at increased risk of developing cancer. Genetic testing is usually not beneficial in these families.

What is familial cancer?

When there are more cases of cancer in a family than chance alone would predict, but the features of hereditary cancer (described below) are not present, a family is said to have "familial cancer." In other words, in these cases, there is a cluster of cancers in the family, but no clear pattern of inheritance, and the cancers occur at the average age of onset. Familial cancers may be due to a combination of genes and shared lifestyle factors or environmental exposures (multifactorial inheritance). On the other hand, some of these histories can represent a chance occurrence of sporadic cancers. A familial history may also arise due to a single gene mutation (hereditary cancer) that has

reduced penetrance (a mutation associated with lower cancer risks and later onset of cancer). In general, with familial cancer, close relatives have a modestly increased risk of developing the cancer in question. The chance that genetic testing will be beneficial in further assessing cancer risks is usually small.

What is inherited cancer?

These families have multiple family members with the same or related cancers. The cancers tend to occur at younger than average ages (usually <50 years). Also, there is often a history of persons who developed two or more separate cancers; i.e., colon cancer in a breast cancer survivor, bilateral cancers (bilateral breast cancer), or multifocal cancers (two or more cancers in the same organ such as two separate colon cancers). Families with inherited cancer often have cancer in two or more generations with cancer displaying an autosomal dominant pattern of inheritance. In other words, when a parent has inherited predisposition to cancer, each child has a 50/50 (one in two) chance of inheriting the predisposition.

How is cancer classified?

There are five broad groups that are used to classify cancer. Carcinomas: are characterized by cells that cover internal and external parts of the body such as lung, breast, and colon cancer. Sarcomas: are characterized by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues. Lymphomas: are cancers that begin in the lymph nodes and immune system tissues. Leukemia: are cancers that begin in the bone marrow and often accumulate in the bloodstream. Adenomas: are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues. Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:

Adeno- = gland Chondro- = cartilage Erythro- = red blood cell Hemangio- = blood vessels Hepato- = liver Lipo- = fat Lympho- = white blood cell Melano- = pigment cell Myelo- = bone marrow Myo- = muscle Osteo- = bone Uro- = bladder

Retino- = eye Neuro- = brain

How is cancer diagnosed and staged?

Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumor is located and what organs may be affected by it. Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyze your body's sugars, fats, proteins, and DNA at the molecular level. After a diagnosis is made, doctors find out how far the cancer has spread and determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The most common cancer staging method is called the TNM system. TNM descriptions then lead to a simpler categorization of stages, from 0 to 4, where lower numbers indicate that the cancer has spread less. While most Stage 1 tumors are curable, most Stage 4 tumors are inoperable or untreatable. 10 common types of cancer :1. Non-melanoma skin cancer. Affecting more than 1 million people a year, skin cancer can form in the skin cells on any part of the body, though most commonly on skin thats been exposed to the sun. 2. Lung cancer. Roughly 219,440 cases of this deadly cancer were diagnosed in 2009. Lung cancer strikes the cells inside the lining of the lungs. 3. Breast cancer. This type of cancer will affect 194,280 people in 2009. This is by far the most common cancer in women. 4. Prostate cancer. Just over 192,200 cases of prostate cancer are diagnosed annually. Dr. Lichtenfeld says that this is the most common cancer to affect men, most often men over age 50. 5. Colorectal cancer. There will be about 146,970 new cases of colon and rectal cancers combined in 2010. 6. Bladder cancer. Nearly 71,000 people will receive this diagnosis in 2010. The bladder can be affected by cancer cells that develop within its tissues. 7. Melanoma. Predicted to strike close to 68,720 people, melanoma is another type of skin cancer. 8. Non-Hodgkin lymphoma. Affecting 65,980 people, this is the term for a number of different but related cancers involving white blood cells, or lymphocytes. 9. Kidney cancer. Kidney cancer is diagnosed in more than 49,000 people each year. 10. Leukemia. Approximately 44,790 cases of leukemia were predicted for 2009. The four main types of leukemia are acute myeloid leukemia, acute lymphocytic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia.

What is Lung Cancer ?

Lung cancer is called "primary" if the cancer originates in the lungs and "secondary" if it originates elsewhere in the body but has metastasized to the lungs. These two types are considered different cancers from diagnostic and treatment perspectives. In 2007, about 15% of all cancer diagnoses and 29% of all cancer deaths were due to lung cancer. It is the number one cause of death from cancer every year and the second most diagnosed after breast and prostate cancers (for women and men, respectively). Lung cancer is usually found in older persons because it develops over a long period of time.

How is lung cancer classified?

Lung cancer can be broadly classified into two main types based on the cancer's appearance under a microscope: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer (NSCLC) accounts for 80% of lung cancers, while small cell lung cancer accounts for the remaining 20%. NSCLC can be further divided into four different types, each with different treatment options:

Squamous cell carcinoma or epidermoid carcinoma. As the most common type of NSCLC and the most common type of lung cancer in men, squamous cell carcinoma forms in the lining of the bronchial tubes. Adenocarcinoma. As the most common type of lung cancer in women and in nonsmokers, adenocarcinoma forms in the mucus-producing glands of the lungs. Bronchioalveolar carcinoma. This type of lung cancer is a rare type of adenocarcinoma that forms near the lungs' air sacs. Large-cell undifferentiated carcinoma. A rapidly growing cancer, large-cell undifferentiated carcinomas form near the outer edges or surface of the lungs. Small cell lung cancer (SCLC) is characterized by small cells that multiply quickly and form large tumors that travel throughout the body. Almost all cases of SCLC are due to smoking.

What causes cancer?

Carcinogens Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. These free radicals damage cells and affect their ability to function and divide normally. About 87% of lung cancers are related to smoking and inhaling the carcinogens in tobacco smoke. Even exposure to second-hand smoke can damage cells so that cancer forms. Genes Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life. Genetic predispositions are thought to either directly cause lung cancer or greatly increase one's chances of developing lung cancer from exposure to certain environmental factors.

What are the symptoms of lung cancer?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Lung cancer symptoms may take years before appearing, usually after the disease is in an advanced stage. Many symptoms of lung cancer affect the chest and air passages. These include:

Persistent or intense coughing Pain in the chest shoulder, or back from coughing Changes in color of the mucus that is coughed up from the lower airways (sputum) Difficulty breathing and swallowing Hoarseness of the voice Harsh sounds while breathing (stridor)

Chronic bronchitis or pneumonia Coughing up blood, or blood in the sputum If the lung cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and broken. It is also possible for the cancer to infect the adrenal glands resulting in hormone level changes.

How is lung cancer treated?

Lung cancer treatments depend on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. As there is usually no single treatment for cancer, patients often receive a combination of therapies and palliative care.

Surgery
Surgery is the oldest known treatment for cancer. If a cancer is in stage I or II and has not metastasized, it is possible to completely cure a patient by surgically removing the tumor and the nearby lymph nodes. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells.

Lung cancer surgery is performed by a specially trained thoracic surgeon. After removing the tumor and the surrounding margin of tissue, the margin is further studied to see if cancer cells are present. If no cancer is found in the tissue surrounding the tumor, it is considered a "negative margin." A "positive margin" may require the surgeon to remove more of the lung tissue.

Radiation
Radiation treatment, also known as radiotherapy, destroys or shrinks lung cancer tumors by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilizes high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Radiation can be used as the main treatment for lung cancer, to kill remaining cells after surgery, or to kill cancer cells that have metastasized.

Chemotherapy
Chemotherapy utilizes strong chemicals that interfere with the cell division process - damaging proteins or DNA - so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is considered systemic because its medicines travel throughout the entire body, killing the original tumor cells as well as cancer cells that have spread throughout the body. A medical oncologist will usually prescribe chemotherapy drugs for lung cancer to be taken intravenously, but there are also drugs available in tablet, capsule, and liquid form. Chemotherapy treatment occurs in cycles so the body has time to heal between doses, and dosages are determined by the type of lung cancer, the type of drug, and how the person responds to treatment. Medicines may be administered daily, weekly, or monthly, and can continue for months or even years.

FAMOUS LUNG CANCER CASES :- (case study ) Lance Armstrong: Lance Armstrong is a professional road-racing cyclist from the US, well-known for his record-breaking performance in the Tour de France for seven consecutive years from 1999 to 2005. In October 1996, he was diagnosed with testicular cancer which had spread to his lungs, brain, and stomach. Armstrong chose the 'VIP' treatment instead of 'BEP', a regular chemotherapeutic treatment. He avoided the BEP treatment as it had bleomycin that could have had a bad effect on his lungs. . Lance Armstrong is one of the famous lung cancer survivor stories.

Dana Reeve: Dana Reeve was an American singer and actress, and the wife of actor Christopher Reeve. She publicly announced that she was diagnosed with lung cancer in August 2005. She suffered from this disease even though she never smoked in her entire life. Later, she informed that the tumor was shrinking as a result of therapy. Unfortunately, in March 2006, Dana died at the age of 44 at the Memorial Sloan-Kettering Cancer Center in New York City.