An Emerging Face of Cancer: Today’s Understanding

Case Study

Sally sat motionless with her hands gripping the steering wheel after

she turned off the car in her driveway. Thirty minutes before she was

meeting with her doctor to review some tests, when she heard the

words that would change her life forever. The words, “You have ovarian

cancer” repeated through her mind ever since the doctor spoke them.

She didn’t remember much after that except looking an x-ray that

showed the cancer had spread from her ovaries to several locations

throughout her “abdominal area”.

Sally did not know what to do next. She had been divorced for 6 months

and did not feel comfortable calling her ex-husband. Sally’s friend had

offered to go to the doctor’s visit with her, but Sally never wanted to

inconvenience her friends. Most had their hands full with children and

elderly parents. She thought having cancer meant you received

chemotherapy and likely may not survive anyway. Sally did not know

what cancer was, how to live with it or what do next.

Introduction

Many years before the body is effected in anyway, a potentially

catastrophic change happens. It is likely an accumulation of one or many

environmental factors that trigger one gene, likely an oncogene, in one

cell projecting a new aberrant genomic pattern that has the potential to

destroy the human body. This is cancer.

Cells of each organ or tissue divide to grow in a controlled manner

specific to that organ. This way when old or poorly functioning cells die

new cells replace them. Thus providing a relatively constant mass of

specialized cells needed to maintain proper function in each organ or

tissue. When the genetic material of a cell (DNA) is damaged or is

triggered “on”, this is considered a mutation and affects the growth and

cell division rate of that cell and subsequent expanding cell line of its

progeny.

Most commonly when a cell is damaged or has genetic malfunction, the

affected cell will simply die. Cancer occurs when cells undergo a series

of genetic alterations that involve a gene responsible for regulating the

rate of cell growth and division to form new cells. As a result, these new

aberrant cancer cells survive longer and still new cells are made when

the body does not need them or have space for them. This accumulation

of extra non-functioning cells form a mass of tissue called a tumor.

Cancer is a very broad term that encompasses diseases that manifest

clinically as a result abnormally dividing cells that lost the ability to

The excessive growth

rate causes a mass of

cancer cells, called a

tumor

control their rate of growth. As a result, the cluster of cells grows to

cause dysfunction in the initial organ and then continue to grow to

invade other organs. The cancer cells “grow wild”, spread to adjacent

tissue and some types spread throughout the body as transported by

the blood stream and lymphatic system. For example, ovarian cancer

starts in the ovaries and usually spreads by into the surrounding

abdominal cavity and colon by the type clinical symptoms warrant a

doctors visit.

Cancer types

There are over 100 types of cancer and the organ that they started

names most by the name of the apparent type of cell involved. A

carcinoma is a cancer of the skin or outside ling of an internal organ.

Squamous cell carcinoma occurs most commonly along the breathing

tract, mouth to lung. Squamous cells cover the majority of the

respiratory tract and after years of carcinogenic irritants (smoke,

chewing tobacco) a gene in one or a group of squamous cells initiates a

cancer genomic process. Sarcoma is cancer of the bone, cartilage, fat,

muscle, blood vessels or connective tissues. Cancer that originates in

the bone marrow, that is responsible for forming blood products

(platelets, red and white blood cells), is called Leukemia. The rapid

production of abnormal blood cells in leukemia take precedence over

production of the critical production of healthy blood cells the body

desperately depends on. Lymphoma and myeloma are cancers of the

immune system. The cancers of the brain and spinal cord are unique

because the cell types primarily exist in the brain. For example, an

astrocytoma originates for the abnormal reproduction of astrocytes,

which are only present in the brain.

Behavior of the tumor

A tumor or cancer cells are usually not detected until they cause enough

interference to prevent one or more organs to function appropriately.

For example, the ovary has space to grow significantly before it

interferes with function of other abdominal organs. However, the local

invasion of cells into the abdominal cavity results in fluid secretion and

accumulation where the weight of fluid is not normally present, creating

discomfort. In addition, the “aggressive” cell type of some ovarian

cancers rapidity invades the colon and produce gastrointestinal

symptoms of bleeding, obstruction or diarrhea. T cell leukemia uses

most bone marrow supplies to produce abnormal T cell’s (one type of

white blood cell) that there is enough to produce red blood cells or

platelets.

Prevalence of Cancer

Cancer continues to be a major health problem throughout the world. In

In the U.S., cancer accounts for approximately 25% of all deaths that

occur each year. Between 2006-2010 over 1.5 million Americans were

diagnosed with cancer. With over one-third of those dying form a

cancer related cause.

(http://onlinelibrary.wiley.com.ezproxy.med.nyu.edu/doi/10.3322/caa

c.21208/pdf)

Although grim, these statistics reflect small improvements. Over the

past 5 years cancer related death rates have decreased by about 1.5%.

The incidence or cancer has decreased 0.6% in men and has remained

unchanged in woman. The death rate from cancer peaked in 1991 and

has been slowing since that time. The largest decline (55%) occurred in

black men aged 40-49 years.

Most Common Cancer Types

Men

Prostate 27%

Lung 14%

Bladder 7%

Melanoma of skin 5%

Women

Breast 29%

Lung 13%

Uterine 6%

Thyroid 6%