Understanding Cancer

1. Understanding Cancer

2. What Is Cancer?

3. Different Kinds of Cancer Leukemias: Bloodstream Some common carcinomas: Lung Breast (women) Colon Bladder Prostate (men) Lymphomas: Lymph nodes Some common sarcomas: Fat Bone Muscle

4. Loss of Normal Growth Control Normal cell division Cell Suicide or Apoptosis Cell damage—no repair Cancer cell division First mutation Second mutation Third mutation Fourth orlater mutation Uncontrolled growth

5. Example of Normal Growth Dead cells shed from outer surface Epidermis Cell migration Dividing cells in basal layer Dermis

6. The Beginning of Cancerous Growth Underlying tissue

7. Tumors (Neoplasms) Underlying tissue

8. Invasion and Metastasis 1 Cancer cells invade surrounding tissues and blood vessels 2 Cancer cells are transported by the circulatory system to distant sites 3 Cancer cells reinvade and grow at new location

9. Why Cancer Is Potentially Dangerous Brain Melanoma cells travel through bloodstream Liver Melanoma(initial tumor)

10. Cancer Detection and Diagnosis

11. Early Cancer May Not Have Any Symptoms

12. Biopsy Pathology Proteomic profile Patient’stissue sample or blood sample Genomic profile

13. Microscopic Appearance of Cancer Cells

14. Tumor Staging Five-Year Survival Rates forPatients with Melanoma (by stage) 100% 50% I II III Stage at Time of Initial Diagnosis

15. What Causes Cancer? Some viruses or bacteria Some chemicals Radiation Heredity Diet Hormones

16. Population-Based Studies Regions of Highest Incidence U.K.: Lung cancer JAPAN: Stomach cancer CANADA: Leukemia U.S.:Colon cancer CHINA: Liver cancer BRAZIL: Cervical cancer AUSTRALIA: Skin cancer

17. Heredity? Behaviors? Other Factors? Colon Cancer(Number of new cases per 100,000 people) Stomach Cancer (Number of new cases per 100,000 people) 100 50 5 0 100 70 7 0 Japan Japanese familiesin U.S. U.S. Japan Japanese familiesin U.S. U.S.

18. Tobacco Use and Cancer Some Cancer-Causing Chemicals in Tobacco Smoke

19. Viruses Virus inserts and changes genes forcell growth Cancer-linked virus

20. Examples of Human Cancer Viruses Some Viruses Associated with Human Cancers

21. AIDS and Kaposi’s Sarcoma Without disease HIV infection Depressed immune system KSHV infection Kaposi’s sarcoma

22. Bacteria and Stomach Cancer Patient’s tissue sample H. pylori

23. Genetic Testing

24. Cancer Risk and Aging Cancer Risk and Aging 400 300 200 100 Colon Breast Number of Cancer Cases (per 100,000 people) 0 20406080 Age of Person (in years)

25. Genes and Cancer Viruses Radiation Chemicals Heredity Chromosomes are DNA molecules

26. DNA Structure Chemical bases A T C G DNA molecule

27. DNA Mutation C A A G C T A A C T DNA Normal gene C A A G C G A A C T Single base change C A A G G C G C T A A C T Additions C T C A A G A A C T Deletions

28. Oncogenes Normal cell Normal genes regulate cell growth An oncogene is a gene that, when mutated or expressed at high levels, helps turn a normal cell into a tumor cell Oncogenes accelerate cell growth and division Cancer cell Mutated/damaged oncogene

29. Tumor Suppressor Genes Normal genes prevent cancer Normal cell Remove or inactivate tumor suppressor genes Cancer cell Damage to both genes leads to cancer Mutated/inactivated tumor suppressor genes

30. Tumor Suppressor Genes Act Like a Brake Pedal Tumor Suppressor Gene Proteins Growth factor Receptor Signaling enzymes Transcriptionfactors DNA Cell nucleus Cell proliferation

31. DNA Repair Genes Normal DNA repair T C G A C Base pair mismatch No cancer T C T A C A G C T G T C T A C T C T A C A G C T G Cancer A G T G A G A T G No DNA repair

32. Cancer Tends to Involve Multiple Mutations Benign tumor cells grow only locally and cannot spread by invasion or metastasis Malignant cells invade neighboring tissues, enter blood vessels, and metastasize to different sites Time Mutation inactivates suppressor gene Cells proliferate Mutations inactivate DNA repair genes Proto-oncogenes mutate to oncogenes More mutations, more genetic instability, metastatic disease

33. Mutations and Cancer Genes Implicated in Cancer

34. Cancer Tends to Corrupt Surrounding Environment Growth factors = proliferation Invasive Matrix Proteases Fibroblasts, adipocytes Cytokines Blood vessel Cytokines, proteases = migration & invasion

35. Cancer Prevention Carcinogenic chemicals Carcinogenic radiation Cancer viruses or bacteria

36. Avoid Tobacco Lung Cancer Risk Increases with Cigarette Consumption 15x 10x 5x Lung Cancer Risk 0 15 30 Non-smoker Cigarettes Smoked per Day

37. Protect Yourself From Excessive Sunlight

38. Limit Alcohol and Tobacco Combination of Alcohol and Cigarettes Increases Risk for Cancer of the Esophagus 40x 30x 20x 10x Risk Increase Alcoholic Drinks Consumed per Day AND Packs of Cigarettes Consumed per Day

39. Diet: Limit Fats and Calories Correlation Between Meat Consumption and Colon Cancer Rates in Different Countries 40 30 Number of Cases (per 100,000 people) 20 10 0 80 100 200 300 Grams (per person per day)

40. Diet: Consume Fruits and Vegetables

41. Avoid Cancer Viruses HPV Infection Increases Risk for Cervical Cancer High Cervical Cancer Risk Low Noninfected women Women infected with HPV

42. Industrial Pollution Incidence of Most Cancers 1930 1950 1970 1990 Year

43. Is There a Cancer "Epidemic"?