Cancer Classification and external resources
When normal cells are damaged beyond repair, they are eliminated by apoptosis (A). Cancer cells avoid apoptosis and continue to multiply in an unregulated manner (B).
DiseasesDB	28843
MedlinePlus	001289
MeSH	D009369

Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display the traits of uncontrolled growth (growth and division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). Malignant (from the Latin roots mal- = "bad" and -genus = "born" is a medical term used to describe a severe and progressively worsening disease A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly The cell is the structural and functional unit of all known living Organisms It is the smallest unit of an organism that is classified as living and is often called Cell division is a process by which a cell, called the parent cell divides into two or more cells called daughter cells. Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize. Malignant (from the Latin roots mal- = "bad" and -genus = "born" is a medical term used to describe a severe and progressively worsening disease A benign tumor is a Tumor that lacks all three of the Malignant properties of a Cancer. Most cancers form a tumor but some, like leukemia, do not. See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood

Cancer may affect people at all ages, even fetuses, but risk for the more common varieties tends to increase with age. A fetus (or foetus or fœtus) is a developing Mammal or other Viviparous Vertebrate, after the Embryonic stage and ^[1] Cancer causes about 13% of all deaths. This list shows causes of Human Deaths worldwide for a single year 2002 arranged by the associated Mortality rate. ^[2] According to the American Cancer Society, 7. The American Cancer Society ( ACS) is the "nationwide community-based voluntary health organization dedicated to 6 million people died from cancer in the world during 2007. ^[3] Cancers can affect other animals besides humans, and plants, too.

Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells. In classical genetics the genome of a Diploid Organism including Eukarya refers to a full set of chromosomes or genes in a Gamete, thereby Malignant transformation is the process by which cells acquire the properties of Cancer. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. The term carcinogen refers to any substance Radionuclide or radiation that is an agent directly involved in the promotion of Cancer or in the fatation of its propagation Tobacco Smoking is the inhalation of smoke from burned dried or cured leaves of the Tobacco plant most often in the form of a Cigarette. Electromagnetic radiation takes the form of self-propagating Waves in a Vacuum or in Matter. A chemical substance is a Material with a definite chemical composition. A pathogen (from Greek πάθος pathos "suffering passion" and γἰγνομαι (γεν- gignomai (gen- "I give birth to" infectious Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. DNA replication is the process of copying a double-stranded DNA molecule to form two double-stranded molecules A genetic disorder is a condition caused by abnormalities in Genes or Chromosomes While some diseases such as Cancer, are due to genetic abnormalities acquired Complex interactions between carcinogens and the host genome may explain why only some develop cancer after exposure to a known carcinogen. In classical genetics the genome of a Diploid Organism including Eukarya refers to a full set of chromosomes or genes in a Gamete, thereby New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly being recognized as important. DNA methylation is a type of chemical modification of DNA that can be inherited and subsequently removed without changing the original DNA sequence In Genetics, microRNAs ( miRNA) are single-stranded RNA molecules of about 21–23 Nucleotides in length which regulate Gene expression

Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are often activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. Programmed cell-death ( PCD) is death of a cell in any form mediated by an intracellular program Tumor suppressor genes are often inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system. A tumor suppressor gene, or antioncogene is a Gene that protects a cell from one step on the path to cancer The cell cycle, or cell-division cycle, is the series of events that take place in a eukaryotic cell leading to its replication An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor

Cancer is usually classified according to the tissue from which the cancerous cells originate, the primary tumor, as well as the normal cell type they most resemble. These are location and histology, respectively. A definitive diagnosis usually requires the histologic examination of a tissue biopsy specimen by a pathologist, although the initial indication of malignancy can be symptoms or radiographic imaging abnormalities. Histology (from the Greek = 'tissue' is the study of the microscopic anatomy of cells and tissues of Plants and A biopsy (in Greek: βίος life and όψη look/appearance is a Medical test involving the removal of cells or tissues Pathology; please do not remove --> ( For medical radiography see Radiology Radiography is the use of X-rays to view unseen or hard-to-image objects Most cancers can be treated and some cured, depending on the specific type, location, and stage. The stage of a cancer is a descriptor (usually numbers I to IV of how much the Cancer has spread Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy. Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Chemotherapy, in its most general sense refers to treatment of disease by chemicals that kill cells specifically those of micro-organisms or Cancer. Radiation therapy (or radiotherapy) is the medical use of Ionizing radiation as part of Cancer treatment to control Malignant As research develops, treatments are becoming more specific for different varieties of cancer. There has been significant progress in the development of targeted therapy drugs that act specifically on detectable molecular abnormalities in certain tumors, and which minimize damage to normal cells. Targeted therapy is a type of Medication that blocks the growth of Cancer cells by interfering with specific targeted Molecules needed for Carcinogenesis The prognosis of cancer patients is most influenced by the type of cancer, as well as the stage, or extent of the disease. The stage of a cancer is a descriptor (usually numbers I to IV of how much the Cancer has spread In addition, histologic grading and the presence of specific molecular markers can also be useful in establishing prognosis, as well as in determining individual treatments. Histology (from the Greek = 'tissue' is the study of the microscopic anatomy of cells and tissues of Plants and In Pathology, grading is a measure of the progress of Tumors and other Neoplasms Some pathology grading systems apply only to Malignant neoplasms

Contents 1 Classification 1.1 Nomenclature 1.2 Adult cancers 1.3 Child cancers 1.4 Infant cancers 2 Signs and symptoms 3 Diagnosis 3.1 Investigation 3.2 Biopsy 4 Treatment 4.1 Surgery 4.2 Radiation therapy 4.3 Chemotherapy 4.4 Targeted therapies 4.5 Immunotherapy 4.6 Hormonal therapy 4.7 Angiogenesis inhibitor 4.8 Symptom control 4.9 Complementary and alternative 4.10 Treatment trials 5 Prognosis 5.1 Emotional impact 6 Causes 6.1 Chemical carcinogens 6.2 Ionizing radiation 6.3 Infectious diseases 6.4 Hormonal imbalances 6.5 Immune system dysfunction 6.6 Heredity 6.7 Other causes 7 Pathophysiology 7.1 Epigenetics 7.2 Oncogenes 7.3 Tumor suppressor genes 7.4 Cancer cell biology 7.4.1 Clonal evolution 7.4.2 Biological properties of cancer cells 8 Prevention 8.1 Modifiable ("lifestyle") risk factors 8.2 Diet 8.3 Vitamins 8.4 Chemoprevention 8.5 Genetic testing 8.6 Vaccination 8.7 Screening 9 Epidemiology 10 History 11 Research 12 See also 13 References 13.1 General references 14 External links 14.1 Professional and research 14.2 Support and advocacy

Classification

Nomenclature

The following closely related terms may be used to designate abnormal growths:

• Tumor: originally, it meant any abnormal swelling, lump or mass. See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic In current English, however, the word tumor has become synonymous with neoplasm, specifically solid neoplasm. Note that some neoplasms, such as leukemia, do not form tumors. Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood
• Neoplasm: the scientific term to describe an abnormal proliferation of genetically altered cells. Neoplasms can be benign or malignant:
  • Malignant neoplasm or malignant tumor: synonymous with cancer.
  • Benign neoplasm or benign tumor: a tumor (solid neoplasm) that stops growing by itself, does not invade other tissues and does not form metastases. A benign tumor is a Tumor that lacks all three of the Malignant properties of a Cancer.
• Invasive tumor is another synonym of cancer. The name refers to invasion of surrounding tissues.
• Pre-malignancy, pre-cancer or non-invasive tumor: A neoplasm that is not invasive but has the potential to progress to cancer (become invasive) if left untreated. These lesions are, in order of increasing potential for cancer, atypia, dysplasia and carcinoma in situ. Atypia is a clinical term for abnormality in a cell The term is medical jargon for an atypical cell Dysplasia (from Greek roughly "bad formation" is a term used in Pathology to refer to an abnormality in maturation of cells within a tissue Carcinoma in situ (CIS is an early form of Carcinoma defined by the absence of invasion of surrounding tissues

The following terms can be used to describe a cancer:

• Screening: a test done on healthy people to detect tumors before they become apparent. A mammogram is a screening test. Mammography is the process of using low-dose X-rays (usually around 0
• Diagnosis: the confirmation of the cancerous nature of a lump. This usually requires a biopsy or removal of the tumor by surgery, followed by examination by a pathologist. A biopsy (in Greek: βίος life and όψη look/appearance is a Medical test involving the removal of cells or tissues Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Surgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists.
• Surgical excision: the removal of a tumor by a surgeon. Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental
  • Surgical margins: the evaluation by a pathologist of the edges of the tissue removed by the surgeon to determine if the tumor was removed completely ("negative margins") or if tumor was left behind ("positive margins"). Surgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists.
• Grade: a number (usually on a scale of 3) established by a pathologist to describe the degree of resemblance of the tumor to the surrounding benign tissue. Surgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists.
• Stage: a number (usually on a scale of 4) established by the oncologist to describe the degree of invasion of the body by the tumor. Oncology is the branch of medicine that studies Tumors ( Cancer) and seeks to understand their development diagnosis treatment and prevention
• Recurrence: new tumors that appear a the site of the original tumor after surgery.
• Metastasis: new tumors that appear far from the original tumor.
• Transformation: the concept that a low-grade tumor transforms to a high-grade tumor over time. Example: Richter's transformation. Richter's transformation, or Richter's syndrome (RS is a rare complication of B cell Chronic lymphocytic leukemia (CLL or Hairy cell leukemia (HCL
• Chemotherapy: treatment with drugs.
• Radiation therapy: treatment with radiations.
• Adjuvant therapy: treatment, either chemotherapy or radiation therapy, given after surgery to kill the remaining cancer cells.
• Prognosis: the probability of cure after the therapy. It is usually expressed as a probability of survival five years after diagnosis. Alternatively, it can be expressed as the number of years when 50% of the patients are still alive. Both numbers are derived from statistics accumulated with hundreds of similar patients to give a Kaplan-Meier curve. The Kaplan-Meier estimator (also known as the product limit estimator) estimates the Survival function from life-time data

Cancers are classified by the type of cell that resembles the tumor and, therefore, the tissue presumed to be the origin of the tumor. Examples of general categories include:

• Carcinoma: Malignant tumors derived from epithelial cells. A carcinoma is any Malignant Cancer that arises from epithelial cells. In biology and medicine epithelium is a tissue composed of cells that line the cavities and surfaces of structures throughout the body This group represents the most common cancers, including the common forms of breast, prostate, lung and colon cancer. Breast cancer is a Cancer that starts in the cells of the Breast in women and men Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and
• Sarcoma: Malignant tumors derived from connective tissue, or mesenchymal cells. A sarcoma (from the Greek 'sarx' meaning "flesh" is a Cancer of the connective or supportive tissue ( Bone, Cartilage, Fat Connective tissue is one of the four types of tissue in traditional classifications (the others being epithelial, Muscle, and Nervous tissue) Mesenchyme refers to loosely organized connective tissue present in the embryo regardless of origin
• Lymphoma and leukemia: Malignancies derived from hematopoietic (blood-forming) cells
• Germ cell tumor: Tumors derived from totipotent cells. Lymphoma a type of Neoplasm that originates in Lymphocytes (a type of White blood cell in the vertebrate Immune system) Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells ��such as nutrients and oxygen—and transports Waste products A germ cell tumor ( GCT) is a Neoplasm derived from Germ cells Germ cells normally occur inside the gonads ( Ovary and Testis) Totipotency is the ability of a single cell to divide and produce all the differentiated cells in an Organism, including extraembryonic tissues In adults most often found in the testicle and ovary; in fetuses, babies, and young children most often found on the body midline, particularly at the tip of the tailbone; in horses most often found at the poll (base of the skull). The testicle (from Latin testiculus, diminutive of testis, meaning "witness" virility plural testes) is the male "Ovaria" redirects here This is also a proposed section and a Synonym of Solanum.
• Blastic tumor: A tumor (usually malignant) which resembles an immature or embryonic tissue. Many of these tumors are most common in children.

Malignant tumors (cancers) are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ of origin as the root. For instance, a cancer of the liver is called hepatocarcinoma; a cancer of the fat cells is called liposarcoma. Hepatocellular carcinoma (HCC also called hepatoma) is a primary malignancy (cancer of the Liver. For common cancers, the English organ name is used. For instance, the most common type of breast cancer is called ductal carcinoma of the breast or mammary ductal carcinoma. Breast cancer is a Cancer that starts in the cells of the Breast in women and men Here, the adjective ductal refers to the appearance of the cancer under the microscope, resembling normal breast ducts.

Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name as the root. A benign tumor is a Tumor that lacks all three of the Malignant properties of a Cancer. For instance, a benign tumor of the smooth muscle of the uterus is called leiomyoma (the common name of this frequent tumor is fibroid). Unfortunately, some cancers also use the -oma suffix, examples being melanoma and seminoma. Melanoma is a Malignant Tumor of Melanocytes which are found predominantly in skin but also in the Bowel and the Eye (see Seminoma is one type of Testicular cancer that is believed to originate from the germinal epithelium of the Seminiferous tubules Presentation

Adult cancers

In the U. S. and other developed countries, cancer is presently responsible for about 25% of all deaths. ^[4] On a yearly basis, 0. 5% of the population is diagnosed with cancer. The statistics below are for adults in the United States, and may vary substantially in other countries:

Male			Female
most common (by occurrence)	most common (by mortality)[4]		most common (by occurrence)	most common (by mortality)[4]
prostate cancer (33%)	lung cancer (31%)		breast cancer (32%)	lung cancer (27%)
lung cancer (13%)	prostate cancer (10%)		lung cancer (12%)	breast cancer (15%)
colorectal cancer (10%)	colorectal cancer (10%)		colorectal cancer (11%)	colorectal cancer (10%)
bladder cancer (7%)	pancreatic cancer (5%)		endometrial cancer (6%)	ovarian cancer (6%)
cutaneous melanoma (5%)	leukemia (4%)		non-Hodgkin lymphoma (4%)	pancreatic cancer (6%)

Child cancers

Cancer can also occur in young children and adolescents, but it is rare (about 150 cases per million yearly in the US). Breast cancer is a Cancer that starts in the cells of the Breast in women and men Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and Bladder cancer refers to any of several types of malignant growths of the Urinary bladder. Pancreatic cancer is a malignant tumor of the Pancreas. Each year about 37680 individuals in the United States are diagnosed with this condition and 34290 Endometrial cancer refers to several types of malignancy which arise from the Endometrium, or lining of the Uterus. Ovarian cancer is a cancerous growth arising from an Ovary. The cancer most commonly forms in the lining of the ovary (resulting in epithelial Melanoma is a Malignant Tumor of Melanocytes which are found predominantly in skin but also in the Bowel and the Eye (see Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood The non-Hodgkin lymphomas are a diverse group of hematologic cancers which encompass any Lymphoma other than Hodgkin lymphoma. Statistics from the SEER program of the US NCI demonstrate that childhood cancers increased 19% between 1975 and 1990, mainly due to an increased incidence in acute leukemia. The National Cancer Institute (NCI is part of the United States Federal government's National Institutes of Health. Since 1990, incidence rates have decreased. ^[5]

There is a reasonable doubt that children living near nuclear facilities face an increased risk of cancer. Nuclear power is any Nuclear technology designed to extract usable Energy from atomic nuclei via controlled Nuclear reactions ^[6]

Infant cancers

The age of peak incidence of cancer in children occurs during the first year of life, in infants. The average annual incidence in the United States, 1975-1995, was 233 per million infants. ^[5] Several estimates of incidence exist. According to SEER,^[5] in the United States:

• Neuroblastoma comprised 28% of infant cancer cases and was the most common malignancy among these young children (65 per million infants). Neuroblastoma is the most common extracranial solid Cancer in childhood and the most common cancer in infancy with an annual incidence of about 650 new cases per year in the
• The leukemias as a group (41 per million infants) represented the next most common type of cancer, comprising 17% of all cases. Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood
• Central nervous system malignancies comprised 13% of infant cancer, with an average annual incidence rate of nearly 30 per million infants. A brain tumor is any intracranial Tumor created by abnormal and uncontrolled cell division, normally either in the Brain itself ( Neurons
• The average annual incidence rates for malignant germ cell and malignant soft tissue tumors were essentially the same at 15 per million infants. Each comprised about 6% of infant cancer.

According to another study:^[4]

• Leukemia (usually ALL) is the most common infant malignancy (30%), followed by the central nervous system cancers and neuroblastoma. Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood Acute lymphoblastic leukemia ( ALL) is a form of Leukemia, or cancer of the white blood cells. A brain tumor is any intracranial Tumor created by abnormal and uncontrolled cell division, normally either in the Brain itself ( Neurons Neuroblastoma is the most common extracranial solid Cancer in childhood and the most common cancer in infancy with an annual incidence of about 650 new cases per year in the The remainder consists of Wilms' tumor, lymphomas, rhabdomyosarcoma (arising from muscle), retinoblastoma, osteosarcoma and Ewing's sarcoma. Wilms' tumor or nephroblastoma is a Tumor of the Kidneys that typically occurs in Children rarely in Adults Its common name is Lymphoma a type of Neoplasm that originates in Lymphocytes (a type of White blood cell in the vertebrate Immune system) A rhabdomyosarcoma is a type of Cancer, specifically a Sarcoma (cancer of Connective tissues, in which the cancer cells are thought to arise from Retinoblastoma is a Cancer of the Retina. Development of this tumor is initiated by Mutations ref> that inactivate both copies of the RB1 Osteosarcoma is the most common type of malignant Bone cancer, accounting for 35% of primary bone malignancies Ewing sarcoma is a malignant round-cell tumor It is a rare disease in which Cancer cells are found in the Bone or in soft tissue.

Teratoma (a germ cell tumor) often is cited as the most common tumor in this age group, but most teratomas are surgically removed while still benign, hence not necessarily cancer. A teratoma is a type of neoplasm. The word teratoma comes from Greek and means roughly "monstrous tumor" A germ cell tumor ( GCT) is a Neoplasm derived from Germ cells Germ cells normally occur inside the gonads ( Ovary and Testis) Benign teratomas are not reportable to SEER. Prior to the widespread routine use of prenatal ultrasound examinations, the incidence of sacrococcygeal teratomas diagnosed at birth was 25 to 29 per million births. See also Teratoma Sacrococcygeal teratoma (SCT is a Teratoma (a kind of tumor located at the base of the Coccyx (tailbone

Female and male infants have essentially the same overall cancer incidence rates, a notable difference compared to older children.

White infants have higher cancer rates than black infants. Leukemias accounted for a substantial proportion of this difference: the average annual rate for white infants (48. 7 per million) was 66% higher than for black infants (29. 4 per million). ^[5]

Relative survival for infants is very good for neuroblastoma, Wilms' tumor and retinoblastoma, and fairly good (80%) for leukemia, but not for most other types of cancer. Wilms' tumor or nephroblastoma is a Tumor of the Kidneys that typically occurs in Children rarely in Adults Its common name is Retinoblastoma is a Cancer of the Retina. Development of this tumor is initiated by Mutations ref> that inactivate both copies of the RB1

Signs and symptoms

Roughly, cancer symptoms can be divided into three groups:

• Local symptoms: unusual lumps or swelling (tumor), hemorrhage (bleeding), pain and/or ulceration. See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic Bleeding, technically known as hemorrhaging / haemorrhaging (see American and British spelling differences) is the loss of Blood from Pain, in the sense of physical pain, is a typical sensory experience that may be described as the unpleasant awareness of a noxious stimulus or bodily harm Ulcers are healing wounds that develop on the skin mucous membranes or eye Compression of surrounding tissues may cause symptoms such as jaundice (yellowing the eyes and skin). Jaundice, also known as icterus (attributive adjective "icteric" is yellowish discoloration of the Skin, sclerae (whites of the eyes
• Symptoms of metastasis (spreading): enlarged lymph nodes, cough and hemoptysis, hepatomegaly (enlarged liver), bone pain, fracture of affected bones and neurological symptoms. Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, A Lymph node ( lɪmf noʊd is an organ consisting of many types of cells and is a part of the Lymphatic system. In Medicine, a cough ( Latin: tussis) is a sudden and often repetitively occurring defence Reflex which helps to clear the large breathing passages Hemoptysis or haemoptysis (see American and British spelling differences) is the expectoration ( Coughing up of Blood or of blood-stained Hepatomegaly is the condition of having an enlarged Liver. It is a nonspecific medical sign having many causes which can broadly be broken down into Infection The liver is a vital organ in the human body and is present in Vertebrates and some other animals A fracture is the (local separation of an object or material into two or more pieces under the action of stress. Although advanced cancer may cause pain, it is often not the first symptom. Pain, in the sense of physical pain, is a typical sensory experience that may be described as the unpleasant awareness of a noxious stimulus or bodily harm
• Systemic symptoms: weight loss, poor appetite, fatigue and cachexia (wasting), excessive sweating (night sweats), anemia and specific paraneoplastic phenomena, i. Weight loss, in the context of Medicine or Health or Physical fitness, is a reduction of the total Body weight, due to a mean loss of fluid Anorexia (deriving from the Greek "α(ν-" ( a(n-, a prefix that denotes absence + "όρεξη (orexe = appetite is the decreased sensation Cachexia (kəˈkɛksiə is loss of weight, Muscle atrophy, fatigue weakness and significant loss of appetite in someone who is not actively trying to Wasting could also mean unefficient and/or uneffective consumption. Sleep hyperhidrosis, more commonly known as the night sweats, is the occurrence of excessive sweating ( Hyperhidrosis) during Sleep. Anemia ( AmE) or anæmia/anaemia ( BrE) (from the Ancient Greek grc-Latn anaîmia, meaning “without blood” is defined as a qualitative A paraneoplastic syndrome is a Disease or Symptom that is the consequence of the presence of Cancer in the body but is not due to the local presence e. specific conditions that are due to an active cancer, such as thrombosis or hormonal changes. Thrombosis is the formation of a blood Clot ( Thrombus) inside a Blood vessel, obstructing the flow of Blood through the Circulatory

Every symptom in the above list can be caused by a variety of conditions (a list of which is referred to as the differential diagnosis). A differential diagnosis (sometimes abbreviated DDx, ddx Cancer may be a common or uncommon cause of each item.

Diagnosis

Most cancers are initially recognized either because signs or symptoms appear or through screening. Neither of these lead to a definitive diagnosis, which usually requires the opinion of a pathologist, a type of physician (medical doctor) who specializes in the diagnosis of cancer and other diseases. Pathology; please do not remove --> (

Investigation

People with suspected cancer are investigated with medical tests. A medical test is a kind of Medical procedure performed to detect, diagnose, or evaluate Disease, disease processes susceptibility and determine These commonly include blood tests, X-rays, CT scans and endoscopy. A blood test is a laboratory analysis performed on a Blood sample that is usually extracted from a Vein in the arm using a needle, or via X-radiation (composed of X-rays) is a form of Electromagnetic radiation. Computed tomography (CT is a Medical imaging method employing Tomography. Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an instrument called an endoscope.

Biopsy

A cancer may be suspected for a variety of reasons, but the definitive diagnosis of most malignancies must be confirmed by histological examination of the cancerous cells by a pathologist. Histology (from the Greek = 'tissue' is the study of the microscopic anatomy of cells and tissues of Plants and Pathology; please do not remove --> ( Tissue can be obtained from a biopsy or surgery. A biopsy (in Greek: βίος life and όψη look/appearance is a Medical test involving the removal of cells or tissues Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Many biopsies (such as those of the skin, breast or liver) can be done in a doctor's office. Biopsies of other organs are performed under anesthesia and require surgery in an operating room. Anesthesia, or anaesthesia (see spelling differences; from Greek grc αν- an-, "without" and grc αἲσθησις Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental An operating theater (or theatre) was a tiered Theater or Amphitheater in which students and other spectators could watch surgeons perform surgery

The tissue diagnosis given by the pathologist indicates the type of cell that is proliferating, its histological grade and other features of the tumor. Diagnosis is the identification by Process of elimination, of the nature of anything In Pathology, grading is a measure of the progress of Tumors and other Neoplasms Some pathology grading systems apply only to Malignant neoplasms Together, this information is useful to evaluate the prognosis of this patient and to choose the best treatment. Prognosis (older Greek πρόγνωσις modern Greek πρόγνωση - literally fore-knowing foreseeing) is a medical term denoting the Cytogenetics and immunohistochemistry are other types of testing that the pathologist may perform on the tissue specimen. Cytogenetics is a branch of Genetics that is concerned with the study of chromosomes and cell division Immunohistochemistry or IHC refers to the process of localizing proteins in cells of a tissue section exploiting the principle of antibodies binding specifically These tests may provide information about future behavior of the cancer (prognosis) and best treatment.

Treatment

Cancer can be treated by surgery, chemotherapy, radiation therapy, immunotherapy, monoclonal antibody therapy or other methods. Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Chemotherapy, in its most general sense refers to treatment of disease by chemicals that kill cells specifically those of micro-organisms or Cancer. Radiation therapy (or radiotherapy) is the medical use of Ionizing radiation as part of Cancer treatment to control Malignant Immunotherapy in medicine refers to an array of treatment strategies based upon the concept of modulating the Immune system to achieve a prophylactic and/or Monoclonal antibody therapy is the use of Monoclonal antibodies (or mAb to specifically target cells The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient (performance status). The stage of a cancer is a descriptor (usually numbers I to IV of how much the Cancer has spread In Medicine ( Oncology and other fields performance status is an attempt to quantify Cancer patients' general wellbeing A number of experimental cancer treatments are also under development. Experimental cancer treatments are medical therapies intended or claimed to treat Cancer (see also Tumor) by improving on supplementing or replacing

Complete removal of the cancer without damage to the rest of the body is the goal of treatment. Sometimes this can be accomplished by surgery, but the propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic metastasis often limits its effectiveness. The effectiveness of chemotherapy is often limited by toxicity to other tissues in the body. Radiation can also cause damage to normal tissue.

Because "cancer" refers to a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases. Cancer research is research into Cancer in order to identify causes and develop strategies for prevention diagnosis treatments and cure An infectious disease is a clinically evident Disease resulting from the presence of Pathogenic microbial agents including Pathogenic viruses Pathogenic

Surgery

In theory, non-hematological cancers can be cured if entirely removed by surgery, but this is not always possible. Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells ��such as nutrients and oxygen—and transports Waste products Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental When the cancer has metastasized to other sites in the body prior to surgery, complete surgical excision is usually impossible. Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, In the Halstedian model of cancer progression, tumors grow locally, then spread to the lymph nodes, then to the rest of the body. William Stewart Halsted ( September 23 1852 &ndash September 7 1922) is considered by many to be the most innovative influential and important This has given rise to the popularity of local-only treatments such as surgery for small cancers. Even small localized tumors are increasingly recognized as possessing metastatic potential.

Examples of surgical procedures for cancer include mastectomy for breast cancer and prostatectomy for prostate cancer. In Medicine, mastectomy is the medical term for the surgical removal of one or both Breasts partially or completely A prostatectomy is the Surgical removal of all or part of the Prostate gland. The goal of the surgery can be either the removal of only the tumor, or the entire organ. A single cancer cell is invisible to the naked eye but can regrow into a new tumor, a process called recurrence. For this reason, the pathologist will examine the surgical specimen to determine if a margin of healthy tissue is present, thus decreasing the chance that microscopic cancer cells are left in the patient. Pathology; please do not remove --> (

In addition to removal of the primary tumor, surgery is often necessary for staging, e. The stage of a cancer is a descriptor (usually numbers I to IV of how much the Cancer has spread g. determining the extent of the disease and whether it has metastasized to regional lymph nodes. Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, A Lymph node ( lɪmf noʊd is an organ consisting of many types of cells and is a part of the Lymphatic system. Staging is a major determinant of prognosis and of the need for adjuvant therapy. Prognosis (older Greek πρόγνωσις modern Greek πρόγνωση - literally fore-knowing foreseeing) is a medical term denoting the

Occasionally, surgery is necessary to control symptoms, such as spinal cord compression or bowel obstruction. Spinal cord compression develops when the Spinal cord is compressed by bone fragments from a vertebral fracture a Tumor, Abscess, ruptured Intervertebral Bowel obstruction (or intestinal obstruction) is a mechanical or functional obstruction of the intestines preventing the normal transit of the products of digestion This is referred to as palliative treatment. Palliative care (from Latin palliare to cloak is any form of medical care or treatment that concentrates on reducing the severity of Disease Symptoms

Radiation therapy

Main article: Radiation therapy

Radiation therapy (also called radiotherapy, X-ray therapy, or irradiation) is the use of ionizing radiation to kill cancer cells and shrink tumors. Radiation therapy (or radiotherapy) is the medical use of Ionizing radiation as part of Cancer treatment to control Malignant Radiation therapy (or radiotherapy) is the medical use of Ionizing radiation as part of Cancer treatment to control Malignant Radiation therapy can be administered externally via external beam radiotherapy (EBRT) or internally via brachytherapy. External beam radiotherapy otherwise known as teletherapy, is the most frequently used form of Radiotherapy. Brachytherapy (from the Greek brachy, meaning "short" also known as sealed source radiotherapy or endocurietherapy, is a form of The effects of radiation therapy are localised and confined to the region being treated. Radiation therapy injures or destroys cells in the area being treated (the "target tissue") by damaging their genetic material, making it impossible for these cells to continue to grow and divide. Although radiation damages both cancer cells and normal cells, most normal cells can recover from the effects of radiation and function properly. The goal of radiation therapy is to damage as many cancer cells as possible, while limiting harm to nearby healthy tissue. Hence, it is given in many fractions, allowing healthy tissue to recover between fractions.

Radiation therapy may be used to treat almost every type of solid tumor, including cancers of the brain, breast, cervix, larynx, lung, pancreas, prostate, skin, stomach, uterus, or soft tissue sarcomas. Radiation is also used to treat leukemia and lymphoma. Radiation dose to each site depends on a number of factors, including the radiosensitivity of each cancer type and whether there are tissues and organs nearby that may be damaged by radiation. Thus, as with every form of treatment, radiation therapy is not without its side effects.

Chemotherapy

Main article: Chemotherapy

Chemotherapy is the treatment of cancer with drugs ("anticancer drugs") that can destroy cancer cells. Chemotherapy, in its most general sense refers to treatment of disease by chemicals that kill cells specifically those of micro-organisms or Cancer. Chemotherapy, in its most general sense refers to treatment of disease by chemicals that kill cells specifically those of micro-organisms or Cancer. Medication, also referred to as medicine, can be loosely defined as any substance intended for use in the diagnosis cure mitigation treatment or prevention of disease In current usage, the term "chemotherapy" usually refers to cytotoxic drugs which affect rapidly dividing cells in general, in contrast with targeted therapy (see below). Chemotherapy drugs interfere with cell division in various possible ways, e. g. with the duplication of DNA or the separation of newly formed chromosomes. Deoxyribonucleic acid ( DNA) is a Nucleic acid that contains the genetic instructions used in the development and functioning of all known A chromosome is an organized structure of DNA and Protein that is found in cells. Most forms of chemotherapy target all rapidly dividing cells and are not specific for cancer cells, although some degree of specificity may come from the inability of many cancer cells to repair DNA damage, while normal cells generally can. DNA repair refers to a collection of processes by which a cell identifies and corrects damage to the DNA molecules that encode its Genome. Hence, chemotherapy has the potential to harm healthy tissue, especially those tissues that have a high replacement rate (e. g. intestinal lining). These cells usually repair themselves after chemotherapy.

Because some drugs work better together than alone, two or more drugs are often given at the same time. This is called "combination chemotherapy"; most chemotherapy regimens are given in a combination.

The treatment of some leukaemias and lymphomas requires the use of high-dose chemotherapy, and total body irradiation (TBI). Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood Lymphoma a type of Neoplasm that originates in Lymphocytes (a type of White blood cell in the vertebrate Immune system) Total body irradiation (TBI is a form of Radiotherapy used primarily as part of the preparative regimen for haematopoietic stem cell (or bone marrow transplantation This treatment ablates the bone marrow, and hence the body's ability to recover and repopulate the blood. For this reason, bone marrow, or peripheral blood stem cell harvesting is carried out before the ablative part of the therapy, to enable "rescue" after the treatment has been given. This is known as autologous stem cell transplantation. Hematopoietic stem cell transplantation (HSCT or bone marrow transplantation is a medical procedure in the field of Hematology and Oncology that involves Alternatively, hematopoietic stem cells may be transplanted from a matched unrelated donor (MUD). Hematopoietic stem cells (HSCs are Stem cells that give rise to all the blood cell types including Myeloid ( Monocytes and Macrophages, Neutrophils

Targeted therapies

Main article: Targeted therapy

Targeted therapy, which first became available in the late 1990s, has had a significant impact in the treatment of some types of cancer, and is currently a very active research area. Targeted therapy is a type of Medication that blocks the growth of Cancer cells by interfering with specific targeted Molecules needed for Carcinogenesis This constitutes the use of agents specific for the deregulated proteins of cancer cells. Small molecule targeted therapy drugs are generally inhibitors of enzymatic domains on mutated, overexpressed, or otherwise critical proteins within the cancer cell. Enzymes are Biomolecules that catalyze ( ie increase the rates of Chemical reactions Almost all enzymes are Proteins Prominent examples are the tyrosine kinase inhibitors imatinib and gefitinib. Imatinib is a drug used to treat certain types of Cancer. It is currently marketed by Novartis as Gleevec ( USA) or Glivec Gefitinib ( INN) (gɛˈfɪtɨnɪb (originally coded ZD1839 is a drug used in the treatment of certain types of Cancer.

Monoclonal antibody therapy is another strategy in which the therapeutic agent is an antibody which specifically binds to a protein on the surface of the cancer cells. Monoclonal antibody therapy is the use of Monoclonal antibodies (or mAb to specifically target cells Antibodies (also known as immunoglobulins, abbreviated Ig) are Gamma globulin Proteins that are found in Blood or other Bodily Examples include the anti-HER2/neu antibody trastuzumab (Herceptin) used in breast cancer, and the anti-CD20 antibody rituximab, used in a variety of B-cell malignancies. HER2/neu (also known as ErbB-2) stands for "Human Epidermal growth factor Receptor 2" and is a protein giving higher aggressiveness in Breast cancers It is a Trastuzumab (more commonly known under the Trade Rituximab, sold under the trade names Rituxan, MabThera and Reditux, is a chimeric Monoclonal antibody against the protein CD20 B cells are Lymphocytes that play a large role in the humoral immune response (as opposed to the cell-mediated immune response, which is governed by

Targeted therapy can also involve small peptides as "homing devices" which can bind to cell surface receptors or affected extracellular matrix surrounding the tumor. Targeted therapy is a type of Medication that blocks the growth of Cancer cells by interfering with specific targeted Molecules needed for Carcinogenesis Peptides (from the Greek πεπτίδια, "small digestibles" are short Polymers formed from the linking in a defined order of α- Amino In Biology, the extracellular matrix ( ECM) is the Extracellular part of animal tissue that usually provides structural support to the cells Radionuclides which are attached to this peptides (e. g. RGDs) eventually kill the cancer cell if the nuclide decays in the vicinity of the cell. Especially oligo- or multimers of these binding motifs are of great interest, since this can lead to enhanced tumor specificity and avidity.

Photodynamic therapy (PDT) is a ternary treatment for cancer involving a photosensitizer, tissue oxygen, and light (often using lasers). Photodynamic therapy (PDT matured as a feasible medical technology in the 1980s at several institutions throughout the world is a third-level treatment for Cancer involving A laser is a device that emits Light ( Electromagnetic radiation) through a process called Stimulated emission. PDT can be used as treatment for basal cell carcinoma (BCC) or lung cancer; PDT can also be useful in removing traces of malignant tissue after surgical removal of large tumors. Basal cell carcinoma is a type of skin cancer It is a malignant epithelial cell tumor that begins as a papule (a small circumscribed solid elevation of the skin and enlarges peripherally developing Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. ^[7]

Immunotherapy

Main article: Cancer immunotherapy

Cancer immunotherapy refers to a diverse set of therapeutic strategies designed to induce the patient's own immune system to fight the tumor. Cancer immunotherapy is the use of the Immune system to reject Cancer. An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor Contemporary methods for generating an immune response against tumours include intravesical BCG immunotherapy for superficial bladder cancer, and use of interferons and other cytokines to induce an immune response in renal cell carcinoma and melanoma patients. Bacillus Calmette-Guérin (or Bacille Calmette-Guérin, BCG) is a vaccine against Tuberculosis that is prepared from a strain of the attenuated Interferons ( IFN s are natural Proteins produced by the cells of the Immune system of most Vertebrates in response to challenges by foreign agents Cytokines are a category of signalling Proteins and Glycoproteins that like Hormones and Neurotransmitters, are used extensively in cellular "Kidney Cancer" redirects here For Wilms' Tumor/Nephroblastoma see Wilms' tumor. Melanoma is a Malignant Tumor of Melanocytes which are found predominantly in skin but also in the Bowel and the Eye (see Vaccines to generate specific immune responses are the subject of intensive research for a number of tumours, notably malignant melanoma and renal cell carcinoma. A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor Melanoma is a Malignant Tumor of Melanocytes which are found predominantly in skin but also in the Bowel and the Eye (see "Kidney Cancer" redirects here For Wilms' Tumor/Nephroblastoma see Wilms' tumor. Sipuleucel-T is a vaccine-like strategy in late clinical trials for prostate cancer in which dendritic cells from the patient are loaded with prostatic acid phosphatase peptides to induce a specific immune response against prostate-derived cells. Dendreon is a Seattle based Biotechnology company Its leading product candidate Sipuleucel-T (known as Provenge during drug trials is an Dendritic cells (DCs are Immune cells and form part of the Mammalian Immune system. Prostatic acid phosphatase ( PAP) also prostatic specific acid phosphatase (PSAP is an Enzyme produced by the Prostate.

Allogeneic hematopoietic stem cell transplantation ("bone marrow transplantation" from a genetically non-identical donor) can be considered a form of immunotherapy, since the donor's immune cells will often attack the tumor in a phenomenon known as graft-versus-tumor effect. For this reason, allogeneic HSCT leads to a higher cure rate than autologous transplantation for several cancer types, although the side effects are also more severe.

Hormonal therapy

Main article: Hormonal therapy (oncology)

The growth of some cancers can be inhibited by providing or blocking certain hormones. Hormonal therapy is one of the major modalities of medical treatment for cancer others being cytotoxic chemotherapy and Targeted therapy (biotherapeutics Common examples of hormone-sensitive tumors include certain types of breast and prostate cancers. Removing or blocking estrogen or testosterone is often an important additional treatment. Estrogens (US otherwise oestrogens or œstrogens) are a group of Steroid compounds named for their importance in the Estrous cycle, Testosterone is a Steroid hormone from the Androgen group In mammals testosterone is primarily secreted in the testes of males and the Ovaries In certain cancers, administration of hormone agonists, such as progestogens may be therapeutically beneficial. Progestagens (also spelled progestogens or gestagens) are Hormones that produce effects similar to those of Progesterone, the only natural progestagen

Angiogenesis inhibitor

Main article: Angiogenesis inhibitor

Angiogenesis inhibitors prevent the extensive growth of blood vessels (angiogenesis) that tumors require to survive. An angiogenesis inhibitor is a substance that inhibits Angiogenesis (the growth of new blood vessels Angiogenesis is a physiological process involving the growth of new Blood vessels from pre-existing vessels Some, such as bevacizumab, have been approved and are in clinical use. Bevacizumab (Avastin Genentech/Roche is a Monoclonal antibody against Vascular endothelial growth factor (VEGF One of the main problems with anti-angiogenesis drugs is that many factors stimulate blood vessel growth, in normal cells and cancer. Anti-angiogenesis drugs only target one factor, so the other factors continue to stimulate blood vessel growth. Other problems include route of administration, maintenance of stability and activity and targeting at the tumor vasculature. In Pharmacology and Toxicology, a route ^[8]

Symptom control

Although the control of the symptoms of cancer is not typically thought of as a treatment directed at the cancer, it is an important determinant of the quality of life of cancer patients, and plays an important role in the decision whether the patient is able to undergo other treatments. Quality of life is the degree of well-being felt by an individual or group of people Although doctors generally have the therapeutic skills to reduce pain, nausea, vomiting, diarrhea, hemorrhage and other common problems in cancer patients, the multidisciplinary specialty of palliative care has arisen specifically in response to the symptom control needs of this group of patients. Palliative care (from Latin palliare to cloak is any form of medical care or treatment that concentrates on reducing the severity of Disease Symptoms

Pain medication, such as morphine and oxycodone, and antiemetics, drugs to suppress nausea and vomiting, are very commonly used in patients with cancer-related symptoms. Medical uses Morphine can be used as an analgesic in hospital settings to relieve pain in Myocardial infarction pain in Oxycodone is an Opioid Analgesic Medication synthesized from Thebaine. An anti-emetic is a drug that is effective against Vomiting and Nausea. Improved antiemetics such as ondansetron and analogues, as well as aprepitant have made aggressive treatments much more feasible in cancer patients. An anti-emetic is a drug that is effective against Vomiting and Nausea. Ondansetron ( INN) (ɒnˈdænsɛtrɒn or Zofran is a Serotonin 5-HT3 receptor antagonist used mainly as an Antiemetic to Aprepitant is a chemical compound that belongs to a class of drugs called Substance P antagonists (SPA

Chronic pain due to cancer is almost always associated with continuing tissue damage due to the disease process or the treatment (i. Chronic pain is defined as Pain that persists longer than the temporal course of natural healing associated with a particular type of injury or disease process e. surgery, radiation, chemotherapy). Although there is always a role for environmental factors and affective disturbances in the genesis of pain behaviors, these are not usually the predominant etiologic factors in patients with cancer pain. Furthermore, many patients with severe pain associated with cancer are nearing the end of their lives and palliative therapies are required. Palliative care (from Latin palliare to cloak is any form of medical care or treatment that concentrates on reducing the severity of Disease Symptoms Issues such as social stigma of using opioids, work and functional status, and health care consumption are not likely to be important in the overall case management. An opioid is a chemical Substance that has a Morphine -like action in the body Hence, the typical strategy for cancer pain management is to get the patient as comfortable as possible using opioids and other medications, surgery, and physical measures. Doctors have been reluctant to prescribe narcotics for pain in terminal cancer patients, for fear of contributing to addiction or suppressing respiratory function. The palliative care movement, a more recent offshoot of the hospice movement, has engendered more widespread support for preemptive pain treatment for cancer patients. Palliative care (from Latin palliare to cloak is any form of medical care or treatment that concentrates on reducing the severity of Disease Symptoms Palliative care (from Latin palliare to cloak is any form of medical care or treatment that concentrates on reducing the severity of Disease Symptoms

Fatigue is a very common problem for cancer patients, and has only recently become important enough for oncologists to suggest treatment, even though it plays a significant role in many patients' quality of life.

Complementary and alternative

Complementary and alternative medicine (CAM) treatments are the diverse group of medical and health care systems, practices, and products that are not part of conventional medicine. The term alternative medicine, as used in the modern western world encompasses any healing practice "that does not fall within the realm of conventional Medicine. ^[9] "Complementary medicine" refers to methods and substances used along with conventional medicine, while "alternative medicine" refers to compounds used instead of conventional medicine. ^[10] CAM use is common among people with cancer; a 2000 study found that 69% cancer patients had used at least one CAM therapy as part of their cancer treatment. ^[11] Most complementary and alternative medicines for cancer have not been rigorously studied or tested. Some alternative treatments which have been investigated and shown to be ineffective continue to be marketed and promoted. ^[12]

Treatment trials

Main articles: Experimental cancer treatment and Unproven cancer therapy

Clinical trials, also called research studies, test new treatments in people with cancer. Experimental cancer treatments are medical therapies intended or claimed to treat Cancer (see also Tumor) by improving on supplementing or replacing In health care clinical trials are conducted to allow safety and Efficacy data to be collected for new drugs or devices The goal of this research is to find better ways to treat cancer and help cancer patients. Clinical trials test many types of treatment such as new drugs, new approaches to surgery or radiation therapy, new combinations of treatments, or new methods such as gene therapy. Gene therapy is the insertion of Genes into an individual's cells and tissues to treat a Disease, and Hereditary diseases in which a

A clinical trial is one of the final stages of a long and careful cancer research process. The search for new treatments begins in the laboratory, where scientists first develop and test new ideas. If an approach seems promising, the next step may be testing a treatment in animals to see how it affects cancer in a living being and whether it has harmful effects. Of course, treatments that work well in the lab or in animals do not always work well in people. Studies are done with cancer patients to find out whether promising treatments are safe and effective.

Patients who take part may be helped personally by the treatment(s) they receive. They get up-to-date care from cancer experts, and they receive either a new treatment being tested or the best available standard treatment for their cancer. Of course, there is no guarantee that a new treatment being tested or a standard treatment will produce good results. New treatments also may have unknown risks, but if a new treatment proves effective or more effective than standard treatment, study patients who receive it may be among the first to benefit.

Prognosis

Cancer has a reputation for being a deadly disease. While this certainly applies to certain particular types, the truths behind the historical connotations of cancer are increasingly being overturned by advances in medical care. Some types of cancer have a prognosis that is substantially better than nonmalignant diseases such as heart failure and stroke. Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply A stroke is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain

Progressive and disseminated malignant disease has a substantial impact on a cancer patient's quality of life, and many cancer treatments (such as chemotherapy) may have severe side-effects. Chemotherapy, in its most general sense refers to treatment of disease by chemicals that kill cells specifically those of micro-organisms or Cancer. In the advanced stages of cancer, many patients need extensive care, affecting family members and friends. Palliative care solutions may include permanent or "respite" hospice nursing. Palliative care (from Latin palliare to cloak is any form of medical care or treatment that concentrates on reducing the severity of Disease Symptoms

Emotional impact

Many local organizations offer a variety of practical and support services to people with cancer. Support can take the form of support groups, counseling, advice, financial assistance, transportation to and from treatment, films or information about cancer. Cancer support groups provide a setting in which Cancer patients can talk about living with cancer with others who may be having similar experiences Neighborhood organizations, local health care providers, or area hospitals may have resources or services available.

Counseling can provide emotional support to cancer patients and help them better understand their illness. Different types of counseling include individual, group, family, peer counseling, bereavement, patient-to-patient, and sexuality.

Many governmental and charitable organizations have been established to help patients cope with cancer. These organizations often are involved in cancer prevention, cancer treatment, and cancer research.

Causes

Main article: Carcinogenesis

Cancer is a diverse class of diseases which differ widely in their causes and biology. Carcinogenesis (meaning literally the creation of Cancer) is the process by which normal cells are transformed into cancer cells The common thread in all known cancers is the acquisition of abnormalities in the genetic material of the cancer cell and its progeny. Research into the pathogenesis of cancer can be divided into three broad areas of focus. The first area of research focuses on the agents and events which cause or facilitate genetic changes in cells destined to become cancer. Second, it is important to uncover the precise nature of the genetic damage, and the genes which are affected by it. The third focus is on the consequences of those genetic changes on the biology of the cell, both in generating the defining properties of a cancer cell, and in facilitating additional genetic events, leading to further progression of the cancer.

Chemical carcinogens

Cancer pathogenesis is traceable back to DNA mutations that impact cell growth and metastasis. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism Substances that cause DNA mutations are known as mutagens, and mutagens that cause cancers are known as carcinogens. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism Particular substances have been linked to specific types of cancer. Tobacco smoking is associated with lung cancer and bladder cancer. Tobacco Smoking is the inhalation of smoke from burned dried or cured leaves of the Tobacco plant most often in the form of a Cigarette. Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Bladder cancer refers to any of several types of malignant growths of the Urinary bladder. Prolonged exposure to asbestos fibers is associated with mesothelioma. Asbestos is a group of Minerals with long thin fibrous Crystals The word "asbestos" (῾ἀσβεστος is derived from a Greek adjective Mesothelioma is a form of Cancer that is almost always caused by previous exposure to Asbestos.

Many mutagens are also carcinogens, but some carcinogens are not mutagens. In Biology, a mutagen ( Latin, literally origin of change) is a physical or chemical agent that changes the genetic information (usually DNA) The term carcinogen refers to any substance Radionuclide or radiation that is an agent directly involved in the promotion of Cancer or in the fatation of its propagation Alcohol is an example of a chemical carcinogen that is not a mutagen. In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon Such chemicals are thought to promote cancers through their stimulating effect on the rate of cell mitosis. Mitosis is the process in which a Eukaryotic cell separates the Chromosomes in its Cell nucleus, into two identical sets in two daughter nuclei Faster rates of mitosis leaves less time for repair enzymes to repair damaged DNA during DNA replication, increasing the likelihood of a genetic mistake. DNA replication is the process of copying a double-stranded DNA molecule to form two double-stranded molecules A mistake made during mitosis can lead to the daughter cells receiving the wrong number of chromosomes (see aneuploidy above). A chromosome is an organized structure of DNA and Protein that is found in cells. Aneuploidy is defined as an abnormal number of Chromosomes Syndromes caused by an extra or missing chromosome are among the most widely recognized Genetic disorders

Decades of research have demonstrated the strong association between tobacco use and cancers of many sites, making it perhaps the most important human carcinogen. Tobacco is an Agricultural product recognized as an addictive drug processed from the fresh Leaves of plants in the genus Nicotiana. Hundreds of epidemiological studies have confirmed this association. Further support comes from the fact that lung cancer death rates in the United States have mirrored smoking patterns, with increases in smoking followed by dramatic increases in lung cancer death rates and, more recently, decreases in smoking followed by decreases in lung cancer death rates in men. Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Tobacco Smoking is the inhalation of smoke from burned dried or cured leaves of the Tobacco plant most often in the form of a Cigarette.

Ionizing radiation

Sources of ionizing radiation, such as radon gas, can cause cancer. Image talkNew_radiation_symbol_ISO_21482svg for details --> Ionizing radiation Radon (ˈreɪdɒn is the Chemical element that has the symbol Rn and Atomic number 86 Prolonged exposure to ultraviolet radiation from the sun can lead to melanoma and other skin malignancies. Ultraviolet ( UV) light is Electromagnetic radiation with a Wavelength shorter than that of Visible light, but longer than X-rays The Sun (Sol is the Star at the center of the Solar System. Melanoma is a Malignant Tumor of Melanocytes which are found predominantly in skin but also in the Bowel and the Eye (see

Infectious diseases

Furthermore, many cancers originate from a viral infection; this is especially true in animals such as birds, but also in humans, as viruses are responsible for 15% of human cancers worldwide. A virus (from the Latin virus meaning Toxin or Poison) is a sub-microscopic infectious agent that is unable An infection is the detrimental Colonization of a host Organism by a foreign Species. Birds ( class Aves) are bipedal endothermic ( Warm-blooded) Vertebrate animals that lay eggs. Human beings, humans or man (Origin 1590–1600 L homō man OL hemō the earthly one (see Humus The main viruses associated with human cancers are human papillomavirus, hepatitis B and hepatitis C virus, Epstein-Barr virus, and human T-lymphotropic virus. A human papillomavirus ( HPV) is a Papillomavirus that infects the skin and Mucous membranes of Humans Approximately 130 HPV types have been Hepatitis C is a blood-borne infectious disease that is caused by the Hepatitis C virus ( HCV) affecting the Liver. The Epstein-Barr Virus ( EBV) also called Human herpesvirus 4 (HHV-4 is a Virus of the herpes family (which includes Herpes Human T-lymphotropic virus (HTLV is a Human, single-stranded RNA Retrovirus that causes T-cell Leukemia and T-cell Lymphoma Experimental and epidemiological data imply a causative role for viruses and they appear to be the second most important risk factor for cancer development in humans, exceeded only by tobacco usage. ^[13] The mode of virally-induced tumors can be divided into two, acutely-transforming or slowly-transforming. In acutely transforming viruses, the viral particles carry a gene that encodes for an overactive oncogene called viral-oncogene (v-onc), and the infected cell is transformed as soon as v-onc is expressed. In contrast, in slowly-transforming viruses, the virus genome is inserted, especially as viral genome insertion is an obligatory part of retroviruses, near a proto-oncogene in the host genome. A retrovirus is any Virus belonging to the viral family Retroviridae. The viral promoter or other transcription regulation elements in turn cause overexpression of that proto-oncogene, which in turn induces uncontrolled cellular proliferation. In Biology, a promoter is a region of DNA that facilitates the transcription of a particular Gene. Because viral genome insertion is not specific to proto-oncogenes and the chance of insertion near that proto-oncogene is low, slowly-transforming viruses have very long tumor latency compared to acutely-transforming viruses, which already carry the viral oncogene.

Hepatitis viruses, including hepatitis B and hepatitis C, can induce a chronic viral infection that leads to liver cancer in 0. Hepatitis C is a blood-borne infectious disease that is caused by the Hepatitis C virus ( HCV) affecting the Liver. Hepatocellular carcinoma (HCC also called hepatoma) is a primary malignancy (cancer of the Liver. 47% of hepatitis B patients per year (especially in Asia, less so in North America), and in 1. 4% of hepatitis C carriers per year. Hepatitis C is a blood-borne infectious disease that is caused by the Hepatitis C virus ( HCV) affecting the Liver. Liver cirrhosis, whether from chronic viral hepatitis infection or alcoholism, is associated with the development of liver cancer, and the combination of cirrhosis and viral hepatitis presents the highest risk of liver cancer development. Hepatocellular carcinoma (HCC also called hepatoma) is a primary malignancy (cancer of the Liver. Hepatocellular carcinoma (HCC also called hepatoma) is a primary malignancy (cancer of the Liver. Worldwide, liver cancer is one of the most common, and most deadly, cancers due to a huge burden of viral hepatitis transmission and disease. Hepatocellular carcinoma (HCC also called hepatoma) is a primary malignancy (cancer of the Liver. Hepatitis (plural hepatitides) implies injury to the Liver characterized by the presence of Inflammatory cells in the tissue of

Advances in cancer research have made a vaccine designed to prevent cancer available. In 2006, the US FDA approved a human papilloma virus vaccine, called Gardasil. A human papillomavirus ( HPV) is a Papillomavirus that infects the skin and Mucous membranes of Humans Approximately 130 HPV types have been Gardasil ( Merck & Co) is a Vaccine against certain types of Human papillomavirus (HPV The vaccine protects against four HPV types, which together cause 70% of cervical cancers and 90% of genital warts. In March 2007, the US CDC Advisory Committee on Immunization Practices (ACIP) officially recommended that females aged 11-12 receive the vaccine, and indicated that females as young as age 9 and as old as age 26 are also candidates for immunization. The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated The Advisory Committee on Immunization Practices (ACIP provides advice and guidance on effective control of Vaccine -preventable Diseases in the U

In addition to viruses, researchers have noted a connection between bacteria and certain cancers. The most prominent example is the link between chronic infection of the wall of the stomach with Helicobacter pylori and gastric cancer. Helicobacter pylori ( is a Gram-negative, microaerophilic Bacterium that inhabits various areas of the stomach and Duodenum. Stomach or gastric cancer can develop in any part of the Stomach and may spread throughout the stomach and to other organs particularly the Esophagus and ^[14]

Hormonal imbalances

Some hormones can act in a similar manner to non-mutagenic carcinogens in that they may stimulate excessive cell growth. A well-established example is the role of hyperestrogenic states in promoting endometrial cancer. Estrogens (US otherwise oestrogens or œstrogens) are a group of Steroid compounds named for their importance in the Estrous cycle, Endometrial cancer refers to several types of malignancy which arise from the Endometrium, or lining of the Uterus.

Immune system dysfunction

HIV is associated with a number of malignancies, including Kaposi's sarcoma, non-Hodgkin's lymphoma, and HPV-associated malignancies such as anal cancer and cervical cancer. Human immunodeficiency virus ( HIV) is a Lentivirus (a member of the Retrovirus family that can lead to acquired immunodeficiency syndrome Kaposi's sarcoma (KS is a tumor caused by Human herpesvirus 8 ( HHV8) also known as Kaposi's sarcoma-associated herpesvirus (KSHV The non-Hodgkin lymphomas are a diverse group of hematologic cancers which encompass any Lymphoma other than Hodgkin lymphoma. A human papillomavirus ( HPV) is a Papillomavirus that infects the skin and Mucous membranes of Humans Approximately 130 HPV types have been Anal cancer is a type of Cancer which arises from the Anus, the distal orifice of the Gastrointestinal tract. Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area AIDS-defining illnesses have long included these diagnoses. The increased incidence of malignancies in HIV patients points to the breakdown of immune surveillance as a possible etiology of cancer. ^[15] Certain other immune deficiency states (e. g. common variable immunodeficiency and IgA deficiency) are also associated with increased risk of malignancy. Common variable immunodeficiency (CVID is a group of 20-30 primary immunodeficiencies (PIDs which have a common set of symptoms (including Hypogammaglobulinemia) Selective immunoglobulin A (IgA deficiency is a relatively mild genetic Immunodeficiency. ^[16]

Heredity

Most forms of cancer are "sporadic", and have no basis in heredity. There are, however, a number of recognised syndromes of cancer with a hereditary component, often a defective tumor suppressor allele. In Medicine and Psychology, the term syndrome refers to the association of several clinically recognizable features signs (observed by a physician An allele (ˈæliːl (UK /əˈliːl/ (US (from the Greek αλληλος allelos, meaning each other) is one member of a pair or series of different forms Famous examples are:

• certain inherited mutations in the genes BRCA1 and BRCA2 are associated with an elevated risk of breast cancer and ovarian cancer
• tumors of various endocrine organs in multiple endocrine neoplasia (MEN types 1, 2a, 2b)
• Li-Fraumeni syndrome (various tumors such as osteosarcoma, breast cancer, soft tissue sarcoma, brain tumors) due to mutations of p53
• Turcot syndrome (brain tumors and colonic polyposis)
• Familial adenomatous polyposis an inherited mutation of the APC gene that leads to early onset of colon carcinoma. BRCA1 ( Breast cancer 1 early onset is a Human Gene, some mutations of which are associated with a significant increase in the risk of Breast cancer Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Breast cancer is a Cancer that starts in the cells of the Breast in women and men Ovarian cancer is a cancerous growth arising from an Ovary. The cancer most commonly forms in the lining of the ovary (resulting in epithelial The term multiple endocrine Neoplasia ( MEN) encompasses several distinct Syndromes featuring tumors of endocrine glands each with its own characteristic Li-Fraumeni syndrome is a rare Autosomal dominant Hereditary disorder. Osteosarcoma is the most common type of malignant Bone cancer, accounting for 35% of primary bone malignancies A soft tissue sarcoma is a rare form of Cancer that develops in mesenchymal tissue the Muscle, Connective tissues and Bones of the body A brain tumor is any intracranial Tumor created by abnormal and uncontrolled cell division, normally either in the Brain itself ( Neurons p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene Turcot syndrome is the association between Familial adenomatous polyposis or Hereditary nonpolyposis colorectal cancer and Brain tumors like Medulloblastoma A brain tumor is any intracranial Tumor created by abnormal and uncontrolled cell division, normally either in the Brain itself ( Neurons Familial adenomatous polyposis ( FAP) is an inherited condition in which numerous polyps form mainly in the Epithelium of the large intestine. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and
• Hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) can include familial cases of colon cancer, uterine cancer, gastric cancer, and ovarian cancer, without a preponderance of colon polyps. Hereditary nonpolyposis colorectal cancer (HNPCC also known as Lynch syndrome, is characterised by a risk of Colorectal cancer and other cancers of the endometrium Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and Stomach or gastric cancer can develop in any part of the Stomach and may spread throughout the stomach and to other organs particularly the Esophagus and Ovarian cancer is a cancerous growth arising from an Ovary. The cancer most commonly forms in the lining of the ovary (resulting in epithelial A polyp is an abnormal growth of tissue ( Tumor) projecting from a Mucous membrane.
• Retinoblastoma, when occurring in young children, is due to a hereditary mutation in the retinoblastoma gene. Retinoblastoma is a Cancer of the Retina. Development of this tumor is initiated by Mutations ref> that inactivate both copies of the RB1
• Down syndrome patients, who have an extra chromosome 21, are known to develop malignancies such as leukemia and testicular cancer, though the reasons for this difference are not well understood. Down syndrome, Down's syndrome, or trisomy 21 is a Chromosomal disorder caused by the presence of all or part of an extra 21st chromosome. Chromosome 21 is one of the 23 pairs of Chromosomes in Humans People normally have two copies of this chromosome Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood Testicular cancer is Cancer that develops in the Testicles a part of the Male reproductive system

Other causes

A few types of cancer in non-humans have been found to be caused by the tumor cells themselves. This phenomenon is seen in Sticker's sarcoma, also known as canine transmissible venereal tumor. Canine transmissible venereal tumor (CTVT also called transmissible venereal tumor (TVT Sticker tumor and infectious sarcoma is a Tumor of ^[17] The closest known analogue to this in humans is individuals who have developed cancer from tumors hiding inside organ transplants.

Pathophysiology

Cancer is fundamentally a disease of regulation of tissue growth. In order for a normal cell to transform into a cancer cell, genes which regulate cell growth and differentiation must be altered. Malignant transformation is the process by which cells acquire the properties of Cancer. History See also History of genetics The existence of genes was first suggested by Gregor Mendel (1822-1884 who in the 1860s studied inheritance Genetic changes can occur at many levels, from gain or loss of entire chromosomes to a mutation affecting a single DNA nucleotide. A single nucleotide polymorphism ( SNP, pronounced snip) is a DNA sequence variation occurring when a single Nucleotide - A, T There are two broad categories of genes which are affected by these changes. Oncogenes may be normal genes which are expressed at inappropriately high levels, or altered genes which have novel properties. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. In either case, expression of these genes promotes the malignant phenotype of cancer cells. Tumor suppressor genes are genes which inhibit cell division, survival, or other properties of cancer cells. A tumor suppressor gene, or antioncogene is a Gene that protects a cell from one step on the path to cancer Tumor suppressor genes are often disabled by cancer-promoting genetic changes. Typically, changes in many genes are required to transform a normal cell into a cancer cell.

There is a diverse classification scheme for the various genomic changes which may contribute to the generation of cancer cells. Most of these changes are mutations, or changes in the nucleotide sequence of genomic DNA. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism Nucleotides are Organic compounds that consist of three joined structures a nitrogenous base a Sugar, and a Phosphate group Aneuploidy, the presence of an abnormal number of chromosomes, is one genomic change which is not a mutation, and may involve either gain or loss of one or more chromosomes through errors in mitosis. Aneuploidy is defined as an abnormal number of Chromosomes Syndromes caused by an extra or missing chromosome are among the most widely recognized Genetic disorders A chromosome is an organized structure of DNA and Protein that is found in cells. Mitosis is the process in which a Eukaryotic cell separates the Chromosomes in its Cell nucleus, into two identical sets in two daughter nuclei

Large-scale mutations involve the deletion or gain of a portion of a chromosome. Genomic amplification occurs when a cell gains many copies (often 20 or more) of a small chromosomal locus, usually containing one or more oncogenes and adjacent genetic material. Translocation occurs when two separate chromosomal regions become abnormally fused, often at a characteristic location. In Genetics, a chromosome translocation is a Chromosome abnormality caused by rearrangement of parts between nonhomologous Chromosomes. A well-known example of this is the Philadelphia chromosome, or translocation of chromosomes 9 and 22, which occurs in chronic myelogenous leukemia, and results in production of the BCR-abl fusion protein, an oncogenic tyrosine kinase. Philadelphia chromosome or Philadelphia translocation is a specific chromosomal abnormality that is associated with Chronic myelogenous leukemia (CML Chronic myelogenous (or myeloid leukemia ( CML) is a form of Leukemia characterized by the increased and unregulated growth of predominantly Myeloid cells The abl gene is associated with Chronic myelogenous leukemia (CML Fusion proteins, also known as chimeric proteins, are proteins created through the joining of two or more Genes which originally coded for separate proteins A tyrosine kinase is an Enzyme that can transfer a Phosphate group from ATP to a Tyrosine residue in a Protein.

Small-scale mutations include point mutations, deletions, and insertions, which may occur in the promoter of a gene and affect its expression, or may occur in the gene's coding sequence and alter the function or stability of its protein product. In Biology, a promoter is a region of DNA that facilitates the transcription of a particular Gene. Gene expression is the process by which inheritable information from a Gene, such as the DNA sequence, is made into a functional Gene product, such The coding region of a Gene is the portion of DNA or RNA that is transcribed into another RNA, such as a messenger RNA Proteins are large Organic compounds made of Amino acids arranged in a linear chain and joined together by Peptide bonds between the Carboxyl Disruption of a single gene may also result from integration of genomic material from a DNA virus or retrovirus, and such an event may also result in the expression of viral oncogenes in the affected cell and its descendants. A provirus is a Virus genome that has integrated itself into the DNA of a host cell. A DNA virus is a Virus that has DNA as its Genetic material and replicates using a DNA-dependent DNA polymerase. A retrovirus is any Virus belonging to the viral family Retroviridae.

Epigenetics

Epigenetics is the study of the regulation of gene expression through chemical, non-mutational changes in DNA structure. In Biology, the term epigenetics refers to changes in Gene expression caused by mechanisms other than changes in the underlying DNA sequence The theory of epigenetics in cancer pathogenesis is that non-mutational changes to DNA can lead to alterations in gene expression. In Biology, the term epigenetics refers to changes in Gene expression caused by mechanisms other than changes in the underlying DNA sequence Normally, oncogenes are silent, for example, because of DNA methylation. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. DNA methylation is a type of chemical modification of DNA that can be inherited and subsequently removed without changing the original DNA sequence Loss of that methylation can induce the aberrant expression of oncogenes, leading to cancer pathogenesis. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. Known mechanisms of epigenetic change include DNA methylation, and methylation or acetylation of histone proteins bound to chromosomal DNA at specific locations. DNA methylation is a type of chemical modification of DNA that can be inherited and subsequently removed without changing the original DNA sequence In Biology, histones are the chief Protein components of Chromatin. Classes of medications, known as HDAC inhibitors and DNA methyltransferase inhibitors, can re-regulate the epigenetic signaling in the cancer cell. Histone deacetylase inhibitors ( HDAC inhibitors, HDI) are a class of compounds that interfere with the function of Histone deacetylase.

Oncogenes

Oncogenes promote cell growth through a variety of ways. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. Many can produce hormones, a "chemical messenger" between cells which encourage mitosis, the effect of which depends on the signal transduction of the receiving tissue or cells. Hormones (from Greek ὁρμή - "impetus" are chemicals released by cells that affect cells in other parts of the body Mitosis is the process in which a Eukaryotic cell separates the Chromosomes in its Cell nucleus, into two identical sets in two daughter nuclei In Biology, signal transduction refers to any process by which a cell converts one kind of signal or stimulus into another In other words, when a hormone receptor on a recipient cell is stimulated, the signal is conducted from the surface of the cell to the cell nucleus to effect some change in gene transcription regulation at the nuclear level. In Cell biology, the nucleus (pl nuclei; from Latin la ''nucleus'' or la ''nuculeus'' "little nut" or kernel is a membrane-enclosed Some oncogenes are part of the signal transduction system itself, or the signal receptors in cells and tissues themselves, thus controlling the sensitivity to such hormones. In Biochemistry, a receptor is a Protein molecule embedded in either the Plasma membrane or Cytoplasm of a cell to which a mobile signaling Oncogenes often produce mitogens, or are involved in transcription of DNA in protein synthesis, which creates the proteins and enzymes responsible for producing the products and biochemicals cells use and interact with. A mitogen is a Chemical substance, usually some form of a Protein, that encourages a cell to commence Cell division, triggering Mitosis. Transcription is the synthesis of RNA under the direction of DNA Protein biosynthesis (synthesis is the process in which cells build Proteins The term is sometimes used to refer only to protein translation but more Proteins are large Organic compounds made of Amino acids arranged in a linear chain and joined together by Peptide bonds between the Carboxyl Enzymes are Biomolecules that catalyze ( ie increase the rates of Chemical reactions Almost all enzymes are Proteins Biochemistry is the study of the chemical processes in living Organisms It deals with the Structure and function of cellular components such as

Mutations in proto-oncogenes, which are the normally quiescent counterparts of oncogenes, can modify their expression and function, increasing the amount or activity of the product protein. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. Gene expression is the process by which inheritable information from a Gene, such as the DNA sequence, is made into a functional Gene product, such When this happens, the proto-oncogenes become oncogenes, and this transition upsets the normal balance of cell cycle regulation in the cell, making uncontrolled growth possible. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. The cell cycle, or cell-division cycle, is the series of events that take place in a eukaryotic cell leading to its replication The chance of cancer cannot be reduced by removing proto-oncogenes from the genome, even if this were possible, as they are critical for growth, repair and homeostasis of the organism. In classical genetics the genome of a Diploid Organism including Eukarya refers to a full set of chromosomes or genes in a Gamete, thereby Homeostasis (from Greek: ὅμος hómos, "equal" and ιστημι istēmi, "to stand" lit It is only when they become mutated that the signals for growth become excessive.

One of the first oncogenes to be defined in cancer research is the ras oncogene. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. In Molecular biology, Ras is the name of a Protein, the Gene that encodes it and the family and superfamily ( see Ras superfamily Mutations in the Ras family of proto-oncogenes (comprising H-Ras, N-Ras and K-Ras) are very common, being found in 20% to 30% of all human tumours. An oncogene is a protein encoding Gene, which — when deregulated — participates in the onset and development of Cancer. ^[18] Ras was originally identified in the Harvey sarcoma virus genome, and researchers were surprised that not only was this gene present in the human genome but that, when ligated to a stimulating control element, could induce cancers in cell line cultures. ^[19]

Tumor suppressor genes

Tumor suppressor genes code for anti-proliferation signals and proteins that suppress mitosis and cell growth. A tumor suppressor gene, or antioncogene is a Gene that protects a cell from one step on the path to cancer Generally, tumor suppressors are transcription factors that are activated by cellular stress or DNA damage. In the field of Molecular biology, a transcription factor (sometimes called a sequence-specific DNA binding factor is a Protein that binds to specific sequences Often DNA damage will cause the presence of free-floating genetic material as well as other signs, and will trigger enzymes and pathways which lead to the activation of tumor suppressor genes. A tumor suppressor gene, or antioncogene is a Gene that protects a cell from one step on the path to cancer The functions of such genes is to arrest the progression of the cell cycle in order to carry out DNA repair, preventing mutations from being passed on to daughter cells. The p53 protein, one of the most important studied tumor suppressor genes, is a transcription factor activated by many cellular stressors including hypoxia and ultraviolet radiation damage. p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene Chronic Hypoxia is a pathological condition in which the body as a whole ( generalized hypoxia) or region of the body ( tissue hypoxia) is deprived of adequate Ultraviolet ( UV) light is Electromagnetic radiation with a Wavelength shorter than that of Visible light, but longer than X-rays

Despite nearly half of all cancers possibly involving alterations in p53, its tumor suppressor function is poorly understood. p53 clearly has two functions: one a nuclear role as a transcription factor, and the other a cytoplasmic role in regulating the cell cycle, cell division, and apoptosis.

The Warburg hypothesis is the preferential use of glycolysis for energy to sustain cancer growth. Warburg's hypothesis was postulated by the Nobel laureate Otto Heinrich Warburg in 1924 p53 has been shown to regulate the shift from the respiratory to the glycolytic pathway. ^[20]

However, a mutation can damage the tumor suppressor gene itself, or the signal pathway which activates it, "switching it off". The invariable consequence of this is that DNA repair is hindered or inhibited: DNA damage accumulates without repair, inevitably leading to cancer.

Mutations of tumor suppressor genes that occur in germline cells are passed along to offspring, and increase the likelihood for cancer diagnoses in subsequent generations. In Biology and Genetics, the germline of a mature or developing individual is the line (sequence of Germ cells that have genetic material that In Biology, offspring are the product of Reproduction, a new Organism produced by one or more Parents Collective offspring may be known Members of these families have increased incidence and decreased latency of multiple tumors. The tumor types are typical for each type of tumor suppressor gene mutation, with some mutations causing particular cancers, and other mutations causing others. The mode of inheritance of mutant tumor suppressors is that an affected member inherits a defective copy from one parent, and a normal copy from the other. For instance, individuals who inherit one mutant p53 allele (and are therefore heterozygous for mutated p53) can develop melanomas and pancreatic cancer, known as Li-Fraumeni syndrome. p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene Zygosity refers to the genetic condition of a Zygote. In genetics zygosity describes the similarity or dissimilarity of DNA between Homologous Melanoma is a Malignant Tumor of Melanocytes which are found predominantly in skin but also in the Bowel and the Eye (see Pancreatic cancer is a malignant tumor of the Pancreas. Each year about 37680 individuals in the United States are diagnosed with this condition and 34290 Li-Fraumeni syndrome is a rare Autosomal dominant Hereditary disorder. Other inherited tumor suppressor gene syndromes include Rb mutations, linked to retinoblastoma, and APC gene mutations, linked to adenopolyposis colon cancer. The retinoblastoma protein (abbreviated pRb or Rb) is a Tumor suppressor Protein that is dysfunctional in many types of Cancer Retinoblastoma is a Cancer of the Retina. Development of this tumor is initiated by Mutations ref> that inactivate both copies of the RB1 Familial adenomatous polyposis ( FAP) is an inherited condition in which numerous polyps form mainly in the Epithelium of the large intestine. Familial adenomatous polyposis ( FAP) is an inherited condition in which numerous polyps form mainly in the Epithelium of the large intestine. Adenopolyposis colon cancer is associated with thousands of polyps in colon while young, leading to colon cancer at a relatively early age. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and Finally, inherited mutations in BRCA1 and BRCA2 lead to early onset of breast cancer. BRCA1 ( Breast cancer 1 early onset is a Human Gene, some mutations of which are associated with a significant increase in the risk of Breast cancer BRCA2 (Breast Cancer Type 2 susceptibility protein is a Human Gene that is involved in the repair of chromosomal Breast cancer is a Cancer that starts in the cells of the Breast in women and men

Development of cancer was proposed in 1971 to depend on at least two mutational events. In what became known as the Knudson two-hit hypothesis, an inherited, germ-line mutation in a tumor suppressor gene would only cause cancer if another mutation event occurred later in the organism's life, inactivating the other allele of that tumor suppressor gene. Alfred George Knudson Jr MD PhD (born in Los Angeles, 1922 is a geneticist specializing in the Cancer Genetics. The Knudson hypothesis is the Hypothesis that Cancer is the result of accumulated Mutations to a cell's DNA. A tumor suppressor gene, or antioncogene is a Gene that protects a cell from one step on the path to cancer An allele (ˈæliːl (UK /əˈliːl/ (US (from the Greek αλληλος allelos, meaning each other) is one member of a pair or series of different forms A tumor suppressor gene, or antioncogene is a Gene that protects a cell from one step on the path to cancer ^[21]

Usually, oncogenes are dominant, as they contain gain-of-function mutations, while mutated tumor suppressors are recessive, as they contain loss-of-function mutations. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism Each cell has two copies of the same gene, one from each parent, and under most cases gain of function mutations in just one copy of a particular proto-oncogene is enough to make that gene a true oncogene. On the other hand, loss of function mutations need to happen in both copies of a tumor suppressor gene to render that gene completely non-functional. However, cases exist in which one mutated copy of a tumor suppressor gene can render the other, wild-type copy non-functional. A tumor suppressor gene, or antioncogene is a Gene that protects a cell from one step on the path to cancer A mutant is an individual organism or new genetic character arising or resulting from an instance of Mutation, which is a base-pair sequence change within the DNA This phenomenon is called the dominant negative effect and is observed in many p53 mutations.

Knudson’s two hit model has recently been challenged by several investigators. Inactivation of one allele of some tumor suppressor genes is sufficient to cause tumors. This phenomenon is called haploinsufficiency and has been demonstrated by a number of experimental approaches. Haploinsufficiency occurs when a Diploid organism only has a single functional copy of a gene (with the other copy inactivated by Mutation) and the single Tumors caused by haploinsufficiency usually have a later age of onset when compared with those by a two hit process. Haploinsufficiency occurs when a Diploid organism only has a single functional copy of a gene (with the other copy inactivated by Mutation) and the single ^[22]

Cancer cell biology

Often, the multiple genetic changes which result in cancer may take many years to accumulate. During this time, the biological behavior of the pre-malignant cells slowly change from the properties of normal cells to cancer-like properties. Pre-malignant tissue can have a distinctive appearance under the microscope. A microscope ( Greek: ( micron) = small + ( skopein) = to look or see is an instrument for viewing objects that are Among the distinguishing traits are an increased number of dividing cells, variation in nuclear size and shape, variation in cell size and shape, loss of specialized cell features, and loss of normal tissue organization. In Cell biology, the nucleus (pl nuclei; from Latin la ''nucleus'' or la ''nuculeus'' "little nut" or kernel is a membrane-enclosed Dysplasia is an abnormal type of excessive cell proliferation characterized by loss of normal tissue arrangement and cell structure in pre-malignant cells. Dysplasia (from Greek roughly "bad formation" is a term used in Pathology to refer to an abnormality in maturation of cells within a tissue These early neoplastic changes must be distinguished from hyperplasia, a reversible increase in cell division caused by an external stimulus, such as a hormonal imbalance or chronic irritation.

The most severe cases of dysplasia are referred to as "carcinoma in situ. Carcinoma in situ (CIS is an early form of Carcinoma defined by the absence of invasion of surrounding tissues " In Latin, the term "in situ" means "in place", so carcinoma in situ refers to an uncontrolled growth of cells that remains in the original location and has not shown invasion into other tissues. Nevertheless, carcinoma in situ may develop into an invasive malignancy and is usually removed surgically, if possible.

Clonal evolution

The process of malignancy can be explained from an evolutionary perspective. Millions of years of biological evolution insure that the cellular metabolic changes that enable cancer to grow occur only very rarely. eVolution is the third Album by eLDee, it was due to be released in 2008 Most changes in cellular metabolism that allow cells to grow in a disorderly fashion lead to cell death. Cancer cells undergo a process analogous to natural selection, in that the few cells with new genetic changes that enhance their survival continue to multiply, and soon come to dominate the growing tumor, as cells with less favorable genetic change are outcompeted. Natural selection is the process by which favorable Heritable traits become more common in successive Generations of a Population of This process is called clonal evolution. Tumors often continue to evolve in response to chemotherapy treatments, and on occasion aberrant cells may acquire resistance to particular anti-cancer pharmaceuticals.

Biological properties of cancer cells

In a 2000 article by Hanahan and Weinberg, the biological properties of malignant tumor cells were summarized as follows:^[23]

• Acquisition of self-sufficiency in growth signals, leading to unchecked growth. Robert Allan Weinberg is a Daniel K Ludwig Professor for Cancer Research at MIT and American Cancer Society Research Professor his research is in the area of Oncogenes The term growth factor refers to a naturally occurring Protein capable of stimulating cellular growth proliferation and Cellular differentiation.
• Loss of sensitivity to anti-growth signals, also leading to unchecked growth.
• Loss of capacity for apoptosis, in order to allow growth despite genetic errors and external anti-growth signals.
• Loss of capacity for senescence, leading to limitless replicative potential (immortality)
• Acquisition of sustained angiogenesis, allowing the tumor to grow beyond the limitations of passive nutrient diffusion. Senescence refers to the biological processes of a living Organism approaching an advanced age (i Angiogenesis is a physiological process involving the growth of new Blood vessels from pre-existing vessels
• Acquisition of ability to invade neighbouring tissues, the defining property of invasive carcinoma. Tissue is a cellular organizational level intermediate between cells and a complete organism
• Acquisition of ability to build metastases at distant sites, the classical property of malignant tumors (carcinomas or others). Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets,

The completion of these multiple steps would be a very rare event without :

• Loss of capacity to repair genetic errors, leading to an increased mutation rate (genomic instability), thus accelerating all the other changes. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism

These biological changes are classical in carcinomas; other malignant tumor may not need all to achieve them all. A carcinoma is any Malignant Cancer that arises from epithelial cells. For example, tissue invasion and displacement to distant sites are normal properties of leukocytes; these steps are not needed in the development of Leukemia. Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood The different steps do not necessarily represent individual mutations. For example, inactivation of a single gene, coding for the P53 protein, will cause genomic instability, evasion of apoptosis and increased angiogenesis. p53 (also known as protein 53 or tumor protein 53) is a Transcription factor encoded by the TP53 gene

Prevention

Cancer prevention is defined as active measures to decrease the incidence of cancer. This can be accomplished by avoiding carcinogens or altering their metabolism, pursuing a lifestyle or diet that modifies cancer-causing factors and/or medical intervention (chemoprevention, treatment of pre-malignant lesions). The term carcinogen refers to any substance Radionuclide or radiation that is an agent directly involved in the promotion of Cancer or in the fatation of its propagation Metabolism is the set of Chemical reactions that occur in living Organisms in order to maintain Life. Chemoprophylaxis refers to the administration of a Medication for the purpose of preventing Disease or Infection. The epidemiological concept of "prevention" is usually defined as either primary prevention, for people who have not been diagnosed with a particular disease, or secondary prevention, aimed at reducing recurrence or complications of a previously diagnosed illness. Epidemiology is the study of factors affecting the Health and Illness of populations and serves as the foundation and Logic of interventions made in the In Medicine, prevention is any activity which reduces the burden of mortality or morbidity from Disease. In Medicine, prevention is any activity which reduces the burden of mortality or morbidity from Disease.

Observational epidemiological studies that show associations between risk factors and specific cancers mostly serve to generate hypotheses about potential interventions that could reduce cancer incidence or morbidity. In Statistics, an observational study draws inferences about the effect of a treatment on subjects where the assignment of subjects into a treated group versus a Control In Medicine, Epidemiology and Actuarial science, the term morbidity can refer to the state of poor health (from Latin Randomized controlled trials then test whether hypotheses generated by epidemiological trials and laboratory research actually result in reduced cancer incidence and mortality. A randomized controlled trial (RCT is a type of scientific Experiment most commonly used in testing the Efficacy or Effectiveness of Healthcare In many cases, findings from observational epidemiological studies are not confirmed by randomized controlled trials. Epidemiology is the study of factors affecting the Health and Illness of populations and serves as the foundation and Logic of interventions made in the

About a third of the twelve most common cancers worldwide are due to nine potentially modifiable risk factors. Men with cancer are twice as likely as women to have a modifiable risk factor for their disease. The nine risk factors are tobacco smoking, excessive alcohol use, diet low in fruit and vegetables, limited physical exercise, human papillomavirus infection (unsafe sex), urban air pollution, domestic use of solid fuels, and contaminated injections (hepatitis B and C). Tobacco Smoking is the inhalation of smoke from burned dried or cured leaves of the Tobacco plant most often in the form of a Cigarette. The term fruit has different meanings dependent on context and the term is not synonymous in Food preparation and Biology. The term " vegetable " generally means the edible parts of Plants The definition of the word is traditional rather than Scientific, however A human papillomavirus ( HPV) is a Papillomavirus that infects the skin and Mucous membranes of Humans Approximately 130 HPV types have been Air pollution is the human introduction into the atmosphere of Chemicals Particulate matter, or Biological materials that cause harm or discomfort ^[24]

Modifiable ("lifestyle") risk factors

Examples of modifiable cancer risk factors include alcohol consumption (associated with increased risk of oral, esophageal, breast, and other cancers), smoking (although 20% of women with lung cancer have never smoked, versus 10% of men^[25]), physical inactivity (associated with increased risk of colon, breast, and possibly other cancers), and being overweight (associated with colon, breast, endometrial, and possibly other cancers). In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected Based on epidemiologic evidence, it is now thought that avoiding excessive alcohol consumption may contribute to reductions in risk of certain cancers; however, compared with tobacco exposure, the magnitude of effect is modest or small and the strength of evidence is often weaker. Other lifestyle and environmental factors known to affect cancer risk (either beneficially or detrimentally) include certain sexually transmitted diseases, the use of exogenous hormones, exposure to ionizing radiation and ultraviolet radiation, and certain occupational and chemical exposures. Image talkNew_radiation_symbol_ISO_21482svg for details --> Ionizing radiation Ultraviolet ( UV) light is Electromagnetic radiation with a Wavelength shorter than that of Visible light, but longer than X-rays

Every year, at least 200,000 people die worldwide from cancer related to their workplace. ^[26] Millions of workers run the risk of developing cancers such as lung cancer and mesothelioma from inhaling asbestos fibers and tobacco smoke, or leukemia from exposure to benzene at their workplaces. Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Mesothelioma is a form of Cancer that is almost always caused by previous exposure to Asbestos. Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood Benzene, or benzol, is an organic Chemical compound and a known Carcinogen with the molecular formula C 6 H 6 ^[26] Currently, most cancer deaths caused by occupational risk factors occur in the developed world. ^[26] It is estimated that approximately 20,000 cancer deaths and 40,000 new cases of cancer each year in the U. S. are attributable to occupation. ^[27]

See alcohol and cancer for more on that topic. "Considerable evidence suggests a connection between heavy alcohol consumption and increased risk for cancer with an estimated 2 to 4 percent of all cancer cases thought to be caused either

Diet

Main article: Diet and cancer

The consensus on diet and cancer is that obesity increases the risk of developing cancer. Dietary patterns foods nutrients and other dietary constituents are closely associated with the risk for several types of Cancer. Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected Particular dietary practices often explain differences in cancer incidence in different countries (e. g. gastric cancer is more common in Japan, while colon cancer is more common in the United States). Stomach or gastric cancer can develop in any part of the Stomach and may spread throughout the stomach and to other organs particularly the Esophagus and For a topic outline on this subject see List of basic Japan topics. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and Studies have shown that immigrants develop the risk of their new country, often within one generation, suggesting a substantial link between diet and cancer. ^[28] Whether reducing obesity in a population also reduces cancer incidence is unknown.

Despite frequent reports of particular substances (including foods) having a beneficial or detrimental effect on cancer risk, few of these have an established link to cancer. These reports are often based on studies in cultured cell media or animals. Public health recommendations cannot be made on the basis of these studies until they have been validated in an observational (or occasionally a prospective interventional) trial in humans.

Proposed dietary interventions for primary cancer risk reduction generally gain support from epidemiological association studies. Examples of such studies include reports that reduced meat consumption is associated with decreased risk of colon cancer,^[29] and reports that consumption of coffee is associated with a reduced risk of liver cancer. ^[30] Studies have linked consumption of grilled meat to an increased risk of stomach cancer,^[31] colon cancer,^[32] breast cancer,^[33] and pancreatic cancer,^[34] a phenomenon which could be due to the presence of carcinogens such as benzopyrene in foods cooked at high temperatures. Stomach or gastric cancer can develop in any part of the Stomach and may spread throughout the stomach and to other organs particularly the Esophagus and Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and Breast cancer is a Cancer that starts in the cells of the Breast in women and men Pancreatic cancer is a malignant tumor of the Pancreas. Each year about 37680 individuals in the United States are diagnosed with this condition and 34290 Benzopyrene, C20H12 is a five-ring Polycyclic aromatic hydrocarbon that is Mutagenic and highly Carcinogenic It is a crystalline

A 2005 secondary prevention study showed that consumption of a plant-based diet and lifestyle changes resulted in a reduction in cancer markers in a group of men with prostate cancer who were using no conventional treatments at the time. In Medicine, prevention is any activity which reduces the burden of mortality or morbidity from Disease. ^[35] These results were amplified by a 2006 study in which over 2,400 women were studied, half randomly assigned to a normal diet, the other half assigned to a diet containing less than 20% calories from fat. The women on the low fat diet were found to have a markedly lower risk of breast cancer recurrence, in the interim report of December, 2006. ^[36]

Recent studies have also demonstrated potential links between some forms of cancer and high consumption of refined sugars and other simple carbohydrates. ^{[37][38][39][40][41]} Although the degree of correlation and the degree of causality is still debated,^[42][43][44] some organizations have in fact begun to recommend reducing intake of refined sugars and starches as part of their cancer prevention regemins. ^{[45][46][47][48]}

Vitamins

There is a concept that cancer can be prevented through vitamin supplementation stems from early observations correlating human disease with vitamin deficiency, such as pernicious anemia with vitamin B12 deficiency, and scurvy with Vitamin C deficiency. Pernicious anemia (also known as Biermer's anemia, Addison's anemia, or Addison-Biermer anemia) is a form of Megaloblastic anemia due to Scurvy (NLat scorbutus is a disease resulting from a deficiency of Vitamin C, which is required for the synthesis of Collagen in humans Vitamin C or L-ascorbate is an Essential nutrient for a large number of higher primate species a small number of other Mammalian This has largely not been proven to be the case with cancer, and vitamin supplementation is largely not proving effective in preventing cancer. The cancer-fighting components of food are also proving to be more numerous and varied than previously understood, so patients are increasingly being advised to consume fresh, unprocessed fruits and vegetables for maximal health benefits. ^[49]

The Canadian Cancer Society has advised Canadians that the intake of vitamin D has shown a reduction of cancers by close to 60%,^[50] and at least one study has shown a specific benefit for this vitamin in preventing colon cancer. Vitamin D is a group of fat-soluble Prohormones, the two major forms of which are vitamin D2 (or Ergocalciferol) and vitamin D3 (or ^[51]

Vitamin D and its protective effect against cancer has been contrasted with the risk of malignancy from sun exposure. Since exposure to the sun enhances natural human production of vitamin D, some cancer researchers have argued that the potential deleterious malignant effects of sun exposure are far outweighed by the cancer-preventing effects of extra vitamin D synthesis in sun-exposed skin. In 2002, Dr. William B. Grant claimed that 23,800 premature cancer deaths occur in the US annually due to insufficient UVB exposure (apparently via vitamin D deficiency). ^[52] This is higher than 8,800 deaths occurred from melanoma or squamous cell carcinoma, so the overall effect of sun exposure might be beneficial. Another research group^[53][54] estimates that 50,000–63,000 individuals in the United States and 19,000 - 25,000 in the UK die prematurely from cancer annually due to insufficient vitamin D.

The case of beta-carotene provides an example of the importance of randomized clinical trials. Beta-carotene is an Organic compound - a Terpenoid, a red-orange pigment abundant in plants and fruits In health care clinical trials are conducted to allow safety and Efficacy data to be collected for new drugs or devices Epidemiologists studying both diet and serum levels observed that high levels of beta-carotene, a precursor to vitamin A, were associated with a protective effect, reducing the risk of cancer. Epidemiology is the study of factors affecting the Health and Illness of populations and serves as the foundation and Logic of interventions made in the Beta-carotene is an Organic compound - a Terpenoid, a red-orange pigment abundant in plants and fruits Vitamin A refers to a family of similarly shaped molecules the Retinoids. This effect was particularly strong in lung cancer. Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. This hypothesis led to a series of large randomized clinical trials conducted in both Finland and the United States (CARET study) during the 1980s and 1990s. A hypothesis (from Greek) consists either of a suggested explanation for a phenomenon (an event that is observable or of a reasoned proposal suggesting a possible In health care clinical trials are conducted to allow safety and Efficacy data to be collected for new drugs or devices Finland, officially the Republic of Finland ( is a Nordic country situated in the Fennoscandian region of northern Europe. The United States of America —commonly referred to as the This study provided about 80,000 smokers or former smokers with daily supplements of beta-carotene or placebos. Placebo is a substance or procedure a patient accepts as medicine or therapy but which has no specific therapeutic activity Contrary to expectation, these tests found no benefit of beta-carotene supplementation in reducing lung cancer incidence and mortality. Beta-carotene is an Organic compound - a Terpenoid, a red-orange pigment abundant in plants and fruits In fact, the risk of lung cancer was slightly, but not significantly, increased by beta-carotene, leading to an early termination of the study. ^[55]

Results reported in the Journal of the American Medical Association (JAMA) in 2007 indicate that folic acid supplementation is not effective in preventing colon cancer, and folate consumers may be more likely to form colon polyps. JAMA The Journal of the American Medical Association is an international peer-reviewed general Medical journal, published 48 times per year by the American ^[56]

Chemoprevention

The concept that medications could be used to prevent cancer is an attractive one, and many high-quality clinical trials support the use of such chemoprevention in defined circumstances.

Daily use of tamoxifen, a selective estrogen receptor modulator (SERM), typically for 5 years, has been demonstrated to reduce the risk of developing breast cancer in high-risk women by about 50%. Tamoxifen is an orally active Selective estrogen receptor modulator (SERM that is used in the treatment of Breast cancer and is currently the world's largest Selective Estrogen Receptor Modulators ( SERMs) are a class of Medication that acts on the Estrogen receptor. Breast cancer is a Cancer that starts in the cells of the Breast in women and men A recent study reported that the selective estrogen receptor modulator raloxifene has similar benefits to tamoxifen in preventing breast cancer in high-risk women, with a more favorable side effect profile. Selective Estrogen Receptor Modulators ( SERMs) are a class of Medication that acts on the Estrogen receptor. Raloxifene is an oral Selective estrogen receptor modulator (SERM that has estrogenic actions on bone and anti-estrogenic actions on the uterus and breast Tamoxifen is an orally active Selective estrogen receptor modulator (SERM that is used in the treatment of Breast cancer and is currently the world's largest ^[57]

Raloxifene is a SERM like tamoxifen; it has been shown (in the STAR trial) to reduce the risk of breast cancer in high-risk women equally as well as tamoxifen. Raloxifene is an oral Selective estrogen receptor modulator (SERM that has estrogenic actions on bone and anti-estrogenic actions on the uterus and breast Tamoxifen is an orally active Selective estrogen receptor modulator (SERM that is used in the treatment of Breast cancer and is currently the world's largest In this trial, which studied almost 20,000 women, raloxifene had fewer side effects than tamoxifen, though it did permit more DCIS to form. Raloxifene is an oral Selective estrogen receptor modulator (SERM that has estrogenic actions on bone and anti-estrogenic actions on the uterus and breast Tamoxifen is an orally active Selective estrogen receptor modulator (SERM that is used in the treatment of Breast cancer and is currently the world's largest ^[57]

Finasteride, a 5-alpha-reductase inhibitor, has been shown to lower the risk of prostate cancer, though it seems to mostly prevent low-grade tumors. Finasteride (marketed as Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, 5α-reductase inhibitors (or 5-alpha-reductase inhibitors) are a group of drugs with Antiandrogenic activity used in the treatment of Benign prostatic ^[58] The effect of COX-2 inhibitors such as rofecoxib and celecoxib upon the risk of colon polyps have been studied in familial adenomatous polyposis patients^[59] and in the general population. COX-2 selective inhibitor is a form of Non-steroidal anti-inflammatory drug (NSAID that directly targets COX-2, an Enzyme responsible for Inflammation Rofecoxib (Rofecoxib is a nonsteroidal anti-inflammatory drug ( NSAID) marketed by Merck & Co Celecoxib ( INN) (sɛlɨˈkɒksɪb is a Non-steroidal anti-inflammatory drug (NSAID used in the treatment of Osteoarthritis, Rheumatoid arthritis Familial adenomatous polyposis ( FAP) is an inherited condition in which numerous polyps form mainly in the Epithelium of the large intestine. ^[60][61] In both groups, there were significant reductions in colon polyp incidence, but this came at the price of increased cardiovascular toxicity. A colorectal polyp (or colon polyp) is a fleshy growth ( polyp) occurring on the lining of the Colon or Rectum. Incidence is a measure of the risk of developing some new condition within a specified period of time

Genetic testing

Genetic testing for high-risk individuals is already available for certain cancer-related genetic mutations. Genetic testing allows the genetic Diagnosis of vulnerabilities to inherited Diseases, and can also be used to determine a person's Ancestry. Carriers of genetic mutations that increase risk for cancer incidence can undergo enhanced surveillance, chemoprevention, or risk-reducing surgery. Early identification of inherited genetic risk for cancer, along with cancer-preventing interventions such as surgery or enhanced surveillance, can be lifesaving for high-risk individuals.

Gene	Cancer types	Availability
BRCA1, BRCA2	Breast, ovarian, pancreatic	Commercially available for clinical specimens
MLH1, MSH2, MSH6, PMS1, PMS2	Colon, uterine, small bowel, stomach, urinary tract	Commercially available for clinical specimens

Vaccination

Considerable research effort is now devoted to the development of vaccines to prevent infection by oncogenic infectious agents, as well as to mount an immune response against cancer-specific epitopes) and to potential venues for gene therapy for individuals with genetic mutations or polymorphisms that put them at high risk of cancer. BRCA1 ( Breast cancer 1 early onset is a Human Gene, some mutations of which are associated with a significant increase in the risk of Breast cancer BRCA2 (Breast Cancer Type 2 susceptibility protein is a Human Gene that is involved in the repair of chromosomal MutL homolog 1 colon cancer nonpolyposis type 2 (E coli, also known as MLH1, is a human Gene. MSH2 is a Gene commonly associated with Hereditary nonpolyposis colorectal cancer. MSH6 is a Gene commonly associated with Hereditary nonpolyposis colorectal cancer. PMS1 postmeiotic segregation increased 1 (S cerevisiae, also known as PMS1, is a human Gene. PMS2 postmeiotic segregation increased 2 (S cerevisiae, also known as PMS2, is a human Gene. A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease An epitope, also known as antigenic determinant, is the part of a Macromolecule that is recognized by the Immune system, specifically by antibodies Gene therapy is the insertion of Genes into an individual's cells and tissues to treat a Disease, and Hereditary diseases in which a

As reported above, a preventive human papillomavirus vaccine exists that targets certain sexually transmitted strains of human papillomavirus that are associated with the development of cervical cancer and genital warts. Human papillomavirus (HPV vaccine is a Vaccine that targets certain strains of Human papillomavirus associated with the development of Cervical A human papillomavirus ( HPV) is a Papillomavirus that infects the skin and Mucous membranes of Humans Approximately 130 HPV types have been Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area Genital warts (or Condyloma, Condylomata acuminata, or venereal warts) is a highly contagious Sexually transmitted The only two HPV vaccines on the market as of October 2007 are Gardasil and Cervarix. October 2007 is the tenth month of that year It began on a Monday and 31 days later ended on a Wednesday. Gardasil ( Merck & Co) is a Vaccine against certain types of Human papillomavirus (HPV Cervarix is a Vaccine against certain types of the Human papillomavirus (HPV

Screening

Cancer screening is an attempt to detect unsuspected cancers in an asymptomatic population. Screening, in medicine is a strategy used in a Population to detect a Disease in individuals without signs or Symptoms of that disease Screening tests suitable for large numbers of healthy people must be relatively affordable, safe, noninvasive procedures with acceptably low rates of false positive results. In Statistics, the terms Type I error (also α error, or false positive) and type II error ( β error, or a false negative If signs of cancer are detected, more definitive and invasive follow up tests are performed to confirm the diagnosis.

Screening for cancer can lead to earlier diagnosis in specific cases. Early diagnosis may lead to extended life, but may also falsely prolong the lead time to death through lead time bias or length time bias. Lead time is the length of time between the detection of a disease (usually based on new experimental criteria and its usual clinical presentation and diagnosis (based on traditional Length time bias is a form of Selection bias, a statistical distortion of results which can lead to incorrect conclusions about the data

A number of different screening tests have been developed for different malignancies. Breast cancer screening can be done by breast self-examination, though this approach was discredited by a 2005 study in over 300,000 Chinese women. Breast self-examination (BSE is an easy but unreliable method for finding possible Breast cancer. Screening for breast cancer with mammograms has been shown to reduce the average stage of diagnosis of breast cancer in a population. Mammography is the process of using low-dose X-rays (usually around 0 Stage of diagnosis in a country has been shown to decrease within ten years of introduction of mammographic screening programs. Colorectal cancer can be detected through fecal occult blood testing and colonoscopy, which reduces both colon cancer incidence and mortality, presumably through the detection and removal of pre-malignant polyps. Faecal occult blood is a term for Blood present in the Faeces that is not visibly apparent Colonoscopy is the endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a Fiber optic Similarly, cervical cytology testing (using the Pap smear) leads to the identification and excision of precancerous lesions. The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in Gynecology Over time, such testing has been followed by a dramatic reduction of cervical cancer incidence and mortality. Cervical cancer is Malignant Cancer of the Cervix uteri or cervical area Testicular self-examination is recommended for men beginning at the age of 15 years to detect testicular cancer. Because Testicular cancer is a significant killer of teenage boys and grown men doctors recommend monthly self-examination Testicular cancer is Cancer that develops in the Testicles a part of the Male reproductive system Prostate cancer can be screened using a digital rectal exam along with prostate specific antigen (PSA) blood testing, though some authorities (such as the US Preventive Services Task Force) recommend against routinely screening all men. A rectal examination or rectal exam is an internal examination of the Rectum such as by a Physician or other healthcare professional Prostate specific antigen ( PSA) is a protein produced by the cells of the Prostate gland

Screening for cancer is controversial in cases when it is not yet known if the test actually saves lives. The controversy arises when it is not clear if the benefits of screening outweigh the risks of follow-up diagnostic tests and cancer treatments. For example: when screening for prostate cancer, the PSA test may detect small cancers that would never become life threatening, but once detected will lead to treatment. Prostate specific antigen ( PSA) is a protein produced by the cells of the Prostate gland This situation, called overdiagnosis, puts men at risk for complications from unnecessary treatment such as surgery or radiation. Follow up procedures used to diagnose prostate cancer (prostate biopsy) may cause side effects, including bleeding and infection. Prostate Biopsy is a procedure in which small samples are removed from a man's Prostate gland to be tested for the presence of cancer Prostate cancer treatment may cause incontinence (inability to control urine flow) and erectile dysfunction (erections inadequate for intercourse). Urinary incontinence ( UI) is any involuntary leakage of Urine. Similarly, for breast cancer, there have recently been criticisms that breast screening programs in some countries cause more problems than they solve. Breast cancer is a Cancer that starts in the cells of the Breast in women and men This is because screening of women in the general population will result in a large number of women with false positive results which require extensive follow-up investigations to exclude cancer, leading to having a high number-to-treat (or number-to-screen) to prevent or catch a single case of breast cancer early.

Cervical cancer screening via the Pap smear has the best cost-benefit profile of all the forms of cancer screening from a public health perspective as, being largely caused by a virus, it has clear risk factors (sexual contact), and the natural progression of cervical cancer is that it normally spreads slowly over a number of years therefore giving more time for the screening program to catch it early. The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in Gynecology Moreover, the test itself is easy to perform and relatively cheap.

For these reasons, it is important that the benefits and risks of diagnostic procedures and treatment be taken into account when considering whether to undertake cancer screening.

Use of medical imaging to search for cancer in people without clear symptoms is similarly marred with problems. Medical imaging refers to the techniques and processes used to create Images of the human body (or parts thereof for clinical purposes ( Medical procedures seeking to There is a significant risk of detection of what has been recently called an incidentaloma - a benign lesion that may be interpreted as a malignancy and be subjected to potentially dangerous investigations. In Medicine, an incidentaloma is a Tumor ( -oma) found by coincidence ( incidental) without clinical Symptoms or suspicion Recent studies of CT scan-based screening for lung cancer in smokers have had equivocal results, and systematic screening is not recommended as of July 2007. Computed tomography (CT is a Medical imaging method employing Tomography. Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Randomized clinical trials of plain-film chest X-rays to screen for lung cancer in smokers have shown no benefit for this approach. A randomized controlled trial (RCT is a type of scientific Experiment most commonly used in testing the Efficacy or Effectiveness of Healthcare A chest X-ray, commonly abbreviated CXR, is a projection radiograph ( X-ray) taken by a Radiographer, of the Thorax which is used

Canine cancer detection has shown promise, but is still in the early stages of research. Canine cancer detection is an approach to Cancer screening that relies upon the olfactory ability of Dogs to detect very low concentrations of the

Epidemiology

Cancer epidemiology is the study of the incidence of cancer as a way to infer possible trends and causes. Epidemiology is the study of factors affecting the Health and Illness of populations and serves as the foundation and Logic of interventions made in the The first such cause of cancer was identified by British surgeon Percivall Pott, who discovered in 1775 that cancer of the scrotum was a common disease among chimney sweeps. Percivall Pott ( January 6, 1714 &ndash December 22, 1788, London, England) was an English surgeon, one of In some Male Mammals the scrotum - also 'scrutum' or 'scrootum' - is a protuberance of Skin and Muscle containing the Testicles A chimney sweep is a person who cleans Chimneys for a living History The occupation of chimney sweep is considered to be one of the oldest in the world as The work of other individual physicians led to various insights, but when physicians started working together they could make firmer conclusions.

A founding paper of this discipline was the work of Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health. Janet Elizabeth Lane-Claypon (1877–1967 was an English physician and one of the founders of the science of Epidemiology, pioneering the use of so-called cohort studies Her ground-breaking work on cancer epidemiology was carried on by Richard Doll and Austin Bradford Hill, who published "Lung Cancer and Other Causes of Death In Relation to Smoking. Sir William Richard Shaboe Doll CH OBE FRS ( 28 October 1912 &ndash 24 July 2005) was a British Sir Austin Bradford Hill FRS ( July 8, 1897 - April 18, 1991) English Epidemiologist and Statistician Lung cancer is a Disease of uncontrolled Cell growth in tissues of the Lung. Smoking is a practice where a substance most commonly Tobacco, is burned and the Smoke tasted or inhaled A Second Report on the Mortality of British Doctors" followed in 1956 (otherwise known as the British doctors study). The British doctors study is the generally accepted name of a Prospective Cohort study which has been running from 1951 to 2001 and in 1956 provided convincing statistical Richard Doll left the London Medical Research Center (MRC), to start the Oxford unit for Cancer epidemiology in 1968. London ( ˈlʌndən is the capital and largest urban area in the United Kingdom. Oxford is currently bidding for the 2010 Wikimania Conference Oxford () is a city, and the County town of Oxfordshire, With the use of computers, the unit was the first to compile large amounts of cancer data. A computer is a Machine that manipulates data according to a list of instructions. Modern epidemiological methods are closely linked to current concepts of disease and public health policy. Public health is "the science and art of preventing disease prolonging life and promoting health through the organised efforts and informed choices of society organisations Over the past 50 years, great efforts have been spent on gathering data across medical practise, hospital, provincial, state, and even country boundaries, as a way to study the interdependence of environmental and cultural factors on cancer incidence.

Cancer epidemiology must contend with problems of lead time bias and length time bias. Lead time is the length of time between the detection of a disease (usually based on new experimental criteria and its usual clinical presentation and diagnosis (based on traditional Lead time bias is the concept that early diagnosis may artificially inflate the survival statistics of a cancer, without really improving the natural history of the disease. Length bias is the concept that slower growing, more indolent tumors are more likely to be diagnosed by screening tests, but improvements in diagnosing more cases of indolent cancer may not translate into better patient outcomes after the implementation of screening programs. A similar epidemiological concern is overdiagnosis, the tendency of screening tests to diagnose diseases that may not actually impact the patient's longevity. Overdiagnosis is the Diagnosis of "disease" that will never cause Symptoms or death during a Patient 's lifetime This problem especially applies to prostate cancer and PSA screening. ^[62]

Some cancer researchers have argued that negative cancer clinical trials lack sufficient statistical power to discover a benefit to treatment. The power of a statistical test is the probability that the test will reject a false Null hypothesis (that it will not make a Type II error) This may be due to fewer patients enrolled in the study than originally planned. ^[63]

State and regional cancer registries are organizations that abstract clinical data about cancer from patient medical records. A cancer registry is a systematic collection of data about Cancer and Tumor diseases These institutions provide information to state and national public health groups to help track trends in cancer diagnosis and treatment. One of the largest and most important cancer registries is SEER, administered by the US Federal government. A cancer registry is a systematic collection of data about Cancer and Tumor diseases The federal government of the United States is the central United States Governmental body established by the United States Constitution. ^[64] Health information privacy concerns have led to the restricted use of cancer registry data in the United States Department of Veterans Affairs^[65][66][67] and other institutions. A cancer registry is a systematic collection of data about Cancer and Tumor diseases The United States Department of Veterans Affairs ( VA) is a government-run military Veteran benefit system with Cabinet -level status ^[68]

In some Western countries, such as the USA,^[4] and the UK^[69] cancer is overtaking cardiovascular disease as the leading cause of death. Cardiovascular disease or cardiovascular diseases refers to the class of diseases that involve the Heart or Blood vessels ( arteries and In many Third World countries cancer incidence (insofar as this can be measured) appears much lower, most likely because of the higher death rates due to infectious disease or injury. Third World is a name given to nations that are generally considered to be underdeveloped economically With the increased control over malaria and tuberculosis in some Third World countries, incidence of cancer is expected to rise; this is termed the epidemiologic transition in epidemiological terminology. Malaria is a vector -borne Infectious disease caused by Protozoan Parasites It is widespread in tropical and subtropical regions including Tuberculosis (abbreviated as TB for tubercle bacillus or T u' b' erculosis Bacillus --> is a common Epidemiology is the study of factors affecting the Health and Illness of populations and serves as the foundation and Logic of interventions made in the

Cancer epidemiology closely mirrors risk factor spread in various countries. Hepatocellular carcinoma (liver cancer) is rare in the West but is the main cancer in China and neighbouring countries, most likely due to the endemic presence of hepatitis B and aflatoxin in that population. Hepatocellular carcinoma (HCC also called hepatoma) is a primary malignancy (cancer of the Liver. The liver is a vital organ in the human body and is present in Vertebrates and some other animals China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National In Epidemiology, an Infection is said to be endemic (from Greek en- in or within + demos people in a Population when Aflatoxins are naturally occurring Mycotoxins that are produced by many species of Aspergillus, a Fungus, most notably Aspergillus Similarly, with tobacco smoking becoming more common in various Third World countries, lung cancer incidence has increased in a parallel fashion. Tobacco Smoking is the inhalation of smoke from burned dried or cured leaves of the Tobacco plant most often in the form of a Cigarette. lung is the essential Respiration organ in air-breathing Animals including most Tetrapods a few Fish and a few Snails The most primitive

History

Today, the Greek term carcinoma is the medical term for a malignant tumor derived from epithelial cells. A carcinoma is any Malignant Cancer that arises from epithelial cells. In biology and medicine epithelium is a tissue composed of cells that line the cavities and surfaces of structures throughout the body It is Celsus who translated carcinos into the Latin cancer, also meaning crab. Aulus Cornelius Celsus (ca 25 BC—ca 50 was a Roman encyclopedist and Physician. Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. Galen used "oncos" to describe all tumours, the root for the modern word oncology. Galen ( Greek: Γαληνός Galēnos; Latin: Claudius Galenus, Aelius Galenus, Claudius Aelius Galenus, or Oncology is the branch of medicine that studies Tumors ( Cancer) and seeks to understand their development diagnosis treatment and prevention ^[70]

Hippocrates described several kinds of cancers. Hippocrates of Cos II or Hippokrates of Kos ( ca. 460 BC – ca He called benign tumours oncos, Greek for swelling, and malignant tumours carcinos, Greek for crab or crayfish. Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly Crabs are decapod Crustaceans of the infraorder Brachyura, which typically have a very short projecting "tail" (βραχύ / brachy Crayfish, crawfish, crawdads, or crodgers are freshwater Crustaceans resembling small Lobsters to which they are closely This name comes from the appearance of the cut surface of a solid malignant tumour, with the veins stretched on all sides as the animal the crab has its feet, whence it derives its name^[71] (see picture). He later added the suffix -oma, Greek for swelling, giving the name carcinoma. Since it was against Greek tradition to open the body, Hippocrates only described and made drawings of outwardly visible tumors on the skin, nose, and breasts. Treatment was based on the humor theory of four bodily fluids (black and yellow bile, blood, and phlegm). Humorism, or humoralism, was a theory of the makeup and workings of the human body adopted by Greek and Roman physicians and philosophers According to the patient's humor, treatment consisted of diet, blood-letting, and/or laxatives. Through the centuries it was discovered that cancer could occur anywhere in the body, but humor-theory based treatment remained popular until the 19th century with the discovery of cells. The cell is the structural and functional unit of all known living Organisms It is the smallest unit of an organism that is classified as living and is often called

The first known surgical treatment for cancer was described in the 1020s by Avicenna (Ibn Sina) in The Canon of Medicine. Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental TemplateInfobox Muslim scholars --> ( Persian /ابو علی الحسین ابن عبدالله ابن سینا (born The Canon of Medicine ( Arabic: القانون في الطب Al-Qanun fi al-Tibb " The Law of Medicine " Persian He stated that the excision should be radical and that all diseased tissue should be removed, which included the use of amputation or the removal of veins running in the direction of the tumor. Tissue is a cellular organizational level intermediate between cells and a complete organism Amputation is the removal of a body extremity by trauma or Surgery. In the Circulatory system, a vein is a Blood vessel that carries Blood back toward the Heart (as opposed to Artery, a blood vessel See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic He also recommended the use of cauterization for the area being treated if necessary. Cauterize redirects here For the band see Cauterize (band Cauterization is a medical term describing the burning of the body to remove ^[72]

In the 16th and 17th centuries, it became more acceptable for doctors to dissect bodies to discover the cause of death. An autopsy, also known as a post-mortem examination, necropsy, or obduction, is a Medical procedure that consists of a thorough Examination The German professor Wilhelm Fabry believed that breast cancer was caused by a milk clot in a mammary duct. Wilhelm Fabry (also William Fabry Guilelmus Fabricius Hildanus or Fabricius von Hilden ( June 25, 1560 in Hilden − February 15, The Dutch professor Francois de la Boe Sylvius, a follower of Descartes, believed that all disease was the outcome of chemical processes, and that acidic lymph fluid was the cause of cancer. Franciscus Sylvius (1614-1672 also known as Franz De Le Boe, was Physician and Scientist ( Chemist, Physiologist and Anatomist The lymphatic system in Vertebrates is a network of conduits that carry a clear fluid called Lymph. His contemporary Nicolaes Tulp believed that cancer was a poison that slowly spreads, and concluded that it was contagious. Nicolaes Tulp ( October 9 1593 - September 12, 1674) was a Dutch Surgeon and Mayor of Amsterdam An infectious disease is a clinically evident Disease resulting from the presence of Pathogenic microbial agents including Pathogenic viruses Pathogenic ^[73]

With the widespread use of the microscope in the 18th century, it was discovered that the 'cancer poison' spread from the primary tumor through the lymph nodes to other sites ("metastasis"). Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, This view of the disease was first formulated by the English surgeon Campbell De Morgan between 1871 and 1874. Campbell Greig De Morgan ( 22 November, 1811 – 12 April, 1876) was a British surgeon who first speculated that Cancer arose locally ^[74] The use of surgery to treat cancer had poor results due to problems with hygiene. Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental The renowned Scottish surgeon Alexander Monro saw only 2 breast tumor patients out of 60 surviving surgery for two years. Three generations of distinguished Scots Physicians &mdash grandfather father and son &mdash were all called Alexander Monro. In the 19th century, asepsis improved surgical hygiene and as the survival statistics went up, surgical removal of the tumor became the primary treatment for cancer. Asepsis is the practice to reduce or eliminate contaminants (such as Bacteria, Viruses Fungi, and Parasites) from entering the operative field With the exception of William Coley who in the late 1800s felt that the rate of cure after surgery had been higher before asepsis (and who injected bacteria into tumors with mixed results), cancer treatment became dependent on the individual art of the surgeon at removing a tumor. Dr William Coley (1862–1936 was an American bone surgeon and Cancer researcher pioneer of Cancer immunotherapy. During the same period, the idea that the body was made up of various tissues, that in turn were made up of millions of cells, laid rest the humor-theories about chemical imbalances in the body. Tissue is a cellular organizational level intermediate between cells and a complete organism The age of cellular pathology was born. Cytopathology (from Greek grc κύτος kytos, "a hollow" grc πάθος pathos, "fate harm" and grc -λογία -logia

When Marie Curie and Pierre Curie discovered radiation at the end of the 19th century, they stumbled upon the first effective non-surgical cancer treatment. Pierre Curie (15 May 1859 &ndash 19 April 1906 was a French physicist, a pioneer in Crystallography, Magnetism, Piezoelectricity Radiation, as in Physics, is Energy in the form of waves or moving Subatomic particles emitted by an atom or other body as it changes from a higher energy With radiation came also the first signs of multi-disciplinary approaches to cancer treatment. The surgeon was no longer operating in isolation, but worked together with hospital radiologists to help patients. The complications in communication this brought, along with the necessity of the patient's treatment in a hospital facility rather than at home, also created a parallel process of compiling patient data into hospital files, which in turn led to the first statistical patient studies.

Cancer patient treatment and studies were restricted to individual physicians' practices until World War II, when medical research centers discovered that there were large international differences in disease incidence. World War II, or the Second World War, (often abbreviated WWII) was a global military conflict which involved a majority of the world's nations, including This insight drove national public health bodies to make it possible to compile health data across practises and hospitals, a process that many countries do today. The Japanese medical community observed that the bone marrow of bomb victims in Hiroshima and Nagasaki was completely destroyed. The Japanese city of ( is the capital of Hiroshima Prefecture, and the largest city in the Chūgoku region of western Honshū, the largest of Japan 's ( is the Capital and the largest city of Nagasaki Prefecture in Japan. They concluded that diseased bone marrow could also be destroyed with radiation, and this led to the discovery of bone marrow transplants for leukemia. Bone marrow is the flexible tissue found in the hollow interior of Bones In adults marrow in large bones produces new Blood cells It constitutes 4% of Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood Since WWII, trends in cancer treatment are to improve on a micro-level the existing treatment methods, standardize them, and globalize them as a way to find cures through epidemiology and international partnerships. Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Epidemiology is the study of factors affecting the Health and Illness of populations and serves as the foundation and Logic of interventions made in the

Research

Main article: Cancer research

Cancer research is the intense scientific effort to understand disease processes and discover possible therapies. Cancer research is research into Cancer in order to identify causes and develop strategies for prevention diagnosis treatments and cure The improved understanding of molecular biology and cellular biology due to cancer research has led to a number of new, effective treatments for cancer since President Nixon declared "War on Cancer" in 1971. Molecular biology is the study of Biology at a molecular level See also List of basic cell biology topics. Cell biology (also called cellular biology or formerly cytology, from the

See also

• List of cancer types
• List of oncology-related terms
• American Association for Cancer Research (AACR)
• American Cancer Society (ACS)
• American Society of Clinical Oncology (ASCO)
• European Organisation for Research and Treatment of Cancer (EORTC)
• National Cancer Institute (NCI)
• National Comprehensive Cancer Network (NCCN)
• Oncology

References

General references

• The Basic Science of Oncology. Tannock IF, Hill RP et al (eds) 4th ed. 2005 McGraw-Hill. ISBN 0-07138-774-9.
• Principles of Cancer Biology. Kleinsmith, LJ (2006). Pearson Benjamin Cummings. ISBN 0-80534-003-3.
• Parkin D, Bray F, Ferlay J, Pisani P. "Global cancer statistics, 2002. ". CA Cancer J Clin 55 (2): 74–108.  Full text
• Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. World Cancer Research Fund (2007). ISBN 978-0-9722522-2-5. Full text
• Cancer Medicine, 6th Edition Textbook
• Robert A. Weinberg (September 1996). "How Cancer Arises; An explosion of research is uncovering the long-hidden molecular underpinnings of cancer—and suggesting new therapies" (PDF): 62–70. “Introductary explanation of cancer biology in layman's language” 

External links

• Cancer at the Open Directory Project
• Cancer at the Yahoo! Directory

Professional and research

Global

• The World Health Organization's cancer site A review of worldwide strategies for the prevention and treatment of cancer. The Open Directory Project ( ODP) also known as dmoz (from directory The Yahoo! Directory is a Web directory which rivals the Open Directory Project in size
• World Health Organization's fact sheet on cancer
• Diet, Nutrition and the prevention of chronic diseases (including cancer) by a Joint WHO/FAO Expert consultation (2003)
• Cancer Research Fund International (WCRF International) leads a global network of cancer charities. Its UK website carries detailed analysis on the global origins and prevention of cancer.
• PACT: Programme of Action for Cancer Therapy An IAEA Program to establish cancer care capacity and comprehensive cancer control in developing world

North America

• American Cancer Society Homepage
• American Cancer Society resources on clinical trials
• American Cancer Society Treatment Decision Tools – Trusted tools for helping patients make informed decisions
• American Society Clinical Oncology Homepage
• ASCO Clinical practice guidelines
• Cancer.net – Oncologist-approved cancer information
• The ASCO Cancer Foundation Homepage
• MyBiopsy.org Information for patients diagnosed with cancer, provided by the College of American Pathologists. The International Atomic Energy Agency ( IAEA) is an international organization that seeks to promote the peaceful use of nuclear energy and to inhibit its
• Cancer Facts & Figures 2005 - 2005 United States Cancer Statistics
• The Leukemia and Lymphoma Society
• National Cancer Institute US Government agency responsible for conducting and supporting research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients.
• Canadian Cancer Statistics 2006 - This publication reports cancer incidence and mortality in Canada, analyzed by gender, age and province/territory.
• Cancer Medicine, 6th Edition Textbook

South America

• Associação Brasileira do Câncer

Europe

• EORTC European Organization for Research and Treatment of Cancer. A European non-profit organization that sets up and executes clinical trials.
• Cancerbackup UK cancer information charity.
• The Institute of Cancer Research One of the world's foremost independent cancer research organisations, based in the United Kingdom.

Support and advocacy

• American Cancer Society Patient advocate group
• American Association for Cancer Research Survivor and Patient Advocacy
• PACT: Programme of Action for Cancer Therapy: An IAEA Program to establish cancer care capacity and comprehensive cancer control in developing world
• Cancer from MedlinePlus - provides links to news, general sites, diagnosis, treatment and alternative therapies, clinical trials, research, related issues, organizations, other MedlinePlus Cancers Topics and Living with Cancer. The International Atomic Energy Agency ( IAEA) is an international organization that seeks to promote the peaceful use of nuclear energy and to inhibit its MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library
• Cancer Research UK - Cancer Resources - In-depth, up-to-date information for people with a professional or general interest in cancer and health.
• Cancer Council of Australia - Australia's national non-government cancer control organisation, involved in research, information, prevention, patient treatment and support.
• ACOR - Association of Cancer Online Resources ACOR is a unique collection of online communities designed to provide timely and accurate information in a supportive environment. ACOR offers access to mailing lists that provide support, information, and community to everyone affected by cancer and related disorders.
• Inside Cancer Multimedia guide to cancer biology from Cold Spring Harbor Laboratory
• Irish Cancer Society

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