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The field of medicine concerned with the treatment of cancer is oncology. Cancer has become an important problem with the rise in life expectancy, as the abovementioned mutations become more likely the longer a person lives. Though great progress in treatment has been made, most cancers in advanced stages remain incurable and ultimately fatal.
A cell that degenerates into a tumor cell does usually not acquire all these properties at once, but its daughter cells are selected to build them. This process is called cellular evolution. A first step in the development of a tumor cell is usually a small change in the DNA, often a point mutation, which leads, among other things, to a genetic instability of the cell. The instability increases to a point where the cell loses whole chromosomes, or has double ones. Also, the DNA methylation pattern of the cell changes, activating and deactivating genes more or less at random. Cells that divide at a high rate, such as stem cells, show a higher risk of becoming tumor cells than those which divide less or not at all, for example neurons. If the initial tumor cell (or group of tumor cells) is not removed by the immune system, it will develop into cancer.
For most of the cancers, it cannot be told which event was the initial cause. However, with molecular biology, it is possible to characterize the mutations within a tumor, and to a certain extent predict its behavior. For example, about half of the tumors are deficient in the tumor suppressor gene p53, also known as "the guardian of the genome". This is associated with poor prospects for the patient, since those tumor cells are unlikely to go into apoptosis (programmed cell death) after they are damaged by therapy. There are more mutations that make a tumor more malignant. Telomerase mutations enable a tumor cell to divide indefinitely. Other mutations enable the tumor to grow new blood vessels to feed it, or to detach from the surrounding tissue, spreading to other parts of the body.
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- The Cancer Supportive Care Programs
Book excerpts covering such topics as psychosocial issues, support, nutrition, pain control and spirituality. - Nature: Cancer Update
Service which provides access to news articles and reports about recent research activity. Registration required. - DIPEx: Cancer
Includes audio and video interviews of patient experiences. - Cancer Mondial
The International Agency for Research on Cancer provides access to reports and databases on occurrence and characteristics. - Shirley's Wellness Cafe
Promotes holistic and alternative approaches for cancer prevention and treatment.