Metastatic bone cancer

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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.

The term cancer is very broad and covers many different illnesses including:

  • Carcinoma (arising from epithelial cells)
  • Bladder carcinoma
  • Breast cancer
  • Cervical cancer
  • Colorectal cancer (includes colon, rectum, anus, and appendix)
  • Esophageal cancer
  • Endometrial cancer (uterus)
  • Hepatocellular carcinoma (liver)
  • Laryngeal cancer
  • Lung cancer
  • Oral cancer
  • Ovarian cancer
  • Pancreatic cancer
  • Prostate cancer
  • Renal cell carcinoma (kidney)
  • Skin cancer
  • Stomach cancer
  • Testicular cancer
  • Thyroid cancer
  • Sarcoma (arising from connective tissue and related)
  • Gastrointestinal stromal cell tumor (GIST)
  • Rhabdomyosarcoma (muscle)
  • Osteosarcoma (bone)
  • Hematological malignancies (blood and bone marrow)
  • Leukemia
  • Lymphomas
  • Hodgkin's disease
  • Non-Hodgkin's lymphoma
  • Multiple myeloma
  • Miscellaneous
  • Brain tumor
  • Melanoma, Moles and dysplastic nevi
  • Teratoma

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.