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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.
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.
Cancer is, ultimately, a disease of genes. Typically, a series of several mutations is required before a cell becomes a cancer cell. We distinguish between oncogenes, which promote cancer when "switched on" by a mutation, and tumor suppressor genes, which prevent cancer unless "switched off" by a mutation. These mutations can have various causes: radiation or chemicals called carcinogens; some inherited predisposition is not uncommon; some viruses that can cause cancer have also been described. Usually, they carry in their genome some oncogene or tumor suppressor inactivating gene. In about 15% of all cancers, viruses seem to play a role; Bacteria, like Helicobacter pylori, also induce carcinogenesis by a process of chronic inflammation. Finally, damage by free radicals, which are a natural by-product of oxygen metabolism, can cause mutations in the DNA.
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- NetHealthBook: Cancer
Symptoms, diagnostic tests and treatments of the most common cancers are described. - Yahoo Health: Radiation Therapy Center
Information including basic facts, what to expect and side effects. - People Living With Cancer
Patient information from the American Society of Clinical Oncology. - The Cancer Supportive Care Programs
Book excerpts covering such topics as psychosocial issues, support, nutrition, pain control and spirituality. - CancerDirect
Patient consultation service offering treatment advice, online second opinions and oncologist referral for individual disease.