A report on Cancer and Carcinogenesis

A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver
Cancers and tumors are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
Symptoms of cancer metastasis depend on the location of the tumor.
The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
The GHS Hazard pictogram for carcinogenic substances
Longitudinally opened freshly resected colon segment showing a cancer and four polyps. Plus a schematic diagram indicating a likely field defect (a region of tissue that precedes and predisposes to the development of cancer) in this colon segment. The diagram indicates sub-clones and sub-sub-clones that were precursors to the tumors.
Share of cancer deaths attributed to tobacco in 2016.
Tissue can be organized in a continuous spectrum from normal to cancer.
The incidence of lung cancer is highly correlated with smoking.
Many tumor suppressor genes effect signal transduction pathways that regulate apoptosis, also known as "programmed cell death".
Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
Multiple mutations in cancer cells
The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
Chest X-ray showing lung cancer in the left lung
Three measures of global cancer mortality from 1990 to 2017
Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689
University of Florida Cancer Hospital
CancerTreeMammal
An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue
An invasive colorectal carcinoma (top center) in a colectomy specimen
A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen
A large invasive ductal carcinoma in a mastectomy specimen

Carcinogenesis, also called oncogenesis or tumorigenesis, is the formation of a cancer, whereby normal cells are transformed into cancer cells.

- Carcinogenesis

Several studies have indicated that the enzyme sirtuin 6 is selectively inactivated during oncogenesis in a variety of tumor types by inducing glycolysis.

- Cancer
A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver

18 related topics with Alpha

Overall

Illustration showing hematogenous metastasis

Metastasis

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Illustration showing hematogenous metastasis
Cut surface of a liver showing multiple paler metastatic nodules originating from pancreatic cancer
Lymph node with almost complete replacement by metastatic melanoma. The brown pigment is focal deposition of melanin
Main sites of metastases for some common cancer types. Primary cancers are denoted by "...cancer" and their main metastasis sites are denoted by "...metastases".
Pulmonary metastases shown on Chest X-Ray
Cut surface of a humerus sawn lengthwise, showing a large cancerous metastasis (the whitish tumor between the head and the shaft of the bone)
Micrograph of thyroid cancer (papillary thyroid carcinoma) in a lymph node of the neck. H&E stain
CT image of multiple liver metastases
CT image of a lung metastasis
Metastasis proven by liver biopsy (tumor (adenocarcinoma)—lower two-thirds of image). H&E stain.
Metastatic cancer in the lungs
Metastases from the lungs to the brain
Metastases from the lungs to the pancreas

Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor.

This malignancy allows for invasion into the circulation, followed by invasion to a second site for tumorigenesis.

Location and appearance of two example colorectal tumors

Colorectal cancer

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Location and appearance of two example colorectal tumors
Longitudinally opened freshly resected colon segment showing a cancer and four polyps. Plus a schematic diagram indicating a likely field defect (a region of tissue that precedes and predisposes to the development of cancer) in this colon segment. The diagram indicates sub-clones and sub-sub-clones that were precursors to the tumors.
Colon cancer with extensive metastases to the liver
Relative incidence of various histopathological types of colorectal cancer. The vast majority of colorectal cancers are adenocarcinomas.
Micrograph of colorectal adenocarcinoma, showing "dirty necrosis".
A diagram of a local resection of early stage colon cancer
A diagram of local surgery for rectal cancer
Colon and rectum cancer deaths per million persons in 2012

Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine).

As summarized in the articles Carcinogenesis and Neoplasm, for sporadic cancers in general, a deficiency in DNA repair is occasionally due to a mutation in a DNA repair gene, but is much more frequently due to epigenetic alterations that reduce or silence expression of DNA repair genes.

Colectomy specimen containing a malignant neoplasm, namely an invasive example of colorectal cancer (the crater-like, reddish, irregularly shaped tumor)

Neoplasm

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Type of abnormal and excessive growth of tissue.

Type of abnormal and excessive growth of tissue.

Colectomy specimen containing a malignant neoplasm, namely an invasive example of colorectal cancer (the crater-like, reddish, irregularly shaped tumor)
Neoplastic tumor of the cheek skin, here a benign neoplasm of the sweat glands called hidradenoma, which is not solid but is fluid-filled
Diagram illustrating benign neoplasms, namely fibroids of the uterus
The central role of DNA damage and epigenetic defects in DNA repair genes in malignant neoplasms
Longitudinally opened freshly resected colon segment showing a cancer and four polyps, plus a schematic diagram indicating a likely field defect (a region of tissue that precedes and predisposes to the development of cancer) in this colon segment. The diagram indicates sub-clones and sub-sub-clones that were precursors to the tumors.

ICD-10 classifies neoplasms into four main groups: benign neoplasms, in situ neoplasms, malignant neoplasms, and neoplasms of uncertain or unknown behavior.

Various other terms have been used to describe this phenomenon, including "field effect", "field cancerization", and "field carcinogenesis".

Lucretius

Evolution

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Change in the heritable characteristics of biological populations over successive generations.

Change in the heritable characteristics of biological populations over successive generations.

Lucretius
Alfred Russel Wallace
Thomas Robert Malthus
In 1842, Charles Darwin penned his first sketch of On the Origin of Species.
DNA structure. Bases are in the centre, surrounded by phosphate–sugar chains in a double helix.
Duplication of part of a chromosome
This diagram illustrates the twofold cost of sex. If each individual were to contribute to the same number of offspring (two), (a) the sexual population remains the same size each generation, where the (b) Asexual reproduction population doubles in size each generation.
Mutation followed by natural selection results in a population with darker colouration.
Simulation of genetic drift of 20 unlinked alleles in populations of 10 (top) and 100 (bottom). Drift to fixation is more rapid in the smaller population.
Homologous bones in the limbs of tetrapods. The bones of these animals have the same basic structure, but have been adapted for specific uses.
A baleen whale skeleton. Letters a and b label flipper bones, which were adapted from front leg bones, while c indicates vestigial leg bones, both suggesting an adaptation from land to sea.
Common garter snake (Thamnophis sirtalis sirtalis) has evolved resistance to the defensive substance tetrodotoxin in its amphibian prey.
The four geographic modes of speciation
Geographical isolation of finches on the Galápagos Islands produced over a dozen new species.
Tyrannosaurus rex. Non-avian dinosaurs died out in the Cretaceous–Paleogene extinction event at the end of the Cretaceous period.
The hominoids are descendants of a common ancestor.
As evolution became widely accepted in the 1870s, caricatures of Charles Darwin with an ape or monkey body symbolised evolution.

If cells ignore these signals and multiply inappropriately, their uncontrolled growth causes cancer.

Viruses, bacteria, fungi and cancers evolve to be resistant to host immune defences, as well as pharmaceutical drugs.

The cell cycle. Many tumor suppressors work to regulate the cycle at specific checkpoints in order to prevent damaged cells from replicating.

Tumor suppressor gene

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Gene that regulates a cell during cell division and replication.

Gene that regulates a cell during cell division and replication.

The cell cycle. Many tumor suppressors work to regulate the cycle at specific checkpoints in order to prevent damaged cells from replicating.
Models of tumor suppression
Illustration of two-hit hypothesis

If the cell grows uncontrollably, it will result in cancer.

The suppression of tumorigenicity in these hybrid cells prompted researchers to hypothesize that genes within the normal somatic cell had inhibitory actions to stop tumor growth.

A red tulip exhibiting a partially yellow petal due to a mutation in its genes

Mutation

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Alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA.

Alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA.

A red tulip exhibiting a partially yellow petal due to a mutation in its genes
Mutation with double bloom in the Langheck Nature Reserve near Nittel, Germany
Prodryas persephone, a Late Eocene butterfly
A covalent adduct between the metabolite of benzo[a]pyrene, the major mutagen in tobacco smoke, and DNA
Five types of chromosomal mutations
Selection of disease-causing mutations, in a standard table of the genetic code of amino acids
The structure of a eukaryotic protein-coding gene. A mutation in the protein coding region (red) can result in a change in the amino acid sequence. Mutations in other areas of the gene can have diverse effects. Changes within regulatory sequences (yellow and blue) can effect transcriptional and translational regulation of gene expression.
The distribution of fitness effects (DFE) of mutations in vesicular stomatitis virus. In this experiment, random mutations were introduced into the virus by site-directed mutagenesis, and the fitness of each mutant was compared with the ancestral type. A fitness of zero, less than one, one, more than one, respectively, indicates that mutations are lethal, deleterious, neutral, and advantageous.
A mutation has caused this moss rose plant to produce flowers of different colors. This is a somatic mutation that may also be passed on in the germline.
Dutch botanist Hugo de Vries making a painting of an evening primrose, the plant which had apparently produced new forms by large mutations in his experiments, by Thérèse Schwartze, 1918

Mutations play a part in both normal and abnormal biological processes including: evolution, cancer, and the development of the immune system, including junctional diversity.

Interstitial deletions: an intra-chromosomal deletion that removes a segment of DNA from a single chromosome, thereby apposing previously distant genes. For example, cells isolated from a human astrocytoma, a type of brain tumor, were found to have a chromosomal deletion removing sequences between the Fused in Glioblastoma (FIG) gene and the receptor tyrosine kinase (ROS), producing a fusion protein (FIG-ROS). The abnormal FIG-ROS fusion protein has constitutively active kinase activity that causes oncogenic transformation (a transformation from normal cells to cancer cells).

Figure 1: Stem cell specific and conventional cancer therapies

Cancer stem cell

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Figure 1: Stem cell specific and conventional cancer therapies
Figure 2: A normal cellular hierarchy comprising stem cells at the apex, which generate common and more restricted progenitor cells and ultimately the mature cell types that constitute particular tissues.
Figure 3. In the cancer stem cell (CSC) model, only the CSCs have the ability to generate a tumor, based on their self-renewal properties and proliferative potential.
Figure 4: In the clonal evolution model, all undifferentiated cells have similar possibility to change into a tumorigenic cell.
Figure 5: Both tumor models may play a role in the maintenance of a tumor. Initially, tumor growth is assured with a specific CSC (CSC1). With tumor progression, another CSC (CSC 2) may arise due to the clonal selection. The development of a new more aggressive CSC may result from the acquisition of an additional mutation or epigenetic modification.
Figure 6: Hierarchical organisation of a tumour according to the CSC model
Figure 7: The concept of migrating cancer stem cells (MSC). Stationary cancer stem cells are embedded in early carcinomas and these cells are detectable in the differentiated central area of a tumor. The important step toward malignancy is the induction of epithelial mesenchymal transition (EMT) in the stationary cancer stem cells (SCS), which become mobile or migrating cancer stem cells. Stem cells divide asymmetrically. One daughter cell will begin proliferation and differentiation. The remaining MCS migrates a short distance before undergoing a new asymmetric division, or disseminates through blood vessels or lymphatic vessels and produces a metastasis.

Cancer stem cells (CSCs) are cancer cells (found within tumors or hematological cancers) that possess characteristics associated with normal stem cells, specifically the ability to give rise to all cell types found in a particular cancer sample.

CSCs are therefore tumorigenic (tumor-forming), perhaps in contrast to other non-tumorigenic cancer cells.

Angiogenesis following vasculogenesis

Angiogenesis

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Physiological process through which new blood vessels form from pre-existing vessels, formed in the earlier stage of vasculogenesis.

Physiological process through which new blood vessels form from pre-existing vessels, formed in the earlier stage of vasculogenesis.

Angiogenesis following vasculogenesis
3D medical animation still showing angiogenesis
Without angiogenesis a tumor cannot grow beyond a limited size

However, it is also a fundamental step in the transition of tumors from a benign state to a malignant one, leading to the use of angiogenesis inhibitors in the treatment of cancer.

Difficulties include effective integration of the therapeutic genes into the genome of target cells, reducing the risk of an undesired immune response, potential toxicity, immunogenicity, inflammatory responses, and oncogenesis related to the viral vectors used in implanting genes and the sheer complexity of the genetic basis of angiogenesis.

Figure 1. During meiosis, homologous recombination can produce new combinations of genes as shown here between similar but not identical copies of human chromosome 1.

Homologous recombination

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Type of genetic recombination in which genetic information is exchanged between two similar or identical molecules of double-stranded or single-stranded nucleic acids .

Type of genetic recombination in which genetic information is exchanged between two similar or identical molecules of double-stranded or single-stranded nucleic acids .

Figure 1. During meiosis, homologous recombination can produce new combinations of genes as shown here between similar but not identical copies of human chromosome 1.
Figure 2. An early illustration of crossing over from Thomas Hunt Morgan
Figure 3. Homologous recombination repairs DNA before the cell enters mitosis (M phase). It occurs only during and shortly after DNA replication, during the S and G2 phases of the cell cycle.
Figure 4. Double-strand break repair models that act via homologous recombination
Figure 5. The DSBR and SDSA pathways follow the same initial steps, but diverge thereafter. The DSBR pathway most often results in chromosomal crossover (bottom left), while SDSA always ends with non-crossover products (bottom right).
Figure 6. Recombination via the SSA pathway occurs between two repeat elements (purple) on the same DNA duplex, and results in deletions of genetic material. (Click to view animated diagram in Firefox, Chrome, Safari, or Opera web browsers.)
Figure 7. Crystal structure of a RecA protein filament bound to DNA. A 3' overhang is visible to the right of center.
Figure 8A. Molecular model for the RecBCD pathway of recombination. This model is based on reactions of DNA and RecBCD with ATP in excess over Mg2+ ions. Step 1: RecBCD binds to a double-stranded DNA end. Step 2: RecBCD unwinds DNA.  RecD is a fast helicase on the 5’-ended strand, and RecB is a slower helicase on the 3'-ended strand (that with an arrowhead) [ref 46 in current Wiki version].  This produces two single-stranded (ss) DNA tails and one ss loop.  The loop and tails enlarge as RecBCD moves along the DNA.  Step 3:  The two tails anneal to produce a second ss DNA loop, and both loops move and grow.  Step 4:  Upon reaching the Chi hotspot sequence (5' GCTGGTGG 3'; red dot) RecBCD nicks the 3’-ended strand.  Further unwinding produces a long 3'-ended ss tail with Chi near its end.  Step 5:  RecBCD loads RecA protein onto the Chi tail.  At some undetermined point, the RecBCD subunits disassemble.  Step 6:  The RecA-ssDNA complex invades an intact homologous duplex DNA to produce a D-loop, which can be resolved into intact, recombinant DNA in two ways.  Step 7:  The D-loop is cut and anneals with the gap in the first DNA to produce a Holliday junction.  Resolution of the Holliday junction (cutting, swapping of strands, and ligation) at the open arrowheads by some combination of RuvABC and RecG produces two recombinants of reciprocal type.  Step 8:  The 3' end of the Chi tail primes DNA synthesis, from which a replication fork can be generated.  Resolution of the fork at the open arrowheads produces one recombinant (non-reciprocal) DNA, one parental-type DNA, and one DNA fragment.
Figure 8B. Beginning of the RecBCD pathway. This model is based on reactions of DNA and RecBCD with Mg2+ ions in excess over ATP. Step 1: RecBCD binds to a DNA double strand break.  Step 2: RecBCD initiates unwinding of the DNA duplex through ATP-dependent helicase activity.  Step 3: RecBCD continues its unwinding and moves down the DNA duplex, cleaving the 3' strand much more frequently than the 5' strand. Step 4: RecBCD encounters a Chi sequence and stops digesting the 3' strand; cleavage of the 5' strand is significantly increased. Step 5: RecBCD loads RecA onto the 3' strand. Step 6: RecBCD unbinds from the DNA duplex, leaving a RecA nucleoprotein filament on the 3' tail.
Schematic representation of the s2m RNA secondary structure, with tertiary structural interactions indicated as long range contacts.
Figure 9. Joining of single-ended double strand breaks could lead to rearrangements
Figure 10. Protein domains in homologous recombination-related proteins are conserved across the three main groups of life: archaea, bacteria and eukaryotes.
Figure 11. As a developing embryo, this chimeric mouse had the agouti coat color gene introduced into its DNA via gene targeting. Its offspring are homozygous for the agouti gene.

Since their dysfunction has been strongly associated with increased susceptibility to several types of cancer, the proteins that facilitate homologous recombination are topics of active research.

Deficiencies in homologous recombination have been strongly linked to cancer formation in humans.

CT scan of a liver with cholangiocarcinoma

Liver cancer

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CT scan of a liver with cholangiocarcinoma
Liver tumor types by relative incidence in adults in the United States (liver cancers in dark red color).
This electron micrograph shows hepatitis B virus "Dane particles", or virions.
High magnification micrograph of a liver with cirrhosis. Trichrome stain. The most common cause of cirrhosis in the Western world is alcohol use disorder – the cause of cirrhosis in this case.
Left lobe liver tumor in a 50-year-old male, operated in King Saud Medical Complex, Riyadh, Saudi Arabia
A surgeon performing photodynamic therapy
Deaths from liver cancer per million persons in 2012

Liver cancer (also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy) is cancer that starts in the liver.

Mutation in p53, presumably in conjunction with other aflatoxin-induced mutations and epigenetic alterations, is likely a common cause of aflatoxin-induced carcinogenesis.