Understanding Cancer Developed by: Lewis J. Kleinsmith, Ph.D. Donna Kerrigan, M.S. Jeanne Kelly Brian Hollen

A) What is cancer? Cancer is the uncontrolled rapid growth and spread of invasive, abnormal cells.

Cell Cycle

Normal Cell Growth Cancer cell division Fourth or later mutation Third mutation Second mutation First mutation Uncontrolled growth Cell Suicide or Apoptosis Normal cell division Cell damage— no repair Damaged cells are programmed to initiate apoptosis.

Repeated genetic cell mutations may lead to loss of apoptosis ability. Cancer cell division Fourth or later mutation Third mutation Second mutation First mutation Uncontrolled growth

B) Characteristics of cancer cells What differences do you observe?

Normal Growth: uniform, organized Cell migration Dermis Dividing cells in basal layer Dead cells shed from outer surface Epidermis

Tumors (Neoplasms) Underlying tissue

Find: the lung cancer the normal fibrous tissue For the hotshots, find: The largest cancer cell (dead), with its nucleus fragmented a blood vessel

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Basal cell carcinoma (epidermis) MDBlogger AC8D6530CD998A7993BD7C6F8B29305&first=120&FORM=IDFRIR

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Normal liver Liver cancer

C) Malignant vs.Benign Tumors Malignant (cancer) cells invade neighboring tissues, metastasize to different sites Time Benign (not cancer) tumor cells only grow locally

Melanoma cells travel through bloodstream Melanoma (initial tumor) Brain Liver D) Metastasis

E) Kinds of Cancer Lung Breast (women) Colon Bladder Prostate (men) common sarcomas: Fat Bone Muscle Lymphomas: Lymph nodes Leukemias: Bloodstream common carcinomas:

F) Cancer Detection

Early Stages of Cancer May NOT Have Any Symptoms!

Tumor Stages Five-Year Survival Rates for Patients with Melanoma (by stage) Stage at Time of Initial Diagnosis 100% 50% IIIIII

Biopsy Patient’s tissue sample or blood sample Genomic profile Proteomic profile Pathology

F) Causes of Cancer

1. Tobacco Use and Cancer Some Cancer-Causing Chemicals in Tobacco Smoke

Year Lag Time Between Smoking and Lung Cancer Cigarettes Smoked per Person per Year Lung Cancer Deaths (per 100,000 people) Year Lung cancer (men) Cigarette consumption (men)

2. Radiation Annual Sunshine (UV radiation) Skin Cancer Incidence Most Dallas Pittsburgh High Detroit Low Least

3. Viruses Virus inserts and changes genes for cell growth Cancer-linked virus

Examples of Human Cancer Viruses

4. Cancer Risk and Aging Cancer Risk and Aging Number of Cancer Cases (per 100,000 people) Age of Person (in years) Colon Breast

5. Heredity and Cancer Inherited factors (1 in 20 breast cancer patients) All Breast Cancer Patients Other factor(s)

6. Environmental carcinogens

viruses or bacteria Heredity Diet Hormones Radiation chemicals (carcinogens)

G) Cancer: Treatment 1. surgery 2. chemotherapy 3. radiation

4. hormone therapy 5. biologic therapy (antibody) 6. targeted therapy (block blood vessels to tumor)

H) Cancer: Prevention cancer

Cancer Prevention Cancer viruses or bacteria Carcinogenic radiation Carcinogenic chemicals

1. Avoid Tobacco 15x 10x 5x Non-smoker Cigarettes Smoked per Day Lung Cancer Risk Increases with Cigarette Consumption Lung Cancer Risk

2. Protect Yourself From Excessive Sunlight

3. Limit Alcohol and Tobacco Intake 40x 30x 20x 10x Alcoholic Drinks Consumed per Day Packs of Cigarettes Consumed per Day Combination of Alcohol and Cigarettes Increases Risk for Cancer of the Esophagus Risk Increase AND

4a. Limit Fats and Calories 0 Number of Cases (per 100,000 people) Grams (per person per day) Correlation Between Meat Consumption and Colon Cancer Rates in Different Countries

4b. Eat Fruits and Vegetables

5. Exercise & maintain healthy body weight

6. Avoid Cancer Viruses Noninfected women HPV Infection Increases Risk for Cervical Cancer Cervical Cancer Risk Low High Women infected with HPV

7.Physical exams & screenings e.g. mammograms, biopsy

8. Reduce exposures to environmental carcinogens

What percentage of people survive cancer? * The 5 year survival rate for all cancers diagnosed between is 66%, up from 51% in * The improvement reflects progress in diagnosing cancers at an earlier stage and improvements in treatment.

The remaining are extra slides, not part of the outlined notes

How Cancer Starts: Genes & Cancer Chromosomes are DNA molecules Heredity Radiation Chemicals Viruses

DNA Mutation Additions Deletions Normal gene Single base change DNA C T AGCGAACTAC AGGCGCTAACACT AGCTAACTAC AGAACTAC

Cancer Genes: Oncogenes Mutated/damaged oncogene Oncogenes accelerate cell growth and division Cancer cell Normal cell Normal genes regulate cell growth

Tumor Suppressor Genes Normal genes prevent cancer Remove or inactivate tumor suppressor genes Mutated/inactivated tumor suppressor genes Damage to both genes leads to cancer Cancer cell Normal cell

p53 Tumor Suppressor Protein Triggers Cell Suicide Normal cellCell suicide (Apoptosis) p53 protein Excessive DNA damage

DNA Repair Genes Cancer No cancer No DNA repair Normal DNA repair Base pair mismatch TCATC AGTCG TCAGC AGTCG AGTGAGTAG TCATCTCATC

Microscopic Appearance of Cancer

Carcinoma in Situ Mild dysplasia Carcinoma in situ (severe dysplasia) Cancer (invasive) NormalHyperplasia

Sources National Cancer Institute (NCI) American Cancer Society (ACS)