1. Understanding Cancer and Related Topics Understanding Cancer Developed by: Lewis J. Kleinsmith, Ph.D. Donna Kerrigan, M.S. Jeanne Kelly Brian Hollen Discusses and illustrates what cancer is, explains the link between genes and cancer, and discusses what is known about the causes, detection, and diagnosis of the disease. These PowerPoint slides are not locked files. You can mix and match slides from different tutorials as you prepare your own lectures. In the Notes section, you will find explanations of the graphics. The art in this tutorial is copyrighted and may not be reused for commercial gain. Please do not remove the NCI logo or the copyright mark from any slide. These tutorials may be copied only if they are distributed free of charge for educational purposes.

2. What Is Cancer?

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

4. Naming Cancers PrefixMeaning adeno-gland chondro-cartilage erythro-red blood cell hemangio-blood vessels hepato-liver lipo-fat lympho-lymphocyte melano-pigment cell myelo-bone marrow myo-muscle osteo-bone Cancer Prefixes Point to Location

5. Loss of Normal Growth Control Cancer cell division Fourth or later mutation Third mutation Second mutation First mutation Uncontrolled growth Cell Suicide or Apoptosis Cell damage— no repair Normal cell division

6. Example of Normal Growth Cell migration Dermis Dividing cells in basal layer Dead cells shed from outer surface Epidermis

7. The Beginning of Cancerous Growth Underlying tissue During the development of skin cancer, the normal balance between cell division and cell loss is disrupted. The basal cells now divide faster than is needed to replenish the cells being shed from the surface of the skin. Each time one of these basal cells divides, the two newly formed cells will often retain the capacity to divide, thereby leading to an increase in the total number of dividing cells.

8. Tumors (Neoplasms) Underlying tissue

9. Invasion and Metastasis 3 Cancer cells reinvade and grow at new location 1 Cancer cells invade surrounding tissues and blood vessels 2 Cancer cells are transported by the circulatory system to distant sites

10. Malignant versus Benign Tumors Malignant (cancer) cells invade neighboring tissues, enter blood vessels, and metastasize to different sites Time Benign (not cancer) tumor cells grow only locally and cannot spread by invasion or metastasis

11. Why Cancer Is Potentially Dangerous Melanoma cells travel through bloodstream Melanoma (initial tumor) Brain Liver

12. Genes and Cancer Chromosomes are DNA molecules Heredity Radiation Chemicals Viruses

13. DNA Structure DNA molecule Chemical bases G C T A

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

15. Oncogenes Mutated/damaged oncogene Oncogenes accelerate cell growth and division Cancer cell Normal cell Normal genes regulate cell growth

16. Proto-Oncogenes and Normal Cell Growth Receptor Normal Growth-Control Pathway DNA Cell proliferation Cell nucleus Transcription factors Signaling enzymes Growth factor

17. Oncogenes are Mutant Forms of Proto-Oncogenes Cell proliferation driven by internal oncogene signaling Transcription Activated gene regulatory protein Inactive intracellular signaling protein Signaling protein from active oncogene Inactive growth factor receptor

18. 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

19. Tumor Suppressor Genes Act Like a Brake Pedal Tumor Suppressor Gene Proteins DNA Cell nucleus Signaling enzymes Growth factor Receptor Transcription factors Cell proliferation

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

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

22. Cancer Tends to Involve Multiple Mutations Malignant cells invade neighboring tissues, enter blood vessels, and metastasize to different sites More mutations, more genetic instability, metastatic disease Proto-oncogenes mutate to oncogenes Mutations inactivate DNA repair genes Cells proliferate Mutation inactivates suppressor gene Benign tumor cells grow only locally and cannot spread by invasion or metastasis Time

23. Mutations and Cancer Genes Implicated in Cancer

24. Cancer Tends to Corrupt Surrounding Environment Growth factors = proliferation Blood vessel Proteases Cytokines Matrix Fibroblasts, adipocytes Invasive Cytokines, proteases = migration & invasion

25. We would like to hear from you... If you have questions about this tutorial’s content, suggestions for new topics, or other feedback on the Web site, please send an e-mail to kerrigad@mail.nih.gov. If you have questions about this tutorial’s artwork or want permission to use it, please send an e-mail to beankelly@verizon.net.