An Emerging Face of
Cancer: Today’s Understanding
Case Study
Sally sat motionless with her hands
gripping the steering wheel after she turned off the car in her driveway.
Thirty minutes before she was meeting with her doctor to review some tests,
when she heard the words that would change her life forever. The words, “You
have ovarian cancer” repeated through her mind ever since the doctor spoke
them. She didn’t remember much after that except looking an x-ray that showed
the cancer had spread from her ovaries to several locations throughout her
“abdominal area”.
Sally did not know what to do next.
She had been divorced for 6 months and did not feel comfortable calling her
ex-husband. Sally’s friend had offered to go to the doctor’s visit with her,
but Sally never wanted to inconvenience her friends. Most had their hands full
with children and elderly parents. She thought having cancer meant you received
chemotherapy and likely may not survive anyway. Sally did not know what cancer
was, how to live with it or what do next.
Introduction
Many years
before the body is effected in anyway, a potentially catastrophic change
happens. It is likely an accumulation of one or many environmental factors that
trigger one gene, likely an oncogene, in one cell projecting a new aberrant
genomic pattern that has the potential to destroy the human body. This is
cancer.
Cells of
each organ or tissue divide to grow in a controlled manner specific to that
organ. This way when old or poorly functioning cells die new cells replace them.
Thus providing a relatively constant mass of specialized cells needed to
maintain proper function in each organ or tissue. When the genetic material of
a cell (DNA) is damaged or is triggered “on”, this is considered a mutation and
affects the growth and cell division rate of that cell and subsequent expanding
cell line of its progeny.
Most commonly when a cell is damaged or has genetic
malfunction, the affected cell will simply die. Cancer occurs when cells
undergo a series of genetic alterations that involve a gene responsible for
regulating the rate of cell growth and division to form new cells. As a
result, these new aberrant cancer cells
survive longer and still new cells are made when the body does not need them or
have space for them. This accumulation of extra non-functioning cells form a
mass of tissue called a tumor.
Cancer is a
very broad term that encompasses diseases that manifest clinically as a result
abnormally dividing cells that lost the ability to control their rate of growth.
As a result, the cluster of cells grows to cause dysfunction in the initial
organ and then continue to grow to invade other organs. The cancer cells “grow
wild”, spread to adjacent tissue and some types spread throughout the body as
transported by the blood stream and lymphatic system. For example, ovarian cancer starts in the
ovaries and usually spreads by into the surrounding abdominal cavity and colon
by the type clinical symptoms warrant a doctors visit.
Cancer types
There are
over 100 types of cancer and the organ that they started names most by the name
of the apparent type of cell involved. A carcinoma is a cancer of the skin or
outside ling of an internal organ.
Squamous cell carcinoma occurs most commonly along the
breathing tract, mouth to lung. Squamous cells cover the majority of the
respiratory tract and after years of carcinogenic irritants (smoke, chewing
tobacco) a gene in one or a group of squamous cells initiates a cancer genomic
process. Sarcoma is cancer of the
bone, cartilage, fat, muscle, blood vessels or connective tissues. Cancer that originates in the bone marrow,
that is responsible for forming blood products (platelets, red and white blood
cells), is called Leukemia. The
rapid production of abnormal blood cells in leukemia take precedence over
production of the critical production of healthy blood cells the body
desperately depends on. Lymphoma and myeloma are cancers of the immune system.
The cancers of the brain and spinal cord
are unique because the cell types primarily exist in the brain. For example, an
astrocytoma originates for the abnormal reproduction of astrocytes, which are
only present in the brain.
Behavior of a tumor
A tumor or
cancer cells are usually not detected until they cause enough interference to
prevent one or more organs to function appropriately. For example, the ovary
has space to grow significantly before it interferes with function of other
abdominal organs. However, the local invasion of cells into the abdominal cavity
results in fluid secretion and accumulation where the weight of fluid is not
normally present, creating discomfort. In addition, the “aggressive” cell type
of some ovarian cancers rapidity invades the colon and produce gastrointestinal
symptoms of bleeding, obstruction or diarrhea. T cell leukemia uses most bone
marrow supplies to produce abnormal T cell’s (one type of white blood cell)
that there is enough to produce red blood cells or platelets.
Prevalence of Cancer
Cancer continues
to be a major health problem throughout the world. In In the U.S., cancer
accounts for approximately 25% of all deaths that occur each year. Between
2006-2010 over 1.5 million Americans were diagnosed with cancer. With over
one-third of those dying form a cancer related
cause. (http://onlinelibrary.wiley.com.ezproxy.med.nyu.edu/doi/10.3322/caac.21208/pdf)
Although
grim, these statistics reflect small improvements. Over the past 5 years cancer
related death rates have decreased by about 1.5%. The incidence or cancer has
decreased 0.6% in men and has remained unchanged in woman. The death rate from
cancer peaked in 1991 and has been slowing since that time. The largest decline
(55%) occurred in black men aged 40-49 years.
