CANCER AND

CARCINOGENS
CANCER
Disease process that begins when
an abnormal cell is transformed by
the genetic mutation of the cellular
DNA.
CANCER
This abnormal cell forms a clone and begins to
proliferate abnormally, ignoring growth-regulating
signals in the environment surrounding the cell.

These cells acquire invasive characteristics, and

changes occur in surrounding tissues

Describes as malignant neoplasms - demonstrate

uncontrolled cell growth that followno physiologic
demand
METASTASIS
A phenomenon where cancer cells
infiltrate surrounding tissues and gain
access to lymph and blood vessels,
which carry the cells to the other areas
of the body.
MALIGNANT CELLS
A term used to describe cancer.
Malignant cells grow in an uncontrolled
way and can invade nearby tissues and
spread to other parts of the body
through the blood and lymph system.
 Characteristics
of Malignant cells:

1. Cell membrane contain proteins called tumor -

specific antigens
These proteins distinguish the malignant cell from a benign cell
of the same tissue type
Examples: Prostate - specific antigen - for prostate cancer in men

2. Nuclei and nucleoli of cancer cells are large and

irregularly shaped
 Characteristics
of Malignant cells:

3. Chromosomal abnormalities (translocation,

deletions, additions) are commonly found

4. Mitosis (cell division) occurs more frequently

than normal cells - the increase in number of
malignant cells is faster than normal cells
EXAMPLE OF TUMORS AND
TISSUE TYPES
 Metastatic Mechanisms
1. Lyphatic spread- most common
Spreading of cancer cells
Tumor emboli enter the lymph channels by
way of the interstitial fluid that
communicates with lymphatic fluid
Example: Breast tumors frequently metastasize
in this matter (cancer cells in the breast can
spread to muscles of the armpits, where lymph
nodess are present)
 Metastatic Mechanisms
2. Hematogenous spread - malignant
cellss are disseminated through the
bloodstream.
Directly related to the vascularity of the
tumor ( the amount of blood vessels
presents and the blood that flows to that
area)
Example: Breast tumor can travel to
the lungs which is very vasccular
 Metastatic Mechanisms

3. Angiogenesis - the ability

of the malignant cells to
induce the growth of new
capillaries from the hosst
(origin) to meet their needs
for nutrients and oxygen.
CARCINOGENESIS

It is the process of transformation of

malignant cells
 STEPS OF THE PROCESS OF
TRANSFORMATION:

Step 1 - Initiation
Initiators (carcinogens) escape normal
enzymatic mechanisms and alter the genetic
structure of the cellular DNA .
Normally, cells have protective mechanisms to
repair these.
These DNA alterations are not significant to
cells until the second step.
 STEPS OF THE PROCESS OF
TRANSFORMATION:

Step 2 - Promotion
Repeated exposure to promoting agents (co-
carcinogens) causes the expression of abnormal or
mutant genetic information after long latency period .
Cells normally have cancer suppressor genes that "turn
off" mutations -example is p53 gene.
When suppressor genes are mutated, they lose their
regulatory capabilities -malignant (abnormal) cells are
allowed to produce.
 STEPS OF THE PROCESS OF
TRANSFORMATION:

Step 3 - Progression

Cellular changes in step 1 and 2 now exhibit

increased malignant behavior.
These cells invade surrounding tissue and
metastasize.
 CARCINOGENS
Carcinogens are substances or factors that can
cause cancer by damaging DNA and triggering
uncontrolled cell growth. They include chemicals
(e.g., tobacco smoke), radiation (e.g., UV rays),
viruses (e.g., HPV), and certain lifestyle factors
(e.g., poor diet and alcohol consumption).
 A. Viruses and Bacteria

These are considered or suspected when

specific cancers appear in clusters

Virus - incorporate themselves in the

genetic structure of cells - cell populations
is altered or changes - leads to cancer
 A. Viruses and Bacteria

Example 1: Epstein-Barr virus -

suspected to cause nasopharyngeal
cancers, some types of non-Hodgkin's
lymphoma and Hodgkin's disease

Example 2: Herpes simplex virus

type II, cytomegalyvirus and
human papillomavirus HPV are
associated with dysplasia and
cancer of the cervix
 B. Physical Agents

These include exposure to sunlight or

radiation, chronic irritation or
inflammation and tobacco use
Exposure to sunlight or radiation is
related to skin cancer.
 B. Physical Agents

These are some of the factors:

c. Occupation (work that needs to
a. Clothing styles (sleeveless
be under the sun)
t-shirts or shorts)
d. Recreational habits (such as
b. Use of sunscreens
swimming)

•Exposure to ionizing radiation can occur with

repeated diagnostic x-ray procedures
 C. Chemical Agents

Accounts for 75% of all cancers

Exposure can be:
1. Tobacco smoke - single most lethal chemical
carcinogen
Associated with cancers of the lung, head and neck,
esophagus, pancreas, cervix and bladder.
Tobacco act synergistically with other substances (eg.
alcohol) to promote cancer development.
 D. Genetic and
Familial Factors

Genetic and familial carcinogens are inherited

mutations that increase cancer risk, often seen in
cancers like breast, ovarian, and colorectal cancer.
However, environmental factors also influence
cancer development.
 D. Genetic and
Familial Factors
Almost every cancer type has been shown to run in
families. This is due to genetics, shared environments,
cultural or lifestyle factors, or chance alone.

- Example cancers with - Example of inherited

underlying genetic abnormalities cancer syndromes:
Leukemia
Premenopausal breast
Skin cancers
cancer
Malignant melanoma
 E. Dietary factors

Accounts for 35% of all environmental cancers

Dietary substances can be proactive (protective), carcinogenic, or

co-carcinogenic

Risk for cancer increases with long-term ingestion or chronic

absence of proactive substances in the diet

Obesity is associated with endometrial cancer, increased risk of

cancers of thecolon, kidney and gallbladder
 E. Dietary factors

Dietary substances associated with increased

cancer risk:
1. Fats 4. Foods containing nitrates
2. Alcohol and nitrites
3. Salt-cured or
5. High caloric dietary intake
smoked meats
 E. Dietary factors

Food substances that appear to reduce cancer

risk:
1 . Cruciferous vegetables
(cabbage, broccoli, 3. Possibly vitamins E
cauliflower) and C

2. Carotenoids (carrots,
4. Zinc and selenium
tomatoes, spinach, dark-green
and deep-yellow vegetables)
 F. Hormonal Agents

Tumor growth may be promoted by disturbances in

hormonal balance.

Oral contraceptives and prolonged estrogen replacement

therapy are associated with hepatocellular, endometrial and
breast cancers, whereas they appear to decrease the risk for
ovarian and endometrial cancers
 DIAGNOSIS OF CANCER

Suspected patients can undergo testing to:

1. Determine the presence of tumor and its extent.
2. Identify possible spread (metastasis) of disease or
invasion of other body tissues.
3. Evaluate the function of involved and uninvolved
body systems.
4. Obtain tissue and cell for analysis, including
evaluation of tumor stage and grade.
 DIAGNOSIS OF CANCER
Stage - staging determines the size of the tumor and the
existence of metastasis. This uses the TNM system: T-extent
of the primary tumor, N-lymph node involvement, M-
metastasis
Grade - grading refers to the classification of the
tumor cell. Seeks to determine the type of tissue from
which the tumor originated and the degree to which
the tumor cell retain the functional characteristics of
the tissue of origin.
 DIAGNOSIS OF CANCER

Cancer Staging (TNM System) Overview

Staging helps doctors plan treatment and predict outcomes.

• T (Tumor Size & Extent) – Ranges from T0 (no tumor) to T4 (large tumor
invading nearby tissues).
• N (Lymph Node Involvement) – N0 means no lymph nodes are affected, while
N1-N3 indicate increasing spread to nodes.
• M (Metastasis) – M0 means no spread, while M1 confirms cancer has reached
distant organs.

Higher stages generally mean more advanced cancer, requiring more aggressive
treatment.
 DIAGNOSIS OF CANCER

Cancer Grading Overview

Grading helps determine how abnormal tumor cells look and how fast they may
grow.
• Low-grade (Well-differentiated) – Cells resemble normal tissue and grow
slowly.
• High-grade (Poorly differentiated) – Cells look very abnormal and grow
aggressively.

Higher grades usually indicate a more aggressive cancer that may require
intensive treatment.
 DETECTION AND
PREVENTION OF CANCER
Primary prevention -
Reduce cancer risk by avoiding
concerned with reducing the
carcinogens (smoking, alcohol,
risks of cancer in healthy UV rays), maintaining a healthy
people. diet and weight, exercising
Focus on education of regularly, getting vaccinated
knowledge and skills (HPV, Hepatitis B), and having
routine check-ups.
Adopting dietary and various
lifestyle changes
 DETECTION AND
PREVENTION OF CANCER
Secondary prevention - detection
Focuses on early and screening to achieve early
detection through diagnosis and prompt
screenings, self-exams, intervention to stop the cancer
process.
and blood tests to
Screening for people with family
diagnose cancer early, history of cancer
allowing for prompt
Involves directed prevention such as:
treatment and better breast and testicular self-
outcomes. examination, and Papanicolaou (Pap)
tests
EXAMPLE IMAGING TESTS USED
TO DETECT CANER
EXAMPLE IMAGING TESTS USED
TO DETECT CANER