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Cancer - Definition
Cancer is an abnormal growth of cells caused by multiple changes in gene expression leading to dysregulated balance of cell proliferation and cell death and ultimately evolving into a population of cells that can invade tissues and metastasize to distant sites, causing significant morbidity and, if untreated, death of the host.
At cellular level: - Excessive cellular proliferation - Uncoordinated growth - Tissue infiltration and role of tissue microenvironment
At molecular level: - Defects in various cell-cycle & growth regulatory genes - Develops in a multi-step fashion
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Cancer
Types of changes: Immortalization: indefinite growth. Transformation: deviation from normal growth requirements and constrains; independent of anchorage and serum growth factors, not inhibited by density/contact. Invasion and metastasis: invasion of normal tissues and dissemination to distant organs.
Cancer-Terms
Benign
Harmless and limited in scope. In cancer, the opposite of malignant.
Malignant
A cancer whose scope extends beyond the initial tumor. Characterized by anaplasia, invasion and metastasis.
Invasion
Movement of cells from a tumor into immediately surrounding tissue.
Metastasis
Movement of cancer cells into tissues beyond the original tumor. Usually involves transit through the blood stream.
Cancer-Terms
Angiogenesis
Growth of new blood vessels from the existing ones.
Proto-oncogene
A normal gene whose normal product does not cause cancer, but in which a mutation (oncogene) will cause cancer.
Tumor-suppressor gene
A gene whose product impedes uncontrolled cell growth.
Apoptosis
Programmed cell death.
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the
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A multistep molecular event model for the development of hereditary adenomatous polyposis, a colorectal cancer.
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Normal function
Promotes division
Mutated function
Promotes division abnormal time or cell type Fails to suppress division
Types of proteins
Growth factors
Checkpoint molecules
Other genes involved in apoptosis, angiogenesis, invasion and metastasis are also disrupted in cancer. 17
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Genes that Control Cell Growth are Either Proto-oncogenes or Tumor-Suppressor Genes Growth factors Growth factor receptors Intracellular signal transduction proteins Transcription factors Anti-apoptosis proteins Cell-cycle control proteins DNA repair proteins
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Burkitts lymphoma
t (9;22)-90-95% of cases
bcr-abl fusion protein is produced, which results in constitutively active abl kinase
bcr-abl fusion protein is produced, which results in constitutively active abl kinase
t (9;22)-10-15% of cases
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Gene Amplification
Oncogene Amplification Tumor
c-myc
N-myc L-myc c-abl c-myb c-erbB K-ras
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20 fold
5-1000 fold 10-20 fold 5 fold 5-10 fold 30 fold 4-20 fold 30-60 fold
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DNA methylation
Loss of heterozygosity
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APC
WT1
Regulates -catenin
Transcription factor
Gardner syndrome
Denys-Drash syndrome
Colorectal cancer
Wilms tumor
Familial retinoblastoma Li-Fraumeni syndrome Inherited breast and ovarian cancer Inherited breast and pancreatic cancer
Osteosarcoma, breast and prostate cancer 50% of all cancers Breast cancer; ovarian cancer Breast and pancreatic cancer
BRCA2
DNA repair
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Hallmarks of Cancer
Activate H-ras oncogene
Loss of Rb
Inactivate E-cadherin