Six Things You Might Not Know About Cancer

MCI Research Symposium 2011
I don't make a habit of touting my qualifications. People that do that bug me. However, since I'm about to write a post about a disease and claim to know some things, it's important to explain why I am a worthy source. After graduating from college in 2006, I taught high school Science for two years (see "What Teaching Taught Me"). I entered graduate school in 2008 (see "Five Reasons I Became a Scientist"); and in 2009 I joined a lab at the Mitchell Cancer Institute in Mobile, Alabama. In that lab I studied mechanisms of breast cancer metastasis (spreading of cancer). I finished my dissertation work in 2012 and graduated in May of that year with my Ph.D. in Biomedical Sciences with an emphasis in Cancer Biology. Since then I have been working as a Postdoctoral Research Associate at St. Jude Children's Research Hospital studying rhabdomyosarcoma (What is that?). I am not a physician or trained in clinical treatment of anything, but I spend time thinking about cancer almost every day of my life.

I hope this post will be both educational and helpful to you. If you have any questions pertaining to this post, feel free to contact me or leave a comment on the blog.

#1 Cancer is not one disease.

In my opinion, this is the most common misconception about cancer. Several people have asked me over the years, "Do you think we'll ever find the cure for cancer?" The answer to that is yes and no. Several cancers have already been dealt with quite handily. St. Jude has almost knocked out several childhood leukemias by itself. Here is an excerpt from St. Jude's website:

"In 1962, the survival rate for acute lymphoblastic leukemia (ALL), the most common form of childhood cancer, was 4 percent. Today, the survival rate for this once deadly disease is 94 percent, thanks to research and treatment protocols developed at St. Jude."

While this is very encouraging, survival rates for several other cancers have remained dismal since the cancer began being treated. 



Every type of cancer is a unique disease. And if that weren't complicated enough, each type of cancer (e.g. breast, prostate, colon, melanoma) has sub-types based on the genetic background of the tumor. As the research community learns more, it is becoming clear that each individual patient must be treated in a unique way based on age, gender, medical history, and genetic background. This is a daunting task, but apparently the only way.

The take-home message from this section is that cancer as a whole will not be cured in one day or with any "magic bullet". But if each cancer type continues to be cured one at a time, hopes are brightened for every cancer patient and their families.

#2 Your immune system is your best defense against cancer.

I hope I don't scare anyone too much, but you might have "cancer" cells in your body right now, and there is no way to know. No test known to man can determine if there are five or ten or a hundred cancer cells lurking within your body somewhere. Why? Because cancer cells are basically the same as the rest of your cells. It is very difficult to develop technologies to delineate between a normal cell and one that has become cancerous.

But be encouraged, because you have an amazing army inside your body called the immune system. It has layers of complicated and ingenuitive methods for seeking out foreign substances or organisms and destroying them before they hurt you. In fact, most cells that become cancerous are quickly removed from your body because your body's cells are programmed to stimulate the immune system when they become cancerous. It's really cool. Even if you have twenty-five nasty little cancer cells in your body right now, it's very likely your immune system will kill them.



Why do people get cancer then? Unfortunately, many cancer cells develop ways to evade the immune system and grow in spite of it. 

How can I "boost" my immune system? I'm not an immunologist, but my general knowledge of human health tells me a healthy mind and body is your best chance at having a healthy immune system. If your lifestyle is bad for your health, it's bad for your immune system, and you're more likely to get cancer. That said, living a healthy life does not exempt a person from cancer! It just gives that person a better chance. Getting cancer does NOT necessarily mean a person has lived an unhealthy life!

#3 Early detection is your next best defense against cancer.

In the event that cancer cells form in a person's body and find a way to escape the army of immune cells, the compilation of those cells is called a tumor. As I'll mention in #4, most tumors are not the type that spread throughout the body (metastatic). This is very good! But there is a nasty twist...

According to current understanding, tumor cells develop their ability to spread throughout the body very early in the formation of the tumor--prior to causing symptoms in the patient. Most people do not know something is wrong with them until they experience a symptom--a headache, bleeding, nausea, localized pain, etc. When patients go to a clinic with a cancer-driven symptom, it might be past the point when the tumor began spreading. It's a very scary fact, but it's true. 

The moral of the story is: "Don't wait until you feel sick to get checked for cancer." That's why the medical community is so adamant about getting checked for breast, ovarian, colon, and prostate cancer. Even if you don't feel it, you might have the beginning stages of it. If doctors can find it sooner, you're chances of surviving are infinitely better!

#4 Most "tumors" are not malignant (metastatic).

It's unsettling that tumors can become malignant so early in their development, but the slightly silver lining is that a very small percentage of tumors develop this ability. Most tumors are comprised of cells that have gained the ability to divide (form more cells) without normal restrictions. The task of leaving that "primary tumor site" is not trivial.

If cells get away from the primary tumor, they can get into the bloodstream or the lymphatic system (What is that?), and that's very bad news. This is how a doctor will determine a cancer patient's "stage". If you hear people talking about "stage 1" or "stage 4" cancer, they're talking about how much the cancer has spread throughout the body.

This information becomes very important if you or your doctor find a "mass" in your body somewhere. These are typically not capable of spreading (termed "benign"). Benign tumors can be surgically removed (most of the time), and that should be the end of the story.

For more information, see this site from the National Cancer Institute.

#5 Cancer is caused by external and/or internal factors.

The big question: Why did I get cancer? Often the answer is unknown, but sometimes it can be figured out. Pause. When I say, "Why did a person get cancer?", I mean, "What scientifically discernible reason can be traced as the cause of cancer?" This does not answer the yearning question that lingers in the minds of patients and their families: "Why me?" That's a different question that you need to bring to God. Science cannot address those questions.

I Peter 5:7 Casting all your care upon him [God]; for he cares for you.

The two major external causes of cancer are radiation and carcinogenic (cancer-causing) chemicals. Both can damage the DNA within your cells and cause cancer.



Internal causes of cancer are based on a person's genetic background. Some people can ingest carcinogenic materials their entire life (e.g. smoking cigarettes) and not get lung cancer. Conversely, some people can get melanoma (skin cancer) after being exposed to small amounts of UV radiation because they might be carrying mutations that limit their cells' ability to prevent cancer formation. 

Consider this metaphor. Your cells are equipped with security guards that sound alarms and lay the smack down when cells start forming cancer. What happens if you remove security guards? Well, nothing--unless there is an attack. Having some of these "security guards" mutated or missing in a person's cells means that they might never get cancer unless they are exposed to certain types of "attacks", like radiation or carcinogens.



Sometimes your cells can mess up DNA on their own when they are dividing within your body (see "somatic mutation"). Cells with damaged DNA can obtain mutations that allow cancer to be more likely to form.

Sadly, many people are born with genetic mutations that cause cancer. This is typically how infants and small children get cancer. Either their parents carried "silent mutations" that were passed along to the child, or the mutations occurred during early embryonic development. Regardless, these mutations are typically forceful enough to form cancer without the need for any external factors.

#6 Three categories of cancer treatment exist.

(1) Surgery

The simplest and oldest method of removing cancer is to perform surgery. However, if the cancer has spread to other parts of the body, surgery doesn't help much.

(2) Chemical therapies ("chemo")

Chemotherapy delivers a chemical to the entire body that is designed to specifically kill cancer cells. Of course, specificity is the big issue. Most chemotherapies have off-target effects and cause a wide range of symptoms in the patients. The advantage of this therapy is it can reach throughout the body to fight cancer that has spread.

(3) Radiation therapies

This treatment is designed to kill cells that are rapidly dividing, which is true of tumor cells. Unfortunately, it is true of other cells in your body, so it makes people sick.

Conclusion:

Cancer is a nasty problem, but I believe research is helping. Living a healthy lifestyle gives you your best chance at not getting cancer, but it can happen to any of us. Let it be a reminder to all of us that each day lived healthily is a fantastic blessing!

Image credits:
Tumor graphic from http://www.medtiblog.org/2013/08/27/what-are-the-most-common-types-of-cancer/
Immune system diagram from http://www.current-opinion.com/journals/current-opinion-in-immunology/
Early detection graphic from http://bcrt.ca/2008/11/04/lungsign-a-new-lung-cancer-detection-method/
DNA graphic from http://mashable.com/category/dna/
Police office graphic from http://sharonhaddock.blogspot.com/2012/05/copping-out.html

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