Cancer

Introduction

Commonly, in an organized way, cell multiply and die, helping the individual to grow, healing

injuries, and replacing the worn-out tissues. Sometimes something in the cells goes wrong and

cells start to grow in an uncontrolled manner. The uncontrolled growth of abnormal cells is

known as cancer. These abnormal cells are named malignant cells, tumor cells, and cancer cells.

These cancer cells penetrate into the tissues of the body. Many abnormal and cancer cells that

consist of the cancer tissue are further categorized by the tissue name from where the cancerous

cells are originated such as lung cancer, breast cancer, colorectal cancer, and brain cancer. When

unrepaired or damaged cells do not die they become tumor cells. They display uncontrolled

growth and division. They developed a cancer cell’s mass. Commonly, from the initial mass of

the cells, cancer cells can break away and travel through the lymph and blood system and

penetrate the other organs of the body and repeat the growth cycle in an uncontrolled manner.

The process of cancer cells leaving one part of the body and growing in other areas of the body is

named metastasis and metastatic spread. E.g. if the cells of breast cancer to the body bone, the

person has metastatic breast cancer to bone (“Australian Cancer Incidence and Mortality (ACIM)

books: All cancers combined”, 2017).

The cell cycle control factors such as cyclin, cyclin-dependent kinase (Cdks) and cyclin-

dependent kinase inhibitors (CdksI) control the cell cycle. Cyclin regulates the cell cycle and

activates the factors that need to enter the next phase of the cell cycle in a positive way There are

2 classes of genes, tumor suppressor gene and oncogenes control the cell cycle. The Oncogenes

drive the cell cycle forward. It permits the cell to proceed from one stage of the cell cycle to

another stage. The tumor suppressant gene restricts the progression of the cell cycle. Their
control of the cell cycle is lost when there is a genetic alteration in the genetic material of the

cells. The loss of their control on the cell cycle leads to the tumor or cancer formation (Coudray

et al., 2018).

Causes of cancer

Any internal or external factor that may involve developing normal cells of the body into

abnormal and leads to cancer. The genetic makeup or any environmental factor may trigger the

changes that may become causes of cancer. Different risk factors may combine to induce cancer

in patients. Diet also plays important role in health and bad diet supplements have a worse effect

on the immune system of a person. The excessive intake of meat may increase the cancer of the

digestive tract. The higher amount of saturated fat involves in prostate cancer. Alcohol adverse

the cancer of the mouth, esophagus, and pharynx. The increased consumption of beer also has

increased chances of colorectal cancer. Heredity may be a risk factor for cancer and some

specific type of cancers (e.g. skin, prostate, breast, ovarian, and melanoma) linked with human

genes. The hormonal imbalance also becomes a source of some specific cancers. The level of

estrogen may have significant importance in endometrial and breast cancer. Whereas stress may

also damage the internal body system. More exposure of a person toward cancer-causing agents,

there is more chance to develop cancer. Stress directly affects the hormonal function of the

thymus gland and indirectly affects on pituitary, adrenal cortex, and hypothalamus. There is a

chance to has a neurologic currency which may lead anxiety to malignancy. The radiations like

X-ray, alpha, gamma, beta and ultraviolet rays and substance like radon and uranium are also

major sources to cause cancer as they induce mutation in the genome. Different carcinogenic

substances as nickel, asbestose, cadmium, benzene, vinyl chloride, N-nitrsomines, and benzidine

may induce mutations in DNA that cause cancer. The smoke of cigarettes and tobacco contains
almost 66 potential carcinogenic toxins that are the major causes of increasing cancer patients.

Various viruses may involve in the development of the disease that is malignant. These viruses

may play a role as a cofactor in the development process. Virus-like hepatitis B has a role in

human liver cancer and Epstein Barr virus and papillomavirus are oncogenic. Age is also the

main factor that enhanced the chance of developing cancer. According to a survey, persons older

than 65 have 6 times more chance to become a cancer patients as compared to 40 to 65 aged

persons. The increased chance of cancer risk with age may be due to the increased level of

accumulated genetic mutations (Golemis et al., 2018).

Symptoms and clinical description of cancer

There are the following symptoms of cancer

1- Change in habits of bladder and bowel

2- Sore throat

3- Lump or thickening in the testicles, breast, or anywhere in the body

4- Swallowing difficulty and indigestion

5- Hoarseness or cough

6- Usually, discharge or bleeding e.g. secretions from nipples.

7- A clear change in shape, color, thickness, and size of mole or wart.

8- Loss of appetite or weight

9- Vomiting, nausea, fatigue (Wayne et al., 2018)

Pathogenesis of cancer

The development of cancer (carcinogenesis) is a multistage process. The application of the

carcinogen doesn’t lead to instant tumor production. There is a sequence of changes in the cell
after the initial step induces by the carcinogen. The further stages of cancer productions may be

produced by promoting agents or carcinogens. Promoting agents do not produce cancer

themselves. The genetic material (DNA) is the most expected site for the primary events. The

carcinogen destroys the particular genes in the population of stem cells of the tissues involved.

The chemical that changes the cell's genetic makeup and reactss with deoxyribonucleic acid

(DNA) is known as the mutagen. A chemical compound that actss as a promoter, as well as an

initiator, is known as a complete carcinogen.

Figure 1: pathogenesis of cancer ((Lindström et al., 2018)

Initiation is the first step in the development of cancer. If the initiator not already reactive with

Deoxyribonucleic acid (DNA), it changes by the enzymes, and then the initiator capable to

produce the alteration in the DNA. The effect of the initiator is not reversible. After an initiator

mutates the cell, it is vulnerable to the promoter effects. Promoter promotes cell proliferation and
producing a large number of daughter cells comprises of mutation that was induced by the

initiator. Promoters within the cell do not react with any macromolecules or DNA. The promoter

bind to the cell receptors that are present on its surface that affect the cellular pathways and leads

to enhance the proliferation of cell (Lindström et al., 2018).

Treatment

There are different kinds of cancer treatments. The type of cancer treatment that a person

receives will also depend upon the cancer typoes she/he has. Many people who are suffering

from cancer will have only one kind of cancer treatment. But in several patients s the

combination of cancer treatment like radiation therapy, chemotherapy, and surgery.

In the surgery, the cancerous part removes from the patient body. In radiation therapy, a high

radiation dose uses to kill the shrinking tumor and cancer cells. In radiation therapy, there high

energy waves or particles such as gamma rays, X-rays, protons, and electrons beams that destroy

the cells. In chemotherapy different kinds of drugs are used to kill the cancer cells. These kinds

of drugs are not specific to the cell cycle. There are several types of alkylating agents, derivatives

of mastered gas, mechlorethamine, ethylenimines, and cyclophosphamide that are used in

chemotherapy. Immunotherapy is a kind of treatment for cancer that aids the immune system of

the body to fight against cancer. Different kinds of drugs are used in immunotherapy that boosts

up the body's immune system. In the treatment of cancer targeted therapy is also used. in this

therapy, we target the changes that occur in the cancer cells that aid them to spread, divide, and

grow. Stem cell transplantation is the procedure in which stem cells that form the blood are

restored in the cancer patient. By the high dose of radiation and chemotherapy stem cells

destroyed in the patient (Qiu et al., 2018).

Main focus of gene therapy approaches before the miRNAs discovery, were to restore the

function of the TS gene in tumor cells. Although this approach of restoring suppressed genes

suppresses the growth of tumors in mice the aim of achieving this in a clinical setting showed

limited success. The main hurdle of this approach is the specific and effective delivery of viral

vectors or large DNA plasmids. The delivery efficiency, vector size, and gene expression are

also the limitations of this strategy. Hence due to these limitations, the attention is being shifted

away from this strategy of gene therapy.

Figure 2: miRNA replacement therapy (Hong et al., 2018)

breakthrough in translation and biomolecular science. miRNAs are smaller than proteins and can

be delivered to cells by using the methods similar used in small interference RNAs (siRNAs)

(Kota et al., 2009). A study reported the suppression of tumors in the murine lung by restoring

the miRNA Let-7. This particular study gives proves the potential of Let-7 as a target for the

treatment of lung cancer. After this study, TS miRNA replacement therapy has gained much

attention. The first replacement of miRNA for the treatment of cancer was performed in 2013 by

using the MRX34. MRX34 is a miR‐34 mimic which is formulated in the liposomes. It was

applied for the treatment of liver cancer in the clinical study (Chou et al., 2016).

Conclusion

Cancer is uncontrolled and abnormal cell growth. Commonly, it is derived from only one

abnormal cell. The cell lost a common mechanism of control and thus cells started to grow and

divide in an uncontrolled manner. Cancer developed due to the mutation in the genes that

control the cell cycle or suppress the cell division. The cell penetrate the nearby cells and started

spread to other parts of the body. A comprehensive plan for the diagnosis and treatment of

cancer is the main component of any plan to control cancer. The main goal of the plan is to cure

the patient having cancer and extend their life span.

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