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How cancer starts,
grows and spreads
1. Home
2. Cancer information
3. What is cancer?
4. How cancer starts, grows and spreads
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What is cancer?
Types of cancer
Human body
Immune system
Lymphatic system
Blood and bone marrow
Endocrine system and hormones
Female sex organs and reproductive system
Male sex organs and reproductive system
How cancer starts, grows and spreads
Types of tumours
Genes and cancer
Stage and grade
Prognosis and survival
What causes cancer?
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Our bodies are made up of trillions of cells grouped to form
tissues and organs.
Genes
inside the nucleus of each cell tell it when to grow, work,
divide and die. Normally, our cells follow these instructions
and we stay healthy.
But when there is a change in our
DNA
or damage to it, a gene can mutate. Mutated genes don’t
work properly because the instructions in their DNA get
mixed up. This can cause cells that should be resting to
divide and grow out of control, which can lead to cancer.
How cancer starts
When genes work properly, they tell cells when it is the right
time to grow and divide. When cells divide, they make exact
copies of themselves. One cell divides into 2 identical cells,
then 2 cells divide into 4, and so on. In adults, cells normally
grow and divide to make more cells only when the body
needs them, such as to replace aging or damaged cells.
Diagram of cell division
But cancer cells are different. Cancer cells have gene
mutations that turn the cell from a normal cell into a cancer
cell. These gene mutations may be inherited, develop over
time as we get older and genes wear out, or develop if we are
around something that damages our genes, like cigarette
smoke, alcohol or ultraviolet (UV) radiation from the sun.
A cancer cell doesn’t act like a normal cell. It starts to grow
and divide out of control instead of dying when it should.
They also don’t mature as much as normal cells so they stay
immature. Although there are many different types of cancer,
they all start because of cells that are growing abnormally
and out of control. Cancer can start in any cell in the body.
How cancer grows
Gene mutations in cancer cells interfere with the normal
instructions in a cell and can cause it to grow out of control or
not die when it should. A cancer can continue to grow
because cancer cells act differently than normal cells. Cancer
cells are different from normal cells because they:
divide out of control
are immature and don’t develop into mature cells with
specific jobs
avoid the immune system
ignore signals that tell them to stop dividing or to die
when they should
don’t stick together very well and can spread to other
parts of the body through the blood or lymphatic system
grow into and damage tissues and organs
As cancer cells divide, a tumour will develop and grow.
Cancer cells have the same needs as normal cells. They need
a blood supply to bring oxygen and nutrients to grow and
survive. When a tumour is very small, it can easily grow, and
it gets oxygen and nutrients from nearby blood vessels.
Diagram of how cancer grows
But as a tumour grows, it needs more blood to bring oxygen
and other nutrients to the cancer cells. So cancer cells send
signals for a tumour to make new blood vessels. This is called
angiogenesis and it is one of the reasons that tumours grow
and get bigger. It also allows cancer cells to get into the
blood and spread more easily to other parts of the body.
There is a lot of research that is looking at using drugs that
stop blood vessel growth (called angiogenesis inhibitors),
causing a tumour to stop growing and even shrink.
How cancer spreads
As a tumour gets bigger, cancer cells can spread to
surrounding tissues and structures by pushing on normal
tissue beside the tumour. Cancer cells also make enzymes
that break down normal cells and tissues as they grow.
Cancer that grows into nearby tissue is called local invasion
or invasive cancer.
Diagram of how cancer spreads
Cancer can also spread from where it first started to other
parts of the body. This process is called metastasis. Cancer
cells can metastasize when they break away from the tumour
and travel to a new location in the body through the blood or
lymphatic system.
Where cancer can spread and staging
Most cancers have a tendency to spread to certain areas of
the body. This has helped doctors develop staging systems
that are used to classify cancers based on information about
where the cancer is in the body and if it has spread from
where it started. Many cancers follow a staging system from
1 to 4 that is usually given in Roman numerals I, II, III or IV.
Knowing how a cancer spreads and where a cancer may
spread helps doctors predict how the cancer will grow. This
also helps them plan treatment and give appropriate
supportive care.
Cancer can spread anywhere in the body, but it’s most likely
to spread to lymph nodes, bones, the brain, the liver or the
lungs.
Why does cancer sometimes come back?
Cancer sometimes comes back after treatment. This is called
a recurrence. Even if one cancer cell is left behind, it can
grow and divide to become a new tumour. A new tumour can
start to grow in the same area of the body where the cancer
first started, or the cancer may have spread through the
blood or lymphatic system to another part of the body, where
it grows into a new tumour. This is why doctors sometimes
use another treatment right after the first treatment, such as
giving chemotherapy after surgery. This is called adjuvant
therapy. The goal of adjuvant therapy is to help prevent the
cancer from coming back in case some cancer cells are left
behind in the body.
In some cases, treatment may stop working (become
resistant) so cancer cells are no longer being destroyed. So
cancer that was shrinking or had disappeared may start to
grow again and get bigger. This can happen when the genes
inside cancer cells mutate. Some gene mutations make
cancer cells resistant to chemotherapy and other drug
treatments. If you become resistant to a treatment, your
doctor may suggest that you try another one.
Cure or remission
Many cancers can be cured with treatment. But cancer that is
thought to be cured can still come back even years later. This
is why some doctors prefer to say that the cancer is in
remission. Remission means there are fewer signs and
symptoms of a disease (such as cancer) or that they have
completely gone away.
Expert review and references
References
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