CARCINOGENESIS

Cancer is when abnormal cells divide in an uncontrolled way. Some cancers may eventually
spread into other tissues

Carcinogenesis, also called oncogenesis or tumorigenesis, is the formation of a cancer, whereby

normal cells are transformed into cancer cells.

Chemical

Tobacco is considered as the most recognised source of chemical carcinogens. Tobacco smoke
generates more than 2000 chemical compounds, most of which are carcinogens. The level of
Carbon monoxide in tobacco smoke is eight times higher than the maximum permissible limits.
Tobacco smoke also contains Nicotine, which is one of the major cancer promoters. Tobacco tar
contains hydrocarbons such as Nitrosamines, Benzene, Benzopyrenes and other carcinogenic
compounds. Tobacco chewing & smoking can cause many cancers including those of the lung,
mouth, larynx, stomach and bladder.

The polluted environment is another major source of chemical carcinogens. Fumes emitted by
vehicles contain many toxic chemical compounds, most of which are carcinogens such as Carbon
monoxide, Lead, Nitrous oxide, Benzene and many other toxic volatile compounds.

Most of the industrial toxic chemicals and heavy metals such as Lead, Arsenic, Mercury,
Aluminium, Nickel and Cadmium having carcinogenic activity. The bioaccumulation of these
industrial carcinogens in different tissues & organs of the human body can cause cancer by
damaging the DNA.

Farmers and agricultural workers are directly exposed to pesticides such as Carbaryl, Chlordane,
Diazinon, Dichlorvos, Dichloro-diphenyl-trichloroethane (DDT), Lindane, Malathion and
Toxaphene, which are carcinogens.

Chlorine is commonly used to purify the drinking water. Chlorine can form cancer-causing
compounds in the drinking water such as Chloroform and Trichloroethylene.

Food containing the residues of pesticides & herbicides is a major source of chemical
carcinogens. Most of the food additives like preservatives, sweeteners and colours can cause
cancer. Saccharin and cyclamates used as artificial sweeteners can cause cancer of the bladder.
Another artificial sweetener called aspartame, which is used in many food products can cause
brain tumours.

Physical

Exposure to ionising radiation such as X-rays, Gamma rays and particle radiation from
radioactive substances form highly reactive ions in the exposed cells that can rupture the DNA
strands, causing mutations in the genes, leading to the development of cancer.

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It has been observed that the exposures to even low-levels of ionising radiation can cause cancer.

Radioactive waves emitted in the atomic explosions have a significant carcinogenic effect. Most
of the survivors of the 1945 atomic bomb explosions at Hiroshima and Nagasaki in Japan
developed leukaemia due to exposure to the atomic radiation.

Solar radiation (ultraviolet B and ultraviolet C) is the causative factor in about 40 per cent of the
skin cancers. Ultraviolet radiation induces permanent mutation in the tumour suppressor gene
(p53 gene) in the exposed cells that causes skin cancer. Exposure to ultraviolet radiation is
increasing, day-by-day, due to the expanding ozone hole in the earth’s upper atmosphere. The
people with darker skin are protected from ultraviolet radiation due to presence of a pigment
called Melanin in their skin. Caucasians of Australia are the worst affected from ultraviolet
radiation, due to over exposure to sunlight and the least amount of melanin in their skin.

Exposure to electromagnetic radiation, emitted by man-made technological devices and

installations can cause cancer. The electromagnetic fields (EMFs) generated by fluorescent
lights, electrical wirings, electric motors, food mixers, hair dryers, heaters, electric shavers,
vacuum cleaners, microwave ovens, televisions, computers, video terminals and cell phones, etc.
emit 30 to 100 times greater EMFs than the permissible limits. Ordinary home appliances
generate large cumulative electromagnetic radiation due to proximity of the user to these
appliances. The EMFs from these appliances drop off at a distance of about 16 feet but the users
usually stand or sit closer to the these appliances. It has been observed that prolonged exposure
to electromagnetic fields causes mutations in the genes.

Physical irritants such as chronic abrasion of mucus membrane of the gastrointestinal tract by
some food item or abrasion of the buccal mucosa by an ill-fitted denture can lead to the
development of cancer. The worn out cells in these tissues are to be replaced by the new cells,
formed as a result of rapid mitosis (cell division) that increases the chance of mutations in the
genes, thus increasing the risk of developing cancer.

Biological Causes

Some of the evidences suggest the causative role of viruses in the human cancers. About 90 per
cent cases of nasopharyngeal carcinoma have the antigens of Epstein-Barr virus (EBV). There is
a link between EBV and Burkitt’s lymphoma. Studies have suggested an association between
EBV and the testicular tumours. Epstein-Barr virus is also associated with leiomyoma in
children.

Similarly, Hepatitis B and Hepatitis C viruses are known to enhance the risk of hepatocellular
carcinoma. Human immunodeficiency virus (HIV) is associated with non-Hodgkin’s lymphoma,
Kaposi’s sarcoma and cancers of the cervix & anus. Sexually transmitted human papilloma virus
(HPV) is a major risk factor of cervical & anal cancers.

It has been observed that the DNA strands of virus insert directly into one of the chromosomes
of the animal cell, causing mutations that can lead to the development of cancer. Some of the
RNA viruses are found to carry an enzyme called reverse transcriptase that transcribes RNA to

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DNA. The strands of transcribed DNA then insert into the chromosomes of the animal cell,
causing mutations in the genes.

cancer classifications

 Carcinoma: This develops in epithelial tissues, such as those in the gastrointestinal tract
or mucous membranes. According to the National Cancer Institute, an estimated 80 to 90
percent of cancer cases are carcinomas.

 Leukemia: This is a cancer that arises in the bone marrow, which produces blood cells.
 Lymphoma: This develops in the lymphatic system that includes the spleen, tonsils, and
thymus. This system relates to immune activity and hormones.
 Mixed types: Mixed cancers develop in two different types of cell from one category or
multiple categories.
 Myeloma: Often occurring in the bone marrow, this type originates in plasma cells that
circulate as part of the blood.
 Sarcoma: These originate in connective tissue, developing in areas such as the bones,
muscle, fat, and cartilage. Sarcomas are more common in young people.

Cancer diagnosis

One or more approaches to diagnose cancer:

 Physical exam. Your doctor may feel areas of your body for lumps that may indicate a
tumor. During a physical exam, he or she may look for abnormalities, such as changes in
skin color or enlargement of an organ, that may indicate the presence of cancer.
 Laboratory tests. Laboratory tests, such as urine and blood tests, may help your doctor
identify abnormalities that can be caused by cancer. For instance, in people with
leukemia, a common blood test called complete blood count may reveal an unusual
number or type of white blood cells. Some tumors release substances called tumor
markers, which can be detected in the blood. A blood test for prostate cancer, for
example, determines the amount of prostate specific antigen (PSA). High PSA levels can
indicate cancer.
 Imaging tests. Imaging tests allow your doctor to examine your bones and internal
organs in a noninvasive way. Imaging tests used in diagnosing cancer may include a
computerized tomography (CT) scan, bone scan, magnetic resonance imaging (MRI),
positron emission tomography (PET) scan, ultrasound and X-ray, among others.
 Biopsy. A small tissue sample is surgically removed and examined under a microscope
for the presence of cancer cells. Depending on tumor location, some biopsies can be done
on an outpatient basis with only local anesthesia. If the tumor is filled with fluid, a type
of biopsy known as a fine needle aspiration is used. A long, thin needle is inserted
directly into the suspicious area to draw out fluid samples for examination.

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 In the laboratory, doctors look at cell samples under the microscope. Normal cells look
uniform, with similar sizes and orderly organization. Cancer cells look less orderly, with
varying sizes and without apparent organization.

 Endoscopy
A flexible plastic tube with a tiny camera on the end is inserted into body cavities and
organs, allowing the physician to view the suspicious area. There are many types of
scopes, each designed to view particular areas of the body. For instance, a colonoscope is
used to detect growths inside the colon, and a laparoscope is used to examine the
abdominal cavity.