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Cancer Final Draft T. J. Cox The problem is cancer. Cancer is the second leading cause of death in the world and my interest in the subject is simple. My mother is the most resilient person I have ever met.

Any time I need any kind of inspiration, I need only to think of her. When she was eighteen she was diagnosed with Hodgkins disease. The doctors gave her a less than thirty percent chance of living. Since then she has had cancer three other times. Breast cancer twice in 85 and 90, and most recently, colon cancer two summers ago.

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She has had many different treatments including chemo and radiation therapy as well as surgery to remove lumps in both breasts and her colon. What is cancer? There are more than 100 different types of cancer. It occurs when cells become abnormal and divide without control or order. Normally, cells divide in an orderly way to produce more cells only when the body needs them. If cells keep dividing when new cells are not needed, a mass of tissue forms. This mass of extra tissue, called a growth or tumor, can be benign or malignant.

(National Institute of Health) Benign tumors are not cancer. They do not invade nearby tissue or spread to other parts of the body. Benign tumors usually can be removed and are seldom a threat to life. Malignant tumors are cancer. They can invade and damage nearby tissues and organs. Cancer can also break away from a malignant tumor and enter the bloodstream and lymphatic system.

Through the lymphatic system is one of cancers best modes of transport for spreading to form new tumors in other parts of the body. The spread of cancer is called metastasis. Malignant tumors must be treated or will be fatal. There are many treatments for cancer. Among these are radiation, chemotherapy, surgery and the rapidly growing field of genetic therapy. It was discovered that when radioactive waves were directed on human cells, the cells would be destroyed. The idea of using this technology on cancer was a good one but was unsuccessful at first due to the damage caused to surrounding tissues.

Then the analogy drawn from a simple story gave insight on how to focus the rays on the cancer and not harm the surrounding tissues and organs. The story goes like this. A small country was ruled from a strong fortress by a dictator. The fortress was situated in the middle of the country, surrounded by farms and villages. Many roads led to the fortress through the countryside. A rebel general vowed to capture the fortress. The general knew that an attack by his entire army would capture the fortress.

He gathered his army at the head of one of the roads, ready to launch a full-scale direct attack. However, the general then learned that the dictator had planted mines on each of the roads. The mines were set so that small bodies of men could pass over them safely, since the dictator needed to move his troops and workers to and from the fortress. However, any large force would detonate the mines. Not only would this blow up the road, but it would also destroy many neighboring villages.

It therefore seemed impossible to capture the fortress. However, the general devised a simple plan. He divided his army into small groups and dispatched each group to the head of a different road. When all were ready he gave the signal and each group marched down a different road. Each group continued down its road to the fortress so that the entire army arrived together at the fortress at the same time. In this way, the general was able to capture the fortress and overthrow the dictator.

This simple story was the basis for intensity modulated radiotherapy (IMRT). This is a technique used to treat cancerous tumors on which a removal operation could not be performed. Interesting dose distributions generated by IMRT allow a better sparing of normal tissues with decreased acute and late toxicity, and offer a window for further dose escalations. (De Neve W; Claus F; Van Houtte P; Derycke S; De Wagter C) In order to get a radiation beam of high enough intensity to hit the tumor, without damaging surrounding tissues, several lower intensity beams were directed to the tumor from different directions. This method decreases damage to surrounding tissues but, it does not work on all cancer and still has some side effects. Another method with side effects used to treat cancer is chemotherapy.

Chemotherapy is a word to describe chemical agents (drugs) that are used in the treatment of various types of cancer. (Medical Oncology and Hematology Associates) Chemotherapy works by killing rapidly dividing cells. Cancer cells are rapidly dividing, but unfortunately so are white blood cells, red blood cells, platelets, cells lining the mouth, stomach and intestines, hair cells, and reproductive cells. These factors are part of the reason there are so many side effects with chemotherapy. Damage to these other rapidly dividing cells lead to loss of hair, nausea, sore mouth and decreased immune response. The side effects still associated with radiation and chemotherapy have led many researchers to look to new areas for cures.

The breathtaking pace of gene discovery in the last two decades, coupled with the birth of recombinant DNA technology, gave rise to the concept that genes may be manipulated and used as drugs. (Kong HL) Family friend and nationally renown genetic therapist, Ken Culver is working on genetic cures for cancer. One technique he and his team are pioneering is the idea of injecting the genetic code of a curable disease into a cancerous lump via recombinant DNA. The theory is that the disease will take over the cancerous cells and then the lump can be cured by the cure for the disease. Gene therapy has the potential to provide cancer treatments based on novel mechanisms of action with potentially low toxicities.

(Roth JA; Swisher SG; Meyn RE) Many of you have probably heard of cancer patients taking a variety of medicines and varying doses. It has been found that naturally occurring P-glycoproteins help in the build up of resistance to this multidrug technique. In a present study, the pharmokinetics of doxorubicin, a P-glycoprotein modulator, and GF120918, a novel potent P-glycoprotein inhibitor, were examined in cancer patients in a search for more selective modulation of multidrug resistance (MDR). (Sparreboom A., Planting A. S., Jewell R. C., van der Burg M.

E., van der Gaast A., de Bruijn P., Loos W. J., Nooter K., Chandler L. H., Paul E. M., Wissel P. S., Verweij J.) Data indicates that GF120918 at the tested doses of combination treatment achieves plasma concentrations that reverse MDR in experimental models and it lacks the significant kinetic interaction with doxorubricin observed previously with other modulators.

(7) Another study found that although multiple genes are involved in carcinogenisis. Carcinogenisis is the mutating of DNA because of a chemical in the body. Mutations of the p53 gene are the most frequent abnormality identified in human tumors. High levels of p53 expression and DNA-damaging agents work synergistcally to induce apoptosis (cell death) in cancer cells. Phase I clinical trials now show that p53 gene replacement therapy using both retroviral and adenoviral vectors(these are ways of getting the replacement genes into the cell) is feasible and safe. (Roth) Carcinoma, cancer of the epithelial cells, is a major cause of mortality in western societies. Clonal fixation and propagation of genetic changes due to oncogenes(cancer causing genes), sporadically accumulating in the epithelial cells, depend on growth factors and their surface receptors.

One of the large families of receptors is that of the ErbB tyrosine kinases. ErbB-2 delays ligand dissociation, enhances coupling to the mitogen-activated protein kinase pathway, and impedes the rate of receptor downregulation. The realization that ErbB-2 is a master regulator of a signaling network that drives epithelial cell prolification identifies this protein as a target for cancer therapy. (Klapper LN; Kirschbaum MH; Sela M; Yarden Y) Cancer is still the second leading cause of death in the world. All though the outlook on where research is going is optimistic, I still feel that the faith of the patient is large factor.

I have had many talks with Ken Culver about patients he has had in the past. One in particular stands out. The patient had a malignant tumor in her lung. She went through every treatment the doctors thought might work and nothing did. The doctors said it was only a matter of time and told her to enjoy the weeks she had left.

To their surprise a month later she was improving and after two months the tumor was gone. When they asked her what she had done in the past two months she talked about positive mental imagery. She said she pictured the tumor as a large block of cheese and her immune system as a pack of mice. She envisioned the mice gnawing away on the cheese and she just started feeling better and better. The doctors had no explanation as to how the woman was sitting in the office telling them all this.

Cancer is a horrible disease that effects millions of people every year. Further improvements are being made in past treatment techniques, and new theories are being formulated as we speak. There are so many different types of cancer that there will never be one pill that can be taken as a cure. Hopefully the rapid new findings in gene therapy will be what the world needs to beat the plague of the twentieth century. Science Essays.


.. Bibliography Of all the diseases and viruses that are known to man, no other can strike fear in so many peoples hearts, as the word cancer. What is cancer? Cancer is a new growth of tissue resulting from a continuous proliferation of abnormal cells that have the ability to invade and destroy other tissues.1 Cancer may be found in any type of cell or tissue in the human body. Cancer is not found in just humans, but also in animals and plants. Cancer cells can grow where ever normal cells grow or divide.

Cancer is not one disease but many single diseases classified under one name.2 In our bodies we produce many thousands of new cells everyday. We produce these cell in order to grow until we reach adulthood. When we reach adulthood, these cells reproduce primarily to heal wounds and to replace the cells that have died.3 When we look at a cancerous cells, we see that it divides endlessly. As the cell divides and multiplies, it takes up more and more of the space that the healthy cells once had to work in. These cells will take up more and more space until they are able to move into new areas of the body or the organism in which they live dies.

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This process of moving to new sites within the body is called metastasis.4 1. Robert A. Weiberg, Racing to the Beginning of the Road,Random House 1996, pg. XI. 2. Excerpted from Comptons Interactive Encyclopedia,1994,NewMedia, Inc.

3. R. Grant Steen, The Basic Science of Cancer, Plenum Press, 1993, pg. 31. 4.

Steven A. Rosenberg, The Transformed Cell G.P. Putnams Sons, 1992, pg. 341. 1. There are many different types of cancer.

Out of the hundreds of different types of cancer, there are three sub types to help classify the different types of cancer. First, Sarcomas, arise from connective and supportive tissue such as bone, cartilage, blood vessels, muscle and fat. Second, Carcinomas, which include the most frequently occurring forms of human cancer, arise from epithelial tissue, such as the skin and the lining of the body cavities and organs, and the glandular tissue of the breast and prostrate. Carcinomas with a structure resembling skin are termed squamous cell carcinomas. Those that resemble glandular tissue are called adenocarcinomas. Third, Leukemias and lymphomas include the cancers that involve blood forming tissues and are typified by the enlargement of the lymph nodes, the invasion of the spleen and bone marrow and the over production of immature white cells.5 The only number greater than the number of different types of cancer is the number of people found to have these deadly diseases. One million new cases of cancer are diagnosed in the United States alone each year.

Five hundred thousand die each 5. Excerpted from Comptons Interactive Encyclopedia, 1994. 2. year from this disease. It is also estimated that about 30% of the Americans living today, or 76 million Americans will develop cancer in their lifetime.6 As scientist search to cure this terrifying disease, with the help of millions of dollars in donations, we still do not even know what causes cancer to invade.

We do understand that the diseases likeliness to form is heightened with the different environments that people live in. Researchers see that with constant contact with carcinogens, substances that promote the development of cancer, is almost a guarantee that the person will develop cancer at some point in their life. Chemicals, radiation and viruses are the main types of carcinogens. Constant exposure to these carcinogens cause gene abnormalities that can be inherited or induced in a body cell. These cells can also be damaged by outside sources.

After many mutations from these carcinogens, it is thought that mutations will occur and will produce a malignant cell that will copy itself into many cancerous cells. Viruses are the cause of about 15% of all cancers. The virus is able to invade cells and cause them to synthesize new viral particles; viruses carry oncogenes that can 6. Excerpted from Encarta Encyclopedia, 1997. 3.

infect cells and cause malignant transformation. Chromosomal structure change has been observed in 90% of all human cancer. Chromosomes are the repository for all genetic information required to build a cell. 7 Chromosomal changes are now considered as common in malignant cells and used to diagnosis cancer. It is said that about 80% of all the cases of cancer which are discovered each year are from environmental factors. Skin cancer for example can be caused by prolonged periods in the sun.

Smoke is said to cause lung cancer. Cancers can be found in people who work with industrial chemicals such as; asbestos, uranium, aniline dyes, arsenic, vinyl chloride, ethylene oxide, benzene, formaldehyde, pesticides and herbicides. 30% of deaths in the United States are smoking related. Dietary factors may account for 40% of deaths from cancer. High fat diets, which are low in fiber can induce colon cancer. Another promoter of cancer is alcohol.

If alcohol and tobacco are used together the risk of cancer to the mouth, larynx, throat, liver and esophagus is greatly enhanced. 8 Even though many different types of cancer are caused by chemicals, radiation, viruses and other sources, it has been found that 20% of cancers are based on inheritance. Some cancers are able to survive in families for generations. Even with such a large number as 20%, only a few cancers are thought to be caused by inheritance. The two 7.

R. Grant Steen, A Conspiracy of Cells Plenum Press, 1993, page 5. 8. Mark Renneker, Cancer, Chelsea House, 1990, pg. 34. 4.

major cancers thought to be Inherited are breast cancer and colon cancer. There is no rhyme or reason why these diseases run through some families but not others. Hopefully, someday, with our scientific advancements we will be able to save many lives. Even scarier than generations of families dying from the same horrible disease, is the way in which cancer spreads through the human body. Some cancers will grow and develop in one part of the body and will never really become dangerous as long as they are detected and removed. The more dangerous cancer cells are the tumors that travel through the body and replace healthy cells with the tainted, fast growing cancer cells.

Normal tissue will be covered and will have cancerous cells running through it, each cell which is now potentially capable of forming a new tumor even if the original tumor mass is surgically removed.9 It seems that these malignant tumors are almost unstoppable. They grow and reproduce at an astonishing rate. Even though they do this very quickly, some cancers follow a very predictable pattern. For example, breast and prostrate cancers usually infect bone and melanomas. Kidney cancer is much the same and usually spreads to the lungs. Although we are aware of these trends, scientist are still unable to stop this infectious disease. 9.

R. Grant Steen, Aconspiracy of Cells, Plenum Press, 1993, pg.93. 5. Five of the major cancers that have become the most predominate of all the cancers are the ones that affect blood forming tissues; lungs, skin, breasts, colon and rectum. These are the standouts and the most deadly of all the cancers. The type of cancer that effect blood forming tissues are leukemias.

Leukemia means white blood. Leukemia causes the body to produce an abnormal number of immature white blood cells. This makes the body susceptible to infection. Leukemia makes up only 3% of all cancers, but what makes this disease so deadly is who it affects. Children are the most at risk for this disease. 10 We live in a very warm and sunny climate, because of this skin cancer is very prevalent. There are two types of skin cancer, basal cell carcinoma and squamous cell carcinoma. These types of cancers are both very dangerous cancers.

They are found in all areas of the body which are exposed to the sun. The areas of the body which are most affected are the hands, face and ears. As long as these diseases are found in the early stages, there is good prognosis for complete cure. Melanomas are more dangerous because they metastasize much more quickly than normal cancer cells and can spread throughout the body. 10.

Steven A. Rosenberg, The Transformed Cells, G.P. Putnams Sons, 1992. Pg.57. 6. Lung cancer is one of the most deadly cancers and is extremely hard to diagnosis.

People are unable to detect the disease within them because the symptoms are not exposed until its final stages. The symptoms are a cough, spetum streaked with blood, chest pain, repeated attacks of pneumonia or bronchitis. The five year survival rate is only 14% overall. This cancer takes the greatest amounts of lives. The cancer that plagues one out of every ten women is breast cancer.

Women as they become older, at about the age of 50, become more susceptible to this form of cancer. Through studies, we have found that over weight women with high fat diets are much more susceptible. Doctors highly recommend self examinations and mammograms to help women protect themselves from this disease. Breast cancer is one of the easiest cancers to be treated if detected at an early stage. 11 The second most common of all cancers is colon and rectal cancer. 70% of all cancers found in large intestines are found in the colon and the other 30% are found in the rectum. Symptoms are constipation, diarrhea, bloody stools and a change in bowel habits.

This cancer can also be successfully treated if found in its earliest stages. 11. American Cancer Society, The American Cancer Society Cancer Book, Doubleday, 1986, pg.24. 7. There are several different types of cancer treatments.

Surgery is the most effective and the most used. About 50% of patients are also treated with radiation. Surgery is often used if the tumor is localized. If the surgeon can remove the entire cancer, the patient may be completely cured. Even if the cancer has metastasized, surgery can often stop the disease from spreading any further.12 Radiation is a very good attempt to stop this invasive disease.

About 50% of all people who have cancer receive radiation therapy. The way in which the cancer is attacked is by damaging the cancer cells by covering them with radiation. The treatment is very effective, except that the healthy cells around the tumor are also damaged. The treatments must be timed for maximum effect because the healthy cells need time to repair. Chemotherapy is the next most effective treatment after radiation. It is used after surgery and is very effective.

Chemotherapy is about 50 drugs which are administered to stop the growth of the cancer or just delay the growth. The drugs often have many very severe side effects. They have a tendency to cause temporary hair loss, vomiting and nausea. Chemotherapy like radiation, damages healthy cells as well as the cancerous cells but is more effective than the radiation when the cancer has spread throughout the body. Today there are more new drugs which help with the side effects of chemotherapy.13 12. Excerpted from Comptons Interactive Encyclopedia 1994. 13. American Cancer Society , American Cancer Society Cancer Book, Doubleday, 1986, pg.104.

8. Cancer today is treated by the clinician and the scientist. The doctors cannot expect to increase the success of their treatment of cancer without ongoing input from basic scientists concerned with cancer research. 14 Both the doctors and scientists must become more tolerant of each other and the science of biology must come together with the art of medicine to help find a real cure for this disease. 14.

R. Grant Steen, The Conspiracy of Cells, Plenum Press, 1993, pg. 383. 9.


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