If I had been born a doctor, I would have never taken any sunbath in my life. Figure 1.a illustrates elders sunbathing.Sunbathing in our teen and early 20s is a very strong risk factor for getting skin cancer (basal cell carcinoma) (The Guardian 2013). Welcome to #blog 5# the focus is on cancer. I will share how engaging with modules has made my understanding of the disease clear. A section on the blog will explain how cancer such a simple concept on molecular bases, yet still individual cancers are highly complex and many difficult to treat? In progress before conclusion, I will give brief reflection on molecular similarities between the pathogenesis of cancer and auto-immunity. Hope you enjoy because this is a life threatening disease more terrifying and most are idiopathic.
I have always wanted to do positive in my life that is why I was a dedicated blood donor. I have learnt that this sets stress on my bone marrow as it results in hyperplasia and hypertrophy of my bones. One other myth that I had always carried with me was the idea that breast cancer is for woman only. I am know aware as I blog that gynaecomastia may lead to premalignant condition in males.
(Figure 1.b shows warning signs for male breast cancer).
They say with aging comes experience after engaging with general pathology I now know that man are risk of contracting prostate cancer as they grow-up. The latter two conditions are related with high levels of estrogen accumulation that comes with ageing in males. (Rippey 1994). It astonished me that a breast lump can be cut off completely, but within few months or years cancers cells present in the brain. The latter depends on whether the lump is benign or malignant and malignant tumors can metastasise.
Table 1 shows characteristics of Benign (B) and Malignant (M) Neoplasms.
|Presentation||(B) as lump
(M) as lump, ulceration common
|(B) Lump well differentiated-resembling tissue of origin
(M) lump poorly differentiated
|Mode of growth||(B) Grow by expiation compressing adjacent tissues. My feel round, smooth, regular, mobile.
|(B) fibrous capsule can be seen, the tissue are compressed.
(M) tentacular growth(may be surrounding inflammation)
|Rate of Growth||(B) grow slowly-man stop growing
(M) grow rapidly and continue to grow if untreated
|(B) Mitoses infrequent 1/1000 cells or less(1<per HPF)
(M) mitoses frequently 20/1000 cells (mitoses>10 per HPF).
|Recurrence||(B) rarely recur after removal
(M) Often recur after removal possibly because of invasive and rapid nature of growth.
|Metastasis||(B) never metastasise
(M) nearly metastasise in time
|(M) tumour cells may be seen invading lymphatic or blood vessels|
|Outcome||(B) usually harmless, but may exert pressure or cause local complication secrete hormone may undergo malignant change
(M) by virtue of invasion + metastasis will kill patient eventually.
Table 1 Shows characteristics of Benign (B) and Malignant (M) Neoplasms.
Cancer begins when a cell breaks free from the normal restraints on cell division and begins to follow its own agenda for proliferation.
All cells produced by this un-coordinated cell from the ancestral one and its progeny also display inappropriate proliferation. A tumour, or mass of cells, formed of these abnormal cells may remain within the tissue in which it originated (a condition called in situ cancer), or it may begin to invade nearby tissues (a condition called invasive cancer). An invasive tumour is said to be malignant, and cells shed into the blood or lymph from a malignant tumour are likely to establish new tumours (metastases) throughout the body sample of what I mentioned latter paragraph. Tumours threaten an individual’s life when their growth disrupts the tissues and organs needed for survival.
One of the main problems is that cancers cells are not foreign invaders. Differentiating between cancer cells and any surrounding healthy cells has proven extremely difficult, which is why chemotherapies are fairly non-specific and presents enormous side effects. Although some patients can be successfully cured and their cancers don’t return – such as is often the case for testicular cancer and some childhood cancers – for other cancers the situation is different. The cells with cancer tend to divide at a high rate compared to normal cells one reason why it’s hard to treat them.
(Video 1 show mitoses of cancer cells compared to normal cell in 5 days)
There is a direct relationship between infection, autoimmunity and cancer. Hepatitis B and C viruses are involved in an autoimmune condition that precedes the development of hepatocellular carcinoma. Adenovirus infection is associated with childhood leukemia. Epstein-Barr virus and human T lymphotropic virus type 1 infection is associated with abnormal lympho proliferation and Hodgkin’s lymphoma. Cytomegalovirus infection is linked to autoimmunity and testicular cancer.
Clinical autoimmunity may develop when persistent infection provides a continuing high dose of antigenic stimulus, and this situation could predispose patients for the development of proliferative disorders.
In conclusion, I would say the concept of molecular cancer is a useful tool in understanding the etiology, pathogenesis, treatment and control of the disease. Cancer is however, a broad group of various diseases, all involving unregulated cell growth. (Walter and Israel 1987) I strongly belief knowing this concept and nature of cancer, can help in initiating an early detection and a strategic mechanism to alert self-exposure to carcinogens. This way, in future we should at least be worried about cancer and heredity, and factors such as tobacco use, unprotected sexual intercourse with multiply partners, radiation, lack of physical activity ,obesity, and environmental pollutants can be eradicated.
1) Kumur V, Cotran RS, Robbins SL. Basic Pathology. 5ed. Philalphia: WB Saunders, 1992
2) Rippey JJ. Illustrated lecture notes –General Pathology, Johannesburg: Witwatersrand University Press, 1994.
3) Rubin E, Farber JL. Pathology, Philadelphia: Lippincott, 1988.
4) Walter JB, Israel MS. General Pathology. 6th ed. Edinburgh: Churchill Livingstone, 1987.
1) The Guardian Saturday 19 January 2013, what doctors won’t do: Available from: