Malignant ?

What is cancer?
Cancer arises from a cell somewhere in the body. If the cancer cell arises in a particular organ, it is given a specific name.

There are two basic types of cancer. Those arising from epithelium (cells lining glands or ducts or surfaces) are called carcinomas. Those arising from connective tissue and muscle are called sarcomas.

What makes a cell become malignant or cancerous? Well, here we have to turn to molecular biology and molecular genetics to get an answer.

Each organ in the body consists of millions and millions of cells. The cells are so tiny that they can only be seen under a microscope. Even so, inside each cell is the most intricate and highly complex machinery imaginable.

Inside the nucleus of the cell are the chromosomes and these cylindrical structures are made up of about 80 000 genes. These genes control what we are and what we look like. The genes code for protein synthesis in the cell cytoplasm, and these proteins make up our body structure. These genes make our eyes (iris) blue or brown, our hair black or brown, our skin dark or light, our bodies muscular or skinny, our fingers long or stubby, and so on. Thus our genes (genotype) control what we are (phenotype).

But our bodies are not solely under gene control. Our environment also has an influence. The environment has many nasty effects on us humans. Examples of this are electromagnetic irradiation, which can damage the purine and pyrimidine molecules that make up the gene spirals. Certain toxic chemicals and viruses can also alter our genetic make-up. Sometimes the genes alter by themselves (spontaneous mutation).

These gene changes or mutations (oncogenes) result in the production of abnormal proteins (oncoproteins) and this in turn causes the cell to act abnormally. The biological mechanisms that control the normal cell no longer have an influence on the cancer cell’s behaviour. So the cell now grows without any form of control, unlike normal cells, which remain under strict control. This results in abnormal behaviour and unrestrained cellular growth and proliferation i.e. a malignant neoplasm (new growth) or a cancer.

The common cancers in women in South Africa are listed in the following table

breast
gynaecological		cervix
		uterus
		ovary
skin		basal cell carcinoma
		squamous cell carcinoma
		malignant melanoma
colon / rectum
oesophagus
lung
stomach
haematological		lymphoma
		leukemia
bladder
soft tissue tumours (e.g. muscle sarcoma)
miscellaneous		pancreas
		thyroid
		kidney
		salivary gland
		brain

So remember 60% of all ladies presenting with breast cancer have no risk factors.

Development of a breast cancer is usually akin to turning a dial to open a safe.

	First turn - genetics
	Second turn - environmental
	Third turn - lifestyle
	Fourth turn - not sure but just unfortunate