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What makes a Cancer Cell, cancerous?


What makes a Cancer Cell, cancerous?

Normal cells have a finite life span. As the old cells die out in their pre-programmed fashion, an equal number of cells must be manufactured to take their place. This is taking place in an orderly fashion. This process is regulated by a complicated system of signals communicating from the outside to the inside of the cell by means of different receptors and proteins.

In Cancer cells, this communication goes awry, and they don’t listen to the regulatory signals, and go on dividing without control. They then go on to form tumors, break away from the original tumor, and travel via the blood stream or the lymphatics. They then grow where they find a home, and wreak havoc throughout the body.

What causes this loss of Control?

Sometimes, it a mutation or defect in the genes, which changes the production of controlling proteins.  This can be an inherited defect or an acquired one. Some defects can be acquired by exposure to viruses and the reaction they elicit in the immune system. Some are a result of environmental toxins. Sometimes, it is a series of defective processes, one leading to the next. Mostly, we cannot yet pinpoint the causes at the cellular level, but we do have associations with smoking, some dietary contents and excess alcohol, which can cause a constant irritation.

Some tissues have a faster turnover rate than others, e.g. blood producing cells in the bone marrow, cells that form the lining of the intestinal tract and other organs, which have “glands”. Tissues with normally higher turnover can have a higher risk for error.

On the other hand, some tissues have no known turnover, that is, there is no rejuvenation, that is known yet. When the cells die e.g. the muscle cells in the heart, and brain cells, they are not replaced. Which is why a “heart attack” or a stroke causes permanent cell death in the tissue affected.
The role of cancer treatment is to interrupt the duplication of the cellular material. As the cancer cells undergo cell death, they cannot be replaced because chemotherapy or radiation has prevented new cells from being manufactured to take their place.

What is Performance Status?

What is Performance Status?

 

It is a score of a person’s Functional State. There are two commonly used scales.

The Karnofsky scale which goes from 0 to 100, where the person who is completely asymptomatic and fully functional scores a 100, and loses points for the onset of pain, mobility, weakness, or other difficulties, which lead to an impairment of function.

What is Grade and Differentiation?

Additional tests you will see on the Pathology report:

Grade: describes the activity of the nucleus. A normal cell has normal activity of the nucleus. A cancer cell nucleus looks different. A grade 1 nucleus is less in disarray than a Grade 3 nucleus. The higher the grade, the worse the cell behaves.

Differentiation: is a measurement of how closely the cancer cell resembles the parent cell or the cell of origin.

What is Cancer Staging?

Cancer Staging:

The next step is to stage the disease. The classical way of staging the disease depends on T (tumor size) N (number of lymph nodes involved with cancer) and M (presence of distant disease). This TNM classification provides the basis of the staging system. The bigger the T, the greater the number of involved lymph nodes, the presence of metastatic disease increases the stage from the lowest (and best) of 1 to the highest (worst) of 4.

Introduction

I am Dr Gauri Bhide, a practicing Oncologist in the Greater Boston area.  I have been in practice for almost 20 years and feel very privileged to be able to be able to help people through the biggest challenge they will face. I grew up in Mumbai, India, went to medical school at one of the premier medical schools there, and moved to the US, where I trained in Internal Medicine, then Hematology/ Oncology. With my training and exposure to both Third World and American medicine, I feel I contribute a state of the art knowledge of modern medicine with strong doses of compassion and patience, clinical judgment and a feel for people’s life situations and resources.
I am starting this blog to be able to explain cancer management