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What is Cancer?? PDF Print E-mail

In order to fight it and make intelligent informed decisions about treatment options, you should know what exactly you're up against.  Here's a primer....

Tissues, Organs & Building Blocks

Your body is made up of cells, the smallest building blocks that you can see under a microscope. Cells aggregate or come together in an orderly fashion and form various tissues, like skin, muscle, bone and your organs. Just to get an idea of how many cells it takes to make tissues, a one cubic inch area has approximately one billion cells connected together. Each cell is composed of a central nucleus surrounded by cytoplasm (fluid in the cell), all of which is contained within a cell membrane (outer thin covering). The nucleus contains the genetic material contained in chromosomes, which harbor many different genes. Genes, in turn, are composed of deoxyribonucleic acid or DNA; the building blocks of life. 

Cell Replication & Growth: Normal and Abnormal

Cells normally grow to replace older cells, which continuously die and are absorbed by the body in a very orderly fashion. That way, in an adult, most organs and tissues stay more or less the same size. In order to grow new cells, the DNA is reproduced and chromosomes divide by an orderly process called mitosis. As you will learn, when Cancer cells grow, they lose control and replicate and divide very rapidly in a dis-orderly fashion. Thus they are often said to have a high “mitotic rate”.

When cancer develops in an organ or tissue, the cells begin growing in an un-controlled fashion and are unchecked by your body's usual immune defense mechanisms. The reason they start mis-behaving is based on very complex interactions between DNA/genes and regulating proteins which support and interact with genes. Some of these proteins turn genes on and some turn various genes off, in a highly orchestrated way. When something goes wrong with this based on environment or other unknown factors, abnormal cell division and growth begins. Up to 85% of ovarian cancer cases arise by this mechanism. This is called sporadic ovarian cancer.

In the remaining 15-20% of cases ovarian cancer occurs as a result of abnormally coded genes passed on through generations. This is called familial ovarian cancer. Most of the known abnormal genes for ovarian cancer risk are located in what are known as the BRCA loci. If genetic counseling determines that there is a strong family history, BRCA gene abnormalities can be tested for in the case of ovarian cancer. For other gynecologic cancers there are no additional genetic tests that are highly reliable.  However, others do exist and may be considered after appropriate genetic counseling .


  Normal cells divide only enough to replace those that die or to repair injuries, then stop dividing. Cancer cells have lost this restraint due to the DNA/gene instructions the cell's biochemical machinery gets and keep dividing and piling up on each other. The mass of cancer cells will eventually become large enough to cause symptoms and to become detectable as a lump or a mass on a X-ray or scan. Usually the smallest lump that can be detected by feeling it or by scan is the size of a pea, and that already contains about 100 million cells.

Assuming cancer starts as a single abnormal cell, and that cell divides and each cell that is produced keeps dividing and so on, the amount of time to get to a pea size mass can take many months to years. At some point, the cells can grow directly into adjacent tissues and organs, or break into into tiny blood vessels or lymphatic vessels and spread to lymph nodes and other parts of the body. These processes are called invasion and metastasis.

Cancer Blood Vessels & Growth Support

The tiny blood vessels that feed cancerous tumors are usually very abnormal and leak or rupture easily. Because of this, abnormal bleeding is one of the signs of cancer in general. In the case of ovarian cancer, occasionally vaginal bleeding can occur but is not common.

Cancerous tumors can also grow rapidly and outgrow their blood supply, making the tumors oxygen deficient. When tumors are partly dying because they are starved for oxygen, the process is called necrosis. Necrosis, or dead tissue, is one of the reasons cancer can have an odor if it is exposed to the surface of the body. In addition, cancerous tumors are more prone to infection, which can also contribute to odor. Fortunately, ovarian cancer rarely extends to the body's surface, so odor is not a problem unless the cancer grows into the vagina. This is rare, but necrosis is still a problem because cancerous ovaries can become infected and poor blood supply can reduce the effectiveness of chemotherapy.

Cancer produces factors called angiogenins, which help create new blood vessels to help the tumor mass grow. Counteracting angiogenesis factors is one of the newest developments in targeting strategies for fighting cancer.

Cancer Cell Types

Cancers can arise from many different cell types. In the ovary there are more than 30 different cell types that can become malignant. Those which develop from epithelial surfaces which line different organs are in a group called carcinoma. This is the most common group of cancers. If the lining is glandular, then the name is extended to adeno-carcinoma. For example, the cells which line the colon, internal cervix and uterus, breast tissue, prostate or ovary are in this grouping. Functional cells which support ovarian eggs can also become malignant and are called germ cell or stromal cancers. Cancers can also arise from various cells and structures such as bone, muscle, and fat and are referred to as sarcomas. These are rare, but can also occur within some gynecologic organs like the uterus and ovaries. Beyond these general categories there is a large list of uncategorized, unusual or rare cancers.

 





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  • Removing ovaries to be safe - good idea???? -1:00 - 20.11.2008

    Dear AllA while ago I posted asking if US could DX ovca at early stage, and got SO MANY wonderful replies, for which I was extremely grateful.I've now gone on to have some investigative work done, and a detailed TVS has shown that I have a cyst on my right ovary which is not functional, but is almost 50:50 either benign or borderline.There doesn't seem to be any invasion of the ovary tissue from the cyst, and it is poorly vascularised, both of which I believe are optimistic signs. I read (on an Internet search) that around 7% of borderline cysts progress to becoming malignant. However, because my husband has Stage IV kidney cancer and 'staying alive' is, right now, our main concern (!!!!), I am thinking of simply having a double oophrenectomy (sp?!) (I'm 55, and my bloods show I'm now perimenopausal, so my ovaries are due for retirement anyway!), and being done with it (I hope....!)  I'm not clear whether suregery would include the fallopian tubes as well. Everything else in my pelvis is showing OK, so far as I understand. (Plus, no family history of ovca etc)Has anyone else been in a similar situation, and what was your decision, and your experience? My husband is worried at the thought of me having surgery (he had his kidney out this year, so knows abdominal surgery isn't a walk in the park!), though the TVS gynae says it could be done with keyhole.However, I also wonder whether it's best NOT to do keyhole, as is there not a risk that the ovary will rupture during removal, and then, if there IS any malignancy (or even proto-malignancy) in the cyst, that may get loose into my body and nest somewhere else!All information on this will be MOST gratefully received.I am very glad I did go ahead and get all this further checked out. I know US has its limitations, but even so, I think it's paid off this time by spotting 'something'.All the very, very best to all of you fighting ovca, and I hope, hope you win your battles.Julie.       

  • Abnormal cells after LEEP -1:00 - 19.11.2008

    I had the leep procedure done in the end of march and I recently had an abnormal pap.Before i had this procedure I was told I could have some difficulties with having children in the future. Well I went in for a pap and she told me everything looks great and now I recieved my results back and it came back abnormal. For once in for all i thought maybe i could have children without worring..but now im going back in on monday and im 24 and i almost want to be selfish and have a child now before its to late and things just get worse. Has anyone experienced a leep and abnormal paps and have had children after?I never thought i would have to think about this at my age but not having  children in the future years and waiting for it will kill me. someone please help me with a story of their own.Danny

  • Cone Biopsy -1:00 - 16.11.2008

    So the background info is that I had an abnormal pap in 2006, was diagnosed with HPV, and had a colposcopy in 2006 that showed low grade dysplasia.  They wanted me to have 6 month paps and would watch and wait I suppose.  From there, I wasn't impressed with my doctor and switched to a different clinic.  I had my records from the previous clinic sent to this one so there wouldn't be any confusion as to what was going on or why I was so persistent to have a repap right then which was 6 months after my previous one.  So, afterwards I recieved a lovely letter in the mail stating that the results were normal for my condition.  I probably should have asked what exactly that meant.  But, I was thrilled with the thought of not having another colpo.  Six months later I was back again for another pap.  Thinking the last one was "normal for my condition" I didn't freak out at all until I got the call saying I needed to schedule a colposcopy because there had been changes.  I'm not really thrilled at this point where I have a month to anxiously wait to have my colpo.  I had the colpo last week and it really wasn't as bad as the first.  Not really any pain except when she took the biopsy.  My Dr. was really good at explaining what she was doing etc. and drew me a picture of what she saw.  So I freak out for a week waiting for the results.  For some reason they didn't have my records from the previous clinic I went to and my Dr. wanted to look at them to make comparisons I suppose.  I was able to track down my records but found out she didn't really need them at this point.  I talked to the Dr. Friday night at around 6pm while I was driving in the rain and couldn't see a thing.  Not the best time to chat since I was a little preoccupied with not driving off the road.  What I got out of the conversation was that my results came back high grade and something about glands.  She wants to do a cone biopsy and I have the option of either doing it in the office with the LEEP or the operating room with the laser.  She did explain the difference between the two but I was so distracted with the rain and driving and the high grade and glands part that I can't remember the difference between the two.  I talked to her nurse today which was no help at all.  She said she was new and didn't have answers to any of my questions but would have someone call me tomorrow.  So I guess my question is...what is the difference?  What does high grade and glands mean?  Do I have cancer?  Will I ever be able to have children?  I don't do well with things that aren't in my control and at this point I'm seriously freaking out.  Any answers or suggestions?  Sorry for the lengthy detail.

  • mouth sores from Doxil -1:00 - 15.11.2008

    I was just wondering if anyone has any cures that have worked for mouth sores from Doxil.  My mom has them very bad.  Her oncologist has given her varies treatments but nothing seems to work, not even the "magic mouthwash"  My mom is a fighter, but this is really kicking her but.  She started getting them with her 3rd treatment, were they were so bad that they even ran down her throat.  Now on her 4th treatment she has them again, luckly not down her throat, but has them really bad, that she can barely even speak.  Please help, she will pretty much try anything just to get rid of them.Sandra  

  • need advice -1:00 - 14.11.2008

    I am recovering from a cone biopsy and scraping of cervix. I am 1 week post op. My wonderful MD called me on thursday 11-13-08 to let me know that my results from the biopsy came back and did show severe displasia of the cervix, which i knew, that was why we did the procedure. He also told me that the scraping that was done further inside my cervix also came back with displasia.  So i am left with not many options. Eaither go for another cone, or have a hysterectomy. I think this has put me in a depression. I feel down, tired, and dont want to talk to anyone. I have one child and probably would not have had anymore, but it is tearing me up to have this taken away from me. I know i have to have it done. I feel like i am not worth anything anymore.                thanks  dancie

  • Radiation or not -1:00 - 13.11.2008

    I am post-op, a month ago I had a hysterectomy  for cervical cancer 1a2, for my two week fallow up my doctor said that the tumor that was removed was bigger than what they thought and I might need radiation if it was bigger than 1/5 of an inch.  My tumor was 3mm by 3.2mm before the surgery. I can not Imagine being much more. Does anyone know what is the cut off mesurement for not reciving anymore treatment after a hysterectomy?

  • after chemo radiation -1:00 - 12.11.2008

    hi! I had treatment of chemo radiation in July. Some side effects i am experiencing still are swelling of the abdomen/ lower back ache/ some spotting - i also started HRT but wonder if anyone else experienced these things ? i am due back to cancer agency next week for check up.

  • Signet Ring Adenocarcinoma -1:00 - 12.11.2008

    Hi, Any information on Signet Ring Abenocarcinoma ?  

  • scared -1:00 - 11.11.2008

    Hi, I am a 23 year old female. Over the past month or so I've developed some symptoms that are concerning me...For the past 2 years or so, I've had very painful intercourse upon deep penetration - I get a shooting pain throughout my pelvis....then about 1 month go, I started to experience burning upon urination & increased frequency...I made an appointment to go see my family doctor (to rule out infection, etc) & get a pap, in between the time of scheduling my appointment & going to see my doctor, I developed a dull aching in my pelvis, mostly in the lower right quadrant. I tell him this informtion, he does a urine test, pregnancy test - all negative. during my pelvic examination, he presses down on my lower right quadrant, & it just about sends me off the bed, I had pushed down on my pelvis on my own standing up & didn't really have much discomfort. Over the next few days I've been experiencing lower back pain & shooting pain into my right groin area. The doctor's next suggestion is to go for a pelvic ultrasound....however, I have to wait until January for an appointment- in the meantime I am beside myself worrying I have cancer! I will note that my periods have remained normal, & I have had no abnormal bleeding

  • Signet Ring Adenocarcinoma/Ovarian Cancer -1:00 - 11.11.2008

    My BFF is 39 and was just diagnosed with Signet Ring Adenocarcinoma/Ovarian Cancer. Her first Chemo treatment is today.Does anyone have any experience with this type of Cancer or any suggestions that can help us better understand it?Any information would be really appreciated!Thanks,Juli