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Cancer: Causes, Development, Types, and Treatments

Comprehensive overview of cancer: how it develops, common forms, metastasis, diagnosis, treatment approaches, prevention, and the role of oncology in research and care.

Overview

Cancer refers to a broad group of diseases in which cells divide abnormally and have the potential to invade other tissues. Normal tissues maintain a balance of cell birth and death through regulated cell division, but cancerous cells evade those controls and can accumulate genetic changes. For a concise introduction to the general concept, see cancer.

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How cancer develops

Cancer usually begins when damage accumulates in a cell's genetic material, the DNA, affecting genes that control growth and repair. Changes may activate genes that promote proliferation or disable genes that restrain growth. Because these alterations are passed to daughter cells, a clone of abnormal cells can expand. The process involves complex interactions between mutated cells, their microenvironment, and the immune system.

Tumours and classification

Not all abnormal growths are malignant. A tumour is any localised mass of tissue resulting from excessive cell proliferation. Tumours that do not invade surrounding tissues and do not spread are called benign; they can often be removed surgically. Malignant tumours are invasive and can form secondary growths. Certain benign tumours may still cause serious problems if they press on vital structures, for example some brain tumours. Some cancers are more common in younger people—testicular cancer is an example—while many other types increase in frequency with age.

Spread and impact

When cancer cells break away from a primary tumour and travel to other parts of the body, the process is called metastasis. Cells commonly use the bloodstream or the lymphatic system to disseminate; see the role of the lymphatic system. Metastatic disease can disrupt the function of organs and is the principal cause of cancer-related illness and death rather than the primary tumour itself.

Signs, diagnosis, and staging

Symptoms vary widely depending on the tumour's type and location; they may include unexplained weight loss, persistent pain, lumps, bleeding, or functional changes in affected organs. Diagnosis typically uses a combination of imaging, laboratory tests, and tissue sampling (biopsy) to identify cell type and molecular characteristics. Staging describes the extent of disease and helps guide treatment decisions.

Treatment approaches and research

Treatment strategies are tailored to the cancer type, stage, and patient health. Conventional modalities include surgery, radiation therapy, and systemic treatments such as chemotherapy. Advances in targeted therapies and immunotherapy have expanded options by aiming at specific molecular features of tumours or by mobilising the immune system. Clinical care and research into these approaches are central to the medical specialty of oncology. In many high-income regions, cancer is a leading cause of mortality and a major focus of research and public-health effort; see additional context at global and regional cancer statistics.

Prevention, risk factors, and notable distinctions

Risk factors include age, tobacco use, certain infections, radiation, environmental exposures, and inherited genetic predispositions. Many cancers are linked to lifestyle and environmental factors and may be reduced by preventive measures such as vaccination against oncogenic viruses, smoking cessation, healthy diet, and screening programs that detect premalignant changes. Distinguishing between benign and malignant growths, between primary and metastatic lesions, and among molecular subtypes is essential for prognosis and management.

Common management elements

  • Surgical removal of localized tumours
  • Radiation to destroy or shrink cancerous tissue
  • Systemic drug therapies: cytotoxic chemotherapy, hormonal agents, targeted drugs, immunotherapies
  • Palliative care to relieve symptoms and maintain quality of life

Because cancer encompasses many distinct diseases with varied biology and outcomes, ongoing research aims to improve early detection, personalise treatment, and reduce side effects. For further reading, consult specialist reviews and guidelines accessible through major medical resources and patient-focused organizations listed at metastasis overview, lymphatic pathways, and other topic-specific references including cell division mechanisms.

For introductory learning, clinical guidelines, and research updates, see resources referenced via: basic definitions, central nervous system tumours, genetic aspects, and specialised sites for younger adult cancers and broader epidemiology at population studies.

Occurrence and course

Standardized incidence (new cases)/100,000 population (European standard)
and relative five-year survival rates in % in Germany 2016

Art

Incidence

5-year survival rate

Current

1980s

Total

348,3

422,9

♀:65; ♂:59

♀:50–53; ♂:38–40

in children

17

approx. 85

approx. 67

Oral cavity and pharynx

6,5

17,6

♀:58–68; ♂:42–50

Esophagus

2,4

9,4

♀:11–36; ♂:14–31

<10

Stomach

7,2

14,8

♀:29–40; ♂:24–42

Intestine

31,8

50,7

♀:60–66; ♂:58–66

approx. 50

Pancreas

10,4

14,4

♀:4–19; ♂:5–14

Larynx

0,8

5,4

♀:63; ♂:50–69

Lung

31,4

57,5

♀:17–26; ♂:10–19

Malignant melanoma

19,9

21,0

♀: 89–96; ♂:83–94

Mammary gland

112,2

1,1

♀: 86–90; ♂:77

Cervix

8,7

62–70

uterine body

16,5

75–82

Ovaries

11,1

38–50

Prostate

91,6

86–91

Testicles

10,2

99–100

Kidney

7,5

15,7

♀:73–82; ♂:69–81

approx. 50

Urinary Bladder

9,0

34,7

♀:36–53; ♂:48–63

Nervous system

5,9

7,6

♀:15–32; ♂:14–38

Thyroid

11,1

5,1

♀:90–97; ♂:71–93

♀:approx. 77; ♂:approx. 67

Hodgkin's disease

2,4

3,2

♀:75–92; ♂:78–94

Non-Hodgkin's Lymphoma

12,0

16,4

♀:67–74; ♂:59–76

Leukemias

8,6

13,5

♀:53–63; ♂:52–60

Source: Cancer in Germany for 2015/2016 - Frequencies and Trends. (PDF) A joint publication of the Robert Koch Institute and the Society of Epidemiological Cancer Registries in Germany. , retrieved on 11 March 2020. 

In principle, any organ of the human body can be affected by cancer. However, there are significant differences in frequency according to age, gender, collective affiliation, geographical region, dietary habits and similar factors. There are over 100 different forms of cancer. In Germany, cancers occur more frequently in organs such as the mammary gland (women), prostate (men), lungs and colon.

Cancer is the second most common cause of death in Germany after cardiovascular diseases. Nevertheless, not every cancer progression is fatal if therapy is started in time or if a slow-growing cancer only appears at such an advanced age that the patient dies of another cause of death. The current data published by the Society of Epidemiological Cancer Registries in Germany e. V. (GEKID) published in 2017 relative 5-year survival rates across all cancer types refer to patients who developed the disease in 2013 and 2014. For women, the value was 65 %, for men 59 %. Northern European countries have even more favorable values. In Finland, for example, the 5-year survival rates for women and men who developed the disease in 2014-2016 were 68.6% and 66.3%, respectively. In oncology, a patient is said to be cured if he or she survives for at least five years without a relapse (recurrence). This definition of "cured" is problematic because many relapses occur at a later stage. Patients who later die of cancer are therefore included in the cancer success statistics. However, for most cancers, after five years of relapse-free survival, the average life expectancy approaches that of people of the same age.

Cancer manifests itself in different forms and clinical pictures. For this reason, no general statements can be made regarding life expectancy and chances of recovery. There are currently about 100 different known cancers, some of which differ greatly in their chances of survival, treatment options and tendency to form metastases.

The incidence of most cancers increases significantly with age, so that cancer can also be regarded as an age-related disease of cell growth. In addition, smoking, other carcinogenic noxae, familial disposition (predisposition) and viral infections are the main causes of cancer. Nobel Prize winner Harald zur Hausen attributes a good 20 per cent of all cancers to infections (human papillomaviruses (HPV), hepatitis B and C, Helicobacter pylori, EBV, human herpesvirus 8 (HHV-8), human T-lymphotropic virus 1 (HTLV-1), certain parasites (bladder cancer in the Nile Delta) and Merkel cell polyoma virus). In Germany and the United States, this proportion is estimated to be much lower and is thought to be about 5 percent. The fact whether a woman has children leads to a reduction of the cancer risk by more than 2/3 compared to childless women, for men the reduction is slightly lower.

Cancer prevention and early detection can significantly reduce the risk of cancer under certain circumstances (depending on the time of diagnosis, the type of cancer and an optimal age of the patient).

Cancer is by no means a disease of modern times. From an evolutionary point of view, it is a very old disease that can, in principle, affect at least all mammals. The oldest cancer finding was found in an Edmontosaurus about three and a half meters tall.

Cancer in the human medical sense probably does not occur in other groups of organisms such as plants or reptiles; tissue proliferations here are more likely to be regarded as benign tumours. The immediate ancestors of humans (Homo), such as Australopithecus (2 to 4.2 million years ago), also had cancer. Cancers have accompanied mankind throughout evolution. In the Papyrus Ebers from the time 1550 before Christ cancer diseases are mentioned.

Name History

The German designation of certain tumors and ulcers with "cancer" (from Middle High German krëbez "feeding ulcer, carcinoma, cancer") comes from Ancient Greek, where by karkínos (καρκίνος) also both the animal (cancer or crab) and the disease (cancerous ulcer, carcinoma) were named. As a name for ulcers, the name first appears in the Corpus Hippocraticum. In the 2nd century AD Galenos explains the origin of the name after the similarity of swollen veins of an external tumor with cancer legs:

"... and on the breast we frequently saw tumors which closely resembled the shape of a cancer. Just as the legs of the animal lie on either side of the body, so the veins leave the tumor, which resembles the body of the cancer in shape."

- Galenus of Pergamum

Aristotle referred to cancer as superficially detectable tumors that infiltrate and grow into adjacent organs (such as advanced skin cancer or breast cancer).

The term "cancer" (Latin cancer) is also found, for example, for ulcers in venereal diseases ("chancroid") and in the word "water cancer" for noma.

In the Middle Ages, the chest area was considered to belong to the zodiac sign Cancer (cf. Homo signorum).

Questions and answers

Q: What is cancer?

A: Cancer is a type of disease where cells grow out of control, divide and invade other tissues.

Q: How does cancer occur?

A: Cancer occurs when mutations have occurred in the genes of cells, causing them to change their nature and divide uncontrollably. All the daughter cells of cancer cells are also cancerous, leading to more cancer cells in the body.

Q: What is the difference between a tumour and cancer?

A: A tumour is an abnormal growth of tissue caused by uncontrolled cell division that does not invade other tissues or organs. If it does, it is called "cancer".

Q: What causes symptoms associated with cancer?

A: Symptoms associated with cancer are caused by the cancerous cells invading other tissues, which is known as metastasis. This happens when the cancer cells move through the bloodstream or lymphatic system.

Q: Who can get affected by cancer?

A: Cancer can affect anybody at any age; however, most types of cancers are more likely to affect people as they get older due to DNA damage that has occurred over time. One type of exception to this rule is testicular cancer which tends to be more common in young men than older people.

Q: Why is studying and treating cancers important?

A: Cancer is one of the biggest and most researched causes of death in developed countries so studying it and its treatment (oncology) has become increasingly important for improving patient outcomes and reducing mortality rates from this disease.

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