PRINCE ASHOKRAJE GAEKWAD SCHOOL

“Unlocking the
secrets of Cell
Mutations.”

Name: - Mihika Vangikar

Std.: - 11-A
House: - Ganga
Roll no.: - 10
-Guided by Dr. Lakshmi Pillai
 INDEX

1) Acknowledgement
2) What is cancer?
i) Definition
ii) Occurrence
iii) Causes
iv) Symptoms
3) Types
4) Metastatic Transformation of Cancer Cells
5) Diagnosis
6) Treatment
7) Preventative Measures
8) Bibliography
 ACKNOWLEDGEMENT

I would like to express my sincere thanks and

gratitude to my biology teacher, Mrs. Lakshmi
Pillai, who presented me with the opportunity
to do this project on the topic Cancer and
provided guidance and technical advice which
enabled us to complete this project.

I would also like to extend my sincere

gratitude to Mr. Ramesh Sharma, our vice
principal & Mr. P Varadarajan, our principal,
for providing all the required facilities and in
enabling me to gain new knowledge and skills.
 What is Cancer?

Definition:
Cancer is a disease involving the rapid creation of
abnormal cells that grow beyond their usual
boundaries, and which can then invade adjoining
parts of the body and spread to other organs –
this process is called Metastasis. Metastasis is the
primary cause of death from cancer.

Occurrence:
Cancer arises from the transformation of normal
cells into tumor cells in a multi-stage process that
generally progresses from the pre-cancerous
lesion to a malignant tumor.

Cells may become cancerous due to the

accumulation of defects or mutations in their
DNA. They can grow, divide & spread abnormally
instead of self-destructing as they should. Cancer
 cells metastasize to other sites via the lymphatic
system and the blood stream.

Causes:
The majority of cancers, some 90-95% of cases are
due to genetic mutations from environmental and
lifestyle factors while the rest 5-10% are due to
inherited genetics.

Genetic Mutations:

Mutations of gene BRCA1 and BRCA2 (linked to an

increased risk of breast and ovarian cancers) can
inhibit the body’s ability to safe guard and repair
DNA. Copies of their mutated genes can be passed
on genetically to future generations, leading to an
increased risk of cancer.
 Environmental Factors

Cancer can also result from the interaction

between a person’s genetic factors and external
agents including:
 Physical Carcinogens – ultraviolet rays,
ionizing radiation
 Chemical Carcinogens – asbestos,
components of tobacco smoke, aflatoxin (food
contaminant) and arsenic (drinking water
contaminant).
 Biological Carcinogens – infections from
certain viruses, bacteria or parasites.

Figure 1 Cancer cells

 Symptoms

A cancer can grow into or begin to push on

nearby organs, blood vessels and nerves. This
pressure causes some signs and symptoms of
cancer.
Cancer cells use up much of the body’s energy
supply and can also cause the immune system
to react in ways that produce these signs and
symptoms.
Common signs and symptoms include:
 Fatigue
 Unexplained weight loss
 Appetite loss
 Unusual lumps or swelling
 Blood in stools
 Cough or hoarseness that does not go away
 Seizures, headaches or vision problems
 Sores that do not heal
 Types of Cancer

There are five main types of cancers. They are:

 Carcinomas – Carcinoma is cancer that forms
in epithelial tissue. Epithelial tissue lines most
of your organs, the internal passageways in
your body (like your esophagus), and your
skin. Most cancers affecting your skin,
breasts, kidney, liver, lungs, pancreas,
prostate gland, head and neck are
carcinomas.
 Most people think of cancer in terms of
where it forms (breast cancer, colon cancer,
etc.), but this is just one way to distinguish
one type of cancer from another. Scientist
also classify cancers based on the types of
tissue where cancer cells start growing.
 Figure 2 Carcinoma Cancer types

 Sarcomas - A sarcoma is a malignant

(cancerous) tumor that develops in bone
and/or soft tissue. Soft tissues support other
body structures and include:
 Muscle
 Fat
 Tendons
 Cartilage
Ligaments
Blood vessels
Nerves
Sarcomas are rare, making up only 1% of all adult
cancer diagnoses and about 15% of childhood
cancer diagnoses. Approximately 16,000 sarcomas
are diagnosed in the United States each year
(around 4,000 bone sarcomas and approximately
13,000 soft tissue sarcomas).

Figure 3 Sarcoma Cancer

 Myeloma - Multiple myeloma is a rare blood

cancer that affects your plasma cells. Plasma
cells are white blood cells and part of
your immune system. Plasma cells (sometimes
called B-cells) make antibodies. These
antibodies, called immunoglobulins, help fight
infection.
 Multiple myeloma happens when healthy cells
turn into abnormal cells that multiply and
produce abnormal antibodies called M
proteins. This change starts a cascade of
 medical issues and conditions that can affect
your bones, your kidneys and your body’s
ability to make healthy white and red blood
cells and platelets.
 Some people have multiple myeloma without
symptoms but blood tests show signs of
conditions that may become multiple
myeloma. In this case, healthcare providers
may recommend watchful waiting or
monitoring your overall health rather than
starting treatment. Healthcare providers can’t
cure multiple myeloma, but they can treat
related conditions and symptoms and slow its
progress.

Figure 4 Multiple forms of Myeloma Cancer

 Lymphoma - “Lymphoma” is the general term
for cancer in your lymphatic system — the
network of tissues, vessels and organs that
help your body fight infection. It’s considered
a blood cancer because the condition starts in
white blood cells (lymphocytes) in your
lymphatic system.
 There are two main lymphoma categories
— Hodgkin lymphoma and non-Hodgkin
lymphoma — and more than 70 lymphoma
subtypes. Lymphomas can be aggressive (fast-
growing) or indolent (slow-growing). Often,
treatment can put lymphoma into remission or
cure it. Children, teenagers and adults may
develop lymphoma.

Figure 5 Lymphoma Cancer

 Leukemias - Leukemia is a cancer of the blood,
characterized by the rapid growth of abnormal
blood cells. This uncontrolled growth takes
place in your bone marrow, where most of
your body’s blood is made. Leukemia cells are
usually immature (still developing) white blood
cells. The term leukemia comes from the
Greek words for “white” (leukoses) and
“blood” (Haim).
 Unlike other cancers, leukemia don’t generally
form a mass (tumor) that shows up in imaging
tests, such as X-rays or CT scans.
 There are many types of leukemia. Some are
more common in children, while others are
more common in adults. Treatment depends
on the type of leukemia and other factors.

Figure 6 Leukemia Cancer

 Figure 7 Multiple Forms of Cancer

Metastatic Transformation of Cancer Cells:

A normal cell is transformed into a cancer cell

through alteration in differentiation of the genes
that regulate cell growth.
The affected genes consist of Oncogenes, which
promote cell growth and reproduction, and tumor
suppressor genes, which inhibit cell division and
survival. Malignant transformation can occur
through the formation of novel oncogenes, the
over-expression or the under-expression of
normal oncogenes, or disabling of tumor
suppressor genes.

Oncogenes code for the proteins that function

to drive the cell cycle forward, typically
causing cells to proceed from one of the G
(gap) phases to either chromosome
replication (S phase) or chromosome
segregation (mitosis).

Genes that code for the normal proteins

controlling these processes are called proto-
oncogenes. However, once they are altered to
become oncogenes, their abnormal protein
products exhibit increased activity that
contributes to tumor growth.
 Therefore, instead of stopping within a G phase,
a tumor cell continues to progress through
subsequent phases of cell cycle leading to
uncontrolled cell division.

Proto-oncogenes turn into oncogene via

mutations which permanently activate
proteins that normally interchange between
active or inactive states.
Proto-oncogene can also turn into an
oncogene through chromosomal translocation
occurs when the pieces of broken
chromosomes reattach haphazardly, leading
either to the formation of a fusion protein or
the altered regulation of protein expression.
 Tumor suppressor genes code for proteins
that normally operate to restrict cellular
growth and division or even promote
programmed cell death.
 A type of this protein is known as
retinoblastoma protein (pRb) and its
corresponding gene, RB1, is a tumor suppressor
gene pRb activity stops the expression of genes
required for progression into S phase of the cell
cycle, and hence its activation allows for
uncontrolled cell division. Therefore, oncogenes
and tumor suppressor genes link cell cycle
control to tumor formation and development.

Figure 8 Metastatic Transformation of Cancer

 Diagnosis:

Various tests may be performed in order to

confirm a cancer diagnosis. These include:
 Lab Tests – High or low levels of certain
substances in your body can be sign of cancer
while some tests involve testing blood or tissue
samples for tumor markers. Tumor markers are
substances secreted by cancer cells in higher
number than that of normal cells.
Example of tumor tissue markers – FGFR3 gene
mutation analysis to help determine treatment
for patients with bladder cancer.

 Bone Scan – Bone scans are a type of nuclear

scan that check for abnormal areas or damage
in the bones. They may be used to diagnose
bone cancer or cancer that has spread to the
bones. This is done by injecting a small amount
of radioactive material into the vein which
detects abnormal areas in the bones as it travels
 through the blood. It is then picked up by the
scanner.

 Biopsy – A biopsy is a procedure where a sample

of tissue of the patient is taken and observed to
identify whether it is cancerous or not.

 PET-CT scan – A small amount of radioactive

glucose is administered, which highlights areas
of your body where the cells are more active
than normal and 3D images are generated. At
the same time, X-rays are passed through your
body and 3D images of CT are generated.
After diagnosis, Doctors use the stages of cancer
to classify cancer according to its size, location
and extent of spread. Staging helps doctors
determine the prognosis and treatment for
cancer. The TNM staging system classifies cancers
according to:
 Tumor (T): Primary tumor size and/or extent.
 Nodes(N): Spread of cancer to lymph nodes in
the regional area of the primary tumor.
  Metastasis (M): Spread of cancer to distant
sites away from the primary tumor.

The TNM classification is combined with the other

factors to determine the stages of cancer:
 Stage 0 – There are abnormal cells, but they
haven’t spread beyond where they started.
Stage 0 can also refer to pre-cancerous cells.
Most stage 0 cancers are curable. This is also
known as ‘in sit neoplasm’
 Stage I – This stage refers to when the
cancerous cells are confined to their site of
origin and has not spread or has not invaded
any other tissues.
 Stage II – This stage refers to cancer if the
tumor has grown larger and possibly spread
to nearby lymph nodes.
 Stage III – The tumor has grown deeper into
the surrounding tissues and has potentially
spread to nearby lymph nodes.
 Stage IV - Cancer has spread (metastasized)
outside of the original site to other organs or
 distant areas of your body. This is also known
as metastatic cancer.

Treatment:
There are numerous treatments for cancer which
differs depending on the type and stage of a
cancer as well as the overall health of the patient.
These include:
Chemotherapy
It is the treatment of cancer with one or more
cytotoxic anti-neoplastic drugs. They consist of
various drugs that act by killing cells that divide
rapidly.
Targeted therapy is a form of chemotherapy that
targets the specific molecular differences between
cancer and normal cells. For example, targeted
therapies block the estrogen receptor molecule
inhibiting the growth of breast cancer.
Chemotherapy is curative for some cancers, such
as leukemias and ineffective in some brain tumors
but its effectiveness if often limited by its toxicity
to other tissues in the body.
 Figure 9 Chemotherapy

Radiation Therapy
Radiation therapy involve the use of ionizing
radiation in an attempt to either cure or improve
symptoms. It damages DNA of cancerous tissue
and kills it while sparing normal tissues. This is
done by shaped radiation beams which are aimed
from multiple angles to intersect at the tumor,
providing a larger dose there than in the
surrounding healthy tissue.
Radiation can be delivered externally where
X-rays, Gamma rays or other high-energy particles
are delivered to the affected area from outside
the body or internally which involves the
placement of radioactive material inside the body
near cancer cells (brachytherapy). Example:
Radioactive iodine (I-131) for thyroid cancer and
Strontium-89 for bone cancer.

Figure 10 Radiation Therapy

 Surgery:
Surgery is often performed to remove malignant
tumors and allows for the determination of the
exact size of the tumor as well as the extent of
spread and invasion into other nearby structures
or lymph nodes.
Sometimes, cancer cannot be entirely removed
through surgeries as it could damage critical
organs or tissues. Therefore, palliative surgery is
performed to reduce the effects of a cancerous
tumor. Reconstructive surgery can also be
performed to restore the look or the function of
part of the body after cancer surgery.

Figure 11 Surgical Treatment of Cancer

Hematopoietic Stem Cell Transplants
Hematopoietic stem cell transplant (HPSCT),
sometimes referred to as bone marrow
transplant, involves administering healthy
hematopoietic stem cells to patients with
dysfunctional or depleted bone marrow. There
are several types of HPSCT in clinical use, and
transplanted cells may be obtained from several
sources. This procedure has several benefits and
may be used to treat malignant and non-
malignant conditions. It helps to augment bone
marrow function. In addition, depending on the
disease being treated, it may allow for the
destruction of malignant tumor cells. It can also
generate functional cells that replace
dysfunctional ones in cases like immune
deficiency syndromes, hemoglobinopathies, and
other diseases. Survival rates after HPSCT are
increasing, but morbidity due to complications
of the procedure continues. This activity reviews
the indications for HPSCT, the different options
by which to obtain donor cells, including the
advantages and disadvantages of each, and the
acute and chronic complications of the
procedure. Additionally, it highlights the role of
the interprofessional team in managing patients
who undergo HPSCT to improve patient
outcomes and decrease procedure-associated
morbidities.

Figure 12 Hematopoietic Stem Cell Transplantation

Photodynamic Therapy (PDT)

Photodynamic therapy (PDT) destroys harmful
cells, including cancer cells, using drugs called
photosensitizers. Light activates these drugs and
creates a chemical reaction that destroys the
harmful cells.
PDT is also used to treat many different types of
cancer. Your healthcare provider may recommend
photodynamic therapy for:
 Skin cancer.
 Lung cancer.
 Oesophageal cancer, including Barrett’s
oesophagus, where cells at the base of your
oesophagus are damaged.
 Bladder cancer.
 Pancreatic cancer.
 Bile duct cancer.
 Head and neck cancer.
 Brain cancer.
Figure 13 Photodynamic Therapy (PDT)

Angiogenesis Inhibitors
Angiogenesis is the formation of new blood
vessels. This process involves the migration,
growth, and differentiation of endothelial cells,
which line the inside wall of blood vessels.
The process of angiogenesis is controlled by
chemical signals in the body. Some of these
signals, such as vascular endothelial growth factor
(VEGF), bind to receptors on the surface of normal
endothelial cells. When VEGF and other
endothelial growth factors bind to their receptors
on endothelial cells, signals within these cells are
initiated that promote the growth and survival of
new blood vessels. Other chemical signals,
called angiogenesis inhibitors, interfere with blood
vessel formation.
Normally, the angiogenesis stimulating and
inhibiting effects of these chemical signals are
balanced so that blood vessels form only when
and where they are needed, such as during
growth and healing. But, for reasons that are not
entirely clear, sometimes these signals can
become unbalanced, causing increased blood
vessel growth that can lead to abnormal
conditions or disease. For example, angiogenesis
is the cause of age-related wet macular
degeneration.

Figure 14 Angiogenesis Inhibitors

 Preventative Measures:
The list below includes the most-studied known or
suspected risk factors for cancer. Although some
of these risk factors can be avoided, others—such
as growing older—cannot. Limiting your exposure
to avoidable risk factors may lower your risk of
developing certain cancers.
 Age
 Alcohol
 Cancer-Causing Substances
 Chronic Inflammation
 Diet
 Hormones
 Immunosuppression
 Infectious Agents
 Obesity
 Radiation
 Sunlight
 Tobacco
Figure 15 Measures to Prevent Cancer

Bibliography:

hmy.clevelandclinic.org/
www.cancer.org
www.wikipedia.org
www.cancer.gov
THANK YOU