About Cancer Cells, Gene Mutations, and Metastasis

Cancer is a condition in which cells have lost control of their normal mechanisms, resulting in abnormal, rapid and uncontrolled growth. These cancer cells will continue to divide (multiply) without following the body's normal physiology (function).

Cancer can affect all parts of the human body, for example eyes, skin, mouth, neck (thyroid), heart, lungs, intestines, liver, reproductive system and so on. As they grow and reproduce, cancer cells form a mass of malignant tissue that infiltrates nearby tissue (invasive) and can spread (metastasize) throughout the body.

Cancer cells are formed from normal cells in a complicated process called transformation. The transformation process consists of:

Initiation stage
At the initiation stage, a change occurs in the cell's genetic material that provokes the cell to become malignant. Changes in the cell's genetic material are caused by an agent called a carcinogen, which can be a chemical, a virus, radiation (irradiation) or sunlight. But not all cells have the same sensitivity to a carcinogen. Genetic abnormalities in cells or other materials, called promoters, make cells more susceptible to a carcinogen. Even chronic physical disorders can make cells become more sensitive to experience a malignancy.

Promotion stage
At the promotion stage, the cells that have undergone initiation will turn malignant. Examples of promoters in the form of: co-carcinogenic (unhealthy lifestyle). Because it takes several factors for the occurrence of malignancy (factors and risks). Cells that have not passed the initiation stage will not be affected by the promotion.

Cancer physiology is formed by two factors that are considered to play an important role in forming cancer, namely:

1. Carcinogenic . Carcinogenic research has resulted in a great deal of knowledge on the natural origins of carcinogenesis. This definition can be summarized as:

• Most carcinogenic substances are mutagens
• The carcinogenic properties depend on the dose and the multiple doses are divided into carcinogenic properties equivalent to the single ingredient given
• Carcinogenic properties can be enhanced by a promoter agent and to be effective the promoter must follow the initiator (in this case a chemical)
• Two or more initiators (a chemical plus another carcinogen) can induce malignant transformation (carcinogenesis).

Carcinogenic as the initiator will interact with DNA to induce mutations and are more irreversible. Exposure of the initiator sequence can multiply new mutations. In addition, there are promoters that induce cell replication and allow aberrant clonal selection to occur. The existence of this aberrant cell replication causes genetic errors thereby solidifying the malignant transformation. It is estimated that the first mutation causes immortalization and is released from growth control, so that this provides an opportunity for further mutations to occur and to occur oncogenic.

2. Genetic Genesis the basic functional unit that is passed from parents to their children. The gene is made in deoxyribonucleic acid (DNA) and contains chromosomes. Genes have a direct role in determining skin or eye color, blood type and currently the development of cancer.

For several reasons, genes can change (mutation). While some of these mutations have no effect on cells, other times they are very harmful or even helpful to body cells. There are two mutations, namely:

1. Inherited mutation(germline mutation) is a mutation passed on by parents to their children. All parent cells are expressed in the child's body, including egg and sperm cells, and this goes on for generations. This inherited mutation plays a role in 5-10% of cases of cancer which is known as familial cancer.

2. Acquired mutations are mutations that occur during a person's lifetime, not hereditary. These mutations can be caused by tobacco, exposure to UV rays, chemicals. This mutation does not occur throughout the body.

The following are the types of genes that contribute to cancer:

• Tumor suppressor gene : This gene is a protective gene, which functions to suppress cell growth by evaluating the rate of cell division, repairing DNA mismatches and controlling cell death (apoptosis). When a tumor suppressor gene is mutated (either by genetic or environmental influences), the body's cells grow continuously and form a tumor. Examples: BRCA1, BRCA2, and p53.

• Oncogene : This gene makes cells that become cancer cells. Examples: HER2/neu and ras.

• Genes that repair DNA:This gene repairs any errors in DNA replication. And if there is damage that cannot be repaired when a mutation occurs, it can lead to a cancerous state. The Body's Immunity to Cancer When a cell becomes malignant, the immune system can often destroy it before the malignant cell multiplies and becomes a cancer. However, if the immune system does not function normally, the body tends to be vulnerable to cancer risk, as occurs in people with AIDS, drug users, steroid drug users (suppressors of the immune system) or those who are suffering from auto-immune diseases (eg lupus). But even the immune system is not always effective, so cancer can sometimes get past this protection even when the immune system is functioning normally. In almost all types of cancer, The success rate of therapy is closely related to the stage at diagnosis and treatment. The higher the stage at diagnosis, the success of therapy will decrease with more aggressive treatment modalities.

METASTASIS
Cancer cells can damage the barrier where they originated and then spread to other parts of the body, which is called metastasis. The naming of metastases from cancer cells is adjusted to the place of origin of these cells. For example, if breast cancer cells spread to the lungs, then the name is metastatic breast cancer, not lung cancer. The spread of cancer can be through:

• Body cavity. This spread means that cancer cells spread to parts of the body that have cavities (eg, intestine, ovary and others), where this cancer can penetrate these hollow organs by invading and then embedding in a new place.
• Lymphogen (via lymphatics). Under normal circumstances, lymph nodes are small, shaped like a bunch of nuts and are found in various parts of the body (neck, groin and armpits). These lymph nodes play an important role as the body's defense system (clearing the lymph flow from germs or in this case cancer cells). When the body's defenses are damaged or no longer able to carry out its functions properly, this gland becomes a medium that helps the spread of cancer. These lymph nodes can also be a measure in determining the prognosis (hope of cure) of cancer. And through this lymph flow anyway, cancer cells can spread hematogenously (blood stream) through the meeting in the thoracic duct.
• Hematogenous (through the bloodstream) . Spread through the bloodstream is the most feared thing because it can spread to all other parts of the body, near or far.

Source: Ikrimah Indonesia Blog
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