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Cancer is a term for diseases in which abnormal cells divide without control and can invade other tissues. Cancer cells can
spread to other parts of the body through the blood and lymph systems.
Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. The main categories of cancer include:
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Carcinoma - cancer that begins in the skin or in tissues that line or cover internal organs.
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Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
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Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.
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Lymphoma and myeloma - cancers that begin in the cells of the immune system.
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Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.
All cancers begin in cells, the body’s basic unit of life. To understand cancer, it’s helpful to know what happens when normal cells become cancer cells.
The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.
But sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.
- Benign tumors aren’t cancerous. They can often be removed, and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body.
- Malignant tumors are cancerous. Cells in these tumors can invade nearby tissues and spread to other parts of the body. The spread of cancer from one part of the body to another is called metastasis.
Most cancers are named for the organ or type of cell in which they begin. For example, cancer that begins in the stomach is called stomach cancer.
Some cancers do not form tumors. For example, leukemia is a cancer of the bone marrow and blood.
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The following closely related terms may be used to designate abnormal growths:
- Tumor: originally, it meant any abnormal swelling, lump or mass. In current English, however, the word Tumor has become synonymous with Neoplasm, specifically solid neoplasm. Note that some neoplasms, such as Leukemia, do not form tumors.
- Neoplasm: the scientific term to describe an abnormal proliferation of genetically altered cells. Neoplasms can be benign or malignant:
- Malignant neoplasm or malignant tumor: synonymous with cancer.
- Benign neoplasm or benign tumor: a tumor (solid neoplasm) that stops growing by itself, does not invade other tissues and does not form metastases.
- Invasive tumor is another synonym of cancer. The name refers to invasion of surrounding tissues.
- Pre-malignancy, pre-cancer or non-invasive tumor: A neoplasm that is not invasive but has the potential to progress to cancer (become invasive) if left untreated. These lesions are, in order of increasing potential for cancer, atypia, dysplasia and carcinoma in situ.
The following terms can be used to describe a cancer:
- Screening: a test done on healthy people to detect tumors before they become apparent. A mammogram is a screening test.
- Diagnosis: the confirmation of the cancerous nature of a lump. This usually requires a biopsy or removal of the tumor by surgery, followed by examination by a pathologist.
- Surgical excision: the removal of a tumor by a surgeon.
- Surgical margins: the evaluation by a pathologist of the edges of the tissue removed by the surgeon to determine if the tumor was removed completely (”negative margins”) or if tumor was left behind (”positive margins”).
- Grade: a number (usually on a scale of 3) established by a pathologist to describe the degree of resemblance of the tumor to the surrounding benign tissue.
- Stage: a number (usually on a scale of 4) established by the oncologist to describe the degree of invasion of the body by the tumor.
- Recurrence: new tumors that appear a the site of the original tumor after surgery.
- Metastasis: new tumors that appear far from the original tumor.
- Transformation: the concept that a low-grade tumor transforms to a high-grade tumor over time.
- Chemotherapy: treatment with drugs.
- Radiation therapy: treatment with radiations.
- Adjuvant therapy: treatment, either chemotherapy or radiation therapy, given after surgery to kill the remaining cancer cells.
- Prognosis: the probability of cure after the therapy. It is usually expressed as a probability of survival five years after diagnosis. Alternatively, it can be expressed as the number of years when 50% of the patients are still alive. Both numbers are derived from statistics accumulated with hundreds of similar patients to give a Kaplan-Meier curve.
Cancers are classified by the type of cell that resembles the tumor and, therefore, the tissue presumed to be the origin of the tumor. Examples of general categories include:
- Carcinoma: Malignant tumors derived from epithelial cells. This group represents the most common cancers, including the common forms of breast, prostate, lung and colon cancer.
- Sarcoma: Malignant tumors derived from connective tissue, or mesenchymal cells.
- Lymphoma and leukemia: Malignancies derived from hematopoetic (blood-forming) cells
- Germ cell tumor: Tumors derived from totipotent cells. In adults most often found in the testicle and ovary; in fetuses, babies, and young children most often found on the body midline, particularly at the tip of the tailbone; in horses most often found at the poll (base of the skull).
- Blastic tumor: A tumor (usually malignant) which resembles an immature or embryonic tissue. Many of these tumors are most common in children.
Malignant tumors (cancers) are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ of origin as the root. For instance, a cancer of the liver is called hepatocarcinoma; a cancer of the fat cells is called liposarcoma. For common cancers, the English organ name is used. For instance, the most common type of breast cancer is called ductal carcinoma of the breast or mammary ductal carcinoma. Here, the adjective ductal refers to the appearance of the cancer under the microscope, resembling normal breast ducts.
Benign tumors are named using -oma as a suffix with the organ name as the root. For instance, a benign tumor of the smooth muscle of the uterus is called leiomyoma (the common name of this frequent tumor is fibroid). Unfortunately, some cancers also use the -oma suffix, examples being melanoma and seminoma.
