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What fundamental characteristics do all cancers have in common? 

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What fundamental characteristics do all cancers have in common? 

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All cancer cells share the same fundamental characteristics of uncontrolled growth and the
ability to invade neighboring tissues and/or spread to distant sites

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In what ways are diagnostic imaging technologies used to diagnose and treat disorders? 

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In what ways are diagnostic imaging technologies used to diagnose and treat disorders? 

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X-rays, CT scans, and MRI scans are used to create pictures of the inside of the body to diagnose and treat many disorders.

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Scientists use DNA microarray technology to determine the differences in gene expression between different tissue samples

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How is DNA microarray technology used to determine the differences in gene expression between different tissue samples? 

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How is DNA microarray technology used to determine the differences in gene expression between different tissue samples? 

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Colors: red-highly expressed in cancerous cells
green- highly expressed in normal cells
yellow- expressed in both
black-neither

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How are the similarities of gene expression patterns between different individuals calculated? 

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How are the similarities of gene expression patterns between different individuals calculated? 

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>1 induced by tumor formation
<1 suppressed by tumor formation
=1 not affected by tumor formation
=0 gene not expressed in either

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Apoptosis -the death of cells that occurs as a normal and controlled part of an organism's growth or development.

Biopsy-an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease.

Bone Scan -helps diagnose and track several types of bone disease.

Cancer -the disease caused by an uncontrolled division of abnormal cells in a part of the body.

Cell Cycle -is a series of events that takes place in a cell as it grows and divides.

Computed Tomography Scan (CT or CAT Scan)-of the bones, blood vessels and soft tissues inside your body.

Diagnostic Imaging-Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention

DNA Microarray-DNA microarrays are microscope slides that are printed with thousands of tiny spots in defined positions

Magnetic Resonance Imaging (MRI)  detailed images of the organs and tissues within your body.

Oncogene a gene that in certain circumstances can transform a cell into a tumor cell.

Osteosarcoma- a type of bone cancer that usually develops in the osteoblast cells that form bone

Proto-oncogene  A normal gene which, when altered by mutation, becomes an oncogene that can contribute to cancer.

Radiology-  a branch of medicine that uses imaging technology to diagnose and treat disease.

Risk Factor- Something that increases the chance of developing a disease.

Tumor Suppressor Gene is a gene that protects a cell from one step on the path to cancer.

X-ray Broken bones

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In what ways do different risk factors increase the chance that a person will develop cancer? 

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In what ways do different risk factors increase the chance that a person will develop cancer? 

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The different risk factors are
- Behavioral
- Biological
- Environmental
- Genetic
Each increase the chance that a person has cancer however some can be controlled (for example behavioral and even environmental up to a point)

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How can lifestyle changes reduce the risk for developing cancer? 

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How can lifestyle changes reduce the risk for developing cancer? 

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get sufficient physical activity, eat healthy foods in moderation, participate in cancer screening according to recommended guidelines, get vaccinated against the Human Papillomavirus (HPV)

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How can molecular tests be used to detect inherited genetic mutations associated with certain cancers? 

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How can molecular tests be used to detect inherited genetic mutations associated with certain cancers? 

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Molecular diagnostic tests, such as marker analysis, can be used to detect inherited genetic mutations associated with certain cancers and can be used to predict risk for developing those cancers

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they have a certain mutation that will go into the cell and cause the mutation to turn into cancer

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What is the importance of routine cancer screenings?

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What is the importance of routine cancer screenings?

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to identify any possible tumors which you could develop at one point.

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Allele-one of two or more alternative forms of a gene that arise by mutation and are found at the same place on a chromosome.

BRCA-BRCA1 and BRCA2 are two genes that are important to fighting cancer. They are tumor suppressor genes

Cryosurgery

Familial Cancer-Cancer that occurs in families more often than would be expected by chance. These cancers often occur at an early age, and may indicate the presence of a gene mutation that increases the risk of cancer.

Genetic Marker-A genetic marker is a DNA sequence with a known physical location on a chromosome

Hereditary Cancer-In a hereditary cancer syndrome, certain patterns of cancer may be seen within families

Marker Analysis-Single marker analysis is one of a series of quantitative trait locus (QTL) analysis techniques that can detect associations between molecular markers and traits of interest to plant breeders

Microsatellite (also known as Short Tandem Repeats-STRs)

Melanoma-Melanoma is a form of skin cancer that begins in the cells (melanocytes) that control the pigment in your skin.

Model System-A model system is scientists' jargon for a particular species of animal that has been developed over many years to be experimentally powerful to answer particular questions.

Screening- Checking for disease when there are no symptoms. Since screening may find diseases at an early stage, there may be a better chance of curing the disease

Sporadic Cancer-Cancer that occurs in people who do not have a family history of that cancer or an inherited change in their DNA that would increase their risk for that cancer.

Virologist-Virologists are highly skilled medical experts who manage the diagnosis, treatment, and prevention of infectious diseases such as hepatitis C

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What can a cancer patient receiving chemotherapy and/or radiation therapy expect during treatment? 

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What can a cancer patient receiving chemotherapy and/or radiation therapy expect during treatment? 

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Technique of making unconscious or involuntarily bodily processes (as heartbeat or brain waves) perceptible to the senses in order to manipulate them by conscious mental control. It works to calm patients and make the treatments more effective. For example when we used it on the 8 year old with ALL

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How is biofeedback therapy used to help patients improve their health or manage pain? 

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How is biofeedback therapy used to help patients improve their health or manage pain? 

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- Changes the mental state of the patient allowing them to calm down
- Patients learn to use their mind to control involuntary actions such as heart rate, muscle tension, and respiration rate
- Overcome pain by relaxing specific muscle groups to relieve certain chronic pain and migranes
- Can help lower blood pressure, anxiety attacks, asthma attacks, or urination problems

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In what ways do artificial limbs allow patients who have suffered from the loss of a limb regain lost function? 

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In what ways do artificial limbs allow patients who have suffered from the loss of a limb regain lost function? 

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- Can offer simple movements, like hooks or pinchers to allow the person to pick objects up
- Prosthetics can be hooked to other functional parts of the body that are used to move the prosthetic
- Patient can use swithces and toggles to control the prosthetic
- Myoelectrics can help move muscle impulses to control the movement of prosthetic

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How do advances in technology allow for the development of artificial limbs that look and move like actual human limbs? 

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How do advances in technology allow for the development of artificial limbs that look and move like actual human limbs? 

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Special dyes can be used to make the prosthetic the same color, with freckles, fingerprnts and a life like appearance
- Myoelectrics can use muscle contractions and EMG signals to control the prosthetic
- Current research is ongoing into the use of brain signals connected to the motor cortex to move robotic arms, which could be the new wave of prosthetics

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How do physical and occupational therapists help patients with disabilities or patients recovering from surgery or injury?  

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How do physical and occupational therapists help patients with disabilities or patients recovering from surgery or injury?  

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- Physical therapists focus on range of motion, movement, and ability to regain proper movement
- Occupation therapists work with patients to practice normal activities they need to do daily such as driving, cooking, using the restroom
- Design appropriate exercises for the patients to practice the intended movement
- Use electric shock, stretching, and massage therapy to relax and test muscles

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Biofeedback- technique of making unconscious or involuntarily bodily processes (as heartbeat or brain waves) perceptible to the senses in order to manipulate them by conscious mental control

Chemotherapy-use of chemical agents in the treatment or control of disease or mental disorder

Metastasis-spread of a disease-producing agency (such as cancer cells or bacteria) from the initial or primary site of disease to another part of the body

Myoelectric-utilizing electricity generated by muscle

Occupational Therapy-therapy based on engagement in meaningful activities of daily life especially to enable or encourage participation in such activities despite impairments or limitations in physical or mental functioning

Physical Therapy-treatment of disease by physical and mechanical means (as massage, regulated exercise, water, light, heat, and electricity)

Prosthesis-artificial device to replace or augument a missing or impaired part of the body

Radiation Therapy-treatment of disease by means of radiation (x-rays)

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Why do some drugs affect individuals in different ways? 

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Why do some drugs affect individuals in different ways? 

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• Using pharmacogenetics, Doctors can see the relationship between someone's genes and their response to certain drugs.
• Understanding a patient's SNP (single nucleotide polymorphism) profile will allow doctors to predict how a patient will react to a particular drug.

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How can information in our genes affect how our bodies interact with certain medications? 

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How can information in our genes affect how our bodies interact with certain medications? 

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• Since each persons genes are different, the proteins that the genes encode are also different
• Proteins process many of the drugs we take
• Pharmacogentics is used to customize treatments based on an individual's genes
• Can cause severe side effects, in some cases death

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How are clinical trials set up to ensure all data collected is valid and that all human subjects are treated ethically? 

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How are clinical trials set up to ensure all data collected is valid and that all human subjects are treated ethically? 

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Randomized, controlled and double blind

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How might nanomedicine change the future of medicine? 

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How might nanomedicine change the future of medicine? 

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• Nano-one billionth (aka very very very small)
• Nanomedicine- The use of nanotechnology to help
prevent, diagnose, and treat cancer
• Developing medical
interventions at cellular and molecular scale
• Two areas: nanodevices that are used to detect
signatures of cancer and
nanovectors which can be loaded with drugs and
targeted to tumors.

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Clinical Trial-A scientifically controlled study of the safety and effectiveness of a therapeutic agent (as a drug or vaccine) using consenting human subjects

Controlled Study-Clinical trial in which the subjects are distributed into groups which are either subjected to the experimental procedure (as use of a drug) or which serve as controls

Double Blind Study-An experimental procedure in which neither the subjects nor the experimenters know which subjects are in the test and control groups during the actual course of the experiments

Nanomedicine-Area of biomedical research that seeks to use tools from the field of nanotechnology to improve health

Open Study-Clinical trial in which both the researchers and the patients know who receives the drug and who receives a placebo

Pharmacogenetics-The study of the interrelation of hereditary constitution and response to drugs

Placebo-An inert or innocuous substance used especially in controlled experiments testing the efficacy of another substance (as a drug)

Single Blind Study-An experimental procedure in which the experimenters but not the subjects know the makeup of the test and control groups during the actual course of the experiments

SNP-Variant DNA sequence in which the purine or pyrimidine base of a single nucleotide has been replaced by another such base (also called single nucleotide polymorphism)

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Targeted therapy is a cancer treatment that uses drugs to target specific genes and proteins that are involved in the growth and survival of cancer cells. Targeted therapy can affect the tissue environment that helps a cancer grow and survive or it can target cells related to cancer growth, like blood vessel cells.

Doctors often use targeted therapy along with chemotherapy and other treatments. The U.S. Food and Drug Administration (FDA) has approved targeted therapies for many types of cancers. Research is also underway to find new targeted therapy treatments.

How does targeted therapy work?

There are many types of cells that make up every tissue in your body. For example, there are blood cells, brain cells, and skin cells. Each type has its own job. Cancer starts when certain genes in healthy cells change and become abnormal over time. This change is called a genetic mutation.

Genes tell cells how to make proteins to keep the cell working. If the genes mutate, these proteins change, too. This can make cells divide too much or too quickly and allow the cells to live much longer than they normally would. When this happens, the cells grow out of control and form a tumor. Learn more about the genetics of cancer.

To develop targeted therapies, researchers first identify the genetic changes that help a tumor grow and change. A potential target for this therapy would be a protein that is present in cancer cells but not healthy cells. This can be caused by a mutation. Once researchers have identified a mutation, they develop a treatment that targets that specific mutation.

Targeted therapies can do different things to the cancer cells they target:

To best match the best targeted therapy for your tumor, your doctor may order tests to learn about the genes, proteins, and other factors that are unique to your tumor. This helps find the most effective treatment. Like other treatments, targeted therapies can cause side effects, so it is important that your doctor matches your tumor to the best possible treatment and dose. The dose of targeted therapy that you will receive is based on many factors, like your body weight and your risk of developing severe side effects. Talk to your health care team about why they recommended a certain dose.

Are there different types of targeted therapy?

There are several different types of targeted therapy. The most common types are monoclonal antibodies or small-molecule drugs.

Monoclonal antibodies. Drugs called monoclonal antibodies block a specific target on the outside of cancer cells. The target might also be in the area around this cancer. Monoclonal antibodies can also send toxic substances right to cancer cells. For example, they can help chemotherapy and radiation therapy reach cancer cells better. Monoclonal antibodies are also a type of immunotherapy.

Small-molecule drugs. Drugs called small-molecule drugs can block the process that helps cancer cells multiply and spread. Angiogenesis inhibitors are an example of this type of targeted therapy. Angiogenesis is the process for making new blood vessels. A tumor needs blood vessels to bring it nutrients. The nutrients help it grow and spread. Angiogenesis inhibitors starve the tumor by keeping new blood vessels from forming in the tissue around it.

Other types of targeted therapy include other immunotherapies, angiogenesis inhibitors, and apoptosis inducers (therapies that start cell death, or apoptosis).

Some types of targeted therapies are specific to a type of cancer. Others are known as tumor-agnostic or site-agnostic treatments. They treat tumors anywhere in the body by focusing on the specific genetic change instead of the type of cell. Learn more about tumor-agnostic treatments.

Examples of targeted therapies

Targeted therapies are a rapidly growing field of cancer research and researchers are studying many new targets and drugs through clinical trials. Below are a few examples of targeted therapies that are available now. Ask your health care team for more information.

Breast cancer. About 20% to 25% of breast cancers have too much of a protein called human epidermal growth factor receptor 2 (HER2). This protein makes tumor cells grow. If the cancer is "HER2 positive", there are many targeted therapy options. Learn more about targeted therapy for breast cancer.

Chronic myeloid leukemia (CML). Almost all cases of chronic myeloid leukemia are driven by the formation of a gene called BCR-ABL. This gene leads to the production of an enzyme called the BCR-ABL protein. This protein causes normal myeloid cells to start behaving like cancer cells. This was the very first mutation and cancer treated with targeted therapy. Learn more about targeted therapy for chronic myeloid leukemia.

Colorectal cancer. Colorectal cancer often makes too much of a protein called epidermal growth factor receptor (EGFR). Drugs that block EGFR may help stop or slow cancer growth. These cancers have no mutation in the KRAS gene. Another option is a drug that blocks vascular endothelial growth factor (VEGF). This protein helps make new blood vessels. Learn more about targeted therapy for colorectal cancer.

Lung cancer. Drugs that block EGFR may also stop or slow lung cancer growth. This may be more likely if the EGFR has certain mutations. There are also drugs for lung cancer with mutations in the ALK and ROS genes. Doctors can also use angiogenesis inhibitors for some lung cancers. Learn more about targeted therapy for non-small cell lung cancer.

Lymphoma. In lymphoma, there is an overproduction of B cells, a type of white blood cell that fights infections. Targeted drugs that block the enzyme that leads to this overproduction of B cells have been very successful for the treatment of lymphomas and some B-cell leukemias. Learn more about targeted therapies for lymphoma.

Melanoma. About half of melanomas have a mutation in the BRAF gene. Researchers know certain BRAF mutations make good drug targets. So there are many FDA-approved BRAF inhibitors. But these drugs can be harmful if your tumor do not have the BRAF mutation. Learn more about targeted therapy for melanoma.

The list of examples above does not include every targeted therapy. You can learn more about targeted therapy in each cancer-specific section on Cancer.Net in the "Types of Treatment" and "Latest Research" pages. You can also learn more about the latest targeted therapy research on the Cancer.Net blog.

Are there limitations to targeted therapy?

As with any cancer treatment, targeted therapy may not be the best treatment for every person with cancer. It may seem simple to use a drug for your specific cancer, but targeted therapy is complex, and it does not always work. It is important to know that:

A targeted treatment will not work if the tumor does not have the target

Having the target does not mean the tumor will respond to the drug

The response to the treatment may not last over time

For example, the target may not be as important for the cancer's growth as previously thought, so the drug does not provide much benefit. Or cells may become resistant to the targeted therapy, so the drug might work at first but then stop working.

Also, targeted therapy drugs may cause serious side effects. These are usually not the same as chemotherapy effects. For example, people who get targeted therapy often have skin, hair, nail, or eye problems. It is always important to talk with your doctor about the specific side effects possible for each drug in your treatment plan.

Targeted therapy is an important type of cancer treatment. But, so far, doctors can only treat a few cancers with targeted therapy. Most people with cancer also need surgery, chemotherapy, radiation therapy, or hormone therapy.

Questions to ask your health care team

Talk with your health care team about whether targeted therapy may be part of your treatment plan. If so, consider asking these questions:

What type of targeted therapy do you recommend? Why?

What are the goals of this treatment?

Will targeted therapy be my only treatment? If not, what other treatments will be a part of my treatment plan?

How will I receive targeted therapy treatment and how often?

What are the possible short-term and long-term side effects of targeted therapy?

How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

What targeted therapy clinical trials are available for me?

Whom should I call with questions or problems?

Related Resources
What is Personalized Cancer Medicine? Introduction to Cancer Research Understanding Pharmacogenomics Understanding Immunotherapy
More Information
National Cancer Institute: Targeted Cancer Therapies My Cancer Genome: Overview of Targeted Therapies for Cancer

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Targeted therapy is a cancer treatment that uses drugs to target specific genes and proteins that are involved in the growth and survival of cancer cells. Targeted therapy can affect the tissue environment that helps a cancer grow and survive or it can target cells related to cancer growth, like blood vessel cells.

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Learn about gene changes called mutations, how inherited mutations can lead to cancer, what types of cancer may be hereditary and how parents can pass gene mutations to their children.

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Cancer Research from Technology Networks

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The body is made up of approximately 37.2 trillion human cells - so you can truly appreciate how many that is, here is the number written out in full, 37,200,000,000,000 - that's a lot of cells.

These "normal" cells act as the body's basic building blocks and possess specific characteristics that enable them to maintain correct functioning of tissues, organs and organ systems. Normal cells:

control their growth using external signals, meaning they only grow and divide when required,

undergo programmed cell death (apoptosis) as part of normal development, to maintain tissue homeostasis, and in response to unrepairable damage,

"stick together" by maintaining selective adhesions that they progressively adjust which ensures they remain in their intended location,

differentiate into specialized cells with specific functions meaning they can adopt different physical characteristics despite having the same genome.

Cancer is a complex genetic disease that is caused by specific changes to the genes in one cell or group of cells. These changes disrupt normal cell function - specifically affecting how a cell grows and divides. In contrast to normal cells, cancer cells don't stop growing and dividing, this uncontrolled cell growth results in the formation of a tumor. Cancer cells have more genetic changes compared to normal cells, however not all changes cause cancer, they may be a result of it. The genetic changes that contribute to cancer usually affect three specific types of gene; proto-oncogenes, tumor suppressor genes and DNA repair genes.

Hallmarks of cancer

"Hallmarks of Cancer" is a term used to describe the specific characteristics that distinguish cancer cells from normal cells.
Figure 1: The 10 hallmarks of cancer, as defined by Douglas Hanahan and Robert A. Weinberg, 2011.

Normal cell vs cancer cell - the key differences

Cell shape: Normal human cells come in many shapes and sizes - as they differentiate and adopt specialized functions their shape changes accordingly - for instance, a red blood cell looks very different to a nerve cell. Different types of cells do not look alike, but, if you analyze cells of the same cell type they will look extremely similar, maintaining a uniform shape.

For years researchers have been peering down microscopes, looking for distinct features that can help them determine the difference between a cancer cell and normal cell. Cancer cells are misshapen, and appear as a chaotic collection of cells, in an array of shapes and sizes. Researchers have been investigating the relationship between cancer cell shape and a patients' outlook, and whether cell shape may also help to distinguish between the different types of cancer.

Nucleus: In normal cells, the nucleus has a smooth appearance and maintains a uniform, spheroid shape. Several structural components are involved in the regulation of nuclear morphology. One of these structural components is the nuclear lamina. Cancer cell nuclei are frequently misshapen and bulges known as "blebs" can often be observed in cells' nuclear membranes. Research suggests that this "blebbing" is caused by an imbalance in the proteins that constitute the nuclear lamina which leads to separation of the lamina fibers.

Chromatin: The fine, evenly distributed chromatin found in normal cells transforms into coarse, chromatin in cancer cells - aggregating into irregular clumps that vary in both size and shape.

Nucleolus: Tumor aggressiveness and clinical outcome can both be measured by observing the morphology of a cancer cell's nucleolus/ nucleoli. The nucleolus becomes increasingly enlarged and more irregular in cancer cells - cells can have multiple nucleoli within the nucleus.

Blood supply: Angiogenesis is defined as the development of new blood vessels that form from pre-existing vasculature. Angiogenesis is a vital process in normal cells that occurs during development, growth, and wound healing. However, it is also implicated in the growth of cancer, through the tumor's ability to secrete chemical signals that stimulate angiogenesis.

Tumors can directly and indirectly influence the blood supply they receive by either releasing pro-angiogenic signals themselves (left) or by exploiting neighboring "normal" cells, stimulating them to release pro-angiogenic signaling molecules (right).

Below we outline some of the key differences between cancer cells and normal cells.

How do cancer cells behave differently from normal ones?

As cancer cells display unique characteristics in comparison to normal cells, researchers can take advantage of these differences when coming up with ways to combat cancer.

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Cancer is a complex genetic disease that is caused by specific changes to the genes in one cell or group of cells. These changes disrupt normal cell function - specifically affecting how a cell grows and divides. This article outlines some of the key differences between cancer cells and normal cells.