What Is Cancer Really? Causes and How It Starts

The World Health Organisation (WHO) ranks cancer as one of the leading causes of death globally, accounting for 1 out of every 6 deaths in 2020.

According to Cancer Research UK, the disease can affect anyone. However, most cases occur in people aged 50 and above. Statistics from the National Cancer Institute reveal that in America, an estimated 2,041,910 new cases of cancer are expected in 2025, out of which 618,120 will die from the disease.

According to the institute, in 2025, prostate, lung, and colon cancers are expected to make up 48% of all cancer cases in men, while breast, lung, and colorectal cancers will be the most common in women, accounting for an estimated 51% of new cancer diagnoses.

With its global health impact and mortality rate, more awareness needs to be created to stem the scourge and investigate cancer clusters in the general population, and that’s why this article was written.

In this article, we will understand what cancer really is, learn about the role of gene mutations in cancer development, and how cancer grows.

Defining Cancer: A Breakdown of The Basics 

According to the American Cancer Society, cancer refers to a group of diseases marked by the uncontrolled growth of abnormal cells that can invade and crowd out normal, healthy cells in the body.

According to the World Health Organisation (WHO) definition of cancer, it is a large group of diseases that involve cell proliferation and the subsequent attack of surrounding organs or tissues, in a process called metastasis, which accounts for most cancer deaths.

The body is made up of billions of cells, which are constantly forming new cells in a process called cell division or mitosis. When a cell grows old or is damaged, it dies, and a new cell replaces it. Unfortunately, this programmed cell death could break down, giving room for damaged cells to grow out of control, potentially becoming cancerous.

Cancers are non-communicable diseases. However, they can be inherited. While some are benign and do not invade surrounding tissues, others can spread through the blood and infect distant organs, depending on the stage of cancer. They are also referred to as neoplasms or malignant tumors. 

How Normal Cells Become Cancerous: The Mutation Process

All cancers begin because of changes within the cell. Cancer can start from changes in just a single cell or from a group of them.

Cell division is a tightly regulated process. In healthy tissues, there is usually a balance between the number of new cells produced through cell division and the number of old and damaged cells that die through a process called apoptosis. This balance maintains tissue health and function.

However, if the signals that regulate this process are faulty or missing, cells may begin to grow out of control and form a lump called a tumor.

Each cell in the body contains thousands of genes made up of DNA with coded instructions that tell cells how to behave.

These instructions can contain the following messages for the cell:

• What sort of cell will it be;
• What it does;
• When it divides;
• When it dies.

During cell division or when a gene instructs a cell to make a copy of itself, errors can sometimes occur in the DNA. These errors are known as mutations. A mutation could mean that a gene has been damaged, lost, or copied too many times.

A mutation in genes could manifest in any of these ways:

• When a cell starts making too many proteins, that acts as a stimulus for it to divide.
• It stops making proteins that usually tell a cell to stop dividing.
• It makes abnormal proteins that work differently from normal ones.

Some genes get damaged daily, but are usually repaired by the cell. However, when the damage accumulates and the repair systems fail or are overwhelmed, coupled with an increased cell division, further mutations can build up and increase cancer risk. This can also hinder the capacity of the cells to repair the damaged genes.

Although gene mutation can happen without any external inputs, habits such as smoking and other external influences can play a role.

The Role of DNA Damage And Gene Mutations in Cancer Development

DNA is a double-helix compound that carries key biological information from one generation to another. It contains the genetic instructions for making all the proteins your body needs. It also ensures that this information can be accurately copied and passed on during cell division.

Genes are segments of the DNA that carry specific instructions for a particular cell function. However, this function can be altered when your DNA is damaged by continuous exposure to genotoxic agents such as UV light, ionising radiation, or intracellularly, through reactive oxygen species that are generated during normal metabolic processes.

In a healthy cell, the preservation of the genome’s architecture is maintained by a very efficient DNA damage response signalling network. This system includes cell cycle checkpoints that prevent cells from dividing with damaged DNA, and DNA repair pathways that correct genetic errors. Without these safeguards, cells can divide uncontrollably – a hallmark of cancer.

Furthermore, the upregulation or downregulation of key DNA repair factors can lead to the accumulation of DNA errors and genomic imbalance, both of which have been implicated in certain neurodegenerative diseases and various types of cancers.

Cancer often arises when mutations occur in critical genes that regulate cell growth and genomic maintenance.

These genes are: 

• Oncogenes: Proto-oncogenes are genes that usually help cells divide safely or stay alive, but when they mutate, they can turn into oncogenes, at which point the cells begin to grow out of control.
• Tumor suppressor genes: These genes help regulate cell division and maintain DNA integrity. They can also trigger apoptosis, but when they’re mutated, cells can grow uncontrollably, which can lead to cancer.
• DNA repair genes: They help to fix errors in DNA. If damage can’t be repaired, checkpoint pathways can halt the cell cycle or trigger the cell to die to avoid further damage down the line.

DNA damage and gene mutations are at the heart of cancer development, disrupting the normal controls that keep cell growth in check. While some mutations occur naturally, others result from environmental exposures or lifestyle factors. Disruption in any of these genes can undermine the cell’s ability to control growth or maintain genetic integrity, setting the stage for tumor growth.

What Causes Cancer? A Look at Internal And External Triggers

Cancer occurs as a result of genetic changes that cause normal cells to become cancerous tumors. These changes are caused by internal or external triggers.

Internal triggers are mostly cancer risk factors that one cannot control. They mostly occur during normal biological processes such as:

• Oxidative stress: Reactive oxygen species, which are the causes of oxidative stress and byproducts of normal metabolic processes, can cause cancer by introducing gene mutations and causing structural alterations to the DNA. It can also contribute to abnormal gene expression and blockage of cell-to-cell communication, thereby increasing cell proliferation and reducing apoptosis.
• Genetic predisposition: Cancer is a genetic disease, and mutations in certain genes, like the DNA repair genes and tumor suppressor genes, can be a predisposing factor.
• Inflammation: Inflammation, normally a protective immune response, can increase the risk of cancer when it becomes chronic. According to this study on the link between inflammation and cancer, chronic inflammation and infections are estimated to contribute approximately 25% of all cancer cases. Infections alone cause 15% of cancers worldwide.

Internal triggers may lead to cancer risks, but cancer development is not determined by internal triggers alone. External triggers significantly contribute to the development of cancer.

External triggers are those that, out of the two, we have the most control over and can usually modify (tobacco, alcohol, UV, etc). They are often referred to as carcinogens or probable carcinogens. Unlike internal triggers, many external factors are preventable or manageable through lifestyle choices and environmental interventions.

Some external triggers for cancer development include:

• Exposure to harmful substances;
• Certain infections;
• Alcoholic beverages;
• Tobacco smoke;
• Ionising radiation;
• UV light;
• Aflatoxin (linked to liver cancer),

Creating cancer awareness, such as urging people to make cancer lifestyle changes, is one way to reduce the incidence of external cancer triggers.

Key Differences Between Benign and Malignant Tumors

While there are clear differences between benign and malignant tumors, it is important to note that a benign tumor can become a malignant or cancerous tumor. However, most do not.

A benign tumor is a non-cancerous tumor that grows slowly and doesn’t attack nearby tissues or invade distant organs, while a malignant tumor is characterised by uncontrolled growth capable of attacking nearby tissues and also metastasising to other organs through the blood or lymphatic system.

The table below provides more detailed information on these differences:

Feature	Benign tumor	Malignant tumor
Nature	Non-cancerous	Cancerous
Growth rate	Slow and controlled	Rapid and uncontrolled
Invasion	Does not invade nearby tissues	Invades nearby tissues
Metastasis	Do not spread to other parts of the body	Spreads to other parts of the body through the blood and lymphatic system
Recurrence after removal	Rarely recurs after complete removal	Often recurs even after treatment
Examples	Lipomas, fibromas, adenomas	Breast cancer, lung cancer, prostate cancer

In summary, while benign and malignant tumors both involve abnormal cell growth, their behaviour, impact and treatment approaches differ greatly. Understanding these differences is essential for timely cancer diagnosis, effective treatment and better health outcomes.

Types of Cancer: Understanding the Major Categories

There are over 200 cancers known to man. However, this study on the development and causes of cancer classifies cancer into six major categories. This classification is based on the type of cell/tissue where the cancer originates.

The six classifications of cancer include:

• Carcinoma: This refers to a malignant neoplasm or a cancer of the epithelial tissue or internal or external lining of the body. Most carcinoma types affect organs and glands in the body capable of secreting, such as the breast, colon, prostate, lung, and bladder. Some specific carcinoma types include adenocarcinoma, squamous cell carcinoma, and carcinoid tumors.

• Sarcoma: These are cancers that often originate from connective or supportive tissue such as the bones, cartilage, tendons, muscle, and fat. Sarcomas, specifically soft tissue sarcomas, often occur in young adults and usually resemble the tissue from which they develop.

• Myeloma: They occur in the plasma cells of the bone marrow. The plasma cells are responsible for producing antibodies in the blood. The most common form is multiple myeloma, which disrupts normal cell production.

• Leukaemia: Leukaemia, commonly referred to as liquid cancer, is a type of cancer of the bone marrow that affects both the white blood cells and it can disrupt the production of other blood cells including, red blood cells. Different leukaemia types vary in terms of aggressiveness and the specific cells they impact.

• Lymphoma: This type of cancer affects the lymphatic system, which is a collection of organs, nodes, and vessels that purify bodily fluids and produce white blood cells. Major lymphoma types include Hodgkin lymphoma and non-Hodgkin lymphoma.

• Mixed types: These cancers contain more than one type of cancerous cell and may involve a combination of tissue types. Some mixed types may contain elements of germ cell tumors, brain tumors, or even spinal cord tumors, depending on the origin and the differentiation of the cancer cells.

These broad categories of cancer represent the various types of cancers that affect different body organs, tissues, and cells. Each type behaves differently, responds to treatment in unique ways, and carries its prognosis

How Cancer Grows and Spreads: The Process of Metastasis

A cancer cell can grow because it can produce its blood vessels in a process called angiogenesis. These newly created blood vessels supply the tumor with nutrients and oxygen for growth.

When cancer cells break away from their primary tumor, they can invade nearby tissues or spread to distant organs, forming secondary tumors in a process known as metastasis, as previously stated.

Cancer cells can metastasise in the following ways:

• Attach to the walls of blood vessels or lymph vessels and travel through them to a new organ or the lymph nodes.
• Produce enzymes that break down tissues in the areas they invade.
• Stop in a new organ or lymph node, penetrate its walls, and burrow into the surrounding tissue.
• Form new blood vessels and evade attacks from the immune system.

Cancer cells are typically recognised as foreign by the immune system and would normally trigger an immune response. However, they have developed clever strategies to evade detection, such as hiding deep within tissues. This ability to escape immune surveillance is one of the major challenges in effective cancer treatment.

Risk Factors: Genetics, Environment, Lifestyle, and Age

A risk factor is something that increases your likelihood of having a disease. Cancer is a disease that affects your DNA, the genetic material that carries your inherited traits. So, having a family history of cancer can increase your risk compared to someone who doesn’t.

However, genetic predisposition is just one piece of the puzzle; cancer risks can also be influenced by environmental exposures such as harmful chemicals, radiation, and certain chronic infections. Prolonged contact with these carcinogens can damage DNA and increase the likelihood of cancer over time.

Lifestyle choices also play a major role, with habits like smoking, heavy drinking, poor diet, and unsafe sexual practices raising risk.

While anyone can develop cancer, the chances rise significantly after age 50. A retrospective study of cancer prevalence from 1975 to 2019 revealed an incidence of 53% among people aged 65 and above.

Despite the downward trend of cancer incidence in older people, the overall burden of cancer remains substantial. Adopting healthier habits and minimising exposure to harmful agents can lower overall risk.

The Role of the Immune System in Detecting and Fighting Cancer

The body usually mobilises its immune defence when it senses cancer antigens through its inflammatory signals. When a cell becomes cancerous, its surface produces unique antigens that the immune system considers foreign and launches an attack to neutralise it.

Additionally, the immune system can sometimes identify cancerous or precancerous cells and eliminate them even before they cause harm-this is known as tumor immune surveillance.

The remarkable aspect of the immune system’s fight against cancerous cells is its ability to specifically target cancerous cells while sparing healthy ones, along with its capacity to remember cancer antigens to help prevent recurrence. This unique precision is a key feature scientists are harnessing in the development of advanced cancer therapy.

While the immune system serves as the first line of defence against cancer, interestingly, it can contribute to tumor progression under certain conditions. This occurs through a process known as immunoediting, where immune pressure can shape and sometimes promote the survival of more aggressive cancer cell variants.

Can Cancer Be Prevented? Insights Into Early Intervention and Risk Reduction

While not all cancers can be prevented, According to the World Health Organisation, about 30% to 50% of all cancer cases can be. Understanding these prevention strategies and associated risk factors is a major step towards cancer prevention.

A prospective cohort study of more than 85,000 individuals discovered that individuals who engaged in light and moderate-to-vigorous-intensity physical activity had a lower risk of developing cancer than people who lived a sedentary life.

Additionally, in a modelling study by researchers, it was discovered that early cancer screening and prevention strategies played the biggest role in reducing mortality rates in breast, cervical, colorectal, lung, and prostate cancer, which are some of the biggest contributors to cancer death. This is against the popular belief that advancement in therapy is the reason for the fall in mortality rate.

Whether you are predisposed to cancer or at a high risk of one, you can reduce your risk by leading a healthy lifestyle, carrying out routine cancer screening, and participating in cancer awareness programs.

Advances in Understanding Cancer at the Molecular Level

Cancer research has increasingly focused on understanding the disease at the molecular level. Specifically, how alterations in signalling pathways, genetic mutations, and epigenetic changes in gene and protein expression contribute to the initiation, progression, and treatment resistance of cancer cells.

The hallmark of molecular oncology is understanding the role oncogenes and tumor suppressor genes play in the disease pathway. Oncogenes, when mutated or overexpressed, promote tumor growth, while tumor suppressor genes, when turned off, allow for abnormal cell division.

Another landmark advancement in molecular oncology is genome sequencing. This technique identifies mutated genes, including “driver” mutations and passenger mutations (non carcinogenic) to see which contribute to the cancer.

These techniques present a pool of cancer information resources that can help healthcare providers individualise cancer therapies, which can improve cancer survival rates.

Conclusion: Why Knowing How Cancer Starts Matters for Prevention and Treatment

Understanding how cancer starts is key to improving cancer prognosis and tailoring effective cancer treatment options. It also empowers individuals to seek timely cancer care, cancer support, and embrace self-care for cancer, enhancing outcomes alongside conventional cancer treatment.

Future research we hope focuses on the complex relationship between genetic, environmental and biological factors that drive cancer development. By doing this, it is possible to dig up more knowledge on how to stop cancer and not just how it starts. This takes us closer to preventive care strategies that stop cancer before it starts.

While genetics and lifestyle play a major role in cancer risk, another key factor is the toxic burden our bodies carry from daily exposure to pollutants, chemicals, and processed foods. Supporting your natural detox pathways is one of the most effective ways to reduce this burden, protect your cells, and strengthen your long-term health.

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Frequently Asked Questions

What is cancer?

Cancer is a group of diseases where abnormal cells grow uncontrollably, invade nearby tissues, and can spread (metastasise) to other parts of the body.

What causes cancer?

Cancer is caused by genetic mutations from internal factors (like oxidative stress, inflammation, and inherited mutations) and external factors (like smoking, UV radiation, certain infections, and harmful chemicals).

What’s the difference between benign and malignant tumors?

Benign tumors grow slowly, have smooth borders, and don’t spread, while malignant tumors grow quickly, invade tissues, and can spread to distant organs.

Can cancer be prevented?

Not all cancers can be prevented. However, 30-50% of cases can be prevented by avoiding known risk factors, adopting a healthy lifestyle, and doing regular screenings.

How does cancer spread in the body?

Cancer spreads when cancer cells break away from the primary tumor, travel through the blood or lymph, invade new tissues, and form secondary tumors.

References

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5. What is Cancer | Cancer Basics
6. What is Cancer
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8. The Genetics of Cancer
9. How Does Cancer Start? 
10. DNA Damage Response Genes And The Development of Cancer Metastasis
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12. Oxidative Stress, Inflammation, And Cancer: How Are They Linked? 
13. Unveiling The Link Between Chronic Inflammation And Cancer
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18. Difference Between Benign and Malignant tumors
19. Types of Cancer
20. Cancer Classification
21. How Does Cancer Spread? 
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24. Immune Surveillance of Tumors
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26. The Immune System-Is it Relevant to Cancer Development, Progression, and Treatment
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