Topic updated: January 2013

Cancer

Understanding Cancer

Cancer begins in cells, the building blocks that form tissues. Tissues make up the organs of the body.

Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.

Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant:

Benign tumors are not cancer:

  • Benign tumors are rarely life-threatening.
  • Generally, benign tumors can be removed, and they usually do not grow back.
  • Cells from benign tumors do not invade the tissues around them.
  • Cells from benign tumors do not spread to other parts of the body.

Malignant tumors are cancer:

  • Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
  • Malignant tumors often can be removed, but sometimes they grow back.
  • Cells from malignant tumors can invade and damage nearby tissues and organs.
  • Cells from malignant tumors can spread (metastasize) to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the bloodstream or lymphatic system. The cells can invade other organs, forming new tumors that damage these organs. The spread of cancer is called metastasis.

Most cancers are named for where they start. For example, lung cancer starts in the lung, and breast cancer starts in the breast. Lymphoma is cancer that starts in the lymphatic system. And leukemia is cancer that starts in white blood cells (leukocytes).

When cancer spreads and forms a new tumor in another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to the bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. For that reason, it is treated as prostate cancer, not bone cancer. Doctors sometimes call the new tumor "distant" or metastatic disease.

Risk Factors

Doctors often cannot explain why one person develops cancer and another does not. But research shows that certain risk factors increase the chance that a person will develop cancer. These are the most common risk factors for cancer:

  • Growing older
  • Tobacco
  • Sunlight
  • Ionizing radiation
  • Certain chemicals and other substances
  • Some viruses and bacteria
  • Certain hormones
  • Family history of cancer
  • Alcohol
  • Poor diet, lack of physical activity, or being overweight

Many of these risk factors can be avoided. Others, such as family history, cannot be avoided. People can help protect themselves by staying away from known risk factors whenever possible.

If you think you may be at risk for cancer, you should discuss this concern with your doctor. You may want to ask about reducing your risk and about a schedule for checkups.

Over time, several factors may act together to cause normal cells to become cancerous. When thinking about your risk of getting cancer, these are some things to keep in mind:

  • Not everything causes cancer.
  • Cancer is not caused by an injury, such as a bump or bruise.
  • Cancer is not contagious. Although being infected with certain viruses or bacteria may increase the risk of some types of cancer, no one can "catch" cancer from another person.
  • Having one or more risk factors does not mean that you will get cancer. Most people who have risk factors never develop cancer.
  • Some people are more sensitive than others to the known risk factors.

Growing Older

The most important risk factor for cancer is growing older. Most cancers occur in people over the age of 65. But people of all ages, including children, can get cancer, too.

Tobacco

Tobacco use is the most preventable cause of death. Each year, more than 180,000 Americans die from cancer that is related to tobacco use.

Using tobacco products or regularly being around tobacco smoke (environmental or secondhand smoke) increases the risk of cancer.

Smokers are more likely than nonsmokers to develop cancer of the lung, larynx (voice box), mouth, esophagus, bladder, kidney, throat, stomach, pancreas, or cervix. They also are more likely to develop acute myeloid leukemia (cancer that starts in blood cells).

People who use smokeless tobacco (snuff or chewing tobacco) are at increased risk of cancer of the mouth.

Sunlight

Ultraviolet (UV) radiation comes from the sun, sunlamps, and tanning booths. It causes early aging of the skin and skin damage that can lead to skin cancer.

Ionizing Radiation

Ionizing radiation can cause cell damage that leads to cancer. This kind of radiation comes from rays that enter the Earth's atmosphere from outer space, radioactive fallout, radon gas, x-rays, and other sources.

Radioactive fallout can come from accidents at nuclear power plants or from the production, testing, or use of atomic weapons. People exposed to fallout may have an increased risk of cancer, especially leukemia and cancers of the thyroid, breast, lung, and stomach.

Radon is a radioactive gas that you cannot see, smell, or taste. It forms in soil and rocks. People who work in mines may be exposed to radon. In some parts of the country, radon is found in houses. People exposed to radon are at increased risk of lung cancer.

Medical procedures are a common source of radiation:

  • Doctors use radiation (low-dose x-rays) to take pictures of the inside of the body. These pictures help to diagnose broken bones and other problems.
  • Doctors use radiation therapy (high-dose radiation from large machines or from radioactive substances) to treat cancer.

The risk of cancer from low-dose x-rays is extremely small. The risk from radiation therapy is slightly higher. For both, the benefit nearly always outweighs the small risk.

Certain Chemicals and Other Substances

People who have certain jobs (such as painters, construction workers, and those in the chemical industry) have an increased risk of cancer. Many studies have shown that exposure to asbestos, benzene, benzidine, cadmium, nickel, or vinyl chloride in the workplace can cause cancer.

Some Viruses and Bacteria

Being infected with certain viruses or bacteria may increase the risk of developing cancer:

  • Human papillomaviruses (HPVs): HPV infection is the main cause of cervical cancer. It also may be a risk factor for other types of cancer.
  • Hepatitis B and hepatitis C viruses: Liver cancer can develop after many years of infection with hepatitis B or hepatitis C.
  • Human T-cell leukemia/lymphoma virus(HTLV-1): Infection with HTLV-1 increases a person's risk of lymphoma and leukemia.
  • Human immunodeficiency virus(HIV): HIV is the virus that causes AIDS. People who have HIV infection are at greater risk of cancer, such as lymphoma and a rare cancer called Kaposi's sarcoma.
  • Epstein-Barr virus(EBV): Infection with EBV has been linked to an increased risk of lymphoma.
  • Human herpesvirus 8(HHV8): This virus is a risk factor for Kaposi's sarcoma.
  • Helicobacter pylori: This bacterium can cause stomach ulcers. It also can cause stomach cancer and lymphoma in the stomach lining.

Certain Hormones

Doctors may recommend hormones (estrogen alone or estrogen along with progestin) to help control problems (such as hot flashes, vaginal dryness, and thinning bones) that may occur during menopause. However, studies show that menopausal hormone therapy can cause serious side effects. Hormones may increase the risk of breast cancer, heart attack, stroke, or blood clots.

Diethylstilbestrol (DES), a form of estrogen, was given to some pregnant women in the United States between about 1940 and 1971. Women who took DES during pregnancy may have a slightly higher risk of developing breast cancer. Their daughters have an increased risk of developing a rare type of cancer of the cervix. The possible effects on their sons are under study.

Family History of Cancer

Most cancers develop because of changes (mutations) in genes. A normal cell may become a cancer cell after a series of gene changes occur. Tobacco use, certain viruses, or other factors in a person's lifestyle or environment can cause such changes in certain types of cells.

Some gene changes that increase the risk of cancer are passed from parent to child. These changes are present at birth in all cells of the body.

It is uncommon for cancer to run in a family. However, certain types of cancer do occur more often in some families than in the rest of the population. For example, melanoma and cancers of the breast, ovary, prostate, and colon sometimes run in families. Several cases of the same cancer type in a family may be linked to inherited gene changes, which may increase the chance of developing cancers. However, environmental factors may also be involved. Most of the time, multiple cases of cancer in a family are just a matter of chance.

Alcohol

Having more than two drinks each day for many years may increase the chance of developing cancers of the mouth, throat, esophagus, larynx, liver, and breast. The risk increases with the amount of alcohol that a person drinks. For most of these cancers, the risk is higher for a drinker who uses tobacco.

Poor Diet, Lack of Physical Activity, or Being Overweight

People who have a poor diet, do not have enough physical activity, or are overweight may be at increased risk of several types of cancer. For example, studies suggest that people whose diet is high in fat have an increased risk of cancers of the colon, uterus, and prostate. Lack of physical activity and being overweight are risk factors for cancers of the breast, colon, esophagus, kidney, and uterus.

Read the rest of this article from the National Cancer Institute.

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