Once a patient can stop asking why cancer happened to him/her, the next question is the fundamental version of the many questions that the researchers ask– “What is cancer really? and “Why can’t they just stop it?”.
The scary part of cancer is that it seems so insidious. Cut it out. Burn it out. Zap or freeze it out. Why doesn’t that work, at least for the solid tumors? Getting rid of the blood cancers, like leukemia and lymphomas seem more difficult, less obvious, but it was really the cases of leukemia which first responded to treatments.
Without going into volumes of discussion about cell and molecular biology (you are safe from that with me), just understand that cells go wild, left to their own with the family checkbook, an endless liquor cabinet, permanent pizza delivery, car keys, disguises, blind neighbors, a fancy cloning machine, and the police on strike. You get the picture. Now a more formal explanation.
Cells are supposed to do their respective duties and then die. That process is called apoptosis. You know that your scabs don’t keeping growing, but cancer cells lose the “time to die” signal.
Foreign bodies are supposed to be cleared by the immune system, and what is more foreign that cancer? However, cancer cells manage to evade immune destruction. And while doing that, they can also evade the growth suppressors, the immune brakes which would otherwise slow and prevent excess growth.
While cutting the brake lines to growth, they can also change the regulating signals for growth (think scars and healing), so those signals all left in permanent “ON” position. No brakes and an open throttle with a very full tank of fuel. To top that, they reprogram the nutrition or energy metabolism to keep the fuel of growth alive.
Liking the growth, the cancer cells override signals that naturally limit the times a cell can divide, creating endless replication instead. With the endless replication, the chances for mistakes, or genetic mutations increase, which can mean changes from the original cancer cells. Sheesh, not only alien cells, but aliens cells making alien-er cells!
To keep tumors growing, cancer cells send out signals to create blood vessels or angiogenesis when tumors outgrowth the local nutrient sources. Running out of room for all these many cells, billions and billions, the cells break down the lining of blood vessels and the lymphatic system to search out new locations, spreading and metastasizing away from the original cancer. Quite naturally, they also provide support to those tumors through inflammation-related factors, mimicking the way that the immune system responds to any injury.
Since a healthy being grows, fights off infections, responds to an allergy or heals after an injury, usually with little support, those healthy responses are amazingly efficient and interactive. Complex cellular, molecular and chemical actions are occurring all the time, and with aging, some genetic dispositions, the harmful things we ingest or do to ourselves, it is no wonder that a few things go on without our noticing it. But when those few things are not noticed by the immune system, slipping into a growth phase, a cancer can begin.
Estimates of the numbers of cells in the human body are calculated from 10 trillion to 100 trillion, so if the occasional cell goes rogue, what’s the problem? When all things are working well, there will be no problem. But when the tiniest cancer is visible with a CT scan, perhaps 1/8 inch, it will have millions of cells. Not all tiny cancer tumors are dangerous. Not all become aggressive. Digging around to cut out a tiny tumor creates plenty of opportunity for infection, for expense and emotional anguish. But does that mean that a “Cancer!” has been prevented. Or would the person and his natural immune system have lived in complete tranquility with his cancer until the end of his days?