Understanding Cancer Biology at a Cellular Level and Treatment Options

It all begins in the cells, we contain billions of them. 

Cells are the smallest building blocks of life which help carry out the body’s main functions including nutrient digestion, oxygen transportation, physical movement, logical thinking. Each cell contains a genetic command centre DNA which defines their growth and parental inheritance pattern. Alterations of mutations in small DNA fragments (genes) leads to impaired cell growth control as well as detection and repair of DNA damage – characteristics of cancerous cells.

Prolonged exposure to UV light on beaches or inherited subsets of genes from our parents can result in cancer development. Indeed, cancer is a genetic disease characterised by the accumulation of mutations in an individual’s DNA over time. Environmental factors such as stress, viral infection, and lifestyle (smoking, diet, sunbathing) may also initiate or enhance the genetic damage. 

Our body contains natural brakes against cancer. For example, cell growth is strictly regulated by multiple checkpoints and signals. The gene p53 produces a protein which normally “switches off” the cell cycle to regulate growth, such genes are “tumour suppressor genes”. In cancerous cells however, if both copies of the p53 gene are mutated this leads to uncontrolled cellular growth. Mutations also give rise to oncogenes, or genes that have gained function allowing them to be constantly “switched on”. 

Tumours that do not spread to other parts of the body are benign. In contrast, malignant cancer cells are more aggressive and invasive. Those that enter the bloodstream to further invade and colonise other sites in the body are metastasised tumour cells. Diagnosing cancer cells early on maximises the effectiveness of cures these may include: urine and blood tests, non-invasive bone and internal organ imaging or sample collection for further microscopic laboratory analysis (biopsy).

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Based on the cancer’s stage (I to IV in increasing severity) different treatment options are proposed:

  • Surgery: identification of the initial cancer site and potential secondary sites allows the removal of most or as much as the cancer as possible 
  • Radiation therapy: irradiation of cancerous cells using high-powered beams such as X-rays. This is often used after surgery to kill any remaining cancer cells and limit recurrence. 
  • Chemotherapy: using drugs to directly kill the cancer cells which can be administered by blood (intravenous) or orally. 
  • Immunotherapy: using the immune system, the body’s surveillance system which normally fends off pathogenic attacks (virus, bacteria, parasites) to battle cancer. The immune system is artificially stimulated with enhanced properties such as the enhanced ability to recognise and destroy cancer cells. 
  • Bone marrow therapy: replaces damaged blood cells with healthy ones in blood cancers (leukaemia, lymphoma, myeloma)