How does a tumor happen? What exactly is a tumor?

Watch Dental Video about Carcinoma - Malignant Tumor

Doctors don’t talk about cancer; they talk about carcinoma or a malignant tumor. Ignorance breeds fear and we would like to reduce that fear for you with a bit of explanation.

People and animals consist of many different cells which develop into groups; the different groups develop into organs with very specialized functions. Every cell holds hereditary information within its nucleus which gives it information about very special tasks. The information is held in long threads made up of sugar, phosphate and four different alkalis (adenine, thymidine, guanine and cytosine). These alkalis are arranged in a row, one after another and so make up the so-called DNA strand.

As you may know, the microprocessor of your computer can only recognise power on or off – or 1 and 0 and through the binary coding of these impulses numbers, letters and a whole lot more can be represented. Thus the binary code 01000010 stands for the letter B, for example. The DNA strand in a cell works in a similar way with 3 pairs of alkalis making up an amino-acid and from amino-acids the cell creates proteins. Proteins are the starting point for all possible "organ cells".

It’s a bit more complex in a cell than it is in a computer since not only the order of the alkali pairs serves as code but also how the DNA itself is organised, i.e. how it is folded.

What will one day become of the cell is determined in this DNA strand; what task it is destined to perform and when it will die. Apart from the nucleus the cell consists of different sections, for example there’s a kind of "stomach", there are "factories" in which proteins are produced out of amino-acids, other "factories" which produce carbohydrates out of sugar molecules, others still produce fats out of fatty acids.

Every cell has its so-called cytoskeleton. This doesn’t only give the cell its shape; it also serves as a transport system in the cell, like a large conveyor belt, transporting material from one location to another within the cell. So a cell is basically made up like us but of course much, much smaller. The DNA is the index of contents – an instruction manual for the cell, where everything is written down exactly since all these many processes must happen in an organised way – otherwise there would be chaos.

Cancer Cell

Cancer Cell

Imagine a young heart cell, made up of precursors to blood cells. It grows and starts to wander in the embryo and then settles down at the place where there will one day be a heart. There it finds like cells and joins itself to them to make up a primitive pre-organ. The information which the cells need to find their right place is also encoded within the nucleus. Other, so-called "guide cells" help the heart cells to find the right location. Many of these "guide cells" take care of the development of the embryo. Sometimes cysts can develop from these cells – more about this in the video "Bone Cyst".

Our heart cell has now reached its specific location and joins itself with its fellows. They develop cell-cell contact. The nucleus registers this and immediately sends out information about what is to be done next – e.g. the order is now "produce more of the protein myosin and build this into the cytoskeleton, since you are a heart cell at last and you must later take part in the heartbeat". This is said and done right away and in the cell’s factories the appropriate proteins are produced and built into the cell’s skeleton accordingly. At some time the primitive heart cell begins to pull together due to the new proteins and in this unit of cells our heartbeat will later appear.

Our heart cell has, just like us, a limited lifetime and must then make way for a new cell – work uses it up and the cytoskeleton changes. This programmed cell death is called apoptosis by biologists. When it’s time the cell’s nucleus tells the cell that it should destroy itself, i.e. begin its apoptosis.

At this point we reach cancer. If the apoptosis doesn’t work then a cancer cell could be formed from this "unwilling to die" cell. But it hasn’t happened yet as whilst our heart cell doesn’t want to die, it does not want to multiply either. Nevertheless its incorrect behaviour will be recognised by special guard cells (the immune system) and the cell will simply be switched off – i.e. destroyed.

Let’s take another heart cell, we have lots of them. As soon as the cells reach their particular places, they normally begin to multiply until such time as they have no more space. Special receptors on the surface of the cell signal to the cell that it is now surrounded on all sides by the same cells and that it no longer needs to multiply. It should in fact start performing its pre-ordained function – in this case producing myosin.

Sometimes not only the apoptosis mechanism fails to work but the cell-division-stop mechanism too. These other cells multiply like wild although they don’t actually have any more space. They won’t die either since the apoptosis mechanism doesn’t work anymore in the cell, or more precisely, something is wrong in the DNA strand; signal pathways don’t work, the wrong proteins are produced and so on.

Each newly formed cell from then on has the same problem and also multiplies wildly but since the entire cell metabolism is out of order more and more new problems appear in the newly-generated cells. These are either so serious that the cell dies immediately or a real tumour cell is created. Since we still don’t have a malignant tumour yet, our cell will rarely die and will multiply like crazy so the guard-cells (our immune system) will observe this and the corresponding cells will be destroyed.

Cancer Research

Cancer Research

Unfortunately, not all are destroyed as a few cells survive the attack of the immune system and through newly acquired errors in the genetic information these cells manage to escape the immune system. The cell contents now go haywire and some of the subsequent cells obtain the ability, through spontaneous mutation, to release themselves from the unit of cells they occupy. To do this they produce an enzyme which enables the cell to crawl through the walls of blood vessels and thus reach another location. A metastasis has been formed and we now speak of a malignant tumour.

The original, i.e. the source cell was a heart cell in our case but we cannot always follow a path back to the source cell, as the cells lose more and more of their original form and function through the newly acquired errors in their genetic information. Such tumours are described as malignant tumours of "unknown origin".

Each of us can imagine that so much work (cell multiplication, wandering) needs a lot of energy. This is what kills people, either the cell moves to a very susceptible location, from which it cannot be removed, or the body loses so much energy that one dies of lack of energy. Usually it is a mixture of both. Fortunately fewer people are dying from malignant tumours even though the frequency of tumours is increasing. Whilst this is due to ever-improving treatment alternatives early recognition is very important.

How do such mistakes occur in this "library"? Let’s stick to our heart cell. Radioactive radiation can damage the DNA and so can chemicals. Each tissue has its damage-inducing substances; lung cells don’t like cigarette smoke; liver cells don’t feel good with alcohol and kidney cells don’t tolerate heavy metals. All this is further complicated by the immune system which, as we have heard, can recognise and switch off tumour cells but which can also trigger tumours, for example through chronic inflammatory stimuli.

A malignant tumour evolves in its own unique way, springing from an out of control cell. It is now probably clearer why substances which can damage our genetic information can trigger tumours. Whatever makes the interior order of the cell go haywire can cause tumours.

Some people have "more order" in their library from the start, some less. This is why every now and again families exist which are affected by particular tumours. Whether we will fall ill with a tumour depends on many factors – for a start from our genetic information itself and from then on from the quantity and frequency of our exposure to damaging substances. It further depends on our immune system, which in turn is modulated by our psyche.

All these factors are woven together in a very complex way. The more precisely one knows how these things relate to each other the better can one adjust his/her life accordingly and so through a well-balanced lifestyle one can have an effect against the degeneration of our cells.

Click here to see the video: Cancer

 

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