Questions to Ask Your Doctor About Cancer Treatment

Before you meet with your doctor to ask questions about your cancer treatment, you should do your homework and be prepared before the appointment.

Tips to Help You Get Your Questions Answered
Your doctor should make time to explain the treatment options and answer your questions. Here are some tips to help you communicate better with your doctor and other members of your health care team:

• Consider writing your questions down before your appointment, which can lower your stress level and help you make the most of your visit. You may want to print this list, starting with the questions below, and bring it to your next appointment. .
• Bring a notebook or a tape recorder to the appointment. During the appointment, write down your doctor's answers, ask a family member or friend to write them down for you, or make an audio recording. That will allow you to read or listen to the information later, taking the time you need to process it.
• Tell your doctor if you are having trouble understanding an explanation or unfamiliar medical words. Sometimes, the doctor may be able to draw a picture or give an example that would help you understand.
• Let your doctor know if you are interested in seeking a second opinion. Most doctors understand the value of a second opinion, and your current doctor may even be able to recommend another doctor.
• Ask your doctor or nurse where you can find additional information or printed materials about your condition. Many offices have this information readily available.
• Talk with your health care team about information you have found on the Internet or in books or magazines. Not all information is accurate and reliable.

Potential Questions to Ask the Doctor
Asking your doctor questions is an important part of managing your care. You will choose to ask specific questions based on your unique needs and interests, and those questions may change over time.

Consider the following questions as you decide what you want to ask your doctor:

General information

• What type of cancer do I have?
• Where is it located?
• What are the risk factors for this disease?
• Is this type of cancer caused by genetic factors? Are other members of my family at risk?
• How many people are diagnosed with this type of cancer each year?
• What lifestyle changes—such as diet, exercise, and rest—do you recommend I make to stay as healthy as possible before, during, and after treatment?
• Where can I find more information about my type of cancer?

Symptoms

• What are some common symptoms of this type of cancer?
• How can I prevent or manage them?
• What are the treatment options for my symptoms?
• Will certain activities make my symptoms worse?
• What should I do if new symptoms arise or existing ones worsen?

Diagnosis                                                                       

• What diagnostic tests or procedures will I need? How often?
• Where will I go to have the tests or procedures?
• How can I prepare myself for them?
• What will we learn from the tests or procedures?
• When will I get the results, and how will I receive them? For example, will I receive them over the phone or at my next appointment?
• What does my pathology report (laboratory test results) tell us about my cancer?
• Will I need to repeat any tests or procedures if I seek a second opinion?
• How and when would you recommend I communicate with loved ones about my diagnosis?

Staging

• What is the stage of my cancer? What does this mean?
• Has cancer spread to my lymph nodes or any other parts of my body?
• How is staging used to help decide the best type of cancer treatment?
• What is my prognosis, also called chance of recovery?

Questions about Finding a Specialist and Getting a Second Opinion
    Will I need a specialist(s) for my cancer treatment?
    Will you help me find a doctor to give me another opinion on the best treatment plan for me?

Treatment

• What are my treatment options?
• Which treatments, or combination of treatments, do you recommend? Why?
• What is the goal of the treatment you are recommending? Is it to eliminate the cancer, help me feel better, or both?
• What clinical trials (research studies involving volunteers) are open to me? Where are they located, and how do I find out more about them?
• Who will be part of my cancer care team, and what does each member do?
• How much experience do you—or other members of the cancer care team—have treating this type of cancer?
• Will I need to be hospitalized for treatment, or will this treatment happen in an outpatient clinic?
• What is the expected timeline for my treatment? Do I need treatment immediately?
• How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
• What are the short- and long-term side effects of this treatment?
• Will this treatment affect my fertility (ability to become pregnant or father children)?
• How will you treat side effects that I experience during treatment?
• How can I keep myself as healthy as possible during treatment?

Questions about Surgery
    Is surgery an option for me?  If so, what kind of surgery do you suggest?
    How long will I stay in the hospital?
    If I have pain, how will it be controlled?

Questions about Other Types of Treatment
    Where will I go for treatment?
    How is the treatment given?
    How long will each treatment session take?
    How many treatment sessions will I have?
    Should a family member or friend come with me to my treatment sessions?

Questions about Side Effects
    What are the possible side effects of the treatment?
    What side effects may happen during or between my treatment sessions?
    Are there any side effects that I should call you about right away?
    Are there any lasting effects of the treatment?
    Will this treatment affect my ability to have children?
    How can I prevent or treat side effects?

Questions about Medicines and Other Products You Might Be Taking
    Do I need to tell you about the medicines I am taking now?
    Should I tell you about dietary supplements (such as vitamins, minerals, herbs, or fish oil) that I am taking?
    Could any drugs or supplements change the way that cancer treatment works?

Clinical trials

• What are clinical trials?
• How do clinical trials help people with cancer?
• Are any clinical trials treatment options for me?
• What happens during a clinical trial?
• What are the benefits and risks of participating in a clinical trial?
• How will I be monitored while participating in a clinical trial?
• What are my responsibilities during the clinical trial?
• Are there any costs associated with my participation in a clinical trial?
• Where can I learn more about clinical trials?

Support

• What support services are available to me? To my family?
• May I contact you or the nurse if I have additional questions?
• Whom should I call with questions or concerns during non-business hours?
• Can you recommend a social worker to help locate support services?
• Where can I find resources for children? For older adults?
• If I'm worried about managing the costs related to my cancer care, who can help me with these concerns?
• Who handles health insurance concerns in your office?

Follow-up care

• What follow-up tests will I need, and how often will I need them?
• Is there anything else I should be asking?

KEY POINT! If you do your homework and research before your doctor's appointment, you should find answers to many of these questions. Then, when you ask the doctor, you'll know two things: (1) What you learned was correct (or wrong); and, (2) What your doctor knows.

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Types of Cancer Treatments
There are many types of cancer treatment. The types of treatment that you receive will depend on the type of cancer you have and how advanced it is.

The main types of cancer treatment include:
Chemotherapy: Uses drugs to kill cancer cells.

Hormone Therapy: Slows or stops the growth of cancer that uses hormones to grow.

Immunotherapy: Helps your immune system fight cancer.

Radiation Therapy: Uses high doses of radiation to kill cancer cells and shrink tumors.

Targeted Therapy: Targets the changes in cancer cells that help them grow, divide, and spread.

Stem Cell Transplant: Procedures that restore blood-forming stem cells in people who have had theirs destroyed by high doses of cancer treatments, such as chemotherapy and radiation therapy.

Surgery: A procedure in which a doctor with special training, called a surgeon, removes cancer from your body.

Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. When you need treatment for cancer, you have a lot to learn and think about. It is normal to feel overwhelmed and confused. But, talking with your doctor and learning about the types of treatment you may have can help you feel more in control.

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Blood Tests
Samples collected for cancer blood tests are analyzed in a lab for signs of cancer. The samples may show cancer cells, proteins or other substances made by the cancer. Blood tests can also give your doctor an idea of how well your organs are functioning and if they've been affected by cancer.

Examples of blood tests used to diagnose cancer include:

Complete blood count (CBC). This common blood test measures the amount of various types of blood cells in a sample of your blood. Blood cancers may be detected using this test if too many or too few of a type of blood cell or abnormal cells are found. A bone marrow biopsy may help confirm a diagnosis of a blood cancer.


A CBC measures the amount of three types of cells in your blood:

• White blood cell count. A white blood cell count, also called a leukocyte count, measures the total number of white blood cells in a sample of blood. These cells protect the body from infection by attacking invading bacteria, viruses, and other foreign materials in the body. Some white blood cells can also attack cancer cells.
  
• White blood cell differential. A white blood cell differential is a test that measures the number of each type of white blood cell. There are five major types of white blood cells, and each type plays a different role in protecting the body. Your doctor can learn valuable information about your health by measuring the levels of these cells.
  
  • Neutrophils
  • Lymphocytes
  • Monocytes
  • Eosinophils
  • Basophils
     
• Red blood cell count. Red blood cells carry oxygen throughout your body. A red blood cell count, also called an erythrocyte count, measures the number of red blood cells in a sample of blood. There are several ways to measure red blood cells. Two of the most common are:Platelet count. A platelet count measures the number of platelets in a sample of blood. Platelets help to stop bleeding by forming blood clots.
  
  • Hematocrit (Hct), the percentage of your blood that is made up of red blood cells
  • Hemoglobin (Hgb), the amount of the protein in red blood cells that carries oxygen

The amounts of each of these types of cells have a normal range. Your health care team will note this range on your CBC lab results. A range is used instead of a specific number because a normal amount is different for each person.

Blood protein testing. A test to examine various proteins in your blood (electrophoresis) can aid in detecting certain abnormal immune system proteins (immunoglobulins) that are sometimes elevated in people with multiple myeloma. Other tests, such as a bone marrow biopsy, are used to confirm a suspected diagnosis.

Tumor marker tests. Tumor markers are chemicals made by tumor cells that can be detected in your blood. But tumor markers are also produced by some normal cells in your body, and levels may be significantly elevated in noncancerous conditions. This limits the potential for tumor marker tests to help in diagnosing cancer.

The best way to use tumor markers in diagnosing cancer hasn't been determined. And the use of some tumor marker tests is controversial.

Examples of tumor markers include prostate-specific antigen (PSA) for prostate cancer, cancer antigen 125 (CA 125) for ovarian cancer, calcitonin for medullary thyroid cancer, alpha-fetoprotein (AFP) for liver cancer and human chorionic gonadotropin (HCG) for germ cell tumors, such as testicular cancer and ovarian cancer.

Circulating tumor cell tests. Experimental blood tests are being developed to find cells that have broken away from an original cancer site and are floating in the bloodstream. More research is needed to understand how these tests can help doctors diagnose advanced cancers.

What the results mean
Test results must be interpreted carefully because several factors can influence test outcomes, such as variations in your body or even what you eat. In addition, keep in mind that noncancerous conditions can sometimes cause abnormal test results. And, in other cases, cancer may be present even though the blood test results are normal.

Your doctor reviews your test results to determine whether your levels fall within a normal range. Or your doctor may compare your results with those from past tests.


Your doctor and other members of your health care team must carefully interpret CBC test results. Keep in mind that many factors, including noncancerous conditions, can lead to results that fall out of the normal range. Ask your doctor to help you understand what your results mean.

• Low white blood cell count. Some cancer treatments, mainly chemotherapy, may cause a decrease in your body's white blood cells. Cancers that affect the blood and bone marrow can also cause a decrease in the count. These types of cancers include leukemia, lymphoma, and multiple myeloma.
  
• Amounts of different white blood cells. Higher-than-normal numbers of lymphocytes or monocytes can indicate the possibility of certain types of cancers. Some cancers and their cancer treatments may cause neutropenia. Neutropenia is a decrease in the number of neutrophils, which increases the chances of a bacterial infection. At times, your doctor may lower your chemotherapy dose to reduce your chance of developing a low neutrophil count. Your doctor may also recommend medication, such as white blood cell growth factors, to increase your body's production of neutrophils, especially if you develop a fever.
  
• Low red blood cell count. Some cancer treatments, mainly chemotherapy and radiation therapy, may cause a decrease in red blood cells. This condition is known as anemia. Blood loss, either from surgery or specific cancers, and cancers that directly involve the bone marrow can also cause or worsen anemia. People whose red blood cell count falls too low may need a blood transfusion or medication to help increase it.
  
• Low platelet count. Some cancer treatments, such as chemotherapy or radiation therapy, may cause a decrease in platelets. Cancers that directly involve the bone marrow can also cause a decrease in platelets. This can result in a condition called thrombocytopenia, which means a person's blood has an unusually low level of platelets. Patients with low platelet levels have a greater risk of serious bleeding or bruising. If your platelet count falls to very low levels, your doctor may recommend platelet transfusions.
  

What happens next
Though blood and urine tests can help give your doctor clues, other tests are usually necessary to make the diagnosis. For most forms of cancer, a biopsy — a procedure to obtain a sample of suspicious cells for testing — is usually necessary to make a definitive diagnosis.

In some cases, tumor marker levels are monitored over time. Your doctor may schedule follow-up testing in a few months. Tumor markers are most often helpful after your cancer diagnosis. Your doctor may use these tests to determine whether your cancer is responding to treatment or whether your cancer is growing.

Discuss test results with your doctor. Ask your doctor what your results say about your health and what the next steps should be.

Diagnostic Tests and Procedures
When a doctor selects a diagnostic test(s), he/she will consider the person’s age and medical condition, the type of cancer suspected, the severity of the symptoms, and previous test results. Not everyone will need all the available diagnostic tests. The most common diagnostic tests are as follows.

Barium Enema: An enema is a procedure that delivers liquid into the rectum and colon through the anus. Barium, which is a special dye called a contrast medium, is the liquid used in a barium enema. When an x-ray is taken, the barium shows up bright white, clearly outlining the colon and rectum. Abnormalities, such as inflammation, polyps (precancerous growths), and cancer, are then visible.

Biopsy: A biopsy is a medical procedure that, for most types of cancer, is the only way to make a definitive cancer diagnosis, as it provides the most accurate analysis of tissue. Often, doctors will recommend a biopsy after a physical examination or imaging study, such as an x-ray, has identified a possible tumor.

Bone Marrow Aspiration and Biopsy: A bone marrow biopsy and aspiration is a diagnostic examination of the bone marrow that can provide information about the development and function of blood cells.
 
Bone Scan: A bone scan is a diagnostic imaging test used to determine if your bone is damaged, either from cancer or from some other cause. The scan will detect cancer that has started in your bones, as well as cancer that has metastasized (spread) to the bone from other areas of your body. It can also track how cancer in the bone is responding to treatment.

Breast MRI for the Early Detection of Breast Cancer: Breast magnetic resonance imaging (MRI) is a procedure being studied more frequently for its role in detecting breast cancer. Although the early results of breast MRI studies are encouraging, breast MRI should not be substituted for mammography for women at average risk for breast cancer. However, it may be an additional tool to screen for breast cancer in women at high risk for developing the disease.

Breast MRI: A breast MRI (magnetic resonance imaging) exam is a diagnostic examination that uses magnetic fields to capture multiple images of the breast tissue, which are combined to create detailed, computer-generated pictures of your breasts. A breast MRI sometimes is used to diagnose and evaluate breast tumors. Under some circumstances, this test may better identify a small mass within a woman's breast than a mammogram or ultrasound, particularly for women with very dense (non-fatty) breast tissue.

Colonoscopy: A colonoscopy is a diagnostic examination used to look inside the entire large intestine, which plays an important role in the body’s ability to process waste. The colon makes up the first five to six feet of the large intestine, and the rectum makes up the last six inches, ending at the anus.

Computed Tomography (CT) Scan: A computed tomography (CT) scan, also called a CAT scan, is a diagnostic exam used to detect tumors, determine the stage of the disease and whether cancerous cells have spread, and find out about the effectiveness of cancer treatment.

Digital Rectal Exam (DRE): A digital rectal exam (DRE) is a screening test that allows a doctor to check the prostate gland in men or the lower colon/rectum in men and women for cancer or other abnormalities. In addition, in association with a vaginal examination, a DRE can check for cancer of the uterus and ovaries in women. A DRE can also be used to check the other organs and structures in the pelvis.

Additional Website Resources

A Cancer Diagnosis: What to Do Next?
http://www.webmd.com/cancer/features/cancer-diagnosis-what-to-do-next

Cancer diagnosis: 11 tips for coping - Mayo Clinic
http://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-diagnosis/art-20044544

The emotional impact of a cancer diagnosis | American Cancer Society
http://www.cancer.org/treatment/treatmentsandsideeffects/emotionalsideeffects/copingwithcancerineverydaylife/a-message-of-hope-emotional-impact-of-cancer

If A Doctor Says You Have Cancer…
http://www.comingtogethertofightcancer.com/if-a-doctor-says-you-have-cancer/

So You Have Cancer: 10 Things to Do Now, Even if You're Not Warren Buffett
http://www.huffingtonpost.com/michael-solomon/cancer-advice_b_1447171.html

Cancer Clinic Dealing with Grief of Diagnosis

http://cancerclinic.com/blog/?p=57

Coping with a cancer diagnosis
http://www.nhs.uk/Livewell/cancer/Pages/coping-with-cancer-diagnosis.aspx

Your Emotions After a Cancer Diagnosis | We Can Help | LIVESTRONG.org
http://www.livestrong.org/we-can-help/just-diagnosed/your-emotions-after-cancer-diagnosis/

Stages of Cancer Grief
http://www.livestrong.com/article/278518-stages-of-cancer-grief/

After cancer diagnosis, what comes next? - CNN.com
http://www.cnn.com/2008/HEALTH/conditions/05/21/ep.cancer.resources/

Coping with a cancer diagnosis - Cancer Council Australia
http://www.cancer.org.au/about-cancer/after-a-diagnosis/coping-with-a-cancer-diagnosis.html

Related Resources
    National Cancer Institute
    National Institute of Health
    Treatment Research
    Chemotherapy and You: Support for People With Cancer
    Radiation Therapy and You: Support for People With Cancer
    Questions to Ask Doctor (Cancer.Net)
 

Types of Cancer

There are more than 200 types of cancer, far too many to discuss in this blog. However, most of these cancers fit into the following major categories.

Carcinoma: These cancers originate in tissues which either cover surfaces or line internal organs. Carcinomas account for 80 to 90 percent of all cancer cases. Carcinomas are divided into two major subtypes: adenocarcinoma, which develops in an organ or gland, and squamous cell carcinoma, which originates in the epithelium (surface layer of cells), often the skin.

Examples of carcinomas include cancers of the breast, prostate, lung, intestine, skin, pancreas, liver, kidneys, colon, pancreas, and bladder; ovarian cancers, epithelial, squamous and basal cell carcinomas, melanomas, papillomas, and adenomas.

Sarcoma: These cancers originate in connective tissue, appearing in bones, muscles, fat, cartilage, nerves, tendons, and joints, mostly of the arms or legs. These are considered to be the rarest and most deadly forms of cancer. There are more than 50 types of sarcomas, belonging to two main classes – bone sarcoma and soft tissue sarcoma. 

Sarcoma includes cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue -- "bone, soft tissue cancers," osteosarcoma, synovial sarcoma, liposarcoma, angiosarcoma, rhabdosarcoma, and fibrosarcoma.

Leukemias:  These are cancers of the blood.  They manifest as overproduction of white blood cells and not as solid tumors.  Leukemias originate in the tissues of the bone marrow, spleen, and lymph nodes.

There are four main types of leukemia, grouped by how fast the disease gets worse and what kind of white blood cell it affects.  While acute leukemia progresses very quickly, chronic leukemia gets worse slowly and may not cause symptoms for years. Leukemias are further classified as lymphocytic or myelogenous. Lymphocytic leukemia affects white blood cells called lymphocytes. Myelogenous leukemia affects other types of cells like red blood cells or platelets.

This cancer starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood -- "leukemia," lymphoblastic leukemias (ALL and CLL), myelogenous leukemias (AML and CML), T-cell leukemia, and hairy-cell leukemia.

Lymphoma and Myeloma: Cancers that begin in the cells of the immune system -- "lymphoma," T-cell lymphomas, B-cell lymphomas, Hodgkin lymphomas, non-Hodgkin lymphoma, and lymphoproliferative lymphomas.

Myelomas are produced in the plasma cells of bone marrow, the soft tissue inside bones. Plasma cells are white blood cells that produce disease-fighting and infection-fighting antibodies. Myeloma cells prevent the normal production of antibodies, leaving the immune system weakened. The multiplication of myeloma cells also interferes with normal production and function of red and white blood cells and can cause bone destruction, leading to bone pain and/or fractures. Because myeloma frequently occurs at many sites in the bone marrow, it is often referred to as multiple myeloma.

Lymphomas are cancers of the white blood cells of the lymphatic system.  The two most prevalent types are Hodgkin disease and non-Hodgkin lymphoma.  The latter group includes common B-cell lymphoma (originating in the B-cells) and the rarer T-cell lymphoma (originating in the T-cells).  Non-Hodgkin lymphomas are also classed as indolent or aggressive, depending on how rapidly they are growing.

Central Nervous System Cancers: Cancers that begin in the tissues of the brain and spinal cord -- "brain and spinal cord tumors," gliomas, meningiomas, pituitary adenomas, vestibular schwannomas, primary CNS lymphomas, and primitive neuroectodermal tumors.

Not included in the above types listed are metastatic cancers; this is because metastatic cancer cells usually arise from a cell type listed above and the major difference from the above types is that these cells are now present in a tissue from which the cancer cells did not originally develop.

Consequently, if the terms "metastatic cancer" is used, for accuracy, the tissue from which the cancer cells arose should be included. For example, a patient may say they have or are diagnosed with "metastatic cancer" but the more accurate statement is "metastatic (breast, lung, colon, or other type) cancer which spread to the organ in which it has been found."

Another example is the following: A doctor describing a man whose prostate cancer has spread to his bones should say the man has metastatic prostate cancer to bone. This is not "bone cancer," which would be cancer that started in the bone cells. Metastatic prostate cancer to bone is treated differently than lung cancer to bone.

Summary
From the point of view of conventional oncology, it is very important to confirm the exact diagnosis and identify the specific cell type and cancer stage in order to determine the appropriate treatment protocol. However, often much precious time is spent sending specimens to laboratories, receiving conflicting or confusing diagnostic results, and getting several treatment opinions from specialists in one type of cancer or another.

If you are diagnosed with cancer, but your doctors are spending a lot of time trying to figure out what to do, you can be proactive by beginning to do your own research and begin changing your diet.

Website References

List of Cancer Types
http://www.cancer.org/cancer/showallcancertypes/index
http://www.webmd.com/cancer/understanding-cancer-basics

Types of Cancer
http://www.cancer.net/cancer-types
Note: Cancer.Net offers individualized guides for more than 120 types of cancer and related hereditary syndromes. Each guide provides comprehensive, oncologist-approved information on: Overview, Medical Illustrations, Risk Factors, Prevention, Symptoms & Signs, Diagnosis, Stages, Treatment Options, About Clinical Trials, Coping with Side Effects, After Treatment, Latest Research, Questions to Ask the Doctor, and Additional Resources

The 10 Most Common Cancers in the U.S.

http://www.sheknows.com/health-and-wellness/articles/823419/10-most-common-cancers-in-the-us

Cancer Etiology

Cancer is a complex group of diseases with many possible causes and contributing risk factors. These causes and risk factors are associated with your physiology, diet, lifestyle, stress level, environment, genetics, and many other factors.

Here is a list of  some of the causes and contributing co-factors that can trigger the development of cancer in your body. Use this information to help determine how to reduce your risk of developing cancer.

Recreational Drugs
Smoking (Tobacco)
Drinking excess alcohol

Environment
Environmental toxins, e.g. radon gas, RF radiation, (e.g. microwaves)
Work environments, e.g. asbestos , benzene
Agricultural practices, e.g. pesticides
Household products, e.g. detergents, cleaning products, sprays
Cosmetics, e.g. facial/body creams, soaps, antiperspirants, hair color
Pollution, e.g. air, water
Other carcinogens, infectious agents


Biological/Physiological
Weak immune system
High blood glucose
High insulin levels
Insulin resistance
Cellular inflammation
Oxidative stress
Hormonal imbalance
Being overweight or obese
Narrowing of the arteries (large blood vessels) supplying the kidneys
High blood viscosity
Enzyme deficiencies
Impaired digestion
Toxicity

Diseases
Diabetes
Obesity
HIV/AIDS
Hepatitis B and C (causes of liver cancer)
Epstein-Barr virus (a cause of some childhood cancers)
Human immunodeficiency virus (HIV)
Hormonal conditions 
Conditions that affect the body’s tissue, such as lupus
Obstructive sleep apnea
Adrenal gland tumors
Thyroid problems
Note: Additional risk factors include anything that suppresses or weakens the immune system and inhibits the body's ability to fight infections and other health problems. 

Nutritional/Dietary
Refined sugar, flour
Lack of raw foods
Processed foods, e.g. canned, pasteurized, soy
Bad fats, e.g. fried meats, excess animal meat, trans fats, canola oil, vegetable oil
Food chemicals, e.g. GMOs, HFCS, artificial sweeteners, food dyes
Beverages, e.g. diet soda, tap water, cow's milk
Macronutrient imbalance
Vitamin deficiency (A, B, C, D, E, K2)
Mineral deficiency (selenium, zinc)
Other nutrient deficiency (pancreatic enzymes, Omega-3 EFAs, probiotics)

Nutritional Supplements
Synthetic vitamins
Herbal supplements

Lifestyle
High stress environment
Lack of exercise
Overexposure to sunlight (UV rays), tanning beds

Medical Practices
X-rays, Mammograms
Chemotherapy
Radiation
Dental practices, e.g. mercury fillings, root canals
Vaccines, e.g. Gardasil (human papillomavirus (HPV) vaccine)

Other Drugs/Medications
Steroids
Painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen  
Recreational drugs, such as cocaine, amphetamines and crystal methamphetamine
Other  medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs

Mental
Emotional stability
Stressful work environment
Negative emotions/thinking, e.g. anger, jealousy, regret
Financial problems
Lack of knowledge/awareness

Family
Race (being of African or Caribbean origin)
Genetics (gene mutation)
Congenital (certain defects you're born with)
Family cooking habits

Societal
Racism, sexism, etc.
Other isms

In most cases, people will have multiple causes and co-factors that contribute to developing cancer. Usually, there is no one single factor that triggers the development of cancer in someone's body.

Note: For more information about cancer, refer to the Death to Diabetes book, Death to Cancer ebook, training program, online training course; and, the Death to Diabetes website, blog and Facebook Page.

Website References:
http://www.cancer.org/cancer/cancercauses/
http://www.mayoclinic.org/diseases-conditions/cancer/basics/causes/con-20032378 
http://www.cancer.gov/about-cancer/causes-prevention 
http://www.cancerresearchuk.org/about-cancer/causes-of-cancer
http://www.ncbi.nlm.nih.gov/pubmed/25554788
http://www.ncbi.nlm.nih.gov/pubmed/?term=cancer+causes
http://www.cancer.org/cancer/cancercauses/othercarcinogens/generalinformationaboutcarcinogens/known-and-probable-human-carcinogens
 

Cancer Epidemiology

Cancers kill thousands of people worldwide. In the United States, for example, cancers form 25% of all deaths. It is also a major health problem in many parts of the world. In the developed world, one in three people will develop cancer during their lifetimes.

Cancer can also occur in young children and adolescents, but it is rare (about 150 cases per million in the U.S.). Among children, leukemia is the commonest cancer and the next common cancer in children is brain cancers (notably neuroblastoma).

Furthermore around one third of cancers worldwide are due to potentially modifiable risk factors, which are headed by tobacco smoking, alcohol use, and diets low in fruit and vegetables. In addition, being obese and having a sexually transmitted infection are also risk factors for cancers.

Cancer Statistics in the USA
Common cancers among men include prostate cancers (144.8 per 100,000 people) and lung cancer (79.5 per 100,000 people). Lung cancer is the second most common cancer among white, black, American Indian/Alaska Native, and Asian/Pacific Islander men and third among Hispanic men.

The third most common cancer among men is Colorectal cancer (51.6 per 100,000 people) that is second among Hispanic men, third among white, black, American Indian/Alaska Native, and Asian/Pacific Islander men. The leading causes of cancer death among men are lung cancer (64.0 per 100,000 people), Prostate cancer (22.8 per 100,000 people), Liver cancer and colorectal cancer (19.7 per 100,000 people).

Among women the three common cancers are breast cancer (121.9 per 100,000 people), lung cancer (54.5 per 100,000 people) and colorectal cancer (38.7 per 100,000 people). Breast cancer is the first common cancer among women of all races and Hispanic origin populations. Lung cancer is second among white, black, and American Indian/Alaska Native women, and third among Asian/Pacific Islander and Hispanic women and colorectal cancer is second among Asian/Pacific Islander and Hispanic women and third among white, black, and American Indian/Alaska Native women.

Among women the leading cause of cancer deaths is lung cancer (39.0 per 100,000 people), breast cancer (22.5 per 100,000 people) and colorectal cancer (13.8 per 100,000 people). Survival rate for many common cancers has increased in the past two decades.

Cancer Statistics in United Kingdom
Overall there are more than 200 types of cancer and in 2009, 320,500 new cases of cancer were detected in UK. Around 800 people were diagnosed every day. More than 1 in 3 people in the UK will develop some form of cancer during their lifetime. Over half of these new cancers are either breast, lung, bowel or prostate cancers.

More than three out of five cancers are diagnosed in people aged 65 and over. Around 1% of all cancers affect children, teenagers and young adults.

Cancer causes more than one in four of all deaths in the UK and more than three-quarters of cancer deaths occur in people aged 65 and over. More than one in five of all cancer deaths are from lung cancer. Survival rate for many common cancers has increased in the past two decades.

Cancer Statistics in Australia
In Australia, an estimated 121,500 new cases are diagnosed in 2012. The number is estimated to rise to 150,000 by 2020. This means that 1 in 2 Australian men and 1 in 3 Australian women will be diagnosed with cancer by the age of 85. In addition, cancer is a leading cause of death in Australia and in 2012 more than 43,000 people died of cancer.

Survival rate for many common cancers has increased by 30 per cent in the past two decades.
The most common cancers in Australia excluding non-melanoma skin cancer are prostate, colorectal, breast, melanoma and lung cancer.

Percent of New Cancers by Age Group: All Cancer Sites

2007-2011, All Races, Both Sexes

Cancer Statistics

The CDC just reported that only ½ to 1% of metastatic cancer patients live longer than 5 years. Another published article in Current Cancer Research stated that chemotherapy is now credited with remissions in only 7% of cancer cases.

A macronutrient-dense plant-based diet in combination with an alternative treatment protocol can help to change the underlying causes of cancer, and thus help the patient's "host defense mechanisms" better fight off the cancer cells. Comprehensive cancer treatment should always include an aggressive nutritional component as part of the overall therapy.

The Truth About Cancer
Cancer - You have read about it - You hear about it -You see it on TV - But there is one thing you are never told - the truth.

You were probably not told the truth about the incidence of cancer. It is growing by leaps and bounds. In 1960 1 out of 4 people had cancer. Today it is 1 out of 3. Soon it will be 1 out of 2. In just the last 30 years the incidence of cancer has gone up a shocking 40%. This year, well over 1,250,000 Americans will get cancer. And all of this while Americans are spending mega billions of dollars on cancer treatment and research.

You were probably not told the truth about cancer death. Death from cancer is on a rapid rise. It will overtake heart disease as America's # 1 killer in the next 2-3 years. This year, over 650,000 Americans will die with cancer in spite of the best therapy that conventional medicine has to offer.

You were probably not told the truth about what causes cancer. Usually it is caused by toxic chemicals, not only by tobacco, but primarily industrial chemicals, pollutants, & radioactive substances in our food, water, air, homes, & workplace. Recently, the FDA found significant traces of 60-80 pesticides in the average American food shopping basket. Incredibly, the government did nothing.

You were probably not told the truth about cancer prevention. We can lower our risk of cancer by eliminating carcinogens from our food, water, air, homes, and workplace. There is valid scientific evidence that we can now significantly lower the risk of cancer by purging the body of all toxins then go on a healthy diet and exercise regularly.

You were probably not told the truth about conventional cancer therapy. For decades, the cancer establishment has foolishly relied on the crude and primitive treatments of surgery, radiation, and chemotherapy as their only weapons. These therapies are generally very dangerous, toxic, and inefficient, but highly profitable for the conventional medical field. Many knowledgeable doctors say that radiation & chemotherapy is murder.

They never tell you that Europe, China, and other countries are far ahead of the U.S. in the prevention and cure of cancer. Those therapies that are successful in other countries are not allowed in the U.S. So much for physicians trying to heal you and the FDA protecting you.

You were probably not told that radiation & chemotherapy is a brew of deadly poisons. Like surgery & radiation, the goal of chemotherapy is to purge the body of cancer by destroying cancer cells. Because the cancer cells divide more rapidly than normal cells, chemotherapeutic agents target rapidly dividing cells.

You may not have been told other cells, such as those in the hair follicles, intestinal lining, & bone marrow, are also seriously affected. It destroys the hair follicles and fast-growing epithelial cells lining the digestive tract. This is why chemotherapy usually results in hair loss & gastrointestinal illness. The truth is, we are not winning the war against cancer.

Over the last 38 years chemotherapy has been unsuccessful in most cases to treat Cancer. Chemo is still not approved by the FDA and continues to be in field trials. There is only one way to successfully treat Cancer and degenerative diseases and that is through the use of a whole body approach. You cannot drug a body into health. 

You must nourish the body, mind and soul. Cancer is a systemic disorder, which means it is in the whole body. It simply manifests itself in a particular organ or site. This is typically one's genetically weak link. This is why you cannot cut an organ out. 96% of all cancer survivors of chemotherapy have a relapse after 5 years. Cancer is an anaerobic organism (without oxygen), which thrives in acidic, low oxygen, dark, moist environment. Cancer feeds on glucose and secretes lactic acid as a by-product. The liver then converts this lactic acid back into glucose, so you end up with a viscous cycle of the cancer feeding itself and wasting away your body.  

In order to stop Cancer growth you must change the body to an alkaline state, provide high levels of oxygen to the tissues and cut off the supply of glucose to the tumor -- these are just a few of many techniques.

If you doubt what you're reading or hearing about cancer and the medical industry, then, here are some of the statistics about cancer -- and, numbers never lie.

U.S. Statistics

Here is a summary of the key statistics concerning cancer in the United States. Below this section are the global statistics.

• In 2015, an estimated 1,658,370 new cases of cancer will be diagnosed in the United States and 589,430 people will die from the disease.
• The most common cancers in 2015 are projected to be breast cancer, lung and bronchus cancer, prostate cancer, colon and rectum cancer, bladder cancer, melanoma of the skin, non-Hodgkin lymphoma, thyroid cancer, kidney and renal pelvis cancer, endometrial cancer, leukemia, and pancreatic cancer.
• The number of new cases of cancer (cancer incidence) is 454.8 per 100,000 men and women per year (based on 2008-2012 cases).
• The number of cancer deaths (cancer mortality) is 171.2 per 100,000 men and women per year (based on 2008-2012 deaths).
• Cancer mortality is higher among men than women (207.9 per 100,000 men and 145.4 per 100,000 women). It is highest in African American men (261.5 per 100,000) and lowest in Asian/Pacific Islander women (91.2 per 100,000). (Based on 2008-2012 deaths.)
• The number of people living beyond a cancer diagnosis reached nearly 14.5 million in 2014 and is expected to rise to almost 19 million by 2024.
• Approximately 39.6 percent of men and women will be diagnosed with cancer at some point during their lifetimes (based on 2010-2012 data).
• In 2014, an estimated 15,780 children and adolescents ages 0 to 19 were diagnosed with cancer and 1,960 died of the disease.
• National expenditures for cancer care in the United States totaled nearly $125 billion in 2010 and could reach $156 billion in 2020.

The 10 Most Common Cancers in the U.S.
Here is a list of the 10 most common cancers in the United States, based on the American Cancer Society Facts & Figures annual report for 2012.

1. Skin cancer
Skin cancer is divided into the non-melanoma and melanoma categories. Non-melanoma (basal cell and squamous cell skin cancer) is the more common form with over 2,000,000 cases expected to be diagnosed in the country in 2012. Most of these forms of cancer are curable. Melanoma, on the other hand, is the more serious type of skin cancer. It affects approximately five percent of people diagnosed with skin cancer, but is attributed to over 75 percent of all skin cancer deaths. In 2012, 76,250 new cases of melanoma were expected to be diagnosed.

2. Lung cancer
During 2012, 226,160 new cases of lung cancer were expected to be diagnosed in the U.S. Lung cancer accounts for about 28 percent of all cancer deaths. An estimated 160,340 deaths were expected to occur from lung cancer in 2012. The 5-year survival rate for all stages of lung cancer combined is just 16 percent. However, for cases detected when the disease is still localized, that number is 53 percent. Cigarette smoking is the most important risk factor for lung cancer.

3. Prostate cancer
It's estimated that 1 in 6 men in the U.S. will be diagnosed with prostate cancer in their lifetime. It's the most commonly diagnosed cancer among men (excluding skin cancer) and the second most common cause of death. Approximately 241,740 new cases were diagnosed in 2012 with an estimated 28,170 men expected to die from the disease in the year. PSA screenings and digital rectal exams (DRE) can help for early detection.

4. Breast cancer
According to the American Cancer Society, 226,870 new cases of invasive breast cancer were expected to occur during 2012 in the U.S. Excluding skin cancer, breast cancer is the most frequently diagnosed cancer among women. Breast cancer ranks second as a cause of cancer death in women (after lung cancer).

5. Colorectal cancer
An estimated 103,170 new cases of colon and 40,290 cases of rectal cancer were expected to occur in 2012. Colorectal cancer doesn't discriminate -- it's the third most common cancer in both men and women. Colorectal cancer was expected to account for nine percent of all cancer deaths in 2012.

6. Kidney (renal) cancer
The American Cancer Society estimated 64,770 new cases of kidney (renal) cancer in 2012 with 13,570 deaths from this disease. Tobacco is a strong risk factor for kidney cancer, as well as obesity and hypertension.

7. Bladder cancer
Blood in the urine is a common symptom of urinary bladder cancer. An estimated 73,510 new cases of this cancer were expect in 2012. With all stages of bladder cancer combined, the five-year relative survival rate is 80 percent. Surgery (alone or in conjunction with other treatments) is used in 90 percent of cases.

8. Non-Hodgkin's lymphoma
As you may know, one of the common symptoms of non-Hodgkin's lymphoma (NHL) is swollen lymph nodes. About 30 different kinds of NHL exist. It was estimated that 70,130 new cases of this type of cancer would be diagnosed in 2012.

9. Thyroid cancer
Three out of four cases of thyroid cancer occur in women. Perhaps surprisingly, it is the fastest-increasing cancer in both men and women. A lump in the neck is the most common symptom of thyroid cancer. An estimated 56,460 new cases of thyroid cancer were expected in 2012 in the U.S., as well as 1,780 deaths from the disease.

10. Endometrial cancer
Cancer of the uterine corpus usually occurs in the endometrium (uterus lining). Abnormal bleeding is often an early sign of this type of cancer. In 2012, the American Cancer Society estimated 47,130 new cases of uterine corpus cancer. Treatment can include surgery, radiation, chemotherapy and/or hormonal methods, depending on the stage of the cancer.
Other common cancers

Also called exocrine cancer, pancreatic cancer often develops without early symptoms. The survival rates for all stages combined are 25 percent for one year and 6 percent for five years. Approximately 43,920 new cases were expected in 2012 along with an estimated 37,390 deaths. Leukemia is also a fairly common cancer in the U.S. with an estimated 47,150 new cases in 2012.

To learn more about the various types of cancer, causes, symptoms and treatment options, visit cancer.org, cancer.gov and other online cancer websites.

CDC - Statistics for Different Kinds of Cancer

http://www.cdc.gov/cancer/dcpc/data/types.htm
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Global Statistics

Number of Cases, Deaths, and Survivors

Statistics at a Glance: The Burden of Cancer Worldwide

• Cancer is among the leading causes of death worldwide. In 2012, there were 14 million new cases and 8.2 million cancer-related deaths worldwide.
• The number of new cancer cases will rise to 22 million within the next two decades.
• More than 60 percent of the world’s new cancer cases occur in Africa, Asia, and Central and South America; 70 percent of the world’s cancer deaths also occur in these regions.
• 32.6 million people were five-year cancer survivors (people who are alive five years after being diagnosed with cancer).

By 2025, 19.3 million new cancer cases are expected to be diagnosed each year.
In less developed regions in 2012—

• 8 million new cancer cases were diagnosed (57% of the global total).
• 5.3 million people died from cancer (65% of the global total).
• 15.6 million people were five-year cancer survivors (48% of the global total).

Cancer Cases

In 2012, the most common cancers worldwide (for both sexes) were*—

1. Lung cancer (13% of all cancers diagnosed; 1.8 million people).
2. Breast cancer (12% of all cancers diagnosed; 1.7 million people).
3. Colorectal cancer (10% of all cancers diagnosed; 1.4 million people).
4. Prostate cancer (8% of all cancers diagnosed; 1.1 million people).
5. Stomach cancer (7% of all cancers diagnosed; 952,000 people).
6. Liver cancer (6% of all cancers diagnosed; 782,000 people).
7. Cervical cancer (4% of all cancers diagnosed; 528,000 people).

In 2012, the most commonly diagnosed cancers worldwide (for males and females) were—

• Among males: Lung, prostate, colorectal, stomach, and liver.
• Among females: Breast, colorectal, lung, cervical, and stomach.

Cancer Deaths

An estimated 168.1 million years of healthy life are lost due to cancer every year.
In 2012, the most common causes of cancer death worldwide (for both sexes) were*—

1. Lung cancer (19% of all cancer deaths; 1.6 million people).
2. Liver cancer (9% of all cancer deaths; 745,000 people).
3. Stomach cancer (9% of all cancer deaths; 723,000 people).
4. Colorectal cancer (9% of all cancer deaths; 694,000 people).
5. Breast cancer (6% of all cancer deaths; 522,000 people).
6. Cancer of the esophagus (5% of all cancers diagnosed; 400,000 people).
7. Pancreas cancer (4% of all cancers diagnosed; 330,000 people).

In 2012, the most common causes of cancer death worldwide (for males and females) were—

• Among males: Lung, liver, stomach, colorectal, and prostate.
• Among females: Breast, lung, colorectal, cervical, and stomach.

*Note: Rankings are defined by the total number of cases and deaths and are not age-standardized.
 
Data source: GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012

All Cancers (excluding non-melanoma skin cancer)
Estimated Incidence, Mortality and Prevalence Worldwide in 2012

Estimated numbers (thousands)	Men			Women			Both sexes
	Cases	Deaths	5-year prev.	Cases	Deaths	5-year prev.	Cases	Deaths	5-year prev.
World	7410	4653	15296	6658	3548	17159	14068	8202	32455
More developed regions	3227	1592	8550	2827	1287	8274	6054	2878	16823
Less developed regions	4184	3062	6747	3831	2261	8885	8014	5323	15632
WHO Africa region (AFRO)	265	205	468	381	250	895	645	456	1363
WHO Americas region (PAHO)	1454	677	3843	1429	618	4115	2882	1295	7958
WHO East Mediterranean region (EMRO)	263	191	461	293	176	733	555	367	1194
WHO Europe region (EURO)	1970	1081	4791	1744	852	4910	3715	1933	9701
WHO South-East Asia region (SEARO)	816	616	1237	908	555	2041	1724	1171	3278
WHO Western Pacific region (WPRO)	2642	1882	4493	1902	1096	4464	4543	2978	8956
IARC membership (24 countries)	3689	1900	9193	3349	1570	9402	7038	3470	18595
United States of America	825	324	2402	779	293	2373	1604	617	4775
China	1823	1429	2496	1243	776	2549	3065	2206	5045
India	477	357	665	537	326	1126	1015	683	1790
European Union (EU-28)	1430	716	3693	1206	561	3464	2635	1276	7157

Cancer Cell vs. Normal Cell

A cancer cell looks, acts and behaves entirely different from a normal (non-cancerous) cell. In fact, there are many differences between cancer cells and normal cells. Some of the differences are well known, whereas others have only been recently discovered and are less well understood.

Why is this important? Because if you understand some of these differences, it will help you to better understand how to fight your cancer via natural means that don't require the use of toxic chemotherapy and radiation.

For true researchers, understanding how cancer cells function differently from normal cells lays the foundation for developing treatments designed to rid the body of cancer cells without damaging normal cells.

From a physical perspective, a cancer cell is characterized by a large nucleus, having an irregular size and shape, the nucleoli are prominent, and the cytoplasm is scarce. A normal cell has a smaller nucleus, has a regular size and shape, and is full of cytoplasm.

Cancer cells often exhibit much more variability in cell size – some are larger than normal and some are smaller than normal. In addition, cancer cells often have an abnormal shape, both of the cell, and of the nucleus (the “brain” of the cell.) The nucleus appears both larger and darker than normal cells. The reason for the darkness is that the nucleus of cancer cells contains excess DNA. Up close, cancer cells often have an abnormal number of chromosomes that are arranged is a disorganized fashion. 

From a functional perspective, a cancer cell divides out of control; avoids programmed cell death (apoptosis); invades other cells and tissues; and, is able to move about freely via the bloodstream and lymphatic system. In addition, a cancer cell has a craving for sugar; a disdain for oxygen; a preference for an acidic environment; has stealth ability (to hide from immune cells); can trigger angiogenesis; and, has the ability to recruit and use our cells against us.

On the other hand, a normal cell  divides in an organized manner; performs suicide after about 50-60 divisions via programmed cell death (apoptosis); does not invade other cells and tissues; and, does not move about freely in the body. In addition, a normal cell loves oxygen; can trigger angiogenesis during the repair and healing process; and, prefers an alkaline environment.

Growth
Although our bodies' cells continue to divide to replace worn-out cells, this happens in a very ordered, systematic way. The reason is that each cell carries genetic instructions that regulate how fast the cell should grow and divide and when the cell should die. A balance between cells growing and dying keeps our bodies functioning normally.

Normal cells stop growing (reproducing) when enough cells are present. For example, if cells are being produced to repair a cut in the skin, when the repair work is done, cells are no longer reproduced to fill in the hole.

Sometimes a cell starts to grow without regard for the normal balance between cell growth and death, and a small, harmless (or benign), lump of cells will form. A benign growth can occur in any part of the body, including the prostate, skin, or intestine.

In other cases, a cell may continue to grow and divide with complete disregard for the needs and limitations of the body. This continued growth often results in a tumor (a cluster of cancer cells) being formed. Cells that have this aggressive behavior are called malignant or cancerous. They have the potential to grow into large masses or spread to other areas of the body.  When clumps of these cells spread to other parts of the body, they are metastases. A cancer that continues to grow can eventually overwhelm and destroy the part of the body or particular organ where it is located.

Note: Each gene in the body carries a blueprint that codes for a different protein. Some of these proteins are growth factors, chemicals that tell cells to grow and divide. If the gene that codes for one of these proteins is stuck in the “on” position by a mutation (an oncogene) – the growth factor proteins continue to be produced. In response, the cells continue to grow.

Evading Growth Suppressors: Normal cells are controlled by growth (tumor) suppressors. There are 3 main types of tumor suppressor genes that code for proteins that suppress growth. One type tells cells to slow down and stop dividing. One type is responsible for fixing changes in damaged cells. The third type is in charge of the apoptosis. Mutations that result in any of these tumor suppressor genes being inactivated allow cancer cells to grow unchecked.

Invasiveness
Normal cells listen to signals from neighboring cells and stop growing when they encroach on nearby tissues (something called contact inhibition). Cancer cells ignore these cells and invade nearby tissues. Benign (non-cancerous) tumors have a fibrous capsule. They may push up against nearby tissues but they do not invade/intermingle with other tissues.

Cancer cells in contrast don’t respect boundaries and invade tissues. This results in the finger-like projections that are often noted on radiologic scans of cancerous tumors. The word cancer, in fact, comes from the Latin word for crab used to describe the crablike invasion of cancers into nearby tissues.

Maturation
Normal cells mature. Cancer cells, because they grow rapidly and divide before cells are fully mature, remain immature. Doctors use the term undifferentiated to describe immature cells (in contrast to differentiated to describe more mature cells).

Another way to explain this is to view cancer cells as cells that don’t “grow up” and specialize into adult cells. The degree of maturation of cells corresponds to the "grade" of a cancer. Cancers are graded on a scale from 1 to 3 with 3 being the most aggressive.

Communication
Cancer cells don’t interact with other cells as normal cells do. Normal cells respond to signals sent from other nearby cells that say, essentially, “you’ve reached your boundary.” When normal cells “hear” these signals they stop growing. Cancer cells do not respond to these signals.

Mobility
Normal cells secrete substances that make them stick together in a group and enable them to remain in the area where they belong and do not spread to other parts of the body.

Cancer cells fail to make these substances and because they lack the adhesion molecules that cause stickiness, they may spread through the body (metastasize) in several ways. These include direct invasion and destruction of the organ of origin, or spread through the lymphatic system or bloodstream to distant organs such as the bone, lung, and liver.

Once they arrive in a new region (such as lymph nodes, the lungs, the liver, or the bones) they begin to grow, often forming tumors far removed from the original tumor.
  
Cell Repair and Cell Death
Normal cells are either repaired or die (undergo apoptosis) when they are damaged or get old. Cancer cells are either not repaired or do not undergo apoptosis.

For example, one protein called p53 has the job of checking to see if a cell is too damaged to repair, and if so advise the cell to kill itself. If this protein p53 is abnormal or inactive (for example, from a mutation in the p53 gene,) then old or damaged cells are allowed to reproduce. The p53 gene is one type of tumor suppressor gene that code for proteins that suppress the growth of cells.

Visibility
The immune system consists of a group of cells called white blood cells (lymphocytes) that are specialized to recognize and destroy "foreign" material in the body such as bacteria, viruses, and unfamiliar or abnormal cells.

So, when normal cells become damaged, these lymphocytes identify and remove them. In addition, normal cells have a built-in identifier so that the immune cells don't attack our own healthy normal cells.

Cancer cells do not have this identifier, so many of them are destroyed before they can grow and multiply. However, as the years pass and our immune system weakens and is not as alert, it overlooks some of these cancer cells, which evade the immune system and begin to multiply. Also, most cancer cells cover themselves with a protein coating that secretes chemicals that inactivate immune cells by "telling" the immune system cells to leave it alone.

By slipping through this detection system without triggering the immune system to start fighting, this allows the cancer cells to continue dividing and growing at the primary cancer site. Eventually, the cancer cells are able to spread to other secondary sites via the blood vessels and/or lymphatic system.

Membrane Coating
Cancer cells have a thick, protein fibrin coating designed to protect them from the body’s immune system. The fibrin coating is a “cloaking device” preventing cancer cells from being recognized by the immune system’s white blood cells (e.g. macrophages, neutrophils), and thus making them immune to attack by natural killer cells.

The sticky fibrin coating is ~15 times thicker than the fibrin which surrounds healthy cells. [Egyud LG, Lipinski B. Significance of fibrin formation and dissolution in the pathogenesis and treatment of cancer. Med Hypotheses. 1991 Dec;36(4):336-40].

Blood Supply
Angiogenesis is the process by which cells attract blood vessels to grow and feed the tissue. Normal cells undergo a process called angiogenesis only as part of normal growth and development and when new tissue is needed to repair damaged tissue.

Cancer cells undergo angiogenesis even when growth is not necessary. As a result, cancer cells are able to obtain their own blood supply (via tumor angiogenesis), enabling the cancer cells (tumor) to grow, invade more tissue and eventually metastasize.

Oxygen
Normal cells produce most of their energy in the presence of oxygen, whereas cancer cells produce most of their energy in the absence of oxygen. 

Normal cells require oxygen in order to produce energy via a process called cellular respiration. Without oxygen, our cells cannot produce the needed amounts of energy that are required to keep us going every day. This energy that our cells produce is called adenosine triphosphate, or ATP for short. Without oxygen, our cells will die.

Cancer cells do not require or like oxygen. Cancer cells produce their energy via a process called fermentation. As a result, cancer cells are able to produce the needed amounts of energy that are required to allow them to grow and multiply.

Glucose
Normal cells require glucose from the food we eat; and, along with oxygen, our cells are able to produce energy (ATP).  Normal cells contain little "garage doors" (insulin receptors) that open up and transport glucose into the cell.

However, cancer cells contain 28 times more "garage doors" than normal cells. As a result, cancer cells are able to absorb 10 to 15 times more glucose than a normal cell. This causes normal cells to starve and cancer cells to flourish.

Energy Efficiency
For every mole of glucose, a normal cell produces 38 moles of ATP.  For every mole of glucose, a cancer cell produces 2 moles of ATP.  Because cancer cells are less efficient (5%) at producing ATP energy, they require a lot more glucose.

Acidic Environment
Normal cells do not like an acidic environment because of the lack of nutrients and oxygen. Cancer cells love an acidic environment. In fact, in order to promote their acidic environment, cancer cells internally produce acidic and poisonous mycotoxins that cause damage to the cell's mitochondria and genetic/DNA material. In addition, cancer cells produce lactic acid, as a byproduct of producing energy (ATP).

This lactic acid is secreted into the bloodstream and sent back to the liver, where the liver converts the lactic acid back to glucose. Then, the glucose is returned to the cancer cells to produce energy and more lactic acid, which, again is sent back to the liver.

Note: This vicious cycle is known as the lactic acid or cachexia cycle, which causes the body to slowly waste away. Refer to the blog post titled "Lactic Acid Cycle" for more details.

Electrical Charge
Cancer cells are positive on the inside and highly negative on the outside due to a heavy fibrin protein coating. Immune cells which carry a negative charge are repelled by the negative charge on the cancer cell's surface.

When a cell becomes cancerous, potassium which has high membrane permeability is pumped out of the cell and sodium enters the cell through the voltage gated ion channels making the inside of the cell potentially positive and the outside of the cell negative by comparison.

Note:  At rest, your cells have more potassium ions inside than sodium ions, and there are more sodium ions outside the cell. Potassium ions are negative, so the inside of a cell has a slightly negative charge. Sodium ions are positive, so the area immediately outside the cell membrane is positive. There isn't a strong enough charge difference to generate electricity, though, in this resting state. Human cells are designed to run at about -20 millivolts (or pH of 7.35). As voltage in cells drops, going from -20 mV to zero mV, their physiology becomes compromised.

Nutrients and Compounds
There are various nutrients and compounds that normal cells like but cancer cells do not. Some examples include: chlorophyll, sulfur, alpha linolenic acid (ALA), beta glucan, certain seed extracts,  certain herbs such as turmeric and ginger, Vitamins A/C/D/E, ellagic acid, pancreatic enzymes, etc. Refer to the nutrition-related posts for more details.

Functioning Purpose
Normal cells perform the function they are meant to perform, whereas cancer cells may not be functional. For example, normal white blood cells help fight off infections. In leukemia, the number of white blood cells may be very high, but since the cancerous white blood cells are not functioning as they should, people can be more at risk for infection even with an elevated white blood cell count.

The same can be true of substances produced. For example, normal thyroid cells produce thyroid hormone. Cancerous thyroid cells (thyroid cancer) may not produce thyroid hormone. In this case the body may lack enough thyroid hormone (hypothyroidism) despite an increased amount of thyroid tissue.

Mortality/Immortality
Normal cells are mortal, that is, they have a life span. Cells aren’t designed to live forever, and just like the humans they make up, cells grow old. Researchers are beginning to look at something called telomeres, structures that hold DNA together at the end of the chromosomes, for their role in cancer.

One of the limitations to growth in normal cells is the length of the telomeres. Every time a cell divides, the telomeres get shorter. When the telomeres become too short, a cell can no longer divide and the cell dies. Cancer cells have figured out a way to renew telomeres so that they can continue to divide. An enzyme called telomerase works to lengthen the telomeres so that the cell can divide indefinitely – essentially becoming immortal.

Genomic Instability
Normal cells have normal DNA and a normal number of chromosomes. Cancer cells often have an abnormal number of chromosomes and the DNA becomes increasingly abnormal as it develops a multitude of mutations. Some of these are “driver” mutations, meaning they drive the transformation of the cell to be cancerous. Many of the mutations are passenger mutations, meaning they don’t have a direct function for the cancer cell.

Summarizing the Differences
As you can see, there are many differences between normal cells and cancer cells. This is a good thing, because it enables researchers to develop counter strategies to fight cancer.

Unfortunately, the majority of researchers who have been successful are those willing to look at non-drug alternative solutions instead of strictly focusing on drug-based solutions. Non-drug solutions cannot be patented or generate a revenue, whereas drug-based solutions have created a multi-billion dollar revenue stream for the medical industry and especially the pharmaceutical industry. As a result, the general public is only made aware of the drug-based solutions from their doctors.

Cancer Cell Anatomy

A cancer cell is characterized by: acceleration of the cell cycle; genomic alterations; invasive growth; increased cell mobility; chemotaxis; changes in the cellular surface; and secretion of lytic factors.

Morphologically, the cancerous cell is characterized by a large nucleus, having an irregular size and shape, the nucleoli are prominent, the cytoplasm is scarce and intensely colored or, on the contrary, is pale.

The nucleus of neoplastic cells plays through its changes a main role in the assessment of tumor malignancy. Changes concern its surface, volume, the nucleus/cytoplasm ratio, shape and density, as well as structure and homogeneity. Ultrastructural characteristics are related to nucleus segmentation, invaginations, changes in chromatin, such as heterochromatin reduction, increase of interchromatin and perichromatin granules, increase of nuclear membrane pores, formation of inclusions, etc.

The nucleolus is characterized by hypertrophy, macro- and microsegregation, its movement towards the membrane, numerical increase and formation of intranuclear canalicular systems between the nuclear membrane and the nucleolus.

Mitoses are characteristic of malignant cells. The number of mitoses increases, atypical mitosis forms with defects in the mitotic spindle appear, which results in triple or quadruple asters and dissymmetrical structures and atypical forms of chromosomes.

Nuclear changes explain the presence of different cell clones and genetic anomalies associated with these changes. In intensely anaplastic tumors, the presence of gigantic nuclei and multinucleate cells expresses abnormal divisions.

These morphological characteristics reflect the changes occurring at metabolic level, with the augmentation of structures in relation to cell division and the attenuation of structures associated to other metabolisms.

The cytoplasm also undergoes changes, new structures appear or normal structures disappear. The accumulation of ribosomal and messanger RNA in the cytoplasm makes it basophilic. Malignant cells have a small cytoplasmic amount, frequently with vacuoles.

The granular endoplasmic reticulum has the appearance of a simplified structure. Amorphous, granular of filamentous material can accumulate in the cisternae. Fragmentation and degranulation are frequently found, with the interruption of connections between the granular endoplasmic reticulum and mitochondria. Fingerprint like formations are not uncommon. The decrease of the granular endoplasmic reticulum from tumor cells occurs concomitantly with an increase of free ribosomes and polysomes, which shows an enhanced production of proteins necessary for the cell growth process.

The agranular endoplasmic reticulum is, during the initiation phase, hyperplastic, without being correlated with functional hyperactivity. In other malignancy phases, the endoplasmic reticulum undergoes a reduction.

The Golgi apparatus in malignant cells is generally poorly developed, which involves a positive correlation with the lack of tumor cell differentiation. The cells that have completely lost differentiation sporadically exhibit a Golgi apparatus.

Mitochondria decrease in volume with tumor development. Mitochondria show a high variability of shape and volume, and huge mitochondria can be sometimes observed. Abnormal glycolysis processes occur in mitochondrial membranes, known in the literature as the “Warburg phenomenon”. Changes in mitochondrial crystals occur, inclusions are present in the matrix, and pyknotic images can appear. The longitudinal distribution of mitochondria involves a cytochrome oxidase insufficiency.

Peroxisomes are only present in tumors formed by cells that normally contain these organelles, such as hepatocytes. It has been established that the number of peroxisomes from malignant cells is reversely proportional to growth speed and expresses the degree of differentiation loss.

Glycogen in high amounts is a characteristic of malignancy, especially in the liver and kidneys, but the already malignant cells generally contain a small amount of glycogen, as it has been found in hepatic and cervical carcinomas. The decrease of glycogen up to its disappearance parallels the increase of lipids.

Lysosomes undergo changes in the process of cell malignization. Thus, secondary lysosomes, myelinic structures and lipofuscin granules appear.

Degenerative cellular changes can be expressed by cytoplasmic inclusions. In some forms of neoplasms, apoptosis occurs, with the presence of apoptotic bodies.

Microfilaments, intermediate filaments and microtubules appear in different proportions, in malignant cells. The capacity of invasion and metastasizing of the cancerous cell depends on its possibility to move, which is ensured by the actin content.

Epithelial carcinomas contain cytokeratins, mesenchymal tumors contain vimentin, and in the central nervous system cells is an acid protein from glial fibers, with a special role in tumor diagnosis.

Cytostatics act by the depolymerization of tumor cell microtubules, which leads to the inhibition of the metastasizing capacity, as well as mitosis and tumor growth.

The cell membrane plays an extremely important role in the malignization process. Surface molecular changes, associated with malignization, are able to influence the evolution of a tumor, as well as the host reactions to the lesion. Proteins and carbohydrates that act as enzymes and as cell surface receptors can also undergo changes:

• increase or diminution in the number of surface receptors, changing cell sensitivity to the regulating mechanisms of the host;
• structural changes of proteins or surface receptors that no longer react with the corresponding ligand;
• presence of new surface molecules, characteristic of the embryonic tissue, which are hidden at the surface of adult cells.

Abnormal surface molecules are able to act as antigens and are recognized by the mechanisms of humoral and cellular defense. Consequently, tumor cells are covered with immune complexes, which allows the complement to destroy the cells covered by antibodies and allows phagocytes to attack the opsonized cells.

Malignant cells change their enzyme content, such as the reduction of acid or alkaline phosphatase. Changes occur in the relation between sugars and the sialic acid from glycolipids and glycoproteins, and also the negative loading of the cell surface. The plasma membrane of malignant cell favors the accelerated transport of nutritive substances, especially sugars and amino acids.

The surface of malignant cells displays differentiation antigens that express a normal development of the cancerous cell and antigens specific for the tumor, which appear with the oncogenic transformation, by the change of the genetic program of the cell. The distribution of receptors in malignant cells is altered, which modifies the cell agglutination behaviour. On the cell surface there are specific surface proteases that are responsible for the agglutination capacity of cells under the action of plant lectins. By losing contact inhibition, tumor cells also acquire metabolic autonomy, both their proliferation and movement being favored.

On the surface of malignant cells, atypical microvilli, pseudopods and vesicles with extremely active enzymatic equipment appear.

Differences between cells from the periphery and the center of tumors have been found. The cell population from the center of the tumor has normal intercellular connections, with the presence of desmosomes and junctional complexes, while these are absent or reduced at the periphery. In areas with a high invasive rhythm, cells are completely detached from the tumor mass, and interconnections disspear altogether.

The presence of desmosomes and tight junctions facilitates the establishment of the epithelial origin of the neoplasm, while their absence indicates the mesenchymal origin.

Note: When a cell becomes cancerous, potassium which has high membrane permeability is pumped out of the cell and sodium enters the cell through the voltage gated ion channels making the inside of the cell potentially positive and the outside of the cell negative by comparison. Immune cells which carry a negative charge are repelled by the negative charge on the cell surface.

The basal membrane is present in benign tumors, while the invasive growth of malignant cells is characterized by fragmentation, reduplication or disappearance of the basal membrane. During the first phases of malignancy, defects are produced with the interruption of the lamina densa. Malignant cells have lytic factors that destroy the basal membrane.

The loss of the basal membrane is considered a fundamental criterion of morphological and biological differentiation between benign and malignant tumors. The basal membrane in malignant cells changes its structure or/and ratios between various components, such as: type IV collagen, laminin, heparan sulfate proteoglycan and fibronectin. Neoplastic cells secrete type IV collagenase that destroys type IV collagen, which facilitates metastasizing through the lysis of basal membranes from blood and lymphatic vessels. Thus, malignant cells are disseminated, but they can also leave the vessels and implant in other tissues and organs, with the formation ofmetastases.

In the process of destruction of the basal membrane, a special role is played by laminin and laminin receptors, receptors that are found in the cell membrane and are reorganized during invasive growth.

The functional changes of neoplastic cells cause the formation and elimination of active substances, such as: growth factors, hormones, molecules similar to hormones, lytic enzymes, etc. Lytic enzymes (collagenase, cathepsin and plasmogen activator) favor the increased mobility and dissemination of neoplastic cells.

Major alterations occur in energy metabolism, between normal and malignant cells, especially regarding the use of glucose. The energy production with the highest efficiency in cells is performed by glycolysis in the tricarboxylic acid cycle (TCA cycle of Krebs cycle), where 36 ATP molecules are produced for each glucose molecule. This metabolism is carried out by oxygen use and represents the main energy production pathway, in the majority of cells.

Cancerous cells exhibit anomalies of both glycolysis and the tricarboxylic acid (TCA) cycle. The cancerous cell is particularly characterized by a poor use of oxygen and the massive use of glucose, which is exclusively converted to lactic acid. Consequently, malignant cells take from blood a 5–10 fold glucose amount compared to normal cells and they produce a corresponding lactic acid amount that will be recycled and changed back to glucose in the liver.

Tumor cells behave like a metabolic parasite for the organism or they drain its energy.

Proliferation is the main characteristic of benign tumors and especially malignant ones. Cells grow continuously, without being submitted to the local or general control of the organism. Benign growth is maintained within certain limits, while malignant growth is invasive, with quiet phases, followed by intense and uncontrollable growth phases.

The cell cycle normally develops along four phases:

• phase S, the cell synthesizes DNA, in order to prepare mitosis;
• phase G₂ follows immediately mitosis (phase in which the genome is equally distributed between the two daughter-cells). It occurs between DNA replication and cell division;
• phase M or mitosis, characterized by the appearance of chromatids migrating separately between the two daughter-cells;
• phase G₁ is the time interval elapsed between the previous nuclear division and the beginning of DNA synthesis. This phase is very short for bone marrow cells and in enterocytes from intestinal crypts or, in other cases, it can be very long. Cancerous cells have an accelerated cell cycle.

In the case in which the division speed in a tumor is not accelerated, neoplastic proliferation is the result of a disorder in cell maturation, a great number of cells being able to divide within the tissue. In such tumors, a slowing down of the rhythm of cellular apoptosis has also been found, as it happens in lymphoid tumors.

Genomic alterations, a cancer initiating process, persist all through the evolution of a tumor. The combined action of alterations in the mitotic cycle, the deficient synchronization between the nuclear and cytoplasmic divisions and the alterations preceding the existence of the genome induce more and more the instability of cell lines. Aneuploidy, polysemy and chromosomal deficits cause extremely variable morphological and behavioral clones. The depression of some segments of the genome can also enhance the pleiomorphic aspect of neoplastic cells and explains their abnormal secretions.

The proliferation and migration of neoplastic cells from a tumor is unpredictable. The movement of neoplastic cells starts with the formation of irregular cytoplasmic pseudopods, which infiltrate through basal membranes. Between the differentiation grade of a tumor, on the one hand, and its invasive growth, on the other hand, there is a correlation, which means that differentiation processes inhibit the capacity of movement of the cell.

The active locomotion of a malignant cell involves the enzymatic dissolution of the surrounding host tissue, especially of the interstitial matrix. At the beginning of the invasion, a loosening of the interstitial matrix of the host tissue occurs, by the appearance of an edema. The edema is explained by a higher permeability of the capillaries and the lack of lymphatic vessels with a draining role inside and in the proximity of the tumor. The size of the interstitial fluid volume facilitates cell locomotion. With the invasive growth, the destruction of the host tissue, its real lysis occurs, which is partially caused by enzymatic processes, and partially by atrophy through the pressure exerted by the tumor tissue.

The invasion and infiltration of malignant cells is characterized by the fact that they leave the tumor tissue and penetrate the neighboring tissue. But this property is not only specific for malignant tumors, this can also be found in other cells, such as: granulocytes, osteoclasts, endothelial cells and trophoblastic cells. Unlike these cells, the invasive growth of malignant cells is a progressive and continuous growth, ending with the destruction of the host tissue.

The malignant cell that grows invasively has the capacity to move, to produce lytic factors and phagocytose the host tissue. It grows especially in preexisting spaces but it can also create new spaces, by the destruction of the surrounding tissue. Between cytokinases and the invading capacity of cells, there are negative correlations, the cells having in certain phases a proliferative behavior, and in other phases an invasive behavior.

Invading cells have a higher content of actinic filaments and they form plasminogen activator, collagenase, elastase and proteoglycan decomposing enzymes. Proteolytic enzymes are secreted by both malignant cells and certain cells of the host tissue, such as: endothelial cells, fibroblasts, macrophages, mastocytes and lymphocytes.

The hypothesis that lytic factors produced by malignant cells can also initiate the angiogenesis process is advanced.

The loss of differentiation of the malignant cell is an important component. A determining role in this process is played by the reduction of cell organelles, especially the endoplasmic reticulum (which synthesizes proteins) and the Golgi apparatus. The loss of polarity of cell organelles, as well as of some properties of the cell membrane, also occurs. Malignant cells morphologically and functionally become similar to the fetal cells of the host tissue.

In reality, malignant cell complexes are composed of three types of various cells, in which not only the loss of differentiation takes place, but also aberrant processes, along with normal ones, excessive maturation and synthesis of new substances. This explains the histological variety of the cell population of a tumor. Multidirectional differentiation explains the appearance of atypical substances; thus, neoplastic epithelial cells can produce collagen.

At ultrastructural level, the main characteristic is not the loss of differentiation and the simplification of malignant cell structures, but structural and functional reorientation.

The loss of differentiation can be explained by the reduction of the postmitotic regeneration time, which results in the diminution of the differentiation time. Genetic information defects can also be mentioned. These processes cause changes in the cytoplasmic composition and intermediate metabolism and glycogen anomalies.

The differentiation process differs from one tumor to another, and it can be characterized by:

• the maintenance of certain structures and functions;
• the appearance of new cell structures and functions;
• the appearance of new structures, such as metaplasia and heteroplasia;
• the appearance of differentiations;
• the disappearance of functions in malignant cells such as anaplasia and cataplasia. Anaplastic tumor cells lose their specific structural characteristics, having small amounts of granular endoplasmic reticulum and some mitochondria.

It can be considered that there is no principle contradiction between malignancy and differentiation, and the loss of differentiation during malignization should be regarded as an epiphenomenon.
In a malignant cell population, subpopulations and subclones develop, which are distinguished in terms of invasiveness, aggressiveness and the capacity of metastasizing. The peculiarities specific for each neoplasm result from heterogeneity, the presence of subclones whose unpredictable appearance and variation, supplemented by the local reaction of the host tissue and of the organism, make difficult tumor therapy.

In addition to these peculiarities of tumor cells, the following should be considered: the relation of the tumor to the stroma; the different behavior regarding the invasion and metastasizing of the different subclones; the different structure of cells, in terms of antigenicity and/or membrane glycoproteins and the variable cell sensitivity to cytostatics, radiation, etc.

Cytostatic treatment should aim to eliminate malignant subpopulations, since these have a high proliferation and invasion capacity. It should be mentioned that only a small part of the tumor cells that reach blood circulation have metastatic properties, and only when they find favorable conditions.

Depending on the metastasizing subclone, the cellular structure of metastases is similar or different, compared to the primary tumor.

The involvement of the host tissue in the development of a tumor is strongly expressed by the growth rhythm and the possibilities of tumor metastasizing. The reactions of the host tissue are initiated by immunological and non-immunological mechanisms  . The invasive cell acts on the extracellular matrix of the host tissue, in particular on collagen and elastin.

This action develops along three successive stages. In a first stage, the receptors of the tumor cell membrane bind to the glycoproteins of the host tissue, especially laminin and fibronectin. In the second stage, tumor cells secrete hydrolytic enzymes that stimulate the secretory activity of host cells. In the third stage, the dissolution of the components of the host tissue matrix occurs, and desmoplasia of these components is stimulated.

According to Carr and Unerwood, 1974, tumor cells stimulate the following phenomena:

• the lymphoreticular reaction, with the invasion of lymphocytes, macrophages, lymphoreticular cells, immunologically active cells;
• the vascular reaction, with the proliferation of endothelial cells and the formation of new capillaries;
• the fibrous reaction, with fibroblast proliferation and collagen deposition;
• the inflammatory reaction, with polymorphonuclear infiltration (neutrophils and eosinophils).

During its development, the malignant tumor needs the host tissue to survive and to grow. As part of the non-immunological defense reaction, a special role is played by activated macrophages, which are tightly bound to T lymphocytes. Some biochemical mediators and chemical reagents are able to destroy tumor cells non-immunologically or to inhibit their growth. In the case of the regression of a tumor, the phagocytic and Killer activity of macrophages increases. Spontaneous regressions have been found in some neoplasms: melanomas, choriocarcinomas, neuroblastomas, hypernephromas, etc.

The immunological cellular response controls through its mechanisms the growth of malignant cells. Complex processes with specific and non-specific immunodepressive effects take place. Immunological factors are supposed to eliminate malignant cells rapidly, before the appearance of clinical manifestations.

Characteristics of benign/malignant tumors

CHARACTERISTICS/TUMORS	BENIGN	MALIGNANT
Growth type	Expansive	Infiltrating
Growth speed	Slow (in general)	Rapid (in general)
Stabilization	Frequent	Exceptional
Structure	Typical	Atypical (dedifferentiation − anaplasia)
Mitoses	Rare + Typical	Numerous + Atypical
Evolution	Local	Local + General
Metastasizing	No	Yes
Local consequences	Variable (compressions, ...)	Severe (infiltration, destruction, necrosis, ...)
General consequences	None (exceptions : secretory tumors or at particular sites)	Constant + severe (in the generalization phase)
Spontaneous evolution	Usually favorable	Always fatal
Evolution after removal	No recurrences	Common recurrences

The growth of a tumor depends on its vascularization. It has been found that poorly vascularized or even avascular tumors slow down their development or they even stop growing. In contrast, the appearance of capillaries, the infiltration of the tumor by a great numer of capillaries, stimulates tumor growth and proliferation. Malignant cells secrete some substances that stimulate the formation of new vessels, which are called by Bassermann (1984) the “tumor angiogenesis factor” (TAP).

Angiogenesis is a normal physiological response that appears in other processes as well, such as cicatrization and inflammation. TAP molecules are probably produced and elaborated by host cells, such as lymphocytes, macrophages, monocytes, etc.

Due to the fact that tumor cell proliferation occurs at a much higher speed compared to the formation of new capillaries, necrobiotic, necrotic and apoptotic processes take place in the tumor.

For more details, refer to the following link:
http://www.ncbi.nlm.nih.gov/books/NBK9553/