How Does a Person Get Cancer?

Certain cancers are due to inherited genetic reasons, but most cancers are due to environmental factors and personal activities.  Indeed, a very small percentage of people may inherit certain genes that have higher tendencies to result in certain cancers.  Unfortunately, no one can choose his/her parents.  For these cancers, specific surgeries or therapies may be applied to the patients.  Furthermore, individualized medicine based on genetic characteristics is being developed and is gradually becoming a reality.

On the other hand, vast majority of people don’t have the inherited problematic genes; thus it is great news for most people.  However, just like nothing is guaranteed in real life, there is no guarantee that nothing will go wrong on life cycles of cells.  Let me elaborate a little more as follows.

In everyone’s lifetime, differentiated normal cells and stem cells in the body have to go through many cell cycles for cell growth and replication.  During the processes, there are many factors that can affect the microenvironment surrounding the cells, thus, the health of the cells.  If a person maintains a healthy microenvironment for the cells, it is very likely that the cells will grow and replicate in a normal manner and the chances for them to become cancerous are low.  However, if the cells are subject to an environment producing significant/sustained stress (chemicals, pH, temperature, etc.), there will be a higher probability for something to go wrong in the cell cycles, which may result in some cells to become abnormal or even cancerous.

Any substances that cause the stress and result in higher cancer risks are generally referred to as carcinogens.  Carcinogens can damage/modify certain genes and/or disrupt cellular metabolic/replication process and significantly increase the risk of cancer.  Because high-energy radiation could also cause cancer, it could be categorized as a carcinogen.

If someone is exposed to carcinogens frequently, there is a higher chance for the person to get cancer. On the other hand, if one can avoid carcinogens as much as possible, one can greatly reduce the risk of getting cancer.

In addition to carcinogens, there are a number of risk factors of cancer; many of them are controllable.  If one can pay attention to these factors, once can greatly reduce the chance of getting cancer.

© Jiajiu Shaw, 2015 

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

Chemoprotective and Chemosensitizing Agents

Chemoprotective agents

Chemoprotective agents are also referred to as chemoprotetors.  These are agents that protect normal cells by reducing the injuries induced by anticancer drugs.  The most prescribed broad spectrum chemoprotective drug is amifostine (trade name, Ethyol®).  There are also other chemoprotective agents that are useful for more specific symptoms.  Examples include Romiplostim (AMG 531) and Eltrombopag.

Our research team has been involved in the research of chemoprotection and we have published a number of scientific papers.  Remember the radioprotective agent, UTL-5g?  UTL-5g is both radioprotective and chemoprotective in our animal studies.  In our mouse studies, cisplatin (a famous anticancer drug) induced several significant side effects, including injuries in liver, kidney, and blood forming cells (such as platelets and white blood cells).  Blood levels of liver enzymes (AST and ALT), BUN, and creatinine were also elevated by cisplatin; platelet count was significantly elevated.  All these indicate that liver, kidney, and blood-forming cells were damages by cisplatin.  However, when the animals were pretreated with UTL-5g before cisplatin was injected, AST and ALT levels were lowered indicating the protection of liver; BUN and creatinine levels were lowered indicating the protection of kidney.  UTL-5g also lowered the elevated platelet count indicating the protecting of platelet producing mechanism.

Chemosensitizing agents

Chemosensitizing agents are also referred to as chemosensitizers.  These are agents that make tumor more sensitive to anticancer drugs.  If cancer cells become more sensitive to anticancer drug, maybe lower doses can be used to achieve the same treatment effect while reducing the side effects.  In our research, we have shown that UTL-5g and its analogs (UTLOH-4a, -4b, and -4c) increase the in vitro potency of cisplatin against human colon cancer cells, HCT-15.  In addition, UTL-5g and UTLOH-4a enhanced the survival of colony forming unit for both granulocyte and macrophage (CFU-GM) in cultures containing cisplatin, carboplatin and oxaliplatin respectively, indicating that both UTL-5g and UTLOH-4a could protect CFU-GM against cisplatin induced cytotoxicity (in press).  

© Jiajiu Shaw, 2015 


Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

Why should anyone read my blog about cancer?

There are several reasons you should give it a try to read my blog about cancer:

• The purpose of my blog is to provide some useful information related to cancer to laymen, not just technical people.
• In addition to using traditional viewpoints to look at cancer, I also use a few analogies to explain some aspects of cancer.
• I’ll post only several paragraphs every time so that it is not a burden for you to read my blog.
• In addition to the important study results from other researchers, some of the study results from my research team will also be summarized.
• All the posts are extracted from my manuscript which will be published as a book by the end of 2015.  If you like my blog, you’ll like my book, which will be a more complete information package to have.
• Last but not least, I am not writing just for the sake of writing.  I am highly motivated.  Why? I lost my father, mother, mother-in-law, a college roommate, and several friends to cancer; thus, I hate to see anyone affected by cancer.

In summary, I think you'd agree that we are all in a war against cancer and knowledge is an important weapon in this war.  If you think my blog at WhatAboutCancer.com is useful, please forward it to your friends who might be interested. Thank you for your positive action in our fight against cancer.

© Jiajiu Shaw, 2015

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

Radiotherapy Technology

In terms of the technology in radiotherapy, there have been a lot of improvements made in recent years to increase the radiation dose to the tumor tissue while decreasing the damage to the surrounding normal tissue(s).  A representative example of these newer technologies is called stereotactic radiotherapy.  Stereotactic radiotherapy utilizes a sophisticated mathematical coordinating system to precisely locate the tumor to direct and deliver multiple fractions of higher dose radiation from different angles to destroy tumor cells.  Stereotactic radiotherapy is now being used to treat many different types of solid tumors.

Sometimes, a very specific form of stereotactic radiotherapy used for solid tumors is referred to as radiosurgery or stereotactic surgery.  It is called radiosurgery because it utilizes high dose radiation (such as x-ray or g-ray) to precisely focus on the specific area and functions almost like a surgery.  The accuracy can be within several millimeters.  When the total radiation dose is divided into several smaller doses, it is called fractionated stereotactic radiosurgery.

Further improvement on radiosurgery is to combine daily CT scan, (X-ray Computed Tomography) with the stereotactic radiotherapy to make it an image-guided radiation therapy that delivers radiation to the tumor side-by-slide, often referred to as TomoTherapy.  TomoTherapy has been used in many solid tumors including prostate cancer, lung cancer, as well as head and neck cancer.

In recent years, stereotactic radiotherapy is being combined with real-time CT scan (instead of daily CT).  This makes the radiosurgery even more precise and produces much better outcome than previous radiotherapy equipment.

Fractionated stereotactic surgery utilizes high dose radiation (x-ray or -ray) to precisely focus on the specific area in the body to destroy tumor tissues, very similar to surgery.  In this treatment, the dose and the treatment area have to be precisely coordinated to ensure that normal tissues in the proximity suffer the least damage by the high dose radiation; the total dose of radiation is divided into several doses and delivered in several days.  A typical radiosurgery takes 4-5 fractions of radiation, once every other day, and the total treatment period is about 8 to 10 days.

© Jiajiu Shaw, 2015 

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

Three types of agents used in conjunction with radiotherapy

Radiosensitizers

Radiosensitizers are agents that make cancer cells more sensitive to radiation, thus, more susceptible to be killed by radiation therapy.  There are a number of potential radiosensitizing agents under investigation including mibefradil dihydrochloride (calcium channel blocker), heat-shock protein 90, histone deacetylase, camptothecin analogs, etc.

Radioprotectors

As discussed before, radiation not only damages DNA in cancer cells, it could also injure normal cells, especially the fast-growing cells (e.g., bone marrow cells, hair follicles, and intestinal cells).  Radioprotectors are agents that protect normal cells from the radiation injury, and they are given either before or during the radiotherapy.  We have conducted research work in this field for a few years and have published a number of scientific papers in this filed [30, 31].  Briefly, we have identified three new compounds as potential radioprotective/chemoprotective agents, UTL-5b, -5d, and -5g.  Among them, UTL-5g showed the most promising protective effects in several animal studies.  In our studies, we have shown that UTL-5g reduced the acute liver toxicity induced by radiation; we also showed that UTL-5g reduced some acute injuries in lung.  UTL-5g also reduced the damages on hair follicles, thus delayed the hair discoloration induced by radiation.

Radiomitigators

Radiomitigators are agents given hours or even days after radiation exposure to reduce the radiation damage and/or speed up the recovery of damaged cells, tissues, or organs.   They are more useful in national defense and less so in radiotherapy because patients to be treated by radiotherapy can always be pretreated by radioprotectors.

© Jiajiu Shaw, 2015

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

Radiotherapy

Radiotherapy is sometimes called radiation therapy.  It is a method of treating cancer patients by using radiation.  Radiation consists of subatomic particles or electromagnetic waves that are energetic enough to knock off electrons from atoms or molecules to ionize them.  Examples of the subatomic particles include alpha particles, beta particles, electrons, protons, and neutrons.  Examples of electromagnetic waves include x-ray, gamma ray, and ultraviolet (UV).

Using the high energy beam, radiation therapy works mainly by ionizing the atoms in the DNA chain and prevent tumor cells from growing/replicating.  Most of the therapeutic effect is resulted from free radicals produced by radiation.  As most people know, chemotherapy could cause damages in normal tissues; the same thing will happen when a patient is treated by radiotherapy.  Fortunately, the good news is that there are significant improvements in today’s radiotherapy and the side effects are much fewer/lower.

Radiotherapy is used to treat almost every type of solid tumor, including cancer of the breast, brain, lung, liver, cervix, pancreas, prostate, skin, stomach, and uterus.  Radiotherapy has been used for curative or adjuvant cancer treatment for many years.  Adjuvant therapy means auxiliary/additional treatment for cancer; it is usually given after surgery or in conjunction with chemotherapy.

To make it more efficient and with fewer/lower side effects, there are three types of agents can be used in conjunction with radiotherapy: radiosensitizers, radioprotectors, and radiomitigators.  We will talk about these agents shortly.

© Jiajiu Shaw, 2015

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

Surgery

For most solid tumors, surgery is usually the first choice of treatment.  If a tumor is small and localized, it can be completely removed.  However, if the tumor is already in late stage and cancer cells have already spread to different organ(s), surgery could become difficult, if not impossible.  In this case, combination therapy may become necessary in order to make the treatment successful.  Many times, both chemotherapy and radiotherapy are used in conjunction.


In terms of the surgery technology, robotic surgery is becoming popular nowadays.  It is one of the most important advancements in cancer treatment.  Robotic surgery is much better than traditional surgery in that complication rates are lower, recovery time can be shortened, and scarring can be reduced.  Robotic surgery has been used in a number of cancer cases including prostate cancer, lung cancer, gastrointestinal cancer, bladder cancer, etc.

© Jiajiu Shaw, 2015

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

Chemotherapy

Because all drugs are essentially chemical materials, use of any drug as a cancer therapy is called chemotherapy.  Most cancer drugs tend to attack fast growing cells, which is one important characteristic of cancer cells.  However, some of the normal cells also have similar fast growing characteristic, including hair follicles, cells in the gastrointestinal tract, and skin, thus they have a high tendency to be attacked by cancer drugs.  This is the main reason why cancer patients often experience hair loss, diarrhea, and rashes during or after chemotherapy.

Generally speaking, chemotherapy drugs may be broadly divided into two basic categories based on their functions:

1. To inhibit or hamper DNA replication or RNA synthesis, thus, cell replication is inhibited or hampered.  
2. To affect cancer cell activities/behaviors and eventually result in cell death.  

© Jiajiu Shaw, 2015 

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

How Do Normal Cells Become Cancer Cells?

Although it is a complex question to answer, scientists have identified a number of major factors that could contribute to the occurrence of cancer. Roughly 5 to 10 percent of cancers are hereditary. In other words, some people are born with certain genes having high tendency to cause cancer; it’s almost like that they are carrying a ticking bomb inherited from the parents. The rest, over 90%, are due to other controllable reasons, including tobacco, infections, radiation, chemicals, and extreme conditions that may cause mutation or damage of certain genes; if the gene mutation or damage is significant, the cells may have a better chance to become cancerous at some point in time. Therefore, avoiding these negative factors should greatly reduce the risk factors. This is why I believe it is highly possible to greatly reduce the chance of getting cancer for anyone.

Let’s think about how normal cells grow in layman’s terms. If normal cells are provided with sufficient and suitable nutrients and placed under appropriate environment, the cells should grow, function, divide, multiply, and die in a normal fashion designed by nature. However, if the growing condition of the cells is not “normal” so that certain genes in the cells are damaged/mutated and if the damage/mutation resulted in uncontrolled cell replication, normal cells could become cancer cells.
© Jiajiu Shaw, 2015 

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.  

Standard Cancer Treatments

Generally, the standard cancer treatments involve one or more of the following methods: surgery, chemotherapy, and radiotherapy. Usually, surgery is the first choice if it’s a solid tumor and cancer cells have not spread to other locations. After the tumor is removed by surgery, chemotherapy and/or radiotherapy are usually employed as additional or adjuvant therapies to clean up any potential trace. If it’s not a solid tumor or tumor spread makes it difficult to remove, surgery becomes impractical. In this case, chemotherapy and radiation are used individually or in combination. However, due to the complexity of cancer, in real life, these three methods are often used simultaneously or in tandem in order to achieve the best results possible.

Although the present treatment methods work for cancer, these methods can also cause damages to patients’ normal tissues; they all cause significant side effects. Therefore, any improvement that reduces the side effects while maintaining the efficacy is welcome by clinicians and patients. Improvements in chemotherapy include the use of chemo/radio sensitizers and chemo/radioprotective drugs as adjuvant therapies. In terms of radiotherapy, there have also been tremendous improvements in the technical aspects in recent years.

© Jiajiu Shaw, 2015 

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.  

Is Cancer in Us?

Although it looks like a simple question, it is actually a complicated question to answer. The short answer could be NO but it could also be YES. In most cases, cancer is transformed from normal cells, thus it is not really wrong to say cancer is in us. On the other hand, for anyone who never has cancer, it is not wrong to say that cancer is not in the body.

No one can guarantee that he or she will never get cancer, but there is a lot we can do to significantly reduce the chances of getting cancer. One fundamental principle is “Do not abuse your body.” Because your body is built according to nature’s rules, it should be used and maintained in the manner it is supposed to. Every part of your body exists for a reason and there are rules set up by nature for us to follow so that every part works properly. In my opinion, if nature’s rules for a human body are not followed, there is a higher chance for a person to get cancer. Therefore, there are some things one can do to reduce the chance of getting cancer. I will blog more about this in the near future.

© Jiajiu Shaw, 2015 

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.

My Background in Cancer Research

Before we go further, I think it is a good idea to let you know a little bit about me. Otherwise, some people might question my credential. A brief description about my background is shown below FYI:

I received my B.S. degree from National Tsing Hua University in Chemistry/Biochemistry in 1972 and my Ph.D. degree from the University of Kansas in 1985. I then did my postdoc research work at the University of North Carolina, Chapel Hill. Subsequently, I worked at several small and large pharmaceutical companies including Ciba-Geigy (now Novartis). In 1997, I started my own company, Unitech Pharmaceuticals, focusing on the discovery of anticancer drugs. Since 2008, I joined 21st Century Therapeutics and is now president of the company. I have been active in the research of cancer and immune-medicated diseases for thirty years. My accomplishments can be reflected partially by my awards of over $3 million in research grants and contracts from National Institutes of Health, mostly from National Cancer Institute. In addition to my scientific publications in peer-reviewed scientific journals, I received 18 patents in the fields of cancer and immune-mediated diseases.

If you think my blog may be worthy of reading, please check my blog from time to time and I sincerely hope you can become more knowledgeable about cancer and reduce the the chance of getting cancer.

© Jiajiu Shaw, 2015

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.  

5 Characteristics of Cancer Cells

Most cancer cells are transformed from normal cells; their characteristics are very different from those of normal cells. Let’s briefly describe these characteristics of cancer cells as follows:

1. Cancer cells grow, divide, and die very differently from normal cells
Unlike normal cells, which grow, function, divide, and die according to nature’s rules, cancer cells are rebellion as opposed to normal cells. Under normal biological environment, normal cells grow in accord, but cancer cells grow faster and they can grow without a complete spectrum of nutrients. Secondly, normal cells can only divide for a limit number of times, but cancer cells have the ability to divide indefinitely. Thirdly, normal cells will age and die according to nature’s design when the time is up (apoptosis), but cancer cells don’t die by natural cause.

2. Cancer cells can create a phenomenon, angiogenesis Angiogenesis is the formation and development of new blood vessels by cancer cells for themselves. It begins when a tumor is growing faster than it can suck up the nutrients from its immediate surroundings. In order to satisfy the ever increasing appetite to continue its growth, cancer cells produce and send out special signals to form new blood vessels nearby in order to obtain the required nutrients for continued fast growth.

 
3. Cancer cells metastasize
After a tumor opens up the new channels (new blood vessels) for more nutrients, the tumor can also uses the new channels to transport cancer cells to other parts of the body and grow there. Cancer cells can also transfer to other location by lymphatic system. This process of cancer cell relocation is called metastasis.

 
4. Cancer cells have different physical properties as compared to normal cells
In general, cancer cells grow and divide without a complete set of signals as required by normal cell growth. In addition, there are several differences in their physical properties. For example, cancer cells have lower adhesion of cell to cell and cell to extra cellular matrix. This makes it easier for cancer cells to grow even when they are surrounded by other cells. In addition, this characteristic makes it easier for cancer cells to move around as compared to normal cells; this is part of the reason cancer cells can move to other tissues or organs. Another difference is that cancer cells secret specific enzymes that allow them to invade neighbouring tissues and migrate.

5. Cancer cells do not have a good cell-to-cell communication
Last but not least is the cell-to-cell intercommunication. Cell-to-cell communication is very important for normal cells to maintain the integrity, proper function, and coordination of different activities. In addition, intercellular communication can amplify and/or propagate signals. In short, normal cells communicate well with one another to coordinate and maintain normal activities. However, many cancer cells do not communicate like normal cells do.



© Jiajiu Shaw, 2015

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months. 

What is Cancer? (1)

Cancer is a broad group of various diseases in that some normal cells are mutated so that they do not undergo normal programmed cell death (apoptosis) and, instead, grow/divide uncontrollably.  If cancer cells grow in a solid tissue, these cancer cells together are broadly referred to as a tumor.  Non-solid tumors include leukemia, lymphoma, and multiple myeloma.

Currently, there are over 200 known cancers that afflict humans; all of which involve uncontrolled cell growth.  Cancer cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body.  Cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream and becomes metastatic, which means cancer cells have spread to another non-adjacent organ or tissue.  

© Jiajiu Shaw, 2015 

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book I am writing, "IS CANCER IN US", to be published in about two months.