Cancer is a broad group of diseases involving unregulated cell growth. There are over 200 different known cancers that affect humans.
In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invading nearby parts of the body. The cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream.
The causes of cancer are diverse, complex, and only partially understood. Many things are known to increase the risk of cancer, including tobacco use, dietary factors, certain infections, exposure to radiation, lack of physical activity, obesity, and environmental pollutants.
These factors can directly damage genes or combine with existing genetic faults within cells to cause cancerous mutations.10% of cancers can be traced directly to inherited genetic defects.
Many cancers could be prevented by not smoking, eating more vegetables, fruits and whole grains, eating less meat and refined carbohydrates, maintaining a healthy weight, exercising, minimizing sunlight exposure, and being vaccinated against some infectious diseases.
Alphabetical List of Cancers
- Acute lymphoblastic leukemia (ALL)
- Acute myeloid leukemia
- Adrenocortical carcinoma
- AIDS-related cancers
- AIDS-related lymphoma
- Anal cancer
- Appendix cancer
- Astrocytoma, childhood cerebellar or cerebral
- Basal-cell carcinoma
- Bile duct cancer, extrahepatic (see cholangiocarcinoma)
- Bladder cancer
- Bone tumor, osteosarcoma/malignant fibrous histiocytoma
- Brainstem glioma
- Brain cancer
- Brain tumor, cerebellar astrocytoma
- Brain tumor, cerebral astrocytoma/malignant glioma
- Brain tumor, ependymoma
- Brain tumor, medulloblastoma
- Brain tumor, supratentorial primitive neuroectodermal tumors
- Brain tumor, visual pathway and hypothalamic glioma
- Breast cancer
- Bronchial adenomas/carcinoids
- Burkitt's lymphoma
- Carcinoid tumor, childhood
- Carcinoid tumor, gastrointestinal
- Carcinoma of unknown primary
- Central nervous system lymphoma, primary
- Cerebellar astrocytoma, childhood
- Cerebral astrocytoma/malignant glioma, childhood
- Cervical cancer
- Childhood cancers
- Chronic lymphocytic leukemia
- Chronic myelogenous leukemia
- Chronic myeloproliferative disorders
- Colon cancer
- Cutaneous T-cell lymphoma
- Desmoplastic small round cell tumor
- Endometrial cancer
- Epithelioid hemangioendothelioma (EHE)
- Esophageal cancer
- Ewing's sarcoma in the Ewing family of tumors
- Extracranial germ cell tumor, childhood
- Extragonadal germ cell tumor
- Extrahepatic bile duct cancer
- Eye cancer, intraocular melanoma
- Eye cancer, retinoblastoma
- Gallbladder cancer
- Gastric (stomach) cancer
- Gastrointestinal carcinoid tumor
- Gastrointestinal stromal tumor (GIST)
- Germ cell tumor: extracranial, extragonadal, or ovarian
- Gestational trophoblastic tumor
- Glioma of the brain stem
- Glioma, childhood cerebral astrocytoma
- Glioma, childhood visual pathway and hypothalamic
- Gastric carcinoid
- Hairy cell leukemia
- Head and neck cancer
- Heart cancer
- Hepatocellular (liver) cancer
- Hodgkin lymphoma
- Hypopharyngeal cancer
- Hypothalamic and visual pathway glioma, childhood
- Intraocular melanoma
- Islet cell carcinoma (endocrine pancreas)
- Kaposi sarcoma
- Kidney cancer (renal cell cancer)
- Laryngeal cancer
- Leukaemia, acute lymphoblastic (also called acute lymphocytic leukaemia)
- Leukaemia, acute myeloid (also called acute myelogenous leukemia)
- Leukaemia, chronic lymphocytic (also called chronic lymphocytic leukemia)
- Leukemia, chronic myelogenous (also called chronic myeloid leukemia)
- Leukemia, hairy cell
- Lip and oral cavity cancer
- Liver cancer (primary)
- Lolerez (primary)
- Lung cancer, non-small cell
- Lung cancer, small cell
- Lymphoma, AIDS-related
- Lymphoma, Burkitt
- Lymphoma, cutaneous T-Cell
- Lymphoma, Hodgkin
- Lymphomas, Non-Hodgkin (an old classification of all lymphomas except Hodgkin's)
- Lymphoma, primary central nervous system
- Male breast cancer
- Malignant fibrous histiocytoma of bone/osteosarcoma
- Medulloblastoma, childhood
- Melanoma, intraocular (eye)
- Merkel cell cancer
- Mesothelioma, adult malignant
- Mesothelioma, childhood
- Metastatic squamous neck cancer with occult primary
- Mouth cancer
- Multiple endocrine neoplasia syndrome, childhood
- Multiple myeloma/plasma cell neoplasm
- Mycosis fungoides
- Myelodysplastic syndromes
- Myelodysplastic/myeloproliferative diseases
- Myelogenous leukemia, chronic
- Myeloid leukemia, adult acute
- Myeloid leukemia, childhood acute
- Myeloma, multiple (cancer of the bone-marrow)
- Myeloproliferative disorders, chronic
- Nasal cavity and paranasal sinus cancer
- Nasopharyngeal carcinoma
- Non-Hodgkin lymphoma
- Non-small cell lung cancer
- Oral cancer
- Oropharyngeal cancer
- Osteosarcoma/malignant fibrous histiocytoma of bone
- Ovarian cancer
- Ovarian epithelial cancer (surface epithelial-stromal tumor)
- Ovarian germ cell tumor
- Ovarian low malignant potential tumor
- Pancreatic cancer
- Pancreatic cancer, islet cell
- Paranasal sinus and nasal cavity cancer
- Parathyroid cancer
- Penile cancer
- Pharyngeal cancer
- Phyllodes breast tumors
- Pineal astrocytoma
- Pineoblastoma and supratentorial primitive neuroectodermal tumors, childhood
- Pituitary adenoma
- Plasma cell neoplasia/Multiple myeloma
- Pleuropulmonary blastoma
- Primary central nervous system lymphoma
- Prostate cancer
- Rectal cancer
- Renal cell carcinoma (kidney cancer)
- Renal pelvis and ureter, transitional cell cancer
- Rhabdomyosarcoma, childhood
- Salivary gland cancer
- Sarcoma, Ewing family of tumors
- Sarcoma, Kaposi
- Sarcoma, soft tissue
- Sarcoma, uterine
- Sézary syndrome
- Skin cancer (non-melanoma)
- Skin cancer (melanoma)
- Skin carcinoma, Merkel cell
- Small cell lung cancer
- Small intestine cancer
- Soft tissue sarcoma
- Squamous cell carcinoma – see skin cancer (non-melanoma)
- Squamous neck cancer with occult primary, metastatic
- Stomach cancer
- Supratentorial primitive neuroectodermal tumor, childhood
- T-Cell lymphoma, cutaneous – see Mycosis Fungoides and Sézary syndrome
- Testicular cancer
- Throat cancer
- Thymoma, childhood
- Thymoma and thymic carcinoma
- Thyroid cancer
- Thyroid cancer, childhood
- Transitional cell cancer of the renal pelvis and ureter
- Trophoblastic tumor, gestational
- Unknown primary site, carcinoma of, adult
- Unknown primary site, cancer of, childhood
- Ureter and renal pelvis, transitional cell cancer
- Urethral cancer
- Uterine cancer, endometrial
- Uterine sarcoma
- Vaginal cancer
- Visual pathway and hypothalamic glioma, childhood
- Vulvar cancer
- Waldenström macroglobulinemia
- Wilms tumor (kidney cancer), childhood
Acute lymphoblastic leukemia, also known as acute lymphocytic leukemia or acute lymphoid leukemia (ALL), is an acute form of leukemia, or cancer of the white blood cells, characterized by the overproduction and accumulation of cancerous, immature white blood cells, known as lymphoblasts.
In persons with ALL, lymphoblasts are overproduced in the bone marrow and continuously multiply, causing damage and death by inhibiting the production of normal cells (such as red and white blood cells and platelets) in the bone marrow and by spreading (infiltrating) to other organs. ALL is most common in childhood, with a peak incidence at 2–5 years of age and another peak in old age.
The symptoms of ALL are indicative of a reduced production of functional blood cells, because leukemia wastes the resources of the bone marrow that are normally used to produce new, functioning blood cells.
These symptoms can include fever, increased risk of infection (especially bacterial infections like pneumonia, due to neutropenia; symptoms of such an infection include shortness of breath, chest pain, cough, vomiting), increased tendency to bleed (due to thrombocytopenia), and signs indicative of anemia, including pallor, tachycardia (high heart rate), fatigue, and headache.
About 6,000 cases are reported in the United States every year. Internationally, ALL is more common in Caucasians than in Africans; it is more common in Hispanics and in Latin America.
Cure is a realistic goal and is achieved in more than 80% of affected children, although only 20-40% of adults are cured.
“Acute” is defined by the World Health organization standards, in which greater than 20% of the cells in the bone marrow are blasts. Chronic lymphocytic leukemia is defined as having less than 20% blasts in the bone marrow.
ALL was one of the first cancers for which an effective chemotherapeutic treatment was developed. Antifolates like aminopterin and methotrexate were developed in the late 1940s by Sidney Farber and Yellapragada Subbarow.
At that time, a doctor did not need a patient’s or parent’s consent to try an experimental treatment as the Nuremberg code had not yet been signed. Desperate to save his patients, Farber initially tried folic acid supplementation as a treatment for ALL. This had disastrous consequences and he likely accelerated the children’s deaths.
Signs and symptoms
Initial symptoms are not specific to ALL, but worsen to the point that medical help is sought. They result from the lack of normal and healthy blood cells because they are crowded out by malignant and immature leukocytes (white blood cells).
Therefore, people with ALL experience symptoms from malfunctioning of their erythrocytes (red blood cells), leukocytes, and platelets. Laboratory tests that might show abnormalities include blood count tests, renal function tests, electrolyte tests, and liver enzyme tests
The signs and symptoms of ALL are variable but follow from bone marrow replacement and/or organ infiltration.
- Generalized weakness and fatigue
- Frequent or unexplained fever and infection
- Weight loss and/or loss of appetite
- Excessive and unexplained bruising
- Bone pain, joint pain (caused by the spread of “blast” cells to the surface of the bone or into the joint from the marrow cavity)
- Enlarged lymph nodes, liver and/or spleen
- Pitting edema (swelling) in the lower limbs and/or abdomen
- Petechiae, which are tiny red spots or lines in the skin due to low platelet levels
Functional germline mutations of some cancer-related genes have been found in familial ALL or enriched in radic cases (e.g., PAX5, ETV6 and CDKN2A) accounting for ALL susceptibility for a small proportion of people, while large genome wide association studies revealed multiple inherited predisposition to ALL risk, including single nucleotide polymorphisms (SNPs) at ARID5B, IKZF1, CEBPE, PIP4K2A, GATA3, and CDKN2A loci among diverse populations.Epidemiological studies suggest that environmental factors on their own make only a minor contribution to disease risk, but environmental factors may interact with genetics.
Genome-wide association studies have found associations with a number of genetic single-nucleotide polymorphisms, including ARID5B, IKZF1 and CEBPE.
There is an increased incidence in people with Down syndrome, Fanconi anemia, Bloom syndrome, ataxia telangiectasia, X-linked agammaglobulinemia, and severe combined immunodeficiency. There is an increased risk in people with a family history of autoimmune diseases, particularly autoimmune thyroid diseases (namely Graves’ disease or Hashimoto’s thyroiditis).
In general, cancer is caused by damage to DNA that leads to uncontrolled cellular growth and spreads throughout the body, either by increasing chemical signals that cause growth or by interrupting chemical signals that control growth.
Damage can be caused through the formation of fusion genes, as well as the dysregulation of a proto-oncogene via juxtaposition of it to the promoter of another gene, e.g. the T-cell receptor gene.
This damage may be caused by environmental factors such as chemicals, drugs or radiation, and occurs naturally during mitosis or other normal processes (although cells have numerous mechanisms of DNA repair that help to reduce this).
Acute lymphoblastic leukemia is associated with exposure to radiation and chemicals in animals and humans. High level radiation exposure is a known risk factor for developing leukemia, as found by studies of survivors of atom bomb exposure in Hiroshima and Nagasaki.In animals, exposure to benzene and other chemicals can cause leukemia.
Epidemiological studies have associated leukemia with workplace exposure to chemicals, but these studies are not as conclusive. Some evidence suggests that secondary leukemia can develop in individuals treated for other cancers with radiation and chemotherapy as a result of that treatment.
Diagnosing acute lymphoid leukemia begins with a medical history, physical examination, complete blood count, and blood smears. Because the symptoms are so general, many other diseases with similar symptoms must be excluded. Typically, the higher the white blood cell count, especially if the number of cancerous malignant abnormal blast cells are also high, the worse the prognosis.
Blast cells are seen on blood smear in the majority of cases (blast cells are precursors — stem cells — to all immune cell lines). A bone marrow biopsy provides conclusive proof of acute lymphocytic leukemia .
A lumbar puncture (also known as a spinal tap) will indicate whether the spinal column and brain have been invaded.
Pathological examination, cytogenetics (in particular the presence of Philadelphia chromosome), and immunophenotyping establish whether myeloblastic (neutrophils, eosinophils, or basophils) or lymphoblastic (B lymphocytes or T lymphocytes) cells are the problem.
RNA testing can establish how aggressive the disease is; different mutations have been associated with shorter or longer survival. Immunohistochemical testing may reveal TdT or CALLA antigens on the surface of leukemic cells.
TdT is a protein expressed early in the development of pre-T and pre-B cells, whereas CALLA is an antigen found in 80% of ALL cases and also in the “blast crisis” of CML.
Medical imaging (such as ultrasound or CT scanning) can find invasion of other organs, commonly the lung, liver, spleen, lymph nodes, brain, kidneys, and reproductive organs.
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