[MOL] Tacking the life of a tumor.... [02266] Medicine On Line

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[MOL] Tacking the life of a tumor....

Double Trouble: Tracking the Life of a Tumor
by: Michael Guthrie, R. Ph.

Deep inside the first cell of a malignancy lurks a fatal flaw, a mistake in the control center, in the DNA itself. It is amazing that this doesn't happen more often, as the incredible 'computer program' in the DNA contains millions upon millions of instructions, and this information is passed on to new cells each time the cell divides. One of those 'instruction sets' tells the cell to multiply only so many times and then stop. This instruction set is actually much more complicated than that, but for the purpose of this article, this description is adequate.

Rapid and aggressive cell growth is actually normal in a few situations. One of the most amazing is the growth of a full term baby in 9 months from a single cell. Another is the repair of tissue damage, for example a cut to the finger. An explosive growth of new cells fills in the gap very quickly and we heal. However, in tissue repair, and in the intrauterine growth of babies, there is control and orchestration. With cancer cells, the switch never turns off as it does in normal growth. Other signals from adjacent cells that say 'enough already' are also ignored. Normal boundaries that separate one tissue type from another are also crossed by the wildfire cell growth. Normal cells receive (and obey) all sorts of messages that are designed to keep this from happening.

Fast growing tumors double around once or twice a month, while slower growing tumors may take up to 6 months to multiply. The mathematics of the growth is exponential. After around 20 divisions, the one cell has grown to around a million cells BUT it is still undetectable. At this point the tumor is about the size of a large pinhead.

Most tumors are not diagnosed until they are comprised of around one billion cells. This would take about two and one half years if the cell divided once per month. This would represent 30 doublings. At 40 doublings, the tumor would be around 1 trillion cells and weigh around 1 kg, which is 2.2 pounds. At 42 doublings, the body could not survive (the body can only tolerate around two or three kilograms of tumor mass before death occurs). If we consider a malignant cell that is doubling once per month, the tumor has become lethal in around three and a half years. Most of you have probably realized by now that the tumor is 75% of the way towards lethality before it is detected, and by this time, it is quite possible that the tumor has seeded into new areas of the body, where new tumor masses are being established. One clear message arises from this discussion: early detection is vital; therefore, early detection has a tremendous impact on survivability.

Mammograms and other diagnostic tools should help in the war on cancer. If prevention is the most important weapon in our arsenal, then the second is quite likely early detection. It is important to take advantage of the tools at your disposal to detect cancer before the mass has a chance to cross into lymphatic or blood circulation where it can send out 'seeds' that will establish new tumors.

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