Cancer At The Level Of The Organism

Part II focuses on the procancer events that occur at the level of the organism and the natural compounds that may inhibit them. These events, which consist of interactions between a population of cancer cells and the body, fall into three primary clusters: events that facilitate angiogenesis, invasion and metastasis, and immune evasion.

In Chapter 7 we discuss the basics of angiogenesis, the growth of new blood vessels. These vessels provide the cells of a tumor not only nutrition and oxygen but also access to the circulation, thereby allowing metastasis. Natural compounds that inhibit angiogenesis are discussed in Chapter 8. In Chapters 9 and 10 we turn our attention to cancer invasion—the spread of cancer cells into adjacent areas—and metastasis—the spread of cancer cells into distant locations via the blood or lymph. We then consider the immune response against cancer, discussing the basics of the immune system in Chapter 11 and natural compounds that affect it in Chapter 12.

As in Part I, we see in Part II that the difference between cancer cells and healthy cells is not that the former have unique ways of acting but that the extent and timing of their actions are abnormal. Angiogenesis, invasion, metastasis, and immune response are all normal processes that occur apart from cancer. For example, wound healing requires angiogenesis and an immune response, and during an immune response, immune cells must invade injured tissues. Similarly, immune cells perform a type of metastasis when they travel from one part of the body to distant parts (although this is not commonly referred to as metastasis). Cancer cells have devised ways to co-opt all these normal processes for their own benefit. There are many parallels between wound healing and immune cell activity on one hand, and cancer cell activity on the other. The analogy between tumors and nonhealing wounds was first mentioned in Chapter 4 with respect to cell proliferation. The analogy between cancer cells and immune cells was first discussed in Chapter 5 with respect to their reliance on activation of the transcription factors NF-kB and AP-1. In Chapter 7 and 8 we see how tumors act like non-healing wounds to facilitate angiogenesis, and in Chapter 9 we examine similarities between immune cell and cancer cell migration.

The abnormal behavior of cancer cells relies largely on the abnormal signaling discussed in detail in Part I, which focused on how abnormal signaling helps cancer cells proliferate and avoid apoptosis. Cancer angiogene-sis, invasion, and metastasis also rely in part on several kinds of abnormal signaling, including production of growth factors; activity of PTK, PKC, ras proteins, and transcription factors; and production of free radicals. Thus many of the natural compounds identified in Part I as inhibitors of cellular activity will also be discussed in Part II as inhibitors of angiogenesis, invasion, and metastasis. Moreover, because Part II reviews interactions between cancer and the body, we will introduce additional compounds that principally affect normal cells, allowing them to resist cancer invasion or, in the case of immune cells, to attack cancer.

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