Category: Cancer

If I had to choose one of the leading causes of death in the country it would be cancer. In 2016, cancer had the second-largest death toll, killing 598,038 people (Zuber, 2019). One of the health disparities being the leading cause of death is that breast cancer tends to affect more black women at a faster rate than it does white women (‘Cancer Disparities’, 2018). Another health disparity that is the leading cause of death is that individuals with low incomes have a higher chance of dying from cancer than individuals with higher incomes (‘Health Disparities in Cancer’, 2018).

The two social determinants of health that contribute factors on why people with low incomes have a greater risk of dying from cancer than people of a higher pay grade are the social gradient and stress. The social gradient is a contributing factor to this health disparity because people with low incomes are not living in the best environment and they may not have a good support system. People with low incomes are most likely brought up where they had a poor education, poor working conditions, and social circumstances that wear down their bodies contributing to the being more at risk for illnesses such as cancer (Wilkinson & Marmot, 2003).

Another social determinant of health that contributes to why people with low incomes are at high risk for cancer than higher-paid people is stress. Lower-income people usually go through a lot of stress because of their economic and social situations, so they get involved in risky behaviors because of stress. Stress also raises a person’s heart rate and makes people feel that they have no control over their lives. Stress from not having a steady job can make you physically and emotionally ill and can contribute to cancer and death (Wilkinson & Marmot, 2003).

A health policy solution that can aim to reduce the risk of death from cancer would be more affordable schools built to provide more skills for better-paying jobs. This will also relieve stress and people will have money to get the treatments they need for cancer because they will have a higher-paying job after school. Another solution would be to create better jobs so that people will not have to break their backs doing hard labor, ruining their health.

References

1. Cancer Disparities. (2018, March 29). Retrieved from https://www.cancer.gov/about-cancer/understanding/disparities
2. Health Disparities in Cancer. (2018, July 05). Retrieved from https://www.cdc.gov/cancer/healthdisparities/basic_info/challenges.htm
3. Wilkinson, Richard, Marmot, Michael, & World Health Organization. Centre for Urban Health. (2003). The Solid Facts: Social Determinants of Health. Copenhagen: Centre for Urban Health, World Health Organization.
4. Zuber, P. (2019). 0.4 Health Ethics [slide 7-8]. Retrieved from the University of North Carolina at Charlotte LBST 2214 Issues of Health and Quality of Life Canvas site: https://canvas.uncc.edu
5. Zuber, P. (2019). 0.1 Measures and Health Disparities [Slide 8]. Retrieved from the University of North Carolina at Charlotte LBST 2214 Issues of Health and Quality of Life Canvas site: https://canvas.uncc.edu

I am applying to your master’s (Taught) course in Cancer Biology for the September 2020-Full Time Semester. After getting my undergraduate degree in Biology-Animal Sciences from the University of Guilan (Rasht, Iran), I was accepted into the Biology-Genetics program to get a master’s degree from that university in 2010. I worked on my thesis, titled ‘Expression of HDAC11 mRNAs in the cerebral cortex and hippocampus of chicken (Gallus gallus) during prenatal and postnatal development under the supervision of Dr. Farzam Ajamian at the Genetic Laboratory of the University of Guilan from 2012 to 2013. I learned much more than the simple roles of genes during our master’s sessions. I passed a lot of captivating courses and became aware of the significance of a unique gene to create a serious disease. I have been fortunate enough to do my thesis research about a rarely known gene (HDAC11), with great success (19.85/20); besides, the related paper was submitted and I look forward to getting a response. After that, I had a project on a truncated form of a gene (TrkB-T1) alongside Dr. Ajamian from 2013 to 2014, and I am preparing the related manuscript titled ‘T1 form of Truncated Tyrosine Kinase B receptor gene (TrkB-T1) has distinguished transcriptional activity during pre- or postnatal mouse brain development to be submitted. I evaluated the expression level of those genes in chicken and mouse brains as model animals during their prenatal and postnatal development via Real-time PCR.

Since, I noticed my hometown lacks an institute with professions in cancer, molecular regulators of cancer, and analyzing genetic data derived from patients; I was incentivized to establish an institute concentrated on Cancer in my hometown (Rasht) and take a small promising step towards health level progression in my country. As my major was Biology-Genetics, I had not earned sufficient knowledge of Medical Genomics and specifically Cancer; Therefore, I needed to be a trained specialist to run a Cancer Institute. Ultimately, I found Cancer Biology the most perfect direction to achieve my career goals.

I was searching for a well-equipped university in London with modern facilities and laboratories; furthermore, as this course will be taught by internationally renowned lecturers, having a collaborative relationship with different expertise in multi-professional education from companies like GlaxoSmithKline or research institutes like the Institute of Cancer Research will help me acquiring relevant skills necessary to my career goals as a founder and entrepreneur. My career goals include entering this field professionally and focusing on giving service to patients and even researchers. Comprehensively, I believe it is worth spending a year of my life, studying Cancer Biology at Kingston University in the hope of starting a new business in my country.

I believe that my education and experience make me a good candidate for a postgraduate degree in your Course. I am highly skilled in molecular techniques due to my research at the university. Despite being experienced in statistic software applied in data analysis, I can work with some bioinformatics software. I intend to broaden my knowledge in Cancer Pathology and acquire professional skills and strategies to search for therapeutics r learn from my work experience already.

Introduction

What is cancer? Cancer can be grouped as more than 100 different diseases and develops all over the body [1]. Abnormal cells will divide uncontrollably leading to the destruction of body tissues. Genetic changes affect the body’s logical processes. The cells that grow uncontrollably may form a tumor that can be benign or cancerous. A cancerous tumor can grow and sometimes it spreads to other parts of the body. A benign tumor can grow, but it will not spread to other parts of the body. Some cancer types don’t form a tumor. So why has cancer not been cured, when billions of Rands have been spent on research over the years? It is because cancer is very complex, not just one disease and one cure a one-size-fits-all cure is not possible. Cancer cells evade the immune system or suppress the normal immune response. A chemical compound can be added to the DNA of a cancer cell and suppress the activity of specific genes, causing cancer to hide in plain sight without causing an immune response. Ingestion of kombucha fermented tea has been associated with many health benefits because there are claims that it is a prophylactic agent, but it has not been scientifically proven. The beneficial effects of kombucha tea are that the bioactive compounds act synergistically, meaning working together, to accomplish more than they could alone. Kombucha is a culture consisting of a symbiosis between acetic acid bacteria (e.g. Gluconobacter oxydans) and different yeasts (e.g. Saccharomyces sp.) and some lactic acid bacteria have also been isolated from some symbiotic kombucha culture. Kombucha tea is a fermented drink consisting of a mixture of the kombucha culture (bacteria and yeast), green and/or black tea, and sugar. Kombucha tea tastes slightly acidic and slightly carbonated. Based on personal observations and testimonials kombucha tea is safe for human consumption. Studies are analyzed to experimentally confirm the health benefits of kombucha tea.

Background

As a cancerous tumor grows, the bloodstream or lymphatic system may carry cancer cells to other parts of the body. During metastasis, cancer cells grow and may develop into new tumors. The lymph nodes, which are small, bean-shaped organs that play a role in fighting infection, are one of the first places cancer spreads to. Lymph node clusters are situated in different parts of the body (e.g. under the arms). Cancer is also able to spread through the bloodstream to parts of the body located far away. Even within the same tumor, cancer cells can be heterogeneous. Biopsies are naturally taken from only one spot within a tumor, this causes implications when trying to improve diagnostics and therapies. This also means that one targeted therapy is not likely to abolish all cancer cells alone. Cancer cells grow and divide extremely fast and must tolerate a lot of strain and harm to their DNA. Cancers rely on a balance between damage and repair of their DNA. Changes in their genes build up over a period of time causing evolution at a rapid pace leading to mutations. This contributes to the heterogeneity of cancer cells and cancer treated today can differ from cancer you treat in the time to come. A kombucha SCOBY is a symbiotic colony of bacteria and yeast. Using this SCOBY kombucha tea is made consisting of two parts: a sour liquid broth and a pellicle layer of floating cellulose. Tea polyphenols (e.g. catechins), sugars, glucuronic acid, gluconic acid, lactic acid, amino acids (e.g. lysine), fibers, vitamins (e.g. vitamin C, vitamin B), essential elements (e.g. Na, K, Ca, Cu, Fe, Mn, Ni, Zn), catalase, carbon dioxide, antibiotics, and different micronutrients are produced when kombucha tea is fermented and most likely contributes to the health benefits observed when consuming kombucha tea. As fermentation takes place, the yeast component breaks down to sucrose to produce fructose, glucose, and carbon dioxide. Carcinogenesis is a multistage, multifactorial process and several genes are affected. Chemo-preventive agents can target these genes and regulate their intracellular, extracellular, or cell-surface functions. The anticancer properties of black tea polyphenols have been studied in the past. One of the components of kombucha tea is black tea, so does this mean it has anti-cancer properties? There are many references to and claims that kombucha tea has anticancer properties, but it has not been scientifically proven yet. There are reports that carcinoma has been successfully cured by the consumption of kombucha tea and that long-term consumption of kombucha tea increases the immune system’s defense against cancer. In this study, kombucha tea was tested for anticancer properties. Kombucha may provide the health benefits of black tea and have health benefits of its own. One of the healthiest beverages is black tea because it consists of a variety of bioactive compounds, including polyphenols, that are powerful antioxidants. Kombucha tea containing black tea consists of the same plant components and presumably has the same health benefits. In previous studies, black tea consumers have a lowered risk of breast, prostate, and colon cancers. Kombucha tea was analyzed in test-tube studies and helped in the prevention of the growth and the spreading of cancer cells because of the high concentration of antioxidants and tea polyphenols. The theory is that tea polyphenols block or suppress the mutation of genes and the growth of cancer cells, promoting the death of cancer cells. Glucose can be converted into gluconic acid and fructose into acetic acid by acetic acid bacteria. Ethanol is produced by the yeast component of kombucha using fructose as a preferred substrate and the bacterial component oxidizes the ethanol into acetaldehyde. The production of ethanol is stimulated by the acetic acid produced and the production of acetic acid is in turn stimulated by the ethanol produced. Some cases of toxicity associated with ingesting large quantities of indecorously prepared kombucha have been reported. These risks can occur when kombucha is over-fermented or home-brewed. Preparing kombucha involves bacteria growing in a liquid that is then consumed. These bacteria are considered to be probiotics, but improperly prepared, harmful bacteria or mold can grow. Improper preparation of kombucha can cause liver problems, the build-up of lactic acid, allergic reactions, and nausea. Proper preparation of kombucha is essential.

Defining the Research

Research question

Does kombucha tea have the ability to prevent or even treat cancer?

Hypothesis

• Ha: There is an association between cancer and kombucha tea.
• Ho: There is no association between cancer and kombucha tea.

Aim and Objectives

The purpose of this study is to determine the effect kombucha tea has on cancer and if it is able to prevent or even treat cancer.

Methods

Plate Count Method to Isolate a Safe, Pure Culture

2 Vials of the kombucha scoby and 1 vial of the reference stock were placed in a freezer and taken out to warm to room temperature. The cap was disinfected with 70% ethanol. The vials were rehydrated and the contents were allowed to reconstitute for 5 minutes. Using inversion, the vials were mixed thoroughly. A tenfold dilution series of the kombucha scoby was prepared in capped tubes and 9.0ml of the diluent was pipetted into each tube using a 10.0ml pipette and labeled. 1.0ml of the first sample was transferred into the first diluent tube using a pipette, capped, and then mixed. The dilution was continued using a pipette to transfer 1.0ml of the first tube into the second tube. The dilution was repeated 10 times. 0.1ml of tubes 8, 9, and 10 were deposited on 3 different plates of agar with a pipette. An inoculum spreader was sterilized in 70% alcohol. The inoculum spreader was used to distribute the inoculum on the agar surface, sterilizing between each distribution. The plates were inverted and incubated.

Preparation of Fermented Kombucha Tea

3.0 g of green tea, 3.0g of black tea, and 3.0g of tea powder were respectively boiled in 400 ml of water for 20min. Each tea infusion was filtered using filter paper and sucrose was dissolved in the clear filtrates and left to cool. The 200ml of the tea infusions were poured into a sterilized flask. The flask was inoculated with 3% of the pure kombucha culture. The flask was covered with a cloth. Fermentation was carried out in the dark at 30°C for two weeks. At 10 000rpm the fermented tea was centrifuged for 10min.

Preparation of Fermented Control Tea

3.0 g of green tea, 3.0g of black tea, and 3.0g of tea powder were respectively boiled in 400 ml of water for 20min. Each tea infusion was filtered using filter paper and sucrose was dissolved in the clear filtrates and left to cool. The 200ml of the tea infusions were poured into a sterilized flask. The flask was covered with a cloth. Fermentation was carried out in the dark at 30°C for two weeks. At 10 000rpm the fermented tea was centrifuged for 10min

Gelatine Zymography

Preparation of Conditioned Media

The cell cultured in fetal bovine serum was put in a flask. At 80% confluency, the fetal bovine serum media was removed. The cells were washed with fetal bovine serum-free media twice and left to grow. The conditioned media was collected and centrifuged to remove the dead cells and then concentrated.

Running the gel

To ensure that all the samples have the same concentration the conditioned media was diluted. A non-reducing sample buffer was added to the samples. A 7.5% acrylamide gel containing gelatine was prepared. Each sample was loaded into a well and ran at 150V until a good band separation was observed.

Gel washing and staining

The gel was washed two times for 30 minutes with a washing buffer to remove SDS from the gel. The gel was rinsed for 10 min with an incubation buffer. The gel was incubated in a fresh incubation buffer for 24 hours. The gel was stained for 1h and then rinsed with water to remove the excess staining solution. The gel was incubated until the bands were clearly visible.

Study Design

The fermented kombucha tea was given to 10 healthy subjects and 10 cancer-infected subjects. The fermented control tea was also given to 10 healthy subjects and 10 cancer-infected subjects.

Pathology Tests

Pathology tests were performed on all 40 subjects, using a microscope to evaluate the presence of abnormal cells.

Diagnostic Imaging

The abnormal masses of all 40 subjects were visualized using high-tech machines (e.g. x-rays and computed tomography scans) to create images.

Blood Tests

Blood tests were performed on all 40 subjects measuring substances indicating how advanced the cancer is.

Tumor Markers

All 40 subjects were tested to detect substances in the blood, urine, or other tissues that would be higher than normal when cancer was present.

Conclusion

The Plate Count Method was used to isolate a kombucha culture. Using this method increases the chances of obtaining a pure, safe culture, reducing the chances of bacteria that can cause harm to the human body. A control fermented tea was used to establish that the results obtained were true because of the fermented kombucha tea and not because of other factors. Molecular processes such as tumor cell apoptosis and tumor growth and invasion inhibition are affected by tea polyphenol. Matrix MMPs are linked to tumor cell evasion and kombucha tea inhibits MMPs. Gelatine zymography assay showed that kombucha tea reduced MMP activity according to the concentration used. Tea polyphenols demonstrated growth inhibitory activities. Pathology tests, diagnostic imaging, blood tests, and tumor markers were used to observe the presence of abnormal cells or cancer cells before and after the consumption of either the fermented kombucha tea or the control tea. The healthy subjects who consumed the kombucha tea showed an increase in immunity and anti-cancer properties. The healthy subjects who consumed the control tea showed little difference in immunity. The cancer-infected subjects who consumed the fermented kombucha tea showed an inhibition of tumor growth and prevented the cancer from spreading. The cancer-infected subjects who consumed the control tea showed no change in tumor growth.

References

1. M. I. Watawana, N. Jayawardena, C. B. Gunawardhana and V. Y. Waisundara, “Health, Wellness, and Safety Aspects of the Consumption of Kombucha,” Journal of Chemistry, 2015.
2. C. Fu, F. Yan, Z. Cao, F. Xie, and J. Lin, “Antioxidant activities of kombucha prepared from three different substrates and changes in the content of probiotics during storage,” Food Science and Technology, 2014.
3. I. Vina, P. Semjonovs, R. Linde and I. Denina, “Current Evidence on Physiological Activity and Expected Health Effects,” Journal of Medicinal Food, 2014.
4. J. M. Leal, L. V. Suárez, R. Jayabalan, J. H. Oros and A. Escalante-Aburto, “A review on health benefits of kombucha nutritional compounds and metabolites,” CyTA – Journal of Food, 2018.
5. “What is Cancer?,” February 2018. [Online]. Available: https://www.cancer.net/navigating-cancer-care/cancer-basics/what-cancer.
6. W. C. Research, “Why Haven’t We Cured Cancer?” 2018. [Online]. Available: https://www.worldwidecancerresearch.org/blog-post/havent-cured-cancer/.
7. K. Zhang, “Why is Cancer so difficult to cure,” 2019. [Online]. Available: https://www.jax.org/news-and-insights/2015/december/why-no-cure-for-cancer#.
8. “Obtaining A Mother Kombucha SCOBY,” [Online]. Available: https://www.culturesforhealth.com/learn/kombucha/obtaining-a-kombucha-scoby/.
9. R. Jayabalan, P.-N. Chen, Y.-S. Hsieh, K. Prabhakaran, P. Pitchai, S. Marimuthu, P. Thangaraj, K. Swaminathan and S. E. Yun, “Effect of solvent fractions of kombucha tea on viability and invasiveness of cancer cells—Characterization of dimethyl 2-(2-hydroxy-2-methoxypropylidine) malonate and vitexin,” Indian Journal of Biotechnology, pp. 75-82, 2011.
10. B. Krietsch, “Is Kombucha Healthy? Here’s What Experts Say,” 11 February 2019. [Online]. Available: http://time.com/5516472/is-kombucha-healthy/.

Cancer is a word that most people think of to be a death sentence. It is one word that nobody wants to hear in a doctor’s office. Sadly, over the past decades, cancer prevalence has continued to rise. It was thought to be more common in elderly people but now it is becoming a lot more common in younger adults and even in children. There are many types of cancer that can develop throughout the body. Luckily, cancer is curable in some cases with treatment. People can be saved at all stages of cancer but sadly, not every person survives. It is a battle that scientists and doctors have been fighting for decades. Cancer is very complex and to get a better understanding of it, first one must have a general idea of what it is, the origin and what causes it.

Cancer is abnormal cell growth within the body. It is when normal cells become mutated and then these mutated cells continue to reproduce. Cancer cells do not differentiate, have abnormal nuclei, and do not undergo apoptosis. What this means is unlike the other cells in our body, cancer cells do not die. They rapidly produce and their nuclei is enlarged. Keep in mind that there are also other abnormal cell growths that can occur within the body and it doesn’t mean that every abnormal cell growth is cancerous. The abnormal cell growth will eventually form tumors. Not all tumors are cancerous. There are two types of tumors; benign and malignant. Benign tumors are noncancerous and malignant tumors are cancerous. Abnormal cells multiply rapidly and cluster up together to form a tumor. Another thing to note is that different kinds of cancers have different mutational signatures (Mike Adams et al.) This is why cancer in general is hard to cure because there are so many types and each type differ from one other in regards to their cells.

The development of cancer isn’t something that happens overnight either. The development of cancer can take years. There are multiple steps or stages that these cells go through to become cancerous. First, the formation of the tumor will occur. Then this tumor will undergo metastasis, which means the tumor will break off into fragments and spread to other parts of the body. Next these tumors will undergo angiogenesis, which is where blood vessels are formed in the tumor and nutrients and oxygen can now be supplied to the tumor. Even though the cancer has spread to different parts of the body from the original starting point, it would still be considered one type of cancer. For example, if a person had a tumor in their pancreas and the cancer spread to the bones or lymph nodes, this cancer would still be called pancreatic cancer because it originated in the pancreas. Knowing this information will make understanding the different stages of cancer much easier. There are technically five stages of cancer and they are: stage 0, stage I, stage II, stage III, and stage IV (‘Stages of Cancer’, 2018). Stage 0 means that the cancer hasn’t spread, it is sedentary in one part of the body. Stage I means that it has started to spread into nearby tissues, but isn’t deep rooted anywhere. Stage II and stage III have spread deeply within the nearby tissues and possibly the lymph nodes. Stage IV is the worst stage of cancer and this means that the cancer has spread to other parts of the body.

The origin of cancer comes from mutated genes. An experiment was performed with mice in an attempt to prove this. Scientists focused on a liver cancer called fibrolamellar hepatocellular carcinoma or fibrolamellar for short. Scientists found that all of the patients with this cancer had the same mutations in their tumor cells. A piece of DNA was missing. This missing DNA is supposed to be between these two genes: DNAJB1 and PRKACA. The deletion of this DNA causes seven other genes to be deleted and a protein to fuse the genes DNAJB1 and PRKACA together. This fusion is call chimera. The formation of chimera is what causes the cancer. This can be clarified by the experiments used on mice. Scientists took the genes of adult mice and mutated their genes. They created the same deletion of DNA missing between DNAJB1 and PRKACA that is found in fibrolamellar patients. After a few months, the mice developed the cancer. Scientists then took another group of mice and added just an extra piece of DNA with the chimera on it and this group of mice also developed the same cancer. These two experiments justify that the formation of chimera in the genes is the cause of fibrolamellar. This is just one example. Referring back to chapter nine, these mutated genes are called ‘oncogenes’. There is another gene called ‘tumor suppressor genes’. An oncogene is a mutated proto-oncogene. This is what can lead to cancer. It basically tells the cells to keep growing and dividing and there is no off switch so a tumor is created. The tumor suppressor genes regulate cell division and reproduction. They tell the cell to stop growing and dividing but if it becomes inactive due to mutation, it can also lead to cancer.

The cause of cancer can be traced back to a number of things. A lot of times doctors can’t even specifically say what caused it because they do not know. It is obvious in some cases; a person who has been diagnosed with lung cancer and also has a vast history of smoking. We are not always that lucky, though. There are many risk factors that have the possibility to lead to cancer. As stated by the National Cancer Institute, some of these factors include: age, diet, sun light, genetics, alcohol, obesity, and etc. Cancer is a lot more common in elderly people. “The median age of a cancer diagnosis is 66 years old. This means that half of cancer cases occur in people below this age and half in people above this age. One-quarter of new cancer cases are diagnosed in people aged 65 to 74” (National Cancer Institute, 2015). Drinking alcohol in excess for long periods of time can possibly lead to the development of multiple cancers such as cancer in the breast, liver, and throat. When it comes to genetics causing cancer, it is because the person has inherited the same genetic mutation that a family member has. Just because the person inherited this genetic mutation does not mean that the person will have cancer. They just have a high risk of getting it or passing on this risk to future offspring. There is some bittersweet hope in this field. If a family has a known history of cancer (not self-induced such as smoking or drinking), genetic testing can be done. The test can tell a person how high the percentage is that they may get cancer. The positive side is that a person can know what to expect but the negative side is there is no preventing it. All one can really do is monitor with regular visits to the doctor and hopefully stop it in time when the time comes. Tobacco is also another leading cause of cancer. When it comes to smokers, not only does the smoker have a high chance of getting cancer but whoever is around that person getting secondhand smoke also has a high chance of developing cancer as well. Tobacco can cause the same cancers as drinking alcohol and more examples also include these cancers: lung (most common), kidney, pancreas, and cervix.

There are some interesting myths when it comes to cancer as well. One myth is, if a person gets cancer, they are going die. Even though a lot of people think of cancer as a death sentence, that is not always the circumstance. Although in some cases it is, depending on how advanced the cancer is. It can reduce a person’s lifespan to numbered years. “Five-year survival rates for some cancers, such as breast, prostate, and thyroid cancers, now are 90 percent or better. The 5-year survival rate for all cancers combined is currently about 67 percent” (National Cancer Institute, 2015). This is very encouraging seeing that the survival rate is increasing. Also, another myth that I myself believed to be true is, eating sugar makes cancer worse. It has not been proven to make cancer worse but the misconception is that eating a lot of sugar all the time can lead to obesity and obesity can lead to several types of cancer. I think this is where people (including myself) mix up sugar worsening cancer. Another big myth that people (including myself) believe to be true is artificial sugars cause cancers. All of the artificial sugars that are used in the United States have been approved by the Food and Drug Administration. Which means that these artificial sweeteners were approved after being evaluated and tested by researchers. There was no evidence that they are linked to cancer. This is why it is important to always check labels of foods when buying especially when they are not fresh foods.

The biggest question is ‘Why isn’t there a cure for cancer yet?’. As I have talked about above, there are many types of cancer and each type of cancer has its own genetic mutation. Since every type of cancer has its own genetic mutation, a cure has to be found for every single type of genetic mutation. In other words, a cure must be found for every type of cancer. Another tricky thing is there can be thousands of genetic mutations within a certain type of cancer. Let’s say two people both have colon cancer; one person may have a different genetic mutation from the other person so generic medication prescribed for colon cancer may not work for both people due to the different genetic mutations. Since this is so common, chemotherapy and radiation are common treatments for cancer. These methods are commonly used because of the many genetic mutations but also if the tumor gets cut out, it may grow back. These treatments can stop potential tumors from growing back. There is also another treatment option called genome sequencing. Scientists test the genes of the cancer cells to determine a specific treatment plan such as developing medications that can combat specific genetic mutations in the genes to stop the cancer. This form of treatment is very helpful compared to chemotherapy and radiation because these treatments are very invasive and have many harmful side effects.

Overall, cancer is a very scary disease to think about or even discuss. However, it should not be something that we live in fear of. We know it can be terminal but we also know it can be treated and managed. It is not something that a person can mentally plan for, even if their chances of becoming diagnosed are high. Even though there isn’t really a preventive measure to getting cancer, a person can get evaluated by a physician regularly and if the cancer does occur, it can be caught in the early stage and hopefully terminated. Living a healthy life free of alcohol and tobacco can help lower the risk of cancer developing in your body. If diagnosed, it does not have to be something that alters the way we live our lives. There is still so much to learn about all the different types of cancers and the genetic mutations that come along with them. I believe that research will have to continue and progress for many years due to the complexity of cancer. I think in the future genome sequencing will become more advanced and hopefully scientists will be able to get rid of the mutated genes that lead to cancer. This could be the cure for cancer we have been searching for. It is only a matter of time before the cure for all cancers is found.

References

1. https://www.nature.com/scitable/ebooks/essentials-of-cell-biology-14749010/122997842/
2. https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/stages-cancer
3. https://www.pnas.org/content/pnas/114/50/13076.full.pdf
4. https://www.cancer.gov/about-cancer/causes-prevention/risk
5. https://www.cancer.gov/about-cancer/treatment/types

Cancer is one of the most well-known life-threatening conditions. The term ‘cancer’ is derived from a Greek word used by Galen in 100-200 AD ‘oncos’ which is Greek for swelling. This term was used to describe tumors. The Greek word, ‘oncos’, has been changed in modern health into oncology which means the study of tumors (Papavramidou N. et al.). A tumor is a swelling on a part of the body which grows abnormally and when there is a growth of abnormal cells in the body due to uncontrolled cell division this is known as cancer. There are many different types of cancers and the most common cancers in humans are; breast, liver, stomach and lung cancer (Dano et al., 2003). Lung cancer is the most common out of all of these cancers listed (Bray et al., 2018). As a result of the fact that cancer is a harmful disease and can spread if not treated properly and quickly. It has been argued that there is a correlation between getting an education and health (Grossman and Kaestner, 1997; Goldman et al., 2011). Education is needed because we would need to learn about what cancer is and once one realizes the symptoms, they would be able to treat it quicker. Getting an education would mean people are more likely to know the risks and ways to prevent themselves from getting cancer (Hemminki et al., 2003; Faggiano et al., 2003; Faggiano et al., 2004). In addition to this, gaining an education means a higher chance of getting a job with a good salary so this means being able to pay for healthcare services if needed. For example, being able to buy sunscreen to protect skin from skin cancer. Therefore, this reduces the risk of cancer for people that have an education as they are more aware of the risks (Levi et al., 1988). In this review, it will be examined on if education can affect the risk of cancer and decide on whether groups that have had an education are likely to get cancer and if there is a causal relationship between the two.

Education Level and Risk of Cancer

Reportedly, it has been suggested that those that have been poorly educated would not receive the proper care and knowledge they need so that they can avoid this life-threatening disease (Braaten et al., 2005). In Lleras-Muney’s 2005 study on education and mortality rates in adults it was shown that there was a causal relationship between education and adult mortality. Researchers found that adding more years to education would decrease percentages of the chances of dying by 3.6%. Lleras-Muney (2005) stated that an extra year of obligatory education would lower death rates after 35 years old by 3% (Lleras-Muney, 2005).

Mouw et al. (2008) further highlighted this in research where it was presented that obtaining a malignant disease, such as lung cancer and other cancers to do with smoking, increased when there was a reduced level of education (Mouw et al., 2008). Mouw et al. conducted a study on 498 455 participants to see the effects of education on the risk of cancer. They found that the more educated the category was the least likely it was that they would get cancer. The most common cancer that they found in less educated people was smoking related cancers like lung cancer. The highly educated group were less likely to smoke therefore they did not have smoking related cancers. They were more likely to have regularly checked themselves in the hospital for any signs of cancer and be fit health wise. Women that were in the study and more educated were said to be non-parous or conceive much later than women that had not had high levels of education. This displays that smoking causes cancer and education can also be a cause of cancer due to education being needed to understand the disease, it’s complications and treatment methods (Wynder EL et al., 1977). This study is more reliable than Lleras-Muney’s study as it is more recent, so it may have more information that is needed.

In a study carried out by Jensen et al. (2008), it was proven that socioeconomic factors had an impact on cancer risk. The study was carried out from 1994-2003 on 3 22 million subjects all aged 30 and above born in the years of 1925-1973 in Denmark, results showed that mortality from cervical cancer was low in women that had a better socioeconomic ranking than women that had a decreased level of education (Jensen et al., 2008). Moreover, endometrial and ovarian cancer death rates increased when linked to women with poor education.

In another similar study carried out by Marsa et al. (2008), socioeconomic position influenced the risk of cancer on male genital organs. This study used the same procedure but on males. It was found that men with higher levels of education had an increased chance of getting prostate cancer (Marsa et al., 2008). However, results showed that the possibility of getting testicular cancer did not depend on socioeconomic factors. Testicular cancer did not show a causal relationship with education in this study. These studies are similar because they are both in Denmark and scientists used male and female participants separately in the two studies.

Opposing Study-Risk of Cancer Linked with Gaining a University Degree

Glioma, a brain tumor that occurs in a big group of cells in the brain called the glial cells (Llaguno et al., 2016). A study carried out in Sweden by Khanolkar et al. (2016) on a large cohort of university students showed that degrees can eventually lead to tumors in the brain (Khanolkar et al., 2016). Demonstrating that, education may not have a causal effect on the risk of cancer. This study is a more recent study so it may be more reliable and have more modern information on the effect of education on cancer. Khanolkar et al.’s study on gliomas and socioeconomic positioning opposes studies such as Mouw et al.’s study and Lleras-Muneys findings as this study claims that high levels of education increase the risk of cancer.

The scientists in this study, Khanolkar et al., used more than 4.3 million Swedish participants in their discoveries and based it on them. Every one of the participants were conceived somewhere in the range of 1911 and 1961 and were also still living in Sweden in 1991. Observations on participants of the study were carried out somewhere in the range of 1993 and 2010 (Khanolkar et al., 2016). This was to check whether they built up a glioma (a brain tumor). Information on their educational level, relationship statuses, income and more were collected via the national census data and labor market. During the time frame given for participants to see if they had gotten a brain tumor, 1.1 million individuals passed on and more than 48,000 emigrated, however 5735 of the men and 7101 of the ladies built up a brain tumor. Men that had achieved a higher-level education such as a university degree for three years, had a 19% higher possibility of being bound to build up a glioma which is a kind of brain tumor emerging in glial cells. Glial cells protect and stay close to neurons in the cerebrum (Llaguno et al., 2016). It was also found that men that did not take part in education or had not been in education for some years of the amount of compulsory years that were meant to be done (9 years) were least likely to build up a glioma. In the women, the possibility of this was 23% higher for getting a glioma in women with an education than women that did not achieve a higher-level education. This study therefore opposes the idea that high levels of education increase risk of cancer but also shows that there is a correlation between cancer and education.

Education Doesn’t Affect the Risk of Cancer

Lund et al.’s (1991) Norwegian study on education and breast cancer carried out on a large cohort of 425,844 married women demonstrated in the results gathered that education had no correlation with cancer. This experiment was carried out from 1970-1985 on Norwegian women aged 35-54 years old (Lund et al., 1991). This opposes arguments that education can affect cancer. However, this study may not be reliable as it is older than other studies arguing that there is a relationship. This means that data is outdated and uses old information which may not be useful. Another limitation is that this study only looks at educations effect on the risk of cancer on a large cohort of married women only and not men too.

To support this a more recent study was carried out by Hemminki et al. (2003). Hemminki et al. (2003) concluded that education had little to no effect on cancer mortality rates in this study as it was found that the development of cancer in men and women in multiple educational levels was 16.7% in women and in men it was 13.8%. This proves that there was not much of a difference between different educational levels. In which further highlighting the point that there is no causal effect between education and cancer. The study took place in Sweden and there were 9 educational groups involved between men and women. There was no specific trend as in all educational levels there was increasing and decreasing risk of cancer in cancer (Hemminki et al., 2003). Scientists in this study used PAF to show educational levels of the experiment (Van Loon et al., 1995).

Discussion

Based on the findings from the studies and on common knowledge, education has an influence on cancer as we would learn about cancer in school and treatments or ways to prevent oneself from getting this disease. Adults that have not had an education in some cases may end up developing cancer as they have not learnt what is taught about cancer in education (Mouw et al., 2008). Furthermore, being in education for longer plays a key role because as one gets older, they learn in more detail and depth (Lleras-Muney, 2005). Therefore, they would learn what cancer is when in for example a science lesson. Later, with more years of education they may have learnt about prevention which some people may miss out on. This was demonstrated in studies and this proves that education can affect the risk of cancer. Future treatments are a vital factor to be considered. Researchers should consider future treatments for education affecting cancer. It can be implemented that everyone does compulsory schooling as that has been proven to have influenced an effect on the risk of cancer (Jensen et al., 2003; Marsa et al., 2003). Another future treatment of education and the risk of cancer could be teaching younger kids about the risk of cancer so that they know the risks earlier in their lives and some can learn to prevent the disease before they have the chance to leave education. Further research should be done on whether there is a trend between education and cancer because some studies are outdated and use old data and figures. Most older studies claim that education cannot affect cancer but more recent studies claim that it can.

My husband’s father, uncle, and aunt passed away after experiencing liver cancer a couple of years. Saying about liver cancer, you might think about poor lifestyle choices such as diabetes, overweight, over consumption of fatty, alcohol drinking or smoking. However, none of these people were involved in the most common risk factors above. We all were shocked about their fatal disease because they ate balanced diets and lived in healthy environment, and they did not experience any signs or symptoms until it had been diagnosed due to tiredness and digestive problems. I would like to learn more on the causes, symptoms, and treatments of this disease as I have seen it dramatically influences our family members’ lives.

Normal Anatomy and Physiology of the Liver

The liver is the human body’s largest internal organ that lies behind the diaphragm in the upper right quadrant of the abdomen (McKinley, OLoughlin, & Bidle, 2016, p.1078). It has hundreds of functions to support the essential processes such as: drug detoxification; metabolism of carbohydrates, lipids, and proteins; and the production of digestive enzymes (McKinley et al., 2016, p.1078-1081). It plays a key role in maintaining homeostasis by taking in glucose during the absorptive state and releasing glucose into the bloodstream during the post-absorptive state of metabolism (McKinley et al., 2016, p.1078-1081). Carrying out these tasks make it a such important organ that is vital to our overall health.

Effects of Liver Cancer to Homeostasis

Damage to the liver results in serious impacts on the entire human body. When liver cells are cancerous, they divide relentlessly and grow into tumors, invading healthy tissues as well as spreading to other organs (‘Liver Cancer Facts’, n.d.). Tumor cells would interfere the homeostatic balance as they cease producing and releasing glucose (Ohio State University Medical Center, 2012). Also, cancer makes liver not to function correctly leading to bilirubin, fluid, and toxic substances build-up that affects other organs in the body (The American Cancer Society medical and editorial content team, 2016).

Types of Liver Cancer

There are two categories of liver cancer: primary and secondary.

Primary Liver Cancer

Primary liver cancer is the cancer that originate in the liver formed in the liver itself. The most common types of primary liver cancer are hepatocellular carcinoma – also called HCC, hepatocellular cancer, or hepatoma – and intrahepatic cholangiocarcinoma (also called ICC).

• Hepatocellular carcinoma (HCC) – that represents 85% of the primaries – starts from liver cells called hepatocytes. This type is more common in people who have liver damage (such as by the hepatitis B or C virus or by alcohol abuse) or metabolic syndrome (such as diabetes, obesity, and hyperlipidemia). Hepatic adenomas, also known as benign tumors, can also cause HCCs in some cases (‘Liver Cancer Facts’, n.d.).
• Intrahepatic cholangiocarcinoma (ICC): this is the second common form of primary liver cancer, which occurs within the bile ducts. People who have chronic liver disease such as cirrhosis, choledochal cysts, or sclerosing cholangitis are more likely to get ICC (‘Liver Cancer Facts’, n.d.).
• Other uncommon types of primary liver cancer: hepatoblastoma (occurs in children), biliary cystadenocarcinoma (usually found in women), and fibrolamellar hepatocellular carcinoma (affects those younger than age 40) (‘Liver Cancer Facts’, n.d.).

Secondary Liver Cancer

Secondary liver cancer is caused by the cancerous cells that grow from other parts of the body then spreads (metastasizes) to the liver and forms new tumors here; and these tumors are called liver metastases. People with breast, bowel, or lung cancer are more likely to develop this category of liver cancer (‘What Is Secondary Liver Cancer?’, 2017).

Causes

The exact cause is not known, but there are a variety of the risk factors that lead to liver cancer. Illnesses such as hepatitis B or C and hemochromatosis are largely to blame as they often lead to cirrhosis – scarring of liver tissues that prevents flood flow through liver. Over time, the scarring will grow, takeover of the healthy cells and therefore damage the function of the liver. Having alcohol abuse (leading to cirrhosis), diabetes, obesity, low immunity (such as those with AIDS), smoking would raise the risk. Males tend to consume larger quantities of alcohol and smoking more than females, thus having higher risk of liver cancer because the liver is damaged more easily. Environmental factors such as prolonged exposure to arsenic or aflatoxin (toxic substance in drinking water and food) can also be contributors. Hemochromatosis is inheritable, and those with family members having liver cancer will have higher risk of liver cancer (Nordqvist, C., 2017, December 5).

Symptoms

The symptoms of liver cancer do not clearly show until the disease has reached certain stages. Some typical symptoms are: uncontrollable weight loss, loss of appetite, vomiting, pain in the right upper quadrant, a buildup of fluid in the abdomen, quickly to feel full even after eating very little food, lump under the ribcage on the right side, jaundice, dark urine, liver or spleen enlargement, fever, pruritus, cirrhosis or cirrhosis gets worse (‘Liver Cancer Facts’, n.d.).

Differential Diagnosis

Due to similar symptoms with other diseases, liver cancer is hard to diagnosed in early stages, therefore delay its detection. Once discovered, the doctors need to determine its stage, the size and location of the tumor as well as whether it has spread to other organs (‘Liver Cancer Facts’, n.d.).

The stage depends on: number and size of tumors, whether blood vessels have been infected, and whether lymph nodes or other organs have been infected (Mayo Clinic Staff, 2019).

Some tests to diagnose liver cancer include: blood tests (to measure the levels of liver protein or certain enzyme to look for any sign of cancer); imaging tests like ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) scan can detect cancer; liver biopsy (take tumor’s sample using a needle through skin or surgery then examine the sample under a microscope).

According to ‘Liver Cancer Facts’, stages of liver cancer can be categorized from I (earlier) to IV (later) (one to four). Specifically:

• Stage I: only one tumor in the liver;
• Stage II: one tumor that has advanced to blood vessels, or multiple tumors which are smaller than 5cm;
• Stage III: multiple tumors with at least one larger than 5cm or growing to veins like portal and hepatic, growing to liver’s outer cover or nearby organs except gall-bladder;
• Stage IV: cancer has spread to other organs and the lymph nodes.

Treatment

The statistics show that, for those are diagnosed, the 5-year survival rate heavily depends on how early the disease has been detected: stage I or II: 31%; stage III: 11%; stage IV: 2% (Cancer.Net Editorial Board, 2019). Notes that, even in later stages, treatments are also available to help maintain a good quality life for the patient. Surgery, if can be done, usually brings a good result (Cancer.Net Editorial Board, 2019).

There is a wide range of treatments for liver cancer. The target is to remove the tumors (for people whose have good liver function and the tumors are within the liver and small), replace the liver (transplant for those with early-stage liver cancer), or kill the cancer cells using different therapies depending on the stage and severity of the disease (for those who cannot get surgery or whose cancer has spread) (Mayo Clinic Staff, 2019). According to Mayo Clinic, the typical therapies are:

• Localized treatments: the cells of the tumors will be destroyed by applying heat to them, freezing them, injecting alcohol to them, or even injecting drugs to the tumor area.
• Chemotherapy: instead of injecting drugs to tumor area locally, this method injects drugs to the entire body, but the drugs are aimed to kill rapidly-growing cells.
• Targeted drug therapy: these drugs help block the abnormalities of cancer cells and eventually kill them; however, additional test may need to be done first to confirm the efficiency of these drugs on each patient.
• Radiation therapy: using high-powered energy beam (e.g., X-rays) to kill cancer cells at small areas in the liver, that might help control symptoms for advanced liver cancer or if other treatments cannot help (Mayo Clinic Staff, 2019).

To lower liver cancer risk, there are some strategies that might help, including avoiding excessive alcohol use, getting Hepatitis B vaccine, avoiding hepatitis C virus by practicing safe sex (because there is no vaccine against hepatitis C), watching your body weight, preventing and treating diabetes as well as hemochromatosis (Nordqvist, C., 2017, December 19).

Conclusion

There are about 42,000 cases have been diagnosed with primary liver cancer in the U.S. in 2019, and, of those, about two-third are men (Cancer.Net Editorial Board, 2019). The number of liver cancer patients keeps increasing, and compared to 1980, it has increased three times, that could result in the death of about 31,000 people this year in the U.S. (Cancer.Net Editorial Board, 2019). Liver cancer is ranked the fifth in cancer death for men and the seventh for women (Cancer.Net Editorial Board, 2019). This disease has a high mortality rate and being on the rise, thus knowing the facts will help rise our awareness to avoid risk factors. To bring awareness and raise funds for liver cancer research, October is chosen as the Liver Cancer Awareness Month, and emerald green is the color of liver cancer ribbon (Johnson, J., 2018, October 24).

This research also gives me an insight at what happened to my husband’s father, uncle, and aunt. Although they lived healthy lifestyles, they might be affected by unknown causes such as infection with the hepatitis B and C viruses or ate aflatoxin-tainted foods. Furthermore, I realize how important to detect the disease early because it decides the survival rate of the patient and gives patients the best chance to be supported and treated.

References

1. Cancer.Net Editorial Board. (2019). ‘Liver Cancer: Statistics’. Cancer.net. Retrieved April 27, 2019, from https://www.cancer.net/cancer-types/liver-cancer/statistics
2. Johnson, J. (2018, October 24). ‘Cancer Ribbon Colors: A Guide.’ Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/323448.php.
3. ‘Liver Cancer Facts’. (n.d). Seattle Cancer Care Alliance. Retrieved April 26, 2019, from https://www.seattlecca.org/diseases/liver-tumors-cancer/liver-cancer-facts
4. Mayo Clinic Staff. (2019). ‘Liver Cancer – Diagnosis & Treatment’. Mayoclinic.org. Retrieved April 27, 2019, from https://www.mayoclinic.org/diseases-conditions/liver-cancer/diagnosis-treatment/drc-20353664
5. McKinley, M. P., OLoughlin, V. D., & Bidle, T. S. (2016). Anatomy & Physiology: An Integrative Approach (2nd ed). New York, NY: McGraw-Hill Education.
6. Nordqvist, C. (2017, December 5). ‘Everything You Need to Know About Cirrhosis’. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/172295.php.
7. Ohio State University Medical Center. (2012). ‘Liver Cancer Cells Stop Making Glucose as They Become Cancerous’. ScienceDaily. Retrieved April 26, 2019, from http://www.sciencedaily.com/releases/2012/07/120730141635.htm
8. Torborg, L. (2018). A Medical Illustration of Liver Cancer. [Digital Image]. Retrieved from https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-for-liver-cancer/
9. The American Cancer Society medical and editorial content team. (2016). ‘Managing Symptoms of Advanced Cancer’. Cancer.org. Retrieved April 27, 2019, from https://www.cancer.org/treatment/understanding-your-diagnosis/advanced-cancer/managing-symptoms.html
10. ‘What Is Secondary Liver Cancer?’ (2017). Cancer Research UK. Retrieved April 27, 2019, from https://www.cancerresearchuk.org/about-cancer/secondary-cancer/secondary-liver-cancer/about

Cancer is defined as a disease caused by uncontrollable cell division of abnormal defective body cells. Cancerous cells have the ability to destroy and damage surrounding organs and healthy tissues. Some cancers metastasize, beginning in one area and then invading and damaging other areas of the body. Cancer cells which group together form tumors, which can be benign (don’t spread) or malignant (metastasize to different areas). Random mutations can often occur in the genetic encoding of cells, but these mutations are quickly detected and cause the cell to undergo apoptosis or ‘cell suicide’. Cancerous cells have mutations which bypass the detection process, allowing for rapid and incontrollable cell division of cells with incorrect genetic coding. The unique difference between cancer and any other illness is that it is caused by the body’s own cells, rather than foreign contaminants or pathogens, such as bacteria or virus. This makes it difficult for the body’s immune system to detect cancerous cells and target them, as well as finding drugs or treatments which will only affect cancerous cells, rather than also killing healthy, functioning body cells.

Treatments for most cancers usually include a combination of surgery to remove tumors, radiotherapy (ionizing radiation is used to kill cancerous cells) and chemotherapy (medication used to kill cancer cells or stop them dividing). A problem with chemotherapy and radiotherapy is that they are treatments designed to target dividing cancer cells. However, some cancer cells lie dormant for long periods of time. This results in cancers returning after many years, despite multiple rounds of treatment. Hormone therapies, immunotherapy (enhancing the body’s natural defense mechanisms to target cancer cells), and targeted treatments tailored for specific types of cancer can also be used. Most cancer treatments are developed using cell cultures grown in labs from samples of human tumors. These cultured cells have allowed oncologists to study the genetics and biology of many different cancers. These cells often lack the complexity of tumors and cancerous cells within patients and other living organisms, meaning drugs designed to target cancers, which show positive results in the lab, often have no effect on real-life patients and fail clinical drug trials.

One of the complexities of aggressive tumors is that they can have multiple populations with slight variations in genetic coding of cancer cells. Over time, distinct genetic mutations arise in cells, in different parts of the tumor, creating unique subclones. For example, aggressive brain tumors called glioblastomas can have up to six different subclones in a single patient. This is called clonal heterogeneity, and it makes treatment difficult because a drug that works on one subclone may have no effect on another due to the wide variation of genes in the mutated DNA of the cells. A tumor is a dynamic interconnected ecosystem where cancerous and healthy cells communicate with each other. Tumors can encourage normal cells to form blood vessels that ‘feed’ the tumor (with essential nutrients and oxygen) and remove waste products (such as carbon dioxide). Tumors can also act as immunosuppressants, keeping the immune system from recognizing and destroying the cancer, as well as pathogenic contaminants. Cancer stem cells have given way to a large array of problems also. These cells, although rare, have special properties which have made them resistant to chemo and radiotherapy. In theory, even if the rest of the tumor minimizes beyond detection, during treatment, a single residual cancer stem cell could seed the growth of a new tumor.

Cancer cells are masters of adaptation, with the ability to adjust their molecular and cellular characteristics to survive under stress. When targeted by radiation or chemotherapy, some cancer cells can effectively switch on ‘protective shields’ by changing their gene expression. Cancer is a disease which does not comply with the ‘one size fits all’ method of treatment, meaning different patients require different treatments and even then, the risk of killing all cancer cells is not always absolute. To conclude, much more in-depth research must be conducted in cancer genetics and biology in order to properly understand how to effectively tackle the problem of cancer, which presents itself in more than 200 different forms.

References

1. Thallinger, C., Füreder, T., Preusser, M., Heller, G., Müllauer, L., Höller, C., Prosch, H., Frank, N., Swierzewski, R., Berger, W., Jäger, U. and Zielinski, C. (2018). Review of Cancer Treatment with Immune Checkpoint Inhibitors: Current Concepts, Expectations, Limitations and Pitfalls. Wiener klinische Wochenschrift, [online] 130(3–4), pp.85–91. Available at: https://www.ncbi.nlm.nih.gov/pubmed29098404 [Accessed 1 Jan. 2021].
2. Jackson, H.J., Rafiq, S. and Brentjens, R.J. (2016). Driving CAR T-cells Forward. Nature Reviews Clinical Oncology, [online] 13(6), pp.370–383. Available at: https://www.nature.com/articlesnrclinonc.2016.36 [Accessed 1 Jan. 2021].
3. Garden, H. HowStuffWorks, Health, Conditions, Cancer and Facts, 2021. Why Is It so Difficult To Find Cancer Cells?. [online] HowStuffWorks.
4. Wanner, M., 2015. Why Is Cancer so Difficult to Cure?. [online] The Jackson Laboratory.
5. nhs.uk. 2019. Cancer. [online].

Many diseases that affect a person are life-threatening. Cancer is one of those fatal diseases. Cancer is basically a general name that is given to a whole group of diseases that have one thing in common – abnormal cell growth. The causes of this disease cannot be traced to a single factor because many factors contribute to its birth. Its effects are explained by the rapid spread of abnormal cells and the way they pile up upon each other. This paper attempts to discuss the causes and effects of cancer.

Firstly, some things have been given the name of carcinogens. Carcinogens refer to cancer-causing substances. Tobacco is an obvious example in this regard. Smoking is one of the most immediate causes of lung cancer. Statistics indicate that lung cancer has been the cause of the greatest number of deaths due to cancer in the USA for both men and women. Research has also found that it is one of the most avoidable forms of cancer death also.

The second important cause of cancer is the genetic makeup. If faulty genes are carried by a person from his birth, the chances of getting inflicted by cancer are raised to a high level. Breast cancer is usually caused due to inherited gene mutation. Colorectal cancer is also usually inherited. Therefore, genetic counseling is usually suggested for those who have a very strong history of cancer in their family. They should seek knowledge about their genetic makeup.

Another important cause of cancer is the everyday environment that a person is exposed to in routine. Different types of radiation, tobacco smoke, ultraviolet light, and some cosmetics products, all contribute towards the cause of cancer. Substances like radon, lead, and arsenic are usually found in homes and can lead to cancer. Furthermore, asbestos is also a contributing factor. Living near cellular phone towers and being exposed to the radio frequency waves used by cell phones all the time are equally dangerous.

One of the effects of cancer is that due to the local overgrowth of abnormal cells a swollen mass is produced. This swollen mass, also known as a tumor, can then become a source of extreme pain. Moreover, metastatic tumors can invade new parts of the body and spread there. For example, cancer spreads from the breast to the bones and then causes fractures. Hence, its fast-spreading ability and the ability to leave the original site and infect some other part of the body is the most alarming aspect.

Another common consequence of cancer is weight loss. Statistics indicate that around eighty percent of people with cancer suffer weight loss. Lastly, cancerous cells also weaken the immune system, and hence the body becomes vulnerable to several kinds of viruses and infections that the immune system would have otherwise been able to recognize and destroy. This explains why pneumonia usually bedevils patients in the last stages of cancer.

Summing up, cancer is a multifactorial disease. Ranging from general exposure to radio frequency waves to genetic makeup, this disease is caused by a variety of factors. Its effects are extremely painful and eventually life-threatening.

If I had to choose one of the leading causes of death in the country it would be cancer. In 2016, cancer had the second-largest death toll, killing 598,038 people (Zuber, 2019). One of the health disparities being the leading cause of death is that breast cancer tends to affect more black women at a faster rate than it does white women (‘Cancer Disparities’, 2018). Another health disparity that is the leading cause of death is that individuals with low incomes have a higher chance of dying from cancer than individuals with higher incomes (‘Health Disparities in Cancer’, 2018).

The two social determinants of health that contribute factors on why people with low incomes have a greater risk of dying from cancer than people of a higher pay grade are the social gradient and stress. The social gradient is a contributing factor to this health disparity because people with low incomes are not living in the best environment and they may not have a good support system. People with low incomes are most likely brought up where they had a poor education, poor working conditions, and social circumstances that wear down their bodies contributing to the being more at risk for illnesses such as cancer (Wilkinson & Marmot, 2003).

Another social determinant of health that contributes to why people with low incomes are at high risk for cancer than higher-paid people is stress. Lower-income people usually go through a lot of stress because of their economic and social situations, so they get involved in risky behaviors because of stress. Stress also raises a person’s heart rate and makes people feel that they have no control over their lives. Stress from not having a steady job can make you physically and emotionally ill and can contribute to cancer and death (Wilkinson & Marmot, 2003).

A health policy solution that can aim to reduce the risk of death from cancer would be more affordable schools built to provide more skills for better-paying jobs. This will also relieve stress and people will have money to get the treatments they need for cancer because they will have a higher-paying job after school. Another solution would be to create better jobs so that people will not have to break their backs doing hard labor, ruining their health.

References

1. Cancer Disparities. (2018, March 29). Retrieved from https://www.cancer.gov/about-cancer/understanding/disparities
2. Health Disparities in Cancer. (2018, July 05). Retrieved from https://www.cdc.gov/cancer/healthdisparities/basic_info/challenges.htm
3. Wilkinson, Richard, Marmot, Michael, & World Health Organization. Centre for Urban Health. (2003). The Solid Facts: Social Determinants of Health. Copenhagen: Centre for Urban Health, World Health Organization.
4. Zuber, P. (2019). 0.4 Health Ethics [slide 7-8]. Retrieved from the University of North Carolina at Charlotte LBST 2214 Issues of Health and Quality of Life Canvas site: https://canvas.uncc.edu
5. Zuber, P. (2019). 0.1 Measures and Health Disparities [Slide 8]. Retrieved from the University of North Carolina at Charlotte LBST 2214 Issues of Health and Quality of Life Canvas site: https://canvas.uncc.edu

Introduction

What is cancer? Cancer can be grouped as more than 100 different diseases and develops all over the body [1]. Abnormal cells will divide uncontrollably leading to the destruction of body tissues. Genetic changes affect the body’s logical processes. The cells that grow uncontrollably may form a tumor that can be benign or cancerous. A cancerous tumor can grow and sometimes it spreads to other parts of the body. A benign tumor can grow, but it will not spread to other parts of the body. Some cancer types don’t form a tumor. So why has cancer not been cured, when billions of Rands have been spent on research over the years? It is because cancer is very complex, not just one disease and one cure a one-size-fits-all cure is not possible. Cancer cells evade the immune system or suppress the normal immune response. A chemical compound can be added to the DNA of a cancer cell and suppress the activity of specific genes, causing cancer to hide in plain sight without causing an immune response. Ingestion of kombucha fermented tea has been associated with many health benefits because there are claims that it is a prophylactic agent, but it has not been scientifically proven. The beneficial effects of kombucha tea are that the bioactive compounds act synergistically, meaning working together, to accomplish more than they could alone. Kombucha is a culture consisting of a symbiosis between acetic acid bacteria (e.g. Gluconobacter oxydans) and different yeasts (e.g. Saccharomyces sp.) and some lactic acid bacteria have also been isolated from some symbiotic kombucha culture. Kombucha tea is a fermented drink consisting of a mixture of the kombucha culture (bacteria and yeast), green and/or black tea, and sugar. Kombucha tea tastes slightly acidic and slightly carbonated. Based on personal observations and testimonials kombucha tea is safe for human consumption. Studies are analyzed to experimentally confirm the health benefits of kombucha tea.

Background

As a cancerous tumor grows, the bloodstream or lymphatic system may carry cancer cells to other parts of the body. During metastasis, cancer cells grow and may develop into new tumors. The lymph nodes, which are small, bean-shaped organs that play a role in fighting infection, are one of the first places cancer spreads to. Lymph node clusters are situated in different parts of the body (e.g. under the arms). Cancer is also able to spread through the bloodstream to parts of the body located far away. Even within the same tumor, cancer cells can be heterogeneous. Biopsies are naturally taken from only one spot within a tumor, this causes implications when trying to improve diagnostics and therapies. This also means that one targeted therapy is not likely to abolish all cancer cells alone. Cancer cells grow and divide extremely fast and must tolerate a lot of strain and harm to their DNA. Cancers rely on a balance between damage and repair of their DNA. Changes in their genes build up over a period of time causing evolution at a rapid pace leading to mutations. This contributes to the heterogeneity of cancer cells and cancer treated today can differ from cancer you treat in the time to come. A kombucha SCOBY is a symbiotic colony of bacteria and yeast. Using this SCOBY kombucha tea is made consisting of two parts: a sour liquid broth and a pellicle layer of floating cellulose. Tea polyphenols (e.g. catechins), sugars, glucuronic acid, gluconic acid, lactic acid, amino acids (e.g. lysine), fibers, vitamins (e.g. vitamin C, vitamin B), essential elements (e.g. Na, K, Ca, Cu, Fe, Mn, Ni, Zn), catalase, carbon dioxide, antibiotics, and different micronutrients are produced when kombucha tea is fermented and most likely contributes to the health benefits observed when consuming kombucha tea. As fermentation takes place, the yeast component breaks down to sucrose to produce fructose, glucose, and carbon dioxide. Carcinogenesis is a multistage, multifactorial process and several genes are affected. Chemo-preventive agents can target these genes and regulate their intracellular, extracellular, or cell-surface functions. The anticancer properties of black tea polyphenols have been studied in the past. One of the components of kombucha tea is black tea, so does this mean it has anti-cancer properties? There are many references to and claims that kombucha tea has anticancer properties, but it has not been scientifically proven yet. There are reports that carcinoma has been successfully cured by the consumption of kombucha tea and that long-term consumption of kombucha tea increases the immune system’s defense against cancer. In this study, kombucha tea was tested for anticancer properties. Kombucha may provide the health benefits of black tea and have health benefits of its own. One of the healthiest beverages is black tea because it consists of a variety of bioactive compounds, including polyphenols, that are powerful antioxidants. Kombucha tea containing black tea consists of the same plant components and presumably has the same health benefits. In previous studies, black tea consumers have a lowered risk of breast, prostate, and colon cancers. Kombucha tea was analyzed in test-tube studies and helped in the prevention of the growth and the spreading of cancer cells because of the high concentration of antioxidants and tea polyphenols. The theory is that tea polyphenols block or suppress the mutation of genes and the growth of cancer cells, promoting the death of cancer cells. Glucose can be converted into gluconic acid and fructose into acetic acid by acetic acid bacteria. Ethanol is produced by the yeast component of kombucha using fructose as a preferred substrate and the bacterial component oxidizes the ethanol into acetaldehyde. The production of ethanol is stimulated by the acetic acid produced and the production of acetic acid is in turn stimulated by the ethanol produced. Some cases of toxicity associated with ingesting large quantities of indecorously prepared kombucha have been reported. These risks can occur when kombucha is over-fermented or home-brewed. Preparing kombucha involves bacteria growing in a liquid that is then consumed. These bacteria are considered to be probiotics, but improperly prepared, harmful bacteria or mold can grow. Improper preparation of kombucha can cause liver problems, the build-up of lactic acid, allergic reactions, and nausea. Proper preparation of kombucha is essential.

Defining the Research

Research question

Does kombucha tea have the ability to prevent or even treat cancer?

Hypothesis

• Ha: There is an association between cancer and kombucha tea.
• Ho: There is no association between cancer and kombucha tea.

Aim and Objectives

The purpose of this study is to determine the effect kombucha tea has on cancer and if it is able to prevent or even treat cancer.

Methods

Plate Count Method to Isolate a Safe, Pure Culture

2 Vials of the kombucha scoby and 1 vial of the reference stock were placed in a freezer and taken out to warm to room temperature. The cap was disinfected with 70% ethanol. The vials were rehydrated and the contents were allowed to reconstitute for 5 minutes. Using inversion, the vials were mixed thoroughly. A tenfold dilution series of the kombucha scoby was prepared in capped tubes and 9.0ml of the diluent was pipetted into each tube using a 10.0ml pipette and labeled. 1.0ml of the first sample was transferred into the first diluent tube using a pipette, capped, and then mixed. The dilution was continued using a pipette to transfer 1.0ml of the first tube into the second tube. The dilution was repeated 10 times. 0.1ml of tubes 8, 9, and 10 were deposited on 3 different plates of agar with a pipette. An inoculum spreader was sterilized in 70% alcohol. The inoculum spreader was used to distribute the inoculum on the agar surface, sterilizing between each distribution. The plates were inverted and incubated.

Preparation of Fermented Kombucha Tea

3.0 g of green tea, 3.0g of black tea, and 3.0g of tea powder were respectively boiled in 400 ml of water for 20min. Each tea infusion was filtered using filter paper and sucrose was dissolved in the clear filtrates and left to cool. The 200ml of the tea infusions were poured into a sterilized flask. The flask was inoculated with 3% of the pure kombucha culture. The flask was covered with a cloth. Fermentation was carried out in the dark at 30°C for two weeks. At 10 000rpm the fermented tea was centrifuged for 10min.

Preparation of Fermented Control Tea

3.0 g of green tea, 3.0g of black tea, and 3.0g of tea powder were respectively boiled in 400 ml of water for 20min. Each tea infusion was filtered using filter paper and sucrose was dissolved in the clear filtrates and left to cool. The 200ml of the tea infusions were poured into a sterilized flask. The flask was covered with a cloth. Fermentation was carried out in the dark at 30°C for two weeks. At 10 000rpm the fermented tea was centrifuged for 10min

Gelatine Zymography

Preparation of Conditioned Media

The cell cultured in fetal bovine serum was put in a flask. At 80% confluency, the fetal bovine serum media was removed. The cells were washed with fetal bovine serum-free media twice and left to grow. The conditioned media was collected and centrifuged to remove the dead cells and then concentrated.

Running the gel

To ensure that all the samples have the same concentration the conditioned media was diluted. A non-reducing sample buffer was added to the samples. A 7.5% acrylamide gel containing gelatine was prepared. Each sample was loaded into a well and ran at 150V until a good band separation was observed.

Gel washing and staining

The gel was washed two times for 30 minutes with a washing buffer to remove SDS from the gel. The gel was rinsed for 10 min with an incubation buffer. The gel was incubated in a fresh incubation buffer for 24 hours. The gel was stained for 1h and then rinsed with water to remove the excess staining solution. The gel was incubated until the bands were clearly visible.

Study Design

The fermented kombucha tea was given to 10 healthy subjects and 10 cancer-infected subjects. The fermented control tea was also given to 10 healthy subjects and 10 cancer-infected subjects.

Pathology Tests

Pathology tests were performed on all 40 subjects, using a microscope to evaluate the presence of abnormal cells.

Diagnostic Imaging

The abnormal masses of all 40 subjects were visualized using high-tech machines (e.g. x-rays and computed tomography scans) to create images.

Blood Tests

Blood tests were performed on all 40 subjects measuring substances indicating how advanced the cancer is.

Tumor Markers

All 40 subjects were tested to detect substances in the blood, urine, or other tissues that would be higher than normal when cancer was present.

Conclusion

The Plate Count Method was used to isolate a kombucha culture. Using this method increases the chances of obtaining a pure, safe culture, reducing the chances of bacteria that can cause harm to the human body. A control fermented tea was used to establish that the results obtained were true because of the fermented kombucha tea and not because of other factors. Molecular processes such as tumor cell apoptosis and tumor growth and invasion inhibition are affected by tea polyphenol. Matrix MMPs are linked to tumor cell evasion and kombucha tea inhibits MMPs. Gelatine zymography assay showed that kombucha tea reduced MMP activity according to the concentration used. Tea polyphenols demonstrated growth inhibitory activities. Pathology tests, diagnostic imaging, blood tests, and tumor markers were used to observe the presence of abnormal cells or cancer cells before and after the consumption of either the fermented kombucha tea or the control tea. The healthy subjects who consumed the kombucha tea showed an increase in immunity and anti-cancer properties. The healthy subjects who consumed the control tea showed little difference in immunity. The cancer-infected subjects who consumed the fermented kombucha tea showed an inhibition of tumor growth and prevented the cancer from spreading. The cancer-infected subjects who consumed the control tea showed no change in tumor growth.

References

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