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Pⁿ Blog
The Pⁿ Blog is a forum for opinions, questions, controversies, and instructive discussions across the field of pathology and its relevant subspecialties.
Friday, September 06, 2013
Hallmarks of Cancer
The next time one of your non-pathology friends asks you what cancer is and how it starts, here's an article from the March 2013 issue of Cell that will answer all their questions, and then some!
Well... maybe if they have a PhD level intellect and a good background in biologic science.  Otherwise, it's way too much for the average person to digest.  Nonetheless, it makes for interesting reading for those of us in the pathology world. 
In 2000 Douglas Hanahan and Robert Weinberg proposed six related, organizing principles for understanding malignant transformation.  These were:
Sustaining proliferative signaling
Evading growth suppressors
Resisting cell death
Enabling replicative immortality
Inducing angiogenesis
Activating invasion and metastasis
The current article in the March 2013 issue of Cell (Cell 2013;144:646) is an update by the same authors on what we have learned in the last 13 years about these principles, along with selected illustrations of the multiple pathways by which neoplastic cells may achieve each of these requirements.  The authors then add two new hallmarks of malignancy:
Reprogramming energy metabolism
Evading immune destruction
This review article by experts in the field is an excellent summary of the complex topic of malignant transformation.  It is a tribute to how far we've come in understanding the complexities of cancer and a roadmap for where we need to go.  You don't need to be a basic researcher (and I'm certainly not!) to completely understand this well-written article.  I found this to be enjoyable and thought-provoking reading.  I hope that you'll agree.
About the Author

Stacey E. Mills, MD
Stacey E. Mills, MD, a graduate of University of Virginia (UVA) and the UVA Medical Center, has authored nearly 230 articles, 20+ books, atlases and monographs—including the renowned Sternberg's Diagnostic Surgical Pathology. He has been a practicing Professor and Staff Pathologist at UVA for 30+ years and is Director of Surgical Pathology and Cytopathology. His clinical specialty is general surgical pathology with emphasis on neoplasms and neoplasm-like lesions. Dr. Mills is also Editor-in-Chief of The American Journal of Surgical Pathology.