How cancers grow

This page tells you about how cancers grow. There is information about

Benign and cancerous (malignant) tumours

Tumours (lumps) can be benign or cancerous (malignant). Benign means it is not cancer.

Benign tumours

  • Usually grow quite slowly
  • Don't spread to other parts of the body
  • Usually have a covering made up of normal cells

Benign tumours are made up of cells that are quite similar to normal cells. They will only cause a problem if they

  • Grow very large
  • Become uncomfortable or unsightly
  • Press on other body organs
  • Take up space inside the skull (such as a brain tumour)
  • Release hormones that affect how the body works

Malignant tumours are made up of cancer cells. They

  • Usually grow faster than benign tumours
  • Spread into and damage surrounding tissues
  • May spread to other parts of the body in the bloodstream or though the lymph system to form secondary tumours. Spreading to other parts of the body is called metastasis

How cancers get bigger

To start with, cancer cells are contained within the body tissue from which they have developed – for example, the lining of the bladder or the breast ducts. Doctors call this superficial cancer growth. It may also be called carcinoma in situ.

The cancer cells grow and divide to create more cells and will eventually form a tumour. A tumour may contain millions of cells. All body tissues have a layer keeping the cells of that tissue inside called the basement membrane. Once the cancer cells have broken through the basement membrane it is called an invasive cancer.

Blood supply and cancer

As the tumour gets bigger, the centre of it gets further and further away from the blood vessels in the area where it is growing. So the centre of the tumour gets less and less of the oxygen and the other nutrients all cells need to survive.

why cancer cells need their own blood supply

Like healthy cells, cancer cells cannot live without oxygen and nutrients. So they send out signals, called angiogenic factors, that encourage new blood vessels to grow into the tumour. This is called angiogenesis. Without a blood supply, a tumour can't grow much bigger than a pin head.

Once a cancer can stimulate blood vessel growth, it can grow bigger and grow more quickly. It will stimulate the growth of hundreds of new capillaries from the nearby blood vessels to bring it nutrients and oxygen.

View a transcript of the video about how cancer gets a blood supply.

Research into blood vessel growth (angiogenesis)

A lot of research is going on into angiogenesis. The research has found that the amount of angiogenic factors is very high at the outer edges of a cancer. Drugs that stop blood vessel growth (anti angiogenic drugs) can stop a cancer from growing into surrounding tissue or spreading. They can't usually get rid of a cancer completely, but may be able to shrink it or stop it growing in some cases.

Some anti angiogenic drugs can control certain types of cancer. More of these drugs are being developed and tested all the time.

We have information about drugs that block blood vessel growth.

You can also find out about trials into anti angiogenic drugs on our clinical trials database.

How cancer spreads into surrounding tissues

As a tumour gets bigger, it takes up more room in the body. The cancer can then cause pressure on surrounding structures. It can also grow directly into body structures nearby. This is called local invasion. How a cancer actually grows into surrounding normal body tissues is not fully understood.

A cancer may just grow out in a random direction from the place where it started. However, tumours can spread into some tissues more easily than others. For example, large blood vessels that have very strong walls and dense tissues such as cartilage are hard for tumours to grow into. So locally, tumours may grow along the 'path of least resistance'. This means that they probably just take the easiest route.

Research has pointed to 3 different ways that tumours may grow into surrounding tissues and they are outlined here. A particular tumour will probably use all 3 of these ways of spreading. Which way is used most will depend partly on the type of tumour, and partly on where in the body it is growing.

Pressure from the growing tumour

As the tumour grows and takes up more space, it begins to press on the normal body tissue nearby. The tumour growth will force itself through the normal tissue, as in the diagram below.

tumour forcing its way through normal tissue

The finger like appearance of the growth happens because it is easier for the growing cancer to force its way through some paths than others. For example, cancers may grow between sheets of muscle tissue rather than straight through one particular muscle.

As the cancer grows, it will squeeze and block small blood vessels in the area. Due to low blood and oxygen levels, some of the normal tissue will begin to die off. This makes it easier for the cancer to continue to push its way through.

Using enzymes

Some normal cells produce chemicals called enzymes that break down cells and tissues. The cells use the enzymes to attack invading bacteria and viruses. They also use them to break down and clear up damaged areas in the body. The damaged cells have to be cleared away so that the body can replace them with new ones. This is all part of the natural healing process.

Many cancers contain larger amounts of these enzymes than normal tissues. Some cancers also contain a lot of normal white blood cells, which produce the enzymes. They are part of the body's immune response to the cancer. We're not yet sure where the enzymes come from, but they are likely to make it easier for the cancer to make a pathway for itself through the healthy tissue.

As the cancer pushes through and breaks down normal tissues, it may cause bleeding due to damage to nearby blood vessels.

Cancer cells moving through the tissue

One of the things that makes cancer cells different to normal cells is that they can move about more easily. So it seems likely that one of the ways that cancers spread through nearby tissues is by the cells directly moving.

Scientists have discovered a substance made by cancer cells which stimulates them to move. They don't know for sure yet, but it seems likely that this substance plays a big part in the local spread of cancers.

This research is interesting because, if a substance has been found that helps cancer cells move, then researchers can start to find ways to stop the substance working. They may also be able to find ways to stop the cancer cells making the substance in the first place. If cancers can be stopped from spreading, it may be easier to cure them.

Researchers are also trying to understand how cancer cells change shape as they move and spread to other parts of the body.

You can read about how cancer may spread to other parts of the body.

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