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Other changes; loss of anti-metastasis gene

The cancer metastasizes (spreads to other tissues).

17.18 Multiple Mutations Transform a Normal Colon Epithelial Cell into a Cancer Cell (a) In colon cancer, at least five genes are mutated in a single cell. (b)Colonoscopy is the current standard screening test for colon cancer. These views reveal (/) normal colon tissue, (/'/') a benign adenoma (stalked polyp), and (/'//) adenocarcinoma (a malignant tumor).

17.18 Multiple Mutations Transform a Normal Colon Epithelial Cell into a Cancer Cell (a) In colon cancer, at least five genes are mutated in a single cell. (b)Colonoscopy is the current standard screening test for colon cancer. These views reveal (/) normal colon tissue, (/'/') a benign adenoma (stalked polyp), and (/'//) adenocarcinoma (a malignant tumor).

come metastatic. Although the occurrence of all these events in a single cell might appear unlikely, remember that the colon has millions of cells, that the cells giving rise to epithelial cells are constantly dividing, and that these changes take place over many years of exposure to natural and synthetic carcinogens as well as spontaneous mutations.

The characterization of the molecular changes in tumor cells has opened up the possibility of genetic diagnosis and screening for cancer. Many cancers are now commonly diagnosed in part by specific oligonucleotide probes for oncogene or tumor suppressor gene alterations. It is also possible to detect early in life whether an individual has inherited a mutated tumor suppressor gene. A person who inherits mutated copies of the tumor suppressor genes involved in colon cancer, for example, normally would have a high probability of developing this cancer by age 40. Surgical removal of the colon would prevent a metastatic tumor from arising.

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