Running head: CANCER: CARCINOGENESIS AND ONCOGENES 6
Initiation
This stage involves the alteration of proto-oncogenes by carcinogens. It can be either spontaneous
or induced. The DNA methylation of promoter gene regions can transcriptionally repress the tumor
suppressor genes. The mutation of the DNA synthesis process due to chemical carcinogens
eventually leads to proliferation of the cells. These cells tend to have a lifespan equal to that of the
organism. Basically, the DNA adduct formation which activates proto-oncogenes and conversely
inactivates tumor suppressor genes is the tumor-initiating event.
Tumor Promotion
This stage is considered to be the longest phase but is reversible. As the rate of proliferation
increases, the probability of the conversion of cells to malignant cells increases. The tumor
promoter can either reduce the rate of malignant conversion or on the other hand speed up the
process Tumor promoters are fundamentally known to be both mutagenic and carcinogenic hence
they can perform both tasks. Carcinogens which display both tumor initiation and promotion
qualities are known to be complete carcinogens. A good example is 4-aminobiphenyl
("Experimental Carcinogenesis," n.d., p. 37).
Malignant conversion and Tumor Progression
This is the stage in which preneoplastic cells are converted to cancerous cells. This only occurs as
a result of further genetic mutation on the cell. It is crucial to note that the level of tumor promoters
must remain constant or increase for this to happen. If not so, the cells form benign lesion (non-
cancerous swellings). The preneoplastic cells are converted to malignant cells which invade the
cellular territories of neighboring cells and tissues.