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The journey of tumor cells in the body obeys a series of complex mechanisms. The scientist Carlos López-Otín explains the ten keys to tumor processes, “the instruction book that cells must follow to transform themselves into selfish, mortal and traveling entities”
Carcinogenic cells. EFE/Rebeca Corcoles
Precisely “Selfish, mortal and traveler” (Editorial Paidós) is the title of the latest book by this biochemist and expert in the human genome, a journey to the heart of cancer that closes a trilogy on human vulnerability together with “Life in four letters” and «The dream of time».
In the chapter entitled “The essence of evil”, López-Otín tries to explain the complex processes of malignant cells based on the scientific and integrative vision of molecular oncologists Douglas Hanahan and Robert Weinberg who, first in the year 2000, and later in In 2011, they published scientific articles in “Cell” in which they described the characteristics of this journey to malignancy.
There are ten processes that cells follow to become malignant that do not keep a strict order, nor is there a specific time for each of them.
This general view of tumor processes opens the way to the development of new therapeutic strategies, now fundamentally based on one of them, the loss of control of cell proliferation.
“The future heralds the possibility of introducing alternative strategies aimed at intervening concomitantly on several of the distinctive properties of cancer that, as a whole, make up its true cellular and molecular essence”, affirms the also professor of the Oviedo University in his book.
The scientist and professor of biochemistry at the University of Oviedo, Carlos López-Otín, in an interview with EFE. EFE/Marshal
The processes that tumor cells go through
1.- Autoactivation of cell proliferation: One of the characteristics of tumor cells is their ability to grow and divide without control and one of the reasons is that some of the signals that determine the time and rate at which they should proliferate are altered.
two.- Insensitivity to cell growth inhibitors: But not all cells are capable of endless proliferation. To try to avoid it, biological evolution itself endowed the human being with a series of genes encoded for cell growth inhibitors.
“Among the genes that put pause and calm in the life of cells, two stand out, TP53 and RB”, but in tumor cells both are usually inactivated and proliferative chaos manages to prevail, explains the author.
3. Resistance to apoptosis: But the growth of tumors does not depend only on the rate of cell division, but also on the rate of cell death, which is called apoptosis.
Proteins are activated that help destroy damaged cells and thus prevent them from dividing further. But the journey on the part of these malignant cells continues to develop various strategies that free them from death, from apoptosis.
4.- Acquisition of replicative immortality: The path towards immortality of tumor cells, which began with the evasion of cell death mechanisms (apoptosis), is completed with the activation of a strategy that ignores the limit that indicates the maximum number of divisions that can undergo normal cells. They then reactivate telomerese, an enzyme with which they manage to jump that barrier and reach a state of replicative immortality that allows them to divide endlessly.
5.- Induction of angiogenesis: The process of formation of new blood vessels from existing vessels is known as angiogenesis and is essential for feeding the primary tumor and also metastases.
6.- Stimulation of invasion and metastasis mechanisms: Some cells of the primary tumor acquire additional mutations that allow them to invade the surrounding tissue, spread and colonize other territories to generate metastases. The journey begins with local invasion, passing through blood or lymphatic vessels and traveling to other distant tissues or organs. There, small nodules or micrometastasis are formed, the processes of angiogenesis (feeding) and colonization begin until a clinically detectable macrometastasis is generated.
7.- Reprogramming of energy metabolism: Tumor cells are metabolically reprogrammed to simultaneously guarantee the supply of energy and that of certain metabolic precursors. “This gives them a notable advantage over normal cells and allows them to continue growing and evolving to face the next stages of their progression,” explains López-Otín.
8.- They escape the immune system: The immune system tries to unmask the tumor cells that hide among the normal ones and activates innate immunity and adaptive immunity to eliminate them. But malignant cells develop immunomodulatory proteins that slow down the activity of the immune system that keeps them under control, as if asleep, for months or years until they wake up due to their tireless adaptive capacity or due to defects in the immune system caused, for example , by the passage of time or by situations such as stress.
9.- Chronic inflamation: The cells of the immune system are responsible for eliminating pre-tumor or tumor cells, a process that has a “dark side” by generating a chronic inflammatory response that favors all stages of tumor development. But it’s also common for inflammation caused by a variety of factors—from viral or bacterial infections to obesity—to contribute to cancer risk.
10. Genomic instability: If tumor cells did not acquire a state of genomic instability that promotes the rapid accumulation of mutations, cancer could not develop in most cases. Normal cells have mechanisms to avoid this instability (from the arrest of cell division to the repair of genetic material or cell death).
But tumor cells deactivate such mechanisms and a genomic instability is produced that stimulates the progression of cancer in this “selfish” and “wandering” journey, explains Dr. López-Otín.
For a relationship to work, two components are needed: physical and psychological attraction and admiration, according to psychiatrist Marian Rojas Estapé, an expert in family therapy, who describes the keys to maintaining these elements, caring for and pampering the relationship, from most idyllic and easy to the most complex
“Why are there people who inspire us with confidence and whose mere presence comforts us? Is about ‘vitamin people’, those that bring out the best in you, inspire you, support you and thereby improve your immune system”, says psychiatrist Marian Rojas Estapé.
“Vitamin people help relieve tension, whose well-given hug can help us get through a tough time, whose trusting gaze can decisively propel us through a difficult challenge, and whose words of encouragement can break a sense of isolation,”
according to this renowned psychiatrist and writer.
The psychiatrist Marian Rojas Estapé. Photo by Editorial Planeta
The Dr. Rojas Estape (Madrid, Spain, 1983) works at the Spanish Institute for Psychiatric Research (IEIP).
She is a visiting professor at the IPADE business school in Mexico and focuses on treating people with anxiety, depression, personality disorders, behavioral disorders, as well as family therapies.
She is the author of the book ‘How to make good things happen to you’, one of the best sellers in 2019 and has recently published ‘Find your vitamin person’, where analyzes the close relationship between our happiness and our good relationships with those around us.
We are designed to live in family and in society, to relate and love each other. Human relationships make us stronger or weaker or can make us feel vulnerable.
Much of the quality of our life depends on how we relate, how we are able to love and receive the affection of others, he points out.
And the couple is one of the fundamental relationships of our lives, according to this expert, for whom “love, passion, attraction, desire, romanticism are different phases and moments of the relationship between two people where a bond is generated affective, physical or of a special partner”.
A relationship in permanent evolution
«Starting from the basis that we have correctly chosen our partner for a relationship and we are with a person who suits us, we can improve the chances of success of the relationship«, indicates the specialist.
“Enhance them beyond the initial crush, and transform them into a ‘vitamin partner’, who, like ‘vitamin people’, is a source of personal growth, confidence, inspiration, support and health,” he adds.
“For a relationship to work, two components are needed: physical and psychological attraction and admiration”,
According to Rojas Estapé.
He explains that a couple evolves through the thousand ups and downs of life, but for the glue that holds affection together to continue to exist, “it is necessary that these elements be maintained or continue to be promoted.”
Add this psychiatrist who couples have a natural and logical evolution that is not always accepted and «sometimes it leads to a point of discomfort, due to natural wear and tear. At that time it is convenient to take back the reins and make an effort to fight for the other.
«We need to look at each other again and say ‘we love each other, we understand each other, we want this to continue but we have worn ourselves out. We have become people who sometimes make us suffer instead of making us happy.”
points out.
“To preserve a relationship, from the most idyllic and easy to the most complex, we must want to take care of it and want to pamper it,” he emphasizes.
«The success of a relationship lies in how well both members know how to get out of conflicts. In generosity in giving and forgiving and in how they communicate with each other«, according to Rojas Estapé.
The expert describes four keys that in moments of difficulties in the couple can help us discover if we are neglecting any of the pillars of healthy love.
The four pillars of a couple that works
1. Work on communication.
This expert recommends paying attention to how we speak, communicate and express what we feel.
He advises avoiding “taking out the list of past grievances and wounds.”
He warns that in anger, the brain brings to light the blows, wounds, damages, offenses, slights and contempt that the other person has done to us.
“One needs to transmit and express their pain and anger for so many bad times.”
In those moments “watch your words, since they have a direct impact on the other person, on you and on the consolidation of the relationship”.
2. Analyze your sensitivity.
How do things affect you? Do you give a second thought to any negative comments? Do you suffer disproportionately in the face of a bad face or an insignificant fact?» asks this psychiatrist.
He recommends giving the things that happen to us the value they truly have: “advice that will help us in all matters of life,” he says.
3. Beware of the imagination.
«90% of the things we worry about never happen. They are not real, they are the product of the imagination, but they have a direct impact on our body », she warns.
«I’m sure he likes someone else», «he ignores me», «he doesn’t care about the children», «he will forget the date of our anniversary», «he doesn’t want to be with me, he prefers to be with his friends»,
These are some examples of toxic and harmful internal dialogues, according to the expert.
That is why he recommends to the members of a couple that, when they are well, in a peaceful moment of the relationship, write a letter or a note on your mobile describing everything that moves you to continue with the other person”.
In the bad stages, rereading that document will become a balm for the mind “that reminds us of how good the other is and keeps us away from negative thoughts,” he proposes.
4. Pay attention to details.
“Love is nourished by details”, points out this psychiatrist who advises to show our love and affection through messagescaresses, pampering, delicacy and hugs.
«Showing what we feel, through a culinary detail, some flowers, a note on the bed, an emoticon, a surprise, a moment of calm and peace together in an unexpected place or a pleasant conversation, are food for the relationship» ,
stands out.
«The one who does not know how to express affection may have a problem maintaining the relationship. If you notice that it is something you do not like or it is difficult for you, he asks for help, reads about it or talks to someone close. Surely little by little you can overcome that barrier », she concludes.
