CANCER – Any Hope?

Differences between Cancer Cells and Normal Cells

Cancer cells differ from normal cells in many ways that allow them to grow out of control and become invasive. One important difference is that cancer cells are less specialized than normal cells. That is, whereas normal cells mature into very distinct cell types with specific functions, cancer cells do not. This is one reason that, unlike normal cells, cancer cells continue to divide without stopping.

In addition, cancer cells are able to ignore signals that normally tell cells to stop dividing or that begin a process known as programmed cell death, or apoptosis, which the body uses to get rid of unneeded cells.

Cancer cells may be able to influence the normal cells, molecules, and blood vessels that surround and feed a tumor—an area known as the microenvironment. For instance, cancer cells can induce nearby normal cells to form blood vessels that supply tumors with oxygen and nutrients, which they need to grow. These blood vessels also remove waste products from tumors.

Cancer cells are also often able to evade the immune system, a network of organs, tissues, and specialized cells that protects the body from infections and other conditions. Although the immune system normally removes damaged or abnormal cells from the body, some cancer cells are able to “hide” from the immune system.

Tumors can also use the immune system to stay alive and grow. For example, with the help of certain immune system cells that normally prevent a runaway immune response, cancer cells can actually keep the immune system from killing cancer cells.

How Cancer Arises

Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.

Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun. (Our Cancer Causes and Prevention section has more information).

Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.

In general, cancer cells have more genetic changes, such as mutations in DNA, than normal cells. Some of these changes may have nothing to do with the cancer; they may be the result of the cancer, rather than its cause.

“Drivers” of Cancer

The genetic changes that contribute to cancer tend to affect three main types of genes—proto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.

Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes), allowing cells to grow and survive when they should not.

Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.

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DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes. Together, these mutations may cause the cells to become cancerous.

As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Because of this, cancers are sometimes characterized by the types of genetic alterations that are believed to be driving them, not just by where they develop in the body and how the cancer cells look under the microscope.

When Cancer Spreads

Metastasis; drawing shows primary cancer that has spread from the colon to other parts of the body (the lung and the brain). An inset shows cancer cells spreading from the primary cancer, through the blood and lymph system, to another part of the body where a metastatic tumor has formed.
In metastasis, cancer cells break away from where they first formed (primary cancer), travel through the blood or lymph system, and form new tumors (metastatic tumors) in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor.

A cancer that has spread from the place where it first started to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to and forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.

Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

Treatment may help prolong the lives of some people with metastatic cancer. In general, though, the primary goal of treatments for metastatic cancer is to control the growth of the cancer or to relieve symptoms caused by it. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.  

Tissue Changes that Are Not Cancer

Not every change in the body’s tissues is cancer. Some tissue changes may develop into cancer if they are not treated, however. Here are some examples of tissue changes that are not cancer but, in some cases, are monitored:

Hyperplasia occurs when cells within a tissue divide faster than normal and extra cells build up, or proliferate. However, the cells and the way the tissue is organized look normal under a microscope. Hyperplasia can be caused by several factors or conditions, including chronic irritation.

Dysplasia is a more serious condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form.

Some types of dysplasia may need to be monitored or treated. An example of dysplasia is an abnormal mole (called a dysplastic nevus) that forms on the skin. A dysplastic nevus can turn into melanoma, although most do not.

An even more serious condition is carcinoma in situ. Although it is sometimes called cancer, carcinoma in situ is not cancer because the abnormal cells do not spread beyond the original tissue. That is, they do not invade nearby tissue the way that cancer cells do. But, because some carcinomas in situ may become cancer, they are usually treated.

Drawing of four panels showing how normal cells may become cancer cells. The first panel shows normal cells. The second and third panels show abnormal cell changes called hyperplasia and dysplasia. The fourth panel shows cancer cells.
Normal cells may become cancer cells. Before cancer cells form in tissues of the body, the cells go through abnormal changes called hyperplasia and dysplasia. In hyperplasia, there is an increase in the number of cells in an organ or tissue that appear normal under a microscope. In dysplasia, the cells look abnormal under a microscope but are not cancer. Hyperplasia and dysplasia may or may not become cancer.
Credit: Terese Winslow

Types of Cancer

There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in cells of the lung, and brain cancer starts in cells of the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

You can search NCI’s website for information on specific types of cancer based on the cancer’s location in the body or by using our A to Z List of Cancers. We also have collections of information on childhood cancers and cancers in adolescents and young adults.

Here are some categories of cancers that begin in specific types of cells:


Carcinomas are the most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. There are many types of epithelial cells, which often have a column-like shape when viewed under a microscope.

Carcinomas that begin in different epithelial cell types have specific names:

Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas.

Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin.

Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.

Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.


Soft tissue sarcoma; drawing shows different types of tissue in the body where soft tissue sarcomas form, including the lymph vessels, blood vessels, fat, muscles, tendons, ligaments, cartilage, and nerves.
Soft tissue sarcoma forms in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints.

Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).

Osteosarcoma is the most common cancer of bone. The most common types of soft tissue sarcoma are leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, liposarcoma, and dermatofibrosarcoma protuberans.

Our page on soft tissue sarcoma has more information.


Cancers that begin in the blood-forming tissue of the bone marrow are called leukemias. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to its tissues, control bleeding, or fight infections.  

There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid).


Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.

There are two main types of lymphoma:

Hodgkin lymphoma – People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells.

Non-Hodgkin lymphoma – This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

Our page on lymphoma has more information.

Multiple Myeloma

Multiple myeloma is cancer that begins in plasma cells, another type of immune cell. The abnormal plasma cells, called myeloma cells, build up in the bone marrow and form tumors in bones all through the body. Multiple myeloma is also called plasma cell myeloma and Kahler disease.

Our page on multiple myeloma and other plasma cell neoplasms has more information.


Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.

Our pages on skin cancer and intraocular melanoma have more information.

Brain and Spinal Cord Tumors

There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Our page on brain and spinal cord tumors in adults has more information, as does our overview of brain and spinal cord tumors in children.

Other Types of Tumors

Germ Cell Tumors

Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.

Our page of cancers by body location/system includes a list of germ cell tumors with links to more information.

Neuroendocrine Tumors

Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.

Our definition of neuroendocrine tumors has more information.

Carcinoid Tumors

Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine). Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

Cancer Statistics

Cancer has a major impact on society in the United States and across the world. Cancer statistics describe what happens in large groups of people and provide a picture in time of the burden of cancer on society. Statistics tell us things such as how many people are diagnosed with and die from cancer each year, the number of people who are currently living after a cancer diagnosis, the average age at diagnosis, and the numbers of people who are still alive at a given time after diagnosis. They also tell us about differences among groups defined by age, sex, racial/ethnic group, geographic location, and other categories.

Statistics at a Glance: The Burden of Cancer in the United States

  • In 2016, an estimated 1,685,210 new cases of cancer will be diagnosed in the United States and 595,690 people will die from the disease.
  • The most common cancers in 2016 are projected to be breast cancer, lung and bronchus cancer, prostate cancer, colon and rectum cancer, bladder cancer, melanoma of the skin, non-Hodgkin lymphoma, thyroid cancer, kidney and renal pelvis cancer, leukemia, endometrial cancer, and pancreatic cancer.
  • The number of new cases of cancer (cancer incidence) is 454.8 per 100,000 men and women per year (based on 2008-2012 cases).
  • The number of cancer deaths (cancer mortality) is 171.2 per 100,000 men and women per year (based on 2008-2012 deaths).
  • Cancer mortality is higher among men than women (207.9 per 100,000 men and 145.4 per 100,000 women). It is highest in African American men (261.5 per 100,000) and lowest in Asian/Pacific Islander women (91.2 per 100,000). (Based on 2008-2012 deaths.)
  • The number of people living beyond a cancer diagnosis reached nearly 14.5 million in 2014 and is expected to rise to almost 19 million by 2024.
  • Approximately 39.6% of men and women will be diagnosed with cancer at some point during their lifetimes (based on 2010-2012 data).
  • In 2014, an estimated 15,780 children and adolescents ages 0 to 19 were diagnosed with cancer and 1,960 died of the disease.
  • National expenditures for cancer care in the United States totaled nearly $125 billion in 2010 and could reach $156 billion in 2020.

Powerful Herbal Help to Defeat Cancer

Both human and animal studies have shown evidence for the use of ashwagandha as an anti-cancer herb. Lab and some animal studies show that ashwagandha components slow the growth of many types of cancer cells, including:

  • Breast
  • Central nervous system (CNS)
  • Colon
  • Leukemia
  • Lung
  • Melanoma
  • Prostate
  • Sarcoma

How does it work?

Numerous studies demonstrate that Ashwagandhanda works in multiple ways to help prevent or stop the growth of the often deadly disease of cancer:

  • Antioxidant protection of normal cells against cancer
  • Pro-oxidant attacks against cancer cells
  • Enhances the effects of chemotherapy and radiation against cancer cells
  • Protects normal cells against damage from conventional cancer therapy
  • Effectively stops growth of treatment-resistant cancer cell lines
  • Stops angiogenesis—the creation of new blood vessels that feed cancer and help it grow and spread
  • Binds to and blocks proteins that cancers need to grow
  • Stimulates proteins that help keep normal cells stable

Evidence of Benefit

Out of 13 different constituents in ashwagandha, 10 of them showed anticancer activity against four difference cancer cell lines (lung, colon, breast, and CNS). The potency of the effect was dependent upon the dosage level. Withaferin A, a steroidal constituent of ashwaghanda had the strongest effect against all four—even more than the chemotherapy drug Adriamycin against the breast and colon cancer lines.

Animal studies show ashwagandha can enhance the effects of conventional cancer treatments on cancer while simultaneously protecting healthy cells from negative side effects. For example, in studies involving mice with fibrosarcoma and treatment-resistant melanoma tumors, ashwagandha extracts increased the effectiveness of radiation in killing cancer cells by sensitizing them.

While ashwagandha provides antioxidant protection against oxidative stress produced by tumor cells and some conventional treatments, it in fact increases the susceptibility of cancer tumor cells to oxidative damage from free radicals.

One of the ways that ashwagandha prevents cancer from proliferating and spreading is by interrupting cell division and inhibiting the development of new blood vessels that feed the voracious cancer cells. An animal study modeling lung cancer demonstrated that ashwagandha supported the chemotherapeutic activity of paclitaxel while its antioxidant properties reduced the oxidative stress caused by the tumors.

In pancreatic cancer, one of the most aggressive and deadly types of cancer, lab studies indicate that one of the withaferin A significantly stimulates cell death in a number of pancreatic cancer cell lines. Withaferin A appears to target and limit the activity of a specific protein (Hsp90) that binds with and helps other proteins mature that then stimulate and promote the growth and survival of cancer cells. Lab and animal research (using grafted human pancreatic tumors) shows that it blocks Hsp90’s cancer-promoting activity in at least four different ways. This makes withaferin A different than other known Hsp90 inhibitors and may explain its potency against pancreatic tumors.

Water extracts of ashwagandha leaves, which also contain withaferin A, may offer a treatment option for another particularly deadly cancer—glioma. One of the most prevalent types of brain tumors, there are few conventional treatment options for this aggressive and invasive cancer.

Lab studies show that ashwagandha blocks the growth and metastatic potential of glioma tumors and at high doses kills the tumor cells. Ashwagandha stimulates Hsp70, a heat-shock protein called mortalin. High levels of this protein are found in brain cell mitochondria that helps regulate mitochondria and normal cell functioning, while dysfunctional mitochondria are associated with cancer. Ashwagandha also appeared to stimulate production of two other proteins that help control the growth and spread of glioma tumor cells.

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Studies Prove Ashwagandha Can Treat More than 50 Conditions

A flurry of new research from around the world on Ashwagandha is proving the medicinal effects of this ancient Ayurvedic herbal remedy are more than just anecdotal.

The past year has been banner year for Ashwagandha research. Numerous studies confirmed its healing properties in a variety of conditions, including stress, toxicity, heart disease, Alzheimer’s disease, diabetes, Parkinson’s, skin cancer, tuberculosis, liver toxicity and many others. Following is a summary of some of the findings of the over fifty different human, laboratory and animal studies conducted using Ashwaghanda published during 2012 and early 2013:

  • Research from the Asha Hospital in Hyderbad found, in a study of 64 people with chronic stress, that Ashwagandha supplementation for two months decreased stress by 44% and decreased depression and/or anxiety by 72%.
  • Tokyo University of Technology researchers found that Ashwagandha slows the process of melanocyte stem cell phosphorylation, giving it the potential of blocking skin cancers.
  • Banasthali University researchers found that Ashwagandha may protect the liver against lead toxicity.
  • Jamia Hamdard University researchers found that Ashwagandha reduces oxidative damage related to brain cell damage – making it useful for reducing dementia and Alzheimer’s risk.
  • Eight weeks of Ashwagandha supplementation increased endurance, respiration capacity and metabolic efficiency among cycling athletes, according to research from Guru Nanak Dev University.
  • Research from Texas’ Baylor University found that Ashwagandha reduced inflammation related to type I diabetes.
  • Research from the College of Pharmacy at University of Hawaii performed assays that found that Ashwagandha inhibited cancer-related cytokines.
  • Researchers from the Indian Institute of Technology found that Ashwagandha compounds inhibited proteins involved in Leishmaniasis.
  • Researchers from Jamia Hamdard University’s Pharmacy Faculty found that Ashwagandha reduces oxidative stress related to type 2 diabetes.
  • Researchers from the Defence Institute of Physiology and Allied Sciences found that Ashwagandha supported memory and helped prevent nerve cell degeneration among rats.
  • Colorado State University researchers found that Ashwagandha and other Ayurvedic herbs help protect the heart from oxidative damage.
  • Researchers from Malaysia’s University Sains found that Ashwagandha reduced fatigue and increased general well-being among patients who were undergoing chemotherapy.
  • Researchers from the Chonbuk National University in the Republic of Korea found that Ashwagandha reduced populations of Streptococcus mutans and Streptococcus sobrinus – oral bacteria known to be at primary agents of tooth decay and periodontal disease.
  • Researchers from Pakistan’s Quaid-i-Azam University found that Ashwagandha inhibited cancer cells from growing.
  • Research from India’s National Research Institute of Ayurvedic Drug Development found that Ashwagandha combined with other Ayurvedic herbs reduced symptoms among tuberculosis patients.
  • Researchers from the ICMR Advanced Centre for Reverse Pharmacology in Traditional Medicine found in a 30-day clinical trial among 18 healthy volunteers that 750-1250 milligrams of Ashwagandha per day reduced cholesterol, improved sleep and increased muscle strength.
  • Researchers from Louisiana State University found that Ashwagandha inhibited cancer tumor growth.
  • Researchers from India’s Central Food Technological Research Institute found Ashwagandha was antioxidant and inhibited oxidative brain cell damage and reversing mechanisms related to Parkinson’s disease.
  • Researchers from India’s Central Drug Research Institute found that coagulanolide from Ashwagandha increased glucose tolerance and decreased fasting blood glucose among mice.
  • Research from the Ayurvedic Hospital in Ahmedabad found that Ashwagandha with an herbal combination called Rasayana significantly reduced coughing, fever and other symptoms among tuberculosispatients.
  • Researchers from Malaysia’s Universiti Sains medical school found that Ashwagandha inhibits several pathogenic bacteria, especially Salmonella.
  • Research from India’s Bankura Sammilani Medical College found that Ashwagandha may treat depression.
  • Research from Germany’s University of Tuebingen discovered that Ashwagandha reduces oxidative stress and alters gene expression to help cells with energy production.
  • Researchers from Brooklyn’s Woodhull Medical Center found that Ashwagandha increases circulating cortisol levels and improves insulin sensitivity. This effect was also found for those with adrenal insufficiency issues or even congenital adrenal hyperplasia – a birth defect of the adrenal glands.
  • Studies from South Korea’s Keimyung University found that Ashwagandha inhibits tumor growth and stimulates the killing of renal cancer cells.
  • Research from the University of Pittsburgh Cancer Institute and the University of Pittsburgh School of Medicine found that Ashwagandha inhibits breast cancer cell migration.
  • Researchers from Detroit’s Wayne State University found that Ashwagandha suppresses the growth of mesothelioma, a lung disease most prominently associated with asbestos toxicity.
  • Research from Saudi Arabia’s King Abdulaziz University found that Ashwagandha helps protect the heart and cardiovascular systemfrom oxidative radicals.
  • Research from the University of Delhi College of Medical Sciences found that Ashwagandha may reduce diabetes, and has anti-hyperglycemic properties.
  • Tokushima Bunri University researchers found that Ashwagandha kills Leishmania major cells – making it an effective treatment for Leishmania.
  • Researchers from India’s Cochin University of Science and Technology found that Ashwagandha increased spatial memory and decreasedoxidative brain stress among rats.
  • Human clinical studies from India’s Banaras Hindu University found that Ashwagandha significantly reduced type 2 diabetes symptoms.
  • Research from Guru Nanak Dev University found that Ashwagandha reduces nerve cell death from oxidative damage.
  • Researchers from South Korea’s Kyungpook National University found that Ashwagandha reduces inflammation and cell adhesion moleculesamong blood vessels.
  • R.K.D.F. College of Pharmacy researchers found that Ashwagandha may effectively treat obsessive compulsive disorder.
  • Research from Panjab University found that Ashwagandha inhibits pro-inflammatory cytokines and reactive oxygen species within the bloodstream.
  • Researchers from Egypt’s National Center for Radiation Research and Technology found that Ashwagandha helps protect against radiation exposure.
  • Research from India’s National Brain Research Center found that Ashwagandha reduces beta-amyloid peptides within the brain – making it protective against Alzheimer’s disease.
  • Scientists from the Indian Institute of Technology found further evidence of Ashwagandha’s neuroprotective effects, in its ability to withanolide A to inhibit acetylcholinesterase.
  • Research from the Council of Scientific and Industrial Research Center found that Ashwagandha significantly stimulates the immune system.







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