Modification of expression of the malignant phenotype in radiation-initiated cells

Carcinogenesis is a multistage process consisting minimally of initiation and promotion/progression stages. Radiation and many environmental xenobiotics are potent initiating agents. We have shown that initiation of carcinogenesis in vivo by these agents is a common cellular event. In the irradiated thyroid (5 Gy) at least one in 20 cells is initiated. Initiation by both radiation and chemicals has also been shown to be a common cellular event in the mammary gland. Initiation therefore is most likely not the sole rate-limiting event in the carcinogenic process. The propensity of the initiated cell to express the malignant phenotype is modulated by many factors, including environmental chemicals and physiological and genetic factors. Scopal and abscopal physiological factors can either enhance or suppress the progression of initiated cells to a frank tumour. For example, prolactin enhances the rate of progression of radiation and chemically initiated mammary tumours while glucocorticoids suppress this progression. TSH enhances the progression of radiation-initiated thyroid tumours while a scopal factor associated with unirradiated thyroid cells suppresses progression of this tumour type.