Hallmarks of Cancer

A guide to the traits that define tumor development

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Sustaining proliferative signaling

Genome instability and mutation

Avoiding immune destruction

Tumor-promoting inflammation

Inducing angiogenesis

Resisting cell death

Enabling replicative immortality

Reprogramming energy metabolism

Evading growth suppressors

Activating invasion and metastasis

The 10 Key Traits of Cancer

What is it?

Over decades of research, scientists have identified 10 key traits that most cancers share. They help explain how cancer begins, grows, survives, and spreads.

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Understanding these traits gives insight into how cancer works and how treatments can target it.

Sustaining proliferative signaling

Cancer cells

Normal cells

Only divide when they receive external signals (like growth factors) from the body.

Don’t wait for external signals. They make their own or keep growth signals permanently “switched on.”

Evading growth suppressors

Cancer cells

Normal cells

Use proteins like p53 or Rb as brakes that stop division when it’s unsafe or unnecessary.

Ignore or disable these growth-stopping mechanisms, allowing uncontrolled cell division.

Resisting cell death

Cancer cells

Normal cells

Undergo apoptosis (programmed cell death) if damaged or no longer needed.

Ignore death signals and keep dividing, even when damaged. They may also switch off the genes that trigger apoptosis.

Enabling replicative immortality

Cancer cells

Normal cells

Can only divide a limited number of times.

Their telomeres (chromosome ends) shorten with each division.

Activate telomerase, an enzyme that rebuilds telomeres, allowing endless cell division.

Inducing angiogenesis

Cancer cells

Normal cells

Only signal for new blood vessels when needed, like during wound healing.

Release signals that force the body to grow new blood vessels to feed the tumor.

Activating invasion and metastasis

Cancer cells

Normal cells

Stay in their original tissue. Strong cell-to-cell connections keep them in place.

Break away, invade nearby tissue, and travel through the body to form new tumors.

Reprogramming energy metabolism

Cancer cells

Normal cells

Use aerobic respiration in the mitochondria to make energy efficiently (ATP).

Prefer glycolysis — a less efficient process that helps them grow quickly by creating building blocks for new cells.

Avoiding immune destruction

Cancer cells

Normal cells

Abnormal or infected cells are detected and destroyed by the immune system.

Develop ways to hide from the immune system by suppressing danger signals or disabling immune cells.

Genome instability and mutation

Cancer cells

Normal cells

Have strict systems that check and repair DNA to keep the genome stable.

Lose these repair systems, leading to mutations that help them evolve and survive.

Tumor-promoting inflammation

Cancer cells

Normal cells

Inflammation is a temporary response to injury or infection and stops once healing is complete.

Use chronic (long-term) inflammation to access growth signals and attract blood vessels, supporting tumor growth.

Sustaining proliferative signaling

Read about the newer hallmarks proposed in 2022.

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Choose two to highlight:

• List their names
• Briefly explain one in your own words
• Describe how it helps cancer grow or spread

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