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How can the role of epigenetics in cancer be reconciled with the idea that cancer is...

How can the role of epigenetics in cancer be reconciled with the idea that cancer is caused by the accumulation of mutations in tumor-suppressor genes and proto-oncogenes?

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Besides the alteration of nucleotide sequences, the other factor that alters the cellular activity is the expression of genes. Altered gene expression changes the protein synthesis (may become hyper or hypo). The expression of genes is influenced by the surrounding environments (nature). For example, the conversion of the proto-oncogenes to oncogenes. The epigenetic changes of genes such as DNA methylation also affect the gene expression levels and thus, the RNA synthesis also.

Epigenetic changes in tumour suppressor genes such as hypermethylation turns them inactive and increase the occurrence of mutations. Similarly, the epigenetic changes can also turn the proto-oncogenes to oncogenes (by hypomethylation). These changes contribute to the occurrence of cancer.

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