Quote from: Vagiña on January 10, 2016, 03:50:36 PM

Quote from: Rylo Ren on January 10, 2016, 03:37:41 PM

this poem paints imagery in my head that is borderline pornographic

pls tag nsfw

For questions or comments, please contact:

        Nabajyoti ("Naba") Barkakati, Ph.D.
         Chief Technologist and Co-Director
            Phone: 202-512-4499
          Email: BarkakatiN@gao.gov

I called that number and got yelled at by an angry southern lady

I'm suing you for emotional trauma.

this poem paints imagery in my head that is borderline pornographic

pls tag nsfw

Vagina convinces isaacisdead to snuggle with him.

If you actually noticed this as a little kid while watching pokemon, chances are that you're fucking autistic.

Quote from: Vagiña on January 10, 2016, 12:49:29 PM

Quote from: isisaacdead on January 10, 2016, 05:49:10 AM

Quote from: SecondClass on January 10, 2016, 03:54:10 AM

what is it about tumblr posts that make people want others to kill them so much

Probably the fact that they stART TYPING ALL CAPS IN THE MIDDLE OF A WORD.

o h,my fuCKING GOD this SITE IM DONE #SCREAMING

did you just

call o fduty

Quote from: Vagiña on January 09, 2016, 07:33:10 PM

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Nigger
From Wikipedia, the free encyclopedia
  (Redirected from Niggers)
This article is about the word and its history. For the colloquial variant, see nigga. For other uses, see Nigger (disambiguation).

1885 illustration from Mark Twain's Adventures of Huckleberry Finn, captioned "Misto Bradish's nigger"
In the English language, the word "nigger" is an ethnic slur, usually directed at black people. The word originated as a neutral term referring to people with black skin,[1] as a variation of the Spanish and Portuguese noun negro, a descendant of the Latin adjective niger ("black").[2] It was often used disparagingly, and by the mid-twentieth century, particularly in the United States, its usage became unambiguously pejorative, a racist insult. Accordingly, it began to disappear from popular culture, and its continued inclusion in classic works of literature has sparked controversy.

In the contemporary United States and United Kingdom, using the word is taboo, and it is often replaced with the euphemism "the N-word". The variant "Nigga" is sometimes used among African Americans in a non-derogatory sense.

Contents  [hide]
1   Etymology and history
2   Usages
2.1   British
2.2   North American
2.2.1   Cultural
2.2.2   Political
2.2.3   Sport
2.2.4   Nature
2.3   Denotational extension
2.4   Other languages
2.5   Literary
2.6   Popular culture
2.6.1   Cinema
2.6.2   Literature
2.6.3   Music
2.6.4   Theatre
2.6.5   Comedy
2.6.6   Translations
2.6.6.1   "Nigger-brown" colored furniture
2.6.6.2   "Nigger brown" pants
2.7   Derivations
2.7.1   Place names
3   Derivatives
3.1   The N-word euphemism
3.2   Homophones
3.3   Intragroup versus intergroup usage
4   See also
5   Footnotes
6   References
7   External links
Etymology and history
Main article: Negro
The variants neger and negar, derive from the Spanish and Portuguese word negro (black), and from the now-pejorative French nègre (negro). Etymologically, negro, noir, nègre, and nigger ultimately derive from nigrum, the stem of the Latin niger (black) (pronounced [ˈniɡer] which, in every other grammatical case, grammatical gender, and grammatical number besides nominative masculine singular, is nigr-, the r is trilled).

In the Colonial America of 1619, John Rolfe used negars in describing the African slaves shipped to the Virginia colony.[3] Later American English spellings, neger and neggar, prevailed in a northern colony, New York under the Dutch, and in metropolitan Philadelphia's Moravian and Pennsylvania Dutch communities; the African Burial Ground in New York City originally was known by the Dutch name "Begraafplaats van de Neger" (Cemetery of the Negro); an early US occurrence of neger in Rhode Island, dates from 1625.[4] An alternative word for African Americans was the English word, "Black", used by Thomas Jefferson in his Notes on the State of Virginia. Among Anglophones, the word nigger was not always considered derogatory, because it then denoted "black-skinned", a common Anglophone usage.[5] Nineteenth-century English (language) literature features usages of nigger without racist connotation, e.g. the Joseph Conrad novella The Nigger of the 'Narcissus' (1897). Moreover, Charles Dickens and Mark Twain created characters who used the word as contemporary usage. Twain, in the autobiographic book Life on the Mississippi (1883), used the term within quotes, indicating reported usage, but used the term "negro" when speaking in his own narrative persona.[6]

During the fur trade of the early 1800s to the late 1840s in the Western United States, the word was spelled "niggur", and is often recorded in literature of the time. George Fredrick Ruxton often included the word as part of the "mountain man" lexicon, and did not indicate that the word was pejorative at the time. "Niggur" was evidently similar to the modern use of dude, or guy. This passage from Ruxton's Life in the Far West illustrates a common use of the word in spoken form—the speaker here referring to himself: "Travler, marm, this niggur's no travler; I ar' a trapper, marm, a mountain-man, wagh!"[7] It was not used as a term exclusively for blacks among mountain men during this period, as Indians, Mexicans, and Frenchmen and Anglos alike could be a "niggur".[8] Linguistically, in developing American English, in the early editions of A Compendious Dictionary of the English Language (1806), lexicographer Noah Webster suggested the neger new spelling in place of negro.[9]

By the 1900s, nigger had become a pejorative word. In its stead, the term colored became the mainstream alternative to negro and its derived terms. Abolitionists in Boston, Massachusetts, posted warnings to the Colored People of Boston and vicinity. Writing in 1904, journalist Clifton Johnson documented the "opprobrious" character of the word nigger, emphasizing that it was chosen in the South precisely because it was more offensive than "colored."[10] Established as mainstream American English usage, the word colored features in the organizational title of the National Association for the Advancement of Colored People, reflecting the members' racial identity preference at the 1909 foundation. In the Southern United States, the local American English dialect changes the pronunciation of negro to nigra.

By the late 1960s, the social change achieved by groups in the United States such as the Civil Rights Movement (1955–68), had legitimized the racial identity word black as mainstream American English usage to denote black-skinned Americans of African ancestry. In the 1990s, "Black" was displaced in favor of the compound blanket term African American. Moreover, as a compound word, African American resembles the vogue word Afro-American, an early-1970s popular usage. Currently, some black Americans continue to use the word nigger, often spelled as nigga and niggah, without irony, either to neutralize the word's impact or as a sign of solidarity.[11]

Usages
British
In the United Kingdom and the Anglophone world, nigger denoted the dark-skinned (non-white) African and Asian (i.e., from India or nearby) peoples colonized into the British Empire, and "dark-skinned foreigners" in general.

In A Dictionary of Modern English Usage (1926), H. W. Fowler states that applying the word nigger to "others than full or partial negroes" is "felt as an insult by the person described, & betrays in the speaker, if not deliberate insolence, at least a very arrogant inhumanity"; but the second edition (1965) states: "N. has been described as 'the term that carries with it all the obloquy and contempt and rejection which whites have inflicted on blacks.'".

Victorian writer Rudyard Kipling used it in 'How the Leopard Got His Spots' and 'A Counting-Out Song' to illustrate the usage of the day. Likewise, P. G. Wodehouse used the phrase "Nigger minstrels" in Thank You, Jeeves (1934), the first Jeeves–Bertie novel, in admiration of their artistry and musical tradition. See also below under "Literary".

As recently as the 1950s, it may have been acceptable British usage to say niggers when referring to black people, notable in mainstream usages such as Nigger Boy brand candy cigarettes,[12] and the color nigger brown or simply nigger (dark brown);[13] however, by the 1970s the term was generally regarded as racist, offensive and potentially illegal along with "nig-nog", and "golliwog". Agatha Christie's book Ten Little Niggers was first published in London in 1939 and continued to appear under that title until the early 1980s, when it became And Then There Were None.[14][15]

North American
Cultural
Addressing the use of nigger by black people, Cornel West said in 2007, "There's a certain rhythmic seduction to the word. If you speak in a sentence, and you have to say cat, companion, or friend, as opposed to nigger, then the rhythmic presentation is off. That rhythmic language is a form of historical memory for black people... When Richard Pryor came back from Africa, and decided to stop using the word onstage, he would sometimes start to slip up, because he was so used to speaking that way. It was the right word at the moment to keep the rhythm together in his sentence making."[16]

Contemporarily, the implied racism of the word nigger has rendered its usages social taboo. In the United States, magazines and newspapers often do not use it but instead print "family-friendly", censored versions, usually "n*gg*r", "n**ger", "n——", and "the N-word";[17] however, historians and social activists, such as Dick Gregory, criticize the euphemisms and their usage as intellectually dishonest because using the euphemism "the N-word" instead of nigger robs younger generations of Americans of the full history of black people in America.[citation needed]

Political

Historical American cartoon titled "Why the nigger is not fit to vote", by Thomas Nast, arguing that the reason Democrats objected to African-Americans having the vote, was that in the 1868 US presidential election African-Americans voted for the Republican candidates Ulysses S. Grant and Schuyler Colfax. "Seymour friends meet here" in the background is a reference to the Democratic Party candidate: Horatio Seymour.
In explaining his refusal to be conscripted to fight the Vietnam War (1965–75), professional boxer Muhammad Ali said, "No Vietcong ever called me nigger";[18] later, his modified answer was the title No Vietnamese Ever Called Me Nigger (1968) of a documentary about the front-line lot of the U.S. Army Black soldier in combat in Vietnam.[19] An Ali biographer reports that, when interviewed by Robert Lipsyte in 1966, the boxer actually said, "I ain't got no quarrel with them Viet Cong".[20] The word can be invoked politically for effect. When Detroit mayor Kwame Kilpatrick came under intense scrutiny for his personal conduct in 2008, he deviated from an address to city council, saying, "In the past 30 days, I've been called a nigger more than any time in my entire life." Opponents accused him of "playing the Race Card" to save his political life.[21]

On February 28, 2007, the New York City Council symbolically banned, with a formal resolution, the use of the word nigger; however, there is no penalty for using it. The New York City resolution also requests excluding from Grammy Award consideration every song whose lyrics contain the word nigger, however Ron Roecker, vice president of communication for the Recording Academy doubts that it will have any effect on actual nominations.[22][23]

Sport
In the first half of the twentieth century, before Major League Baseball was racially integrated, dark-skinned and dark-complexion players were nicknamed Nig;[24][25] examples are: Johnny Beazley (1941–49), Joe Berry (1921–22), Bobby Bragan (1940–48), Nig Clarke (1905–20), Nig Cuppy (1892–1901), Nig Fuller (1902), Johnny Grabowski (1923–31), Nig Lipscomb (1937), Charlie Niebergall (1921–24), Nig Perrine (1907), and Frank Smith (1904–15). The 1930s movie The Bowery with George Raft and Wallace Beery includes a sports-bar in New York City named "Nigger Joe's".

Nature
In some parts of the U.S., including the Midwest, Brazil nuts are known (decreasingly commonly) as "nigger toes".[26] Similarly, some cormorants have been known in the past as "nigger geese".[27]

Denotational extension
The denotations of nigger also comprehend non-black/non-white and other disadvantaged people; the U.S. politician Ron Dellums said, "... it's time for somebody to lead all of America's niggers".[28] Jerry Farber's 1967 protest, The Student as Nigger invoked the word as a metaphor for the victims of an authoritarian society. In 1969, in the UK, in the course of being interviewed by a Nova magazine reporter, artist Yoko Ono said, "... woman is the nigger of the world"; three years later, her husband, John Lennon, published the song "Woman Is the Nigger of the World" (1972)—about the worldwide phenomenon of discrimination against women–which was socially and politically controversial to US sensibilities. In 1978 singer Patti Smith used the word in "Rock N Roll Nigger". In 1979 singer Elvis Costello used the phrase white nigger in "Oliver's Army", a song describing the experiences of working-class soldiers in the British military forces on the "murder mile" (a term used to describe Belfast during The Troubles), where white nigger was a common British pejorative for Irish Catholics. Later, the producers of the British talent show Stars in Their Eyes forced a contestant to censor one of its lines, changing "... all it takes is one itchy trigger – One more widow, one less white nigger" to "... one less white figure". In his autobiography White Niggers of America: The Precocious Autobiography of a Quebec "Terrorist" (1968), Pierre Vallières, a Front de libération du Québec leader refers to the oppression of the Québécois people in North America.

In his memoir, All Souls, Michael Patrick MacDonald describes how many white residents of the Old Colony housing project in South Boston used this meaning to degrade the people considered to be of lower status, whether white or black.[29]

Of course, no one considered himself a nigger. It was always something you called someone who could be considered anything less than you. I soon found out there were a few black families living in Old Colony. They'd lived there for years and everyone said that they were okay, that they weren't niggers but just black. It felt good to all of us to not be as bad as the hopeless people in D Street or, God forbid, the ones in Columbia Point, who were both black and niggers. But now I was jealous of the kids in Old Harbor Project down the road, which seemed like a step up from Old Colony...

Other languages
Many other languages have words that sound the same as 'nigger' (are homophonic), but do not mean the same, and have ethnic slurs dissimilar to 'nigger' but meaning the same.

Some examples of how other languages refer to a black person in a neutral and in a pejorative way:

Dutch: neger is neutral, zwartje (little black one) can be amicably or offensively used, nikker is always pejorative[30]
Brazilian Portuguese: negro and preto are neutral,[31] nevertheless preto can be offensively used, is sometimes regarded as 'politically incorrect' and almost never proudly used by Afro-Brazilians, crioulo and macaco are always extremely pejorative[32]
Haitian Creole: nèg is used for any man in general, regardless of skin color (like "guy" in American English) although it is derived from French nègre, which is used pejoratively.
Literary
Historically, nigger is controversial in literature because of its usage as both a racist insult and a common noun. The white photographer and writer, Carl Van Vechten, a supporter of the Harlem Renaissance (1920s–30s), provoked controversy in the black community with the title of his novel Nigger Heaven (1926), of the controversy, Langston Hughes wrote:

No book could possibly be as bad as Nigger Heaven has been painted. And no book has ever been better advertised by those who wished to damn it. Because it was declared obscene, everybody wanted to read it, and I'll venture to say that more Negroes bought it than ever purchased a book by a Negro author. Then, as now, the use of the word nigger by a white was a flashpoint for debates about the relationship between black culture and its white patrons.

In the US, the recurrent reading curricula controversy about the vocabulary of the novel Adventures of Huckleberry Finn (1885) by Mark Twain about the slave South, risks censorship because of 215 (counted) occurrences of the word nigger, most refer to Jim, Huckleberry's escaped-slave raft-mate.[33][34] Twain's advocates note that the novel is composed in then-contemporary vernacular usage, not racist stereotype, because Jim, the black man, is a sympathetic character in the nineteenth-century Adventures of Huckleberry Finn. The book was re-published in 2010 with edits removing "the 'N' word" as reported in Time online.[35] The Adventures of Huckleberry Finn has been the subject of controversy in Arizona, where a parent group's attempt to have it removed from a required reading list was struck down by the court.

Moreover, unlike the literary escaped slave Jim, antebellum slaves used the artifice of self-deprecation (known as "Uncle Toms"), in pandering to societal racist assumptions about the black man's low intelligence, by advantageously using the word nigger to escape the violence inherent to slavery.[36] Implicit to "Uncle Tomming" was the unspoken reminder to white folk that a presumably inferior and sub-human person could not, reasonably, be held responsible for poorly realized work, a kitchen fire, or any such catastrophic offense. The artificial self-deprecation deflected responsibility, in hope of escaping the violent wraths of overseer and master. Using nigger as a self-referential identity term also was a way of avoiding white suspicion, of encountering an intelligent slave, and so put whites at their ease. In context, a slave who referred to himself, or another black man, as a nigger presumed the master's perceiving him as a slave who has accepted his societally sub-ordinate role as private property, thus, not (potentially) subversive of the authority of the master's white supremacy.

Other late-nineteenth- and early twentieth-century British literary usages suggest neutral usage. The popular Victorian era entertainment, the Gilbert and Sullivan operetta The Mikado (1885) twice uses the word nigger. In the song As some day it may happen, the executioner, Ko-ko, sings of executing the "nigger serenader and the others of his race", personified by black-faced singers singing minstrel songs. In the song A more humane Mikado, the Mikado sings of the punishment for older women who dye their hair or wear corsets, to be "Blacked like a nigger/With permanent walnut juice." Both lyrics are usually changed for modern performances.[37]

In Joseph Conrad's The Nigger of the 'Narcissus' (1897) the main character is a black man from the West Indies; the book was published in America as The Children of the Sea. Ten Little Niggers (1939) was the original British title of Agatha Christie's novel And Then There Were None, which has also been known by the alternative title Ten Little Indians. The word is used in some of the Swallows and Amazons series (1930s) of children's books by Arthur Ransome, e.g. "Look like niggers to me" in The Big Six.

The Reverend W. V. Awdry's The Railway Series (1945–72) story Henry's Sneeze, originally described soot-covered boys with the phrase "as black as niggers".[38] In 1972, after complaints, the description was edited to "as black as soot", in the subsequent editions.[38] Rev. Awdry is known for Thomas the Tank Engine (1946).

How the Leopard Got His Spots, in Just So Stories (1902), by Rudyard Kipling, tells of an Ethiopian man and a leopard, both originally sand-colored, deciding to camouflage themselves with painted spots, for hunting in tropical forest. The story originally included a scene wherein the leopard (now spotted) asks the Ethiopian man why he does not want spots. In contemporary editions of How the Leopard Got His Spots, the Ethiopian's original reply: "Oh, plain black's best for a nigger", has been edited to, "Oh, plain black's best for me." Again, Kipling uses the word in A Counting-Out Song (Land and Sea Tales for Scouts and Guides, 1923), the rhyme reads: "Eenie Meenie Mainee, Mo! Catch a nigger by the toe!"

In short story, The Basement Room (1935), by Graham Greene, the (sympathetic) servant character, Baines, tells the admiring boy, son of his employer, of his African British colony service, "You wouldn't believe it now, but I've had forty niggers under me, doing what I told them to". Replying to the boy's question: "Did you ever shoot a nigger?" Bains answers: "I never had any call to shoot. Of course I carried a gun. But you didn't need to treat them bad, that just made them stupid. Why, I loved some of those dammed niggers." The cinematic version of The Basement Room short story, The Fallen Idol (1948), directed by Carol Reed, replaced novelist Greene's niggers usage with natives.[citation needed] Flannery O'Connor's 1955 short story uses a black lawn jockey as a representative symbol in The Artificial Nigger.

Popular culture

Poster for "Nigger Hair" tobacco, later known as "Bigger Hair"
In the US and the UK, the word nigger featured in branding and packaging consumer products, e.g. "Nigger Hair Tobacco" and "Niggerhead Oysters", Brazil nuts were called nigger toes, et cetera. As the term became less acceptable in mainstream culture, the tobacco brand became "Bigger Hair" and the canned goods brand became "Negro Head".[39][40][41]

Cinema
The movie Blazing Saddles (1974) used nigger to ridicule US racism.[citation needed] In The Kentucky Fried Movie (1977), the sequence titled "Danger Seekers" features a stuntman effecting the dangerous stunt of shouting "Niggers!" at a group of black people, then fleeing when they chased him.

The movie Full Metal Jacket (1987) depicts black and white U.S. Marines enduring boot camp and later fighting together in Vietnam. "Nigger" is used by soldiers of both races in jokes and as expressions of bravado ("put a nigger behind the trigger", says the black Corporal "Eightball"), with racial differences among the men seen as secondary to their shared exposure to the dangers of combat: Gunnery Sergeant Hartman (R. Lee Ermey) says, "There is no racial bigotry here. I do not look down on niggers, kikes, wops or greasers. Here you are all equally worthless."

Gayniggers From Outer Space (1992) features black homosexual male aliens who commit gendercide to free the men of Earth from female oppression.

Die Hard with a Vengeance (1995) featured a scene where villain Simon Peter Gruber (Jeremy Irons) required New York City Police Department Lt. John McClane (Bruce Willis) to wear a sandwich board reading "I hate niggers" while standing on a street corner in predominantly-black Harlem, resulting in McClane meeting Zeus Carver (Samuel L. Jackson) as Carver rescued McClane from being attacked by neighborhood toughs.

Nigger was the name given to a black Labrador dog that belonged to British Royal Air Force Wing Commander Guy Gibson during World War II.[42] In 1943, Gibson led the successful Operation Chastise attack on dams in Germany. The dog's name was used as a single codeword whose transmission conveyed that the Möhne dam had been breached. In the 1955 film The Dam Busters about the raid, the dog was portrayed in several scenes; his name and the codeword were mentioned several times. Some of the scenes in which the dog's name is uttered were later shown in the 1982 film Pink Floyd – The Wall.[43]

In 1999, the British television network ITV broadcast a censored version with each of the twelve[44] utterances of Nigger deleted. Replying to complaints against its censorship, ITV blamed the regional broadcaster, London Weekend Television, which, in turn, blamed a junior employee as the unauthorised censor. In June 2001, when ITV re-broadcast the censored version of The Dam Busters, the Index on Censorship criticised it as "unnecessary and ridiculous" censorship breaking the continuity of the film and the story.[45] In January 2012 the film was shown uncensored on ITV4, but with a warning at the start that the film contained racial terms from the historical period which some people could find offensive. Versions of the film edited for US television have the dog's name altered to "Trigger".[44]

In a remake of The Dam Busters by Peter Jackson announced in 2008, Stephen Fry, the writer of the screenplay, said there was "no question in America that you could ever have a dog called the N-word". In the remake the dog's name is "Digger".[46]

American director Quentin Tarantino has been criticized by some critics for the heavy usage of the word nigger in his movies, especially in Jackie Brown, where the word is used 38 times[47] and Django Unchained, used 110 times.[48]

Literature
In 1897, Joseph Conrad penned a novella titled The Nigger of the 'Narcissus', whose titular character, James Wait, is a West Indian black sailor on board the merchant ship Narcissus sailing from Bombay to London. In the United States, the novel was first published with the title The Children of the Sea: A Tale of the Forecastle, at the insistence by the publisher, Dodd, Mead and Company, that no one would buy or read a book with the word nigger in its title,[49] not because the word was deemed offensive but that a book about a black man would not sell.[50] In 2009, WordBridge Publishing published a new edition titled The N-Word of the Narcissus, which also excised the word nigger from the text. According to the publisher, the point was to get rid of the offensive word, which may have led readers to avoid the book, and make it more accessible.[51] Though praised in some quarters, many others denounced the change as censorship. The author Carl Van Vechten took the opposite view to Conrad's publishers when he advised the British novelist Ronald Firbank to change the title of his 1924 novel Sorrow in Sunlight to Prancing Nigger for the American market,[52] and it became very successful there under that title.[53]

Mark Twain's novel Adventures of Huckleberry Finn has long been the subject of controversy for its racial content, including its use of the word "nigger" as applied to the escaped slave character Jim. Huckleberry Finn was the fifth most challenged book during the 1990s, according to the American Library Association.[54] In 2011, a new edition of the book published by NewSouth Books replaced the word "nigger" throughout the book with the word "slave" and also removed the word "injun". The change was spearheaded by Twain scholar Alan Gribben in the hope of "countering the 'pre-emptive censorship'" that results from the book's being removed from school curricula over language concerns.[55] The changes sparked outrage from critics and scholars.[56]

Music
The Bohemian composer Antonín Dvořák wrote the String Quartet No. 12 in 1893 during his time in the United States. For its presumed association with African-American music, the quartet was referred to until the 1950s with nicknames such as Negro Quartet and Nigger Quartet before being called the American Quartet.

Responding to accusations of racism after referring to "niggers" in the lyrics of the Guns N' Roses song, "One in a Million", Axl Rose stated "I was pissed off about some black people that were trying to rob me. I wanted to insult those particular black people. I didn't want to support racism."[57]

The folk song Oh! Susanna by Stephen Foster had originally been written in four verses. The second verse describes an industrial accident which "kill’d five hundred Nigger" by electrocution.

The country music artist David Allan Coe used the racial terms "redneck", "white trash", and "nigger" in the songs "If That Ain't Country, I'll Kiss Your Ass" and "Nigger Fucker".[58] In the 1960s, record producer J. D. "Jay" Miller published pro-racial segregation music with the "Reb Rebel" label featuring racist songs by Johnny Rebel and others, demeaning black Americans and the Civil Rights movement.[59]

The punk band the Dead Kennedys used the word in their song Holiday in Cambodia in the line, Bragging that you know how the niggers feel cold and the slum's got so much soul. The context of the line is a section mocking champagne socialists.

Contemporarily, rap groups such as N.W.A (Niggaz with Attitudes), re-popularized the usage in their songs. One of the earliest uses of the word in hip hop was in the song "New York New York" by Grandmaster Flash and the Furious Five in 1983.

The term white nigger is also used in music, most notably in Elvis Costello's song Oliver's Army.

Theatre
The musical Show Boat (from 1927 until 1946) features the word "nigger" as originally integral to the lyrics of "Ol' Man River" and "Cotton Blossom"; although deleted from the cinema versions, it is included in the 1988 EMI recording of the original score. Musical theatre historian Miles Kreuger and conductor John McGlinn propose that the word was not an insult, but a blunt illustration of how white people then perceived black people.

Comedy
Some comedians have broached the subject, almost invariably in the form of social commentary. This was perhaps most famously done by stand-up comedian Chris Rock in his Niggas vs. Black People routine.

Translations
"Nigger" or "nigger brown" were used in Britain as standard colour names, in the same way as "lime green". This may have been included in some language translation sources.

"Nigger-brown" colored furniture
In April 2007, a dark brown leather sofa set, sold by Vanaik Furniture and Mattress Store in Toronto, Canada, was labelled as "Nigger-brown" color. Investigation determined that the Chinese manufacturer used an outdated version of Kingsoft's Chinese-to-English translation software for writing the tags; it translated the Chinese "dark-brown" characters to "Nigger-brown", and neither the Canadian supplier nor the store owner had noticed the incorrectly translated tag; subsequently, Kingsoft corrected its translation software.[60][61][62][63]

"Nigger brown" pants
In 2012, a typosquatting website called abercrombie-and-fitchoutlet.com, purporting to be of the clothing branch Abercrombie & Fitch and based in China, offered "nigger brown pants" for sale as the result of a faulty Chinese-to-English translator. This went viral on social media after people mistakenly believed that Abercrombie & Fitch were selling the product.[64] A similar translation mistake was made in 2014, involving a Chinese typosquatting counterfeit site purporting to be the clothing branch Ralph Lauren.[65]

Derivations

Anti-abolitionist cartoon from the 1860 presidential campaign illustrating colloquial usage of "Nigger in the woodpile"

Graffiti in Palestine referring to Arabs as "sand niggers"
Nigger as "defect" (a hidden problem), derives from "nigger in the woodpile", a US slave-era phrase denoting escaped slaves hiding in train-transported woodpiles.[5]
In American English: nigger lover initially applied to abolitionists, then to white people sympathetic towards black Americans.[66]
Sand nigger, an ethnic slur against Arabs, and timber nigger and prairie nigger, ethnic slurs against Native Americans, are examples of the racist extension of nigger upon other non-white peoples.[67]
In several English-speaking countries, "Niggerhead" or "nigger head" was used as a name for many sorts of things, including commercial products, places, plants, and animals, as well as a colloquial technical term in industry, mining, and seafaring.
In the Victorian era, the 1840s Morning Chronicle newspaper report series London Labour and the London Poor, by Henry Mayhew, records the usages of both nigger and its false cognate niggard denoting a false bottom for a grate.[68]
Flora and fauna nomenclatures include the word nigger. The Arizonan nigger-head cactus, Echinocactus polycephalus is a round, cabbage-sized plant covered with large, crooked thorns. The colloquial names for echinacea (coneflower) are "Kansas niggerhead" and "Wild niggerhead". In Oceania, the "niggerhead termite" (Nasutitermes graveolus) is a native of Australia.[69]
During the Spanish–American War US Army General John J. Pershing's original nickname, Nigger Jack, given to him as an instructor at West Point because of his service with "Buffalo Soldier" units, was euphemized to Black Jack by reporters.[70][71]
In 1960, a stand at the stadium in Toowoomba, Australia, was named the "E. S. 'Nigger' Brown Stand" honoring 1920s rugby league player Edwin Brown, so nicknamed since early life because of his pale white skin; so known all his life, his tombstone is engraved Nigger. Stephen Hagan, a lecturer at the Kumbari/Ngurpai Lag Higher Education Center of the University of Southern Queensland, sued the Toowoomba council over the use of nigger in the stand's name; the district and state courts dismissed his lawsuit. He appealed to the High Court of Australia, who ruled the naming matter beyond federal jurisdiction. At first some local Aborigines did not share Mr Hagan's opposition to nigger.[72] Hagan appealed to the United Nations, winning a committee recommendation to the Australian federal government, that it force the Queensland state government to remove the word nigger from the "E. S. 'Nigger' Brown Stand" name. The Australian federal government followed the High Court's jurisdiction ruling. In September 2008, the stand was demolished. The Queensland Sports Minister, Judy Spence, said that using nigger would be unacceptable, for the stand or on any commemorative plaque. The 2005 book The N Word: One Man's Stand by Hagan includes this episode.[72][73]
Place names
The word nigger features in official place-names, such as "Nigger Bill Canyon", "Nigger Hollow", and "Niggertown Marsh". In 1967, the United States Board on Geographic Names changed the word nigger to Negro in 143 place names. First changed to "Negrohead Mountain", a peak above Santa Monica, California was renamed on (February 2010) to Ballard Mountain in honor of John Ballard, a black pioneer who settled the area in the nineteenth century. "Nigger Head Mountain", at Burnet, Texas, was so named because the forest atop it resembled a black man's hair. In 1966, the US first lady, Lady Bird Johnson, denounced the racist name, asking the U.S. Board on Geographic Names and the U.S. Forest Service to rename it, becoming "Colored Mountain" in 1968; and in West Texas, "Dead Nigger Creek" was renamed "Dead Negro Draw".[74] "Nigger Nate Grade", near Temecula, California, named for Nate Harrison, an ex-slave and settler, was renamed "Nathan Harrison Grade Road" in 1955, at the request of the NAACP.[75][76][77][78][79]

In northwestern North America, particularly in Canada and the US, there are places which feature many uses of the word nigger.[80][81][82][83] At Penticton, British Columbia, Canada, "Niggertoe Mountain" was renamed Mount Nkwala. The place-name derived from a 1908 Christmas story about three black men who died in a blizzard; the next day, the bodies of two were found at the foot of the mountain.[84] A point on the Lower Mississippi River, in West Baton Rouge Parish, named "Free Nigger Point" until the late twentieth century, first was renamed "Free Negro Point", but currently is named "Wilkinson Point".[85] "Nigger Head Rock", protruding from a cliff above Highway 421, north of Pennington Gap, Virginia, was renamed "Great Stone Face" in the 1970s.

Derivatives
The N-word euphemism
Notable usage[86]
The prosecutor [Christopher Darden], his voice trembling, added that the "N-word" was so vile that he would not utter it. "It's the filthiest, dirtiest, nastiest word in the English language."

“”
— Kenneth B. Noble, January 14, 1995 The New York Times[87]
The euphemism the N-word became mainstream American English usage during the racially contentious murder trial of ex-football player O. J. Simpson in 1995.

Key prosecution witness Detective Mark Fuhrman, of the Los Angeles Police Department (LAPD) – who denied using racist language on duty – impeached himself with his prolific use of nigger in tape recordings about his police work. The recordings, by screenplay writer Laura McKinney, were from a 1985 research session wherein the detective assisted her with a screenplay about LAPD policewomen. Fuhrman excused his use of the word saying he used nigger in the context of his "bad cop" persona. Linguistically, the popular press reporting and discussing Fuhrman's testimony substituted the N-word in place of nigger.

Homophones
Niger (Latin for "black") occurs in Latinate scientific nomenclature and is the root word for some homophones of nigger; sellers of niger seed (used as bird feed), sometimes use the name Nyjer seed. The classical Latin pronunciation /ˈniɡeɾ/ sounds like the English /ˈnɪɡər/, occurring in biologic and anatomic names, such as Hyoscamus niger (black henbane), and even for animals that are not in fact black, such as Sciurus niger (fox squirrel).

Nigra is the Latin feminine form of niger (black), used in biologic and anatomic names such as substantia nigra (black substance).

The word niggardly (miserly) is etymologically unrelated to nigger, derived from the Old Norse word nig (stingy) and the Middle English word nigon. In the US, this word has been misinterpreted as related to nigger and taken as offensive. In January 1999, David Howard, a white Washington, D.C. city employee, was compelled to resign after using niggardly—in a financial context—while speaking with black colleagues, who took umbrage. After reviewing the misunderstanding, Mayor Anthony Williams offered to reinstate Howard to his former position. Howard refused reinstatement but took a job elsewhere in the mayor's government.[88]

The portmanteau word wigger (white + nigger) denotes a white person emulating "street black behavior", hoping acceptance to the hip hop, thug, and gangsta sub-cultures.

Intragroup versus intergroup usage
Main article: Nigga
Black listeners often react to the term differently, depending on whether it is used by white speakers or by black speakers. In the former case, it is regularly understood as insensitive or insulting; in the latter, it may carry notes of in-group disparagement, and is often understood as neutral or affectionate, a possible instance of reappropriation.[citation needed]

Among the black community, the slur nigger is almost always rendered as nigga, representing the pronunciation of the word in African American Vernacular English. This usage has been popularized by the rap and hip-hop music cultures and is used as part of an in-group lexicon and speech. It is not necessarily derogatory and, when used among black people, the word is often used to mean homie or friend.[89]

Acceptance of intra-group usage of the word nigga is still debated,[89] although it has established a foothold amongst younger generations. The NAACP denounces the use of both "nigga" and "nigger". Mixed-race usage of "nigga" is still considered taboo, particularly if the speaker is white. However, trends indicate that usage of the term in intragroup settings is increasing even amongst white youth due to the popularity of rap and hip hop culture.[90]

According to Arthur K. Spears (Diverse Issues in Higher Education, 2006)

In many African-American neighborhoods, nigga is simply the most common term used to refer to any male, of any race or ethnicity. Increasingly, the term has been applied to any person, male or female. "Where y'all niggas goin?" is said with no self-consciousness or animosity to a group of women, for the routine purpose of obtaining information. The point: Nigga is evaluatively neutral in terms of its inherent meaning; it may express positive, neutral or negative attitudes;[91]

While Kevin Cato observes:

For instance, a show on Black Entertainment Television, a cable network aimed at a black audience, described the word nigger as a "term of endearment." "In the African American community, the word nigga (not nigger) brings out feelings of pride" (Davis 1). Here the word evokes a sense of community and oneness among black people. Many teens I interviewed felt that the word had no power when used amongst friends, but when used among white people the word took on a completely different meaning. In fact, comedian Alex Thomas on BET stated, "I still better not hear no white boy say that to me... I hear a white boy say that to me, it means 'White boy, you gonna get your ass beat.'"[92]

See also
Portal icon   Language portal
Controversies about the word "niggardly"
Cultural appropriation
Guilty or Innocent of Using the N Word
Kaffir (ethnic slur)
Murzyn
List of ethnic group names used as insults
List of ethnic slurs
List of topics related to Black and African people
"Niggas vs. Black People"
Profanity
Reappropriation
Taboo
The Student as Nigger (essay)
"With Apologies to Jesse Jackson", an episode of the animated comedy series South Park, in which Stan's dad, Randy, becomes a social pariah after saying "niggers" on Wheel of Fortune
Profanity by language
Category of English profanity
Category:African-American society
Footnotes
Jump up ^ "nigger (n.)". Online Etymology Dictionary.
Jump up ^ Pilgrim, David (September 2001). "Nigger and Caricatures". Retrieved June 19, 2007.
Jump up ^ Randall Kennedy (January 11, 2001). "Nigger: The Strange Career of a Troublesome Word". The Washington Post. Retrieved August 17, 2007. (Book review)
Jump up ^ Hutchinson, Earl Ofari (1996). The Assassination of the Black Male Image. Simon and Schuster. p. 82. ISBN 978-0-684-83100-8.
^ Jump up to: a b The Oxford English Reference Dictionary, second edition, (1996) p. 981
Jump up ^ Twain, Mark (1883). Life on the Mississippi. James R. Osgood & Co., Boston (U.S. edition). p. 11,13,127,139,219. ISBN 978-0-486-41426-3.
Jump up ^ Ruxton, George Frederick (1846). Life In the Far West. University of Oklahoma Press. ISBN 978-0-8061-1534-4.
Jump up ^ "Language of the Rendezvous".
Jump up ^ Mencken, H. L. (1921). "Chapter 8. American Spelling > 2. The Influence of Webster". The American Language: An Inquiry into the Development of English in the United States (2nd rev. and enl. ed.). New York: A.A. Knopf.
Jump up ^ Johnson, Clifton (October 14, 1904). "They Are Only "Niggers" in the South". The Seattle Republican (Seattle, Wash.: Republican Pub. Co.). Retrieved January 23, 2011.
Jump up ^ Allan, Keith. The Pragmatics of Connotation. Journal of Pragmatics 39:6 (June 2007) 1047–57
Jump up ^ "Advertisement – Nigger Boy Licorice, National Licorice Pty Ltd, circa 1950s–1960s". Museum Victoria.
Jump up ^ "Target Wools advertisement". Vogue Knitting Book (33). c. 1948. Nigger and Pink Cardigan
Jump up ^ Peers, C; Spurrier A & Sturgeon J (1999). Collins Crime Club – A checklist of First Editions (2nd ed.). Dragonby Press. p. 15. ISBN 1-871122-13-9.
Jump up ^ Pendergast, Bruce (2004). Everyman's Guide To The Mysteries Of Agatha Christie. Victoria, BC: Trafford Publishing. p. 393. ISBN 1-4120-2304-1.
Jump up ^ Mohr, Tim (November 2007). "Cornel West Talks Rhymes and Race". Playboy 54 (11): 44.
Jump up ^ "Nigger Usage Alert". dictionary.com. Retrieved 23 July 2015.
Jump up ^ Kennedy, Randall (2002). Nigger: The Strange Career of a Troublesome Word. Random House. p. 28. ISBN 978-0-375-42172-3.
Jump up ^ Rollins, Peter C. (2003). The Columbia Companion to American History on Film: How the Movies Have Portrayed the American Past. Columbia UP. p. 341. ISBN 978-0-231-11222-2.
Jump up ^ Lemert, Charles (2003). Muhammad Ali: Trickster in the Culture of Irony. Wiley-Blackwell. pp. 105–107. ISBN 978-0-7456-2871-4.
Jump up ^ French, Ron (March 13, 2008). "Attorney General Cox: Kilpatrick should resign". detnews.com. The Detroit News. Retrieved March 13, 2008.
Jump up ^ Ed Pilkington (March 1, 2007). "New York city council bans use of the N-word". The Guardian Unlimited (London). Retrieved August 17, 2007.
Jump up ^ "Res. No. 693-A – Resolution declaring the NYC Council's symbolic moratorium against using the "N" word in New York City.". New York City Council. Retrieved August 17, 2007.
Jump up ^ "1920: Corsicana's Finest Hour".
Jump up ^ "Jay Justin "Nig" Clark of Navarro County, Texas".
Jump up ^ Brazili, Matt (July 14, 2000). "Actually, My Hair Isn't Red". The Wall Street Journal (Dow Jones & Company, Inc.). Retrieved 2014-11-15. Hearing angmo so often took me back to my childhood, when my friends and I used the words Jew and Gyp (the latter short for Gypsy) as verbs, meaning to cheat. At that time, in the 1960s, other racial epithets, these based on physical appearance, were commonly heard: cracker, slant-eye, bongo lips, knit-head. To digress to the ludicrous, Brazil nuts were called "nigger toes."
Jump up ^ Williams, John (1919). "Notes on Birds of Wakulla County, Florida" (PDF). Wilson Bulletin. Retrieved 30 July 2015.
Jump up ^ send2press newswire. "Does the News Media Patronize the Black Community? asks United Voices for a Common Cause". News Blaze. Retrieved August 17, 2007.
Jump up ^ MacDonald, Michael Patrick. All Souls: A Family Story from Southie Publisher Random House, Inc., 2000. Page 61. ISBN 0-345-44177-X, 9780345441775
Jump up ^ Van Dale, Groot Woordenboek der Nederlandse taal, 2010
Jump up ^ "Tabela 1.2 – População residente, por cor ou raça, segundo a situação do domicílio e o sexo – Brasil – 2009" (PDF). and "Evolutio da populaco brasileira, segundo a cor – 1872/1991".
Jump up ^ Man is arrested after calling a policeman a crioulo using uniform
Jump up ^ "Adventures Of Huckleberry Finn". The Complete Works of Mark Twain. Retrieved March 12, 2006.
Jump up ^ "Academic Resources: Nigger: The Strange Career of a Troublesome Word". Random House. Retrieved March 13, 2006.
Jump up ^ Twain, Mark (January 7, 2011). "'The Adventures of Huckleberry Finn' – Removing the N Word from Huck Finn: Top 10 Censored Books". TIME. Retrieved January 23, 2011.
Jump up ^ Stephen Railton (2005). "Tomming In Our Time". University of Virginia, Institute for Advanced Technology in the Humanities. Retrieved March 13, 2006.
Jump up ^ Michael Sragow (December 23, 1999). "The roar of the greasepaint, the smell of the crowd". Retrieved March 13, 2006.
^ Jump up to: a b Sibley, Brian (1995). The Thomas the Tank Engine Man. London: Heinemann. pp. 272–5. ISBN 0-434-96909-5.
Jump up ^ Ravernell, Wanda J. (June 15, 2005). "What's cute about racist kitsch?". San Francisco Chronicle. Retrieved March 13, 2006.
Jump up ^ "Jim Crow Museum". Ferris State University. Retrieved March 13, 2006.
Jump up ^ "Hue & Cry". Urban Legends Reference Pages: Racist Sofa Label. Retrieved August 11, 2007.
Jump up ^ "Warbird Photo Album – Avro Lancaster Mk.I". Ww2aircraft.net. March 25, 2006. Retrieved January 23, 2011.
Jump up ^ "Analysis of the symbols used within the film, "Pink Floyd's The Wall"". Thewallanalysis.com. Retrieved January 23, 2011.
^ Jump up to: a b Chapman, Paul (May 6, 2009). "Fur flies over racist name of Dambuster's dog". The Daily Telegraph (London).
Jump up ^ ITV attacked over Dam Busters censorship, The Guardian, June 11, 2001
Jump up ^ "Dam Busters dog renamed for movie remake". BBC News.
Jump up ^ "Review Django Unchained- Spaghetti southern style". http://thephoenix.com. Retrieved 27 December 2012. External link in |work= (help)
Jump up ^ "Django Unchained – Audio Review". Spill.com. Retrieved 27 December 2012.
Jump up ^ Orr, Leonard (1999). A Joseph Conrad Companion. Greenwood Press. ISBN 0-313-29289-2.
Jump up ^ "Children of the Sea|The – Sumner & Stillman". Sumnerandstillman.com. 2006-12-01. Retrieved 2012-07-13.[dead link]
Jump up ^ Joseph Conrad, foreword by Ruben Alvarado. The N-word of the Narcissus. WorldBridge. ISBN 9789076660110. Retrieved 2012-07-13.
Jump up ^ Bernard, Emily (2012). Carl Van Vechten and the Harlem Renaissance. Yale University Press. p. 79. ISBN 9780300183290.
Jump up ^ Jocelyn Brooke. "Novels of Ronald Firbank by Jocelyn Brooke". ourcivilisation.com.
Jump up ^ "100 most frequently challenged books: 1990–1999". ala.org.
Jump up ^ "New Huckleberry Finn edition censors 'n-word'". the Guardian.
Jump up ^ The Christian Science Monitor. "The 'n'-word gone from Huck Finn – what would Mark Twain say?". The Christian Science Monitor.
Jump up ^ MNeely, Kim (April 2, 1992). "Axl Rose: The RS Interview". Rolling Stone. Retrieved 2007-12-20.
Jump up ^ [1][dead link]
Jump up ^ John Broven, South to Louisiana: The Music of the Cajun Bayous. Gretna, Louisiana: Pelican, 1983, p. 252f.
Jump up ^ Racial slur on sofa label stuns family by Jim Wilkes, Toronto Star, April 6, 2007 . Retrieved February 2, 2009.
Jump up ^ Racist Sofa Label: Huy & Cry at Snopes.com
Jump up ^ Offensive Couch Update City News, April 13, 2007 (retrieved on February 2, 2009).
Jump up ^ Translation software blamed for sofa tag by Furniture Today staff, May 7, 2007. Retrieved February 2, 2009.
Jump up ^ "Brown Pants". Snopes.com. 22 March 2012.
Jump up ^ "Brown Shirts". Snopes.com. 18 August 2014.
Jump up ^ "The Color of Words", by Philip Herbst, 1997, ISBN 1-877864-97-8, p. 166
Jump up ^ Kennedy, Randall L. (Winter 1999–2000). "Who Can Say "Nigger"? And Other Considerations". The Journal of Blacks in Higher Education (26): 86–96 [87]. JSTOR 2999172.
Jump up ^ vol 2 p6
Jump up ^ "Semiochemicals of Nasutitermes graveolus, the Niggerhead termite". The Pherobase. Retrieved March 12, 2006.
Jump up ^ "Buffalo Soldier Cavalry Commander: General John J. Pershing". U.S. National Park Service. Retrieved August 17, 2007.
Jump up ^ Vandiver, Frank E. Black Jack: The Life and Times of John J. Pershing – Volume I (Texas A&M University Press, Third printing, 1977) ISBN 0-89096-024-0 , p. 67.
^ Jump up to: a b Monaghan, Peter: Taking a Stand, July 29, 2005 in The Chronicle of Higher Education, available at "Australia's E. S. 'Nigger' Brown Stand and "Judicial Restraint"". Prof. Andrew V. Uroskie. July 29, 2005. Retrieved September 27, 2008.
Jump up ^ Bita, Natasha (September 27, 2008). "League legend would have wanted sign to stay: grandson". The Australian. Retrieved September 27, 2008.
Jump up ^ "Dead Negro Draw". Handbook of Texas Online. Retrieved February 19, 2010.
Jump up ^ "Nathan Harrison (1823–1920)". San Diego Biographies. San Diego Historical Society. Archived from the original on December 10, 2007. Retrieved July 1, 2011.
Jump up ^ "Nigger Hill in Mariposa County, California". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Nigger Slough in Los Angeles County, California". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Nigger Valley in San Diego County, California". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Nigger Canyon in San Diego County, California". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Nigger Joe Ridge in Humboldt County, California". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Nigger Gulch in Butte County, California". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Nigger Sam Slough in Glenn County, California". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Golden Gate Genealogy Forum". CaliforniaMaps.org. Retrieved July 14, 2007.
Jump up ^ "Niggertoe Mountain". BC Geographical Names.
Jump up ^ "Free Negro Point". USGS Geographic Names Information System. Retrieved March 12, 2006.
Jump up ^ Arac, Jonathan (November 1997). Huckleberry Finn as idol and target. Madison, Wisconsin: University of Wisconsin Press. p. 29. ISBN 978-0-299-15534-6. Retrieved August 18, 2010.
Jump up ^ Noble, Kenneth B. (January 14, 1995). "Issue of Racism Erupts in Simpson Trial". The New York Times.
Jump up ^ Yolanda Woodlee (February 4, 1999). "D.C. Mayor Acted 'Hastily,' Will Rehire Aide". Washington Post. Retrieved August 17, 2007.
^ Jump up to: a b "Nigga Usage Alert". dictionary.com. Retrieved 23 July 2015.
Jump up ^ Kevin Aldridge, Richelle Thompson and Earnest Winston. "The evolving N-word." The Cincinnati Enquirer, August 5, 2001.
Jump up ^ Spears, Dr. Arthur K. (12 July 2006). "Perspectives: A View of the 'N-Word' from Sociolinguistics". Diverse Issues in Higher Education.
Jump up ^ "Nigger". Wrt-intertext.syr.edu. Retrieved January 23, 2011.
References
"nigger". The Oxford English Dictionary (2 ed.). 1989.
Fuller, Neely Jr. (1984). The United Independent Compensatory Code/System/Concept: A Textbook/Workbook for Thought, Speech, and/or Action, for Victims of Racism (white supremacy). ASIN B000BVZW38.
Kennedy, Randall (2002). Nigger: The Strange Career of a Troublesome Word. New York: Pantheon Books. ISBN 0-375-42172-6.
Smith, Stephanie (2005). Household Words: Bloomers, Sucker, Bombshell, Scab, Nigger, Cyber. Minneapolis: University of Minnesota Press. ISBN 0-8166-4552-3.
Swan, Robert J. (2003). New Amsterdam Gehenna: Segregated Death in New York City, 1630–1801. Brooklyn: Noir Verite Press. ISBN 0-9722813-0-4.
Worth, Robert F. (Fall 1995). "Nigger Heaven and the Harlem Renaissance". African American Review 29 (3): 461–473. doi:10.2307/3042395. JSTOR 3042395.
External links
   Look up nigger or N-word in Wiktionary, the free dictionary.
Analysis of the cultural uses of the word Nigga by Alex Alonso of Street Gangs Magazine
"Nigger and Caricatures," Jim Crow Museum of Racist Memorabilia, Ferris State University
"Nigger (the word), a brief history!" from the African American Registry
Appropriating a Slur in M/C: A Journal of Media and Culture
"Let's Make a Deal on the N-Word: White folks will stop using it, and black folks will stop pretending that quoting it is saying it," John McWhorter, The Root
[show] v t e
Ethnic and religious slurs
Categories: American English wordsAnti-African and anti-black slursProfanityAfrican-American-related

Quote from: Vagiña on January 09, 2016, 07:26:15 PM

From Wikipedia, the free encyclopedia




Defecation is the final act of digestion, by which organisms eliminate solid, semisolid, and/or liquid waste material from the digestive tract via the anus.

Humans expel feces with a frequency varying from a few times daily to a few times weekly.[1] Waves of muscular contraction (known as peristalsis) in the walls of the colon move fecal matter through the digestive tract towards the rectum. Undigested food may also be expelled this way, in a process called egestion.

Open defecation is the practice of defecating outside or in public, i.e. without using a toilet of any kind, mostly due to extreme poverty in developing countries.

Contents  [hide]
1   Description
1.1   Physiology
1.2   Voluntary and involuntary control
2   Anal cleansing
3   Posture
4   Society and culture
4.1   Mythology and tradition
5   See also
6   References
7   Further reading
Description[edit]
Physiology[edit]
The rectum ampulla (anatomically also: ampulla recti) temporarily stores fecal waste. As the waste fills the rectum and expands the rectal walls, nervous system stretch receptors in the rectal walls stimulate the desire to defecate. This urge to defecate arises from the reflex contraction of rectal muscles, relaxation of the internal anal sphincter, and an initial contraction of the skeletal muscle of the external anal sphincter. If the urge is not acted upon, the material in the rectum is often returned to the colon by reverse peristalsis, where more water is absorbed and the faeces is stored until the next mass peristaltic movement of the transverse and descending colon. If defecation is delayed for a prolonged period the fecal matter may harden, resulting in constipation. If defecation occurs too fast, before excess liquid is absorbed, diarrhea may occur.[2]

When the rectum is full, an increase in intra-rectal pressure forces apart the walls of the anal canal, allowing the fecal matter to enter the canal. The rectum shortens as material is forced into the anal canal and peristaltic waves push the feces out of the rectum. The internal and external anal sphincters along with the puborectalis muscle allow the feces to be passed by muscles pulling the anus up over the exiting feces.[citation needed]

Defecation is normally assisted by taking a deep breath and trying to expel this air against a closed glottis (Valsalva maneuver). This contraction of expiratory chest muscles, diaphragm, abdominal wall muscles, and pelvic diaphragm exerts pressure on the digestive tract. Ventilation at this point temporarily ceases as the lungs push the chest diaphragm down to exert the pressure. Thoracic blood pressure rises and as a reflex response the amount of blood pumped by the heart decreases. Death has been known to occur in cases where defecation causes the blood pressure to rise enough to cause the rupture of an aneurysm or to dislodge blood clots (see thrombosis). Also, in releasing the Valsalva maneuver blood pressure falls; this, coupled with standing up quickly to leave the toilet, can result in a blackout.[citation needed] [3]

When defecating, the external sphincter muscles relax. The anal and urethral sphincter muscles are closely linked. Experiments by Dr. Harrison Weed at the Ohio State University Medical Center have shown they can only be contracted together, not individually, and that both show relaxation during urination[citation needed]. This explains why defecation is frequently accompanied by urination.

Voluntary and involuntary control[edit]
Defecation may be involuntary or under voluntary control.  Young children learn voluntary control through the process of toilet training.  Once trained, loss of control called fecal incontinence, may be caused by physical injury, nerve injury, prior surgeries (such as an episiotomy), constipation, diarrhea, loss of storage capacity in the rectum, intense fright, inflammatory bowel disease, psychological or neurological factors, birth, or death.[4]

Anal cleansing[edit]
Main article: Anal cleansing
The anus and buttocks may be cleansed after defecation with toilet paper, similar paper products, or other absorbent material. In many cultures, e.g. in Muslim culture, water is used for anal cleansing, either in addition or exclusively.

Posture[edit]
Main article: Human defecation postures
The positions and modalities of defecation are culture-dependent. The natural and instinctive method used by all primates, including humans, is the squatting position. Squat toilets are still used by the vast majority of the world, including most of Africa, Asia and the Middle East.[5] The widespread use of sit-down toilets in the Western world is a recent development, beginning in the 19th century with the advent of indoor plumbing.[6]

Bockus' Gastroenterology, the standard textbook on the subject, states: "The ideal posture for defecation is the squatting position, with the thighs flexed upon the abdomen. In this way the capacity of the abdominal cavity is greatly diminished and intra-abdominal pressure increased, thus encouraging the expulsion of the fecal mass."[7]

Society and culture[edit]
Mythology and tradition[edit]

The caganer is a defecating figurine in Spanish Nativity scenes
Some peoples have culturally significant stories in which defecation plays a role. In a Wemale and Alune legend from the island of Seram, Maluku Province, Indonesia, the mythical girl Hainuwele defecates valuable objects.[8] One of the traditions of Catalonia (Spain) relates to the Caganer, a figurine depicted in the act of defecation appearing in nativity scenes in Catalonia and neighbouring areas with Catalan culture. The exact origin of the Caganer is lost, but the tradition has existed since at least the 18th century.[9]

See also[edit]
Flatulence
Toilet god
Shit

Cancer
For otheTumor Mesothelioma2 legend.jpg
A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver.
Classification and external resources
Pronunciation   Listeni/ˈkænsər/
Specialty   Oncology
ICD-10   C00—C97
ICD-9-CM   140—239
DiseasesDB   28843
MedlinePlus   001289
MeSH   D009369
Cancer, also known as a malignant tumor or malignant neoplasm, is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.[1][2] Not all tumors are cancerous; benign tumors do not spread to other parts of the body.[2] Possible signs and symptoms include: a new lump, abnormal bleeding, a prolonged cough, unexplained weight loss, and a change in bowel movements among others.[3] While these symptoms may indicate cancer, they may also occur due to other issues.[3] There are over 100 different known cancers that affect humans.[2]

Tobacco use is the cause of about 22% of cancer deaths.[1] Another 10% is due to obesity, a poor diet, lack of physical activity, and consumption of alcohol.[1][4] Other factors include certain infections, exposure to ionizing radiation, and environmental pollutants.[5] In the developing world nearly 20% of cancers are due to infections such as hepatitis B, hepatitis C, and human papillomavirus (HPV).[1] These factors act, at least partly, by changing the genes of a cell.[6] Typically many such genetic changes are required before cancer develops.[6] Approximately 5–10% of cancers are due to genetic defects inherited from a person's parents.[7] Cancer can be detected by certain signs and symptoms or screening tests.[1] It is then typically further investigated by medical imaging and confirmed by biopsy.[8]

Many cancers can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruits and whole grains, being vaccinated against certain infectious diseases, not eating too much processed and red meat, and avoiding too much exposure to sunlight.[9][10] Early detection through screening is useful for cervical and colorectal cancer.[11] The benefits of screening in breast cancer are controversial.[11][12] Cancer is often treated with some combination of radiation therapy, surgery, chemotherapy, and targeted therapy.[1][13] Pain and symptom management are an important part of care. Palliative care is particularly important in those with advanced disease.[1] The chance of survival depends on the type of cancer and extent of disease at the start of treatment.[6] In children under 15 at diagnosis the five-year survival rate in the developed world is on average 80%.[14] For cancer in the United States the average five-year survival rate is 66%.[15]

In 2012 about 14.1 million new cases of cancer occurred globally (not including skin cancer other than melanoma).[6] It caused about 8.2 million deaths or 14.6% of all human deaths.[6][16] The most common types of cancer in males are lung cancer, prostate cancer, colorectal cancer, and stomach cancer, and in females, the most common types are breast cancer, colorectal cancer, lung cancer, and cervical cancer.[6] If skin cancer other than melanoma were included in total new cancers each year it would account for around 40% of cases.[17][18] In children, acute lymphoblastic leukaemia and brain tumors are most common except in Africa where non-Hodgkin lymphoma occurs more often.[14] In 2012, about 165,000 children under 15 years of age were diagnosed with cancer. The risk of cancer increases significantly with age and many cancers occur more commonly in developed countries.[6] Rates are increasing as more people live to an old age and as lifestyle changes occur in the developing world.[19] The financial costs of cancer have been estimated at $1.16 trillion US dollars per year as of 2010.[20]

Contents  [hide]
1   Definitions
2   Signs and symptoms
2.1   Local effects
2.2   Systemic symptoms
2.3   Metastasis
3   Causes
3.1   Chemicals
3.2   Diet and exercise
3.3   Infection
3.4   Radiation
3.5   Heredity
3.6   Physical agents
Cancers are a large family of diseases that involve abnormal cell growth with the potential to invade or spread to other parts of the body.[1][2] They form a subset of neoplasms. A neoplasm or tumor is a group of cells that have undergone unregulated growth, and will often form a mass or lump, but may be distributed diffusely.[21][22]

All tumor cells show the six hallmarks of cancer. These are characteristics that the cancer cells need to produce a malignant tumor. They include:[23]

Cell growth and division without the proper signals to do so
Continuous growth and division even when there are signals telling them to stop
Avoidance of programmed cell death
Limitless number of cell divisions
Promoting blood vessel construction
Invasion of tissue and formation of metastases[24]
The progression from normal cells to cells that can form a detectable mass to outright cancer involves multiple steps known as malignant progression.[24][25]

Signs and symptoms
Main article: Cancer signs and symptoms

Symptoms of cancer metastasis depend on the location of the tumor.
When cancer begins, it invariably produces no symptoms. Signs and symptoms only appear as the mass continues to grow or ulcerates. The findings that result depend on the type and location of the cancer. Few symptoms are specific, with many of them also frequently occurring in individuals who have other conditions. Cancer is the new "great imitator". Thus, it is not uncommon for people diagnosed with cancer to have been treated for other diseases, which were assumed to be causing their symptoms.[26]

Local effects
Local symptoms may occur due to the mass of the tumor or its ulceration. For example, mass effects from lung cancer can cause blockage of the bronchus resulting in cough or pneumonia; esophageal cancer can cause narrowing of the esophagus, making it difficult or painful to swallow; and colorectal cancer may lead to narrowing or blockages in the bowel, resulting in changes in bowel habits. Masses in breasts or testicles may be easily felt. Ulceration can cause bleeding that, if it occurs in the lung, will lead to coughing up blood, in the bowels to anemia or rectal bleeding, in the bladder to blood in the urine, and in the uterus to vaginal bleeding. Although localized pain may occur in advanced cancer, the initial swelling is usually painless. Some cancers can cause a buildup of fluid within the chest or abdomen.[26]

Systemic symptoms
General symptoms occur due to distant effects of the cancer that are not related to direct or metastatic spread. These may include: unintentional weight loss, fever, being excessively tired, and changes to the skin.[27] Hodgkin disease, leukemias, and cancers of the liver or kidney can cause a persistent fever of unknown origin.[26]

Some cancers may cause specific groups of systemic symptoms, termed paraneoplastic phenomena. Examples include the appearance of myasthenia gravis in thymoma and clubbing in lung cancer.[26]

Metastasis
Main article: Metastasis
Cancer can spread from its original site by local spread, lymphatic spread to regional lymph nodes or by blood (haematogenous spread) to distant sites, known as metastasis. When cancer spreads by a haematogenous route, it usually spreads all over the body. However, cancer 'seeds' grow in certain selected site only ('soil') as hypothesized in the soil and seed hypothesis of cancer metastasis. The symptoms of metastatic cancers depend on the location of the tumor, and can include enlarged lymph nodes (which can be felt or sometimes seen under the skin and are typically hard), enlarged liver or enlarged spleen, which can be felt in the abdomen, pain or fracture of affected bones, and neurological symptoms.[26]

Causes
Main article: Causes of cancer
The great majority of cancers, some 90–95% of cases, are due to environmental factors. The remaining 5–10% are due to inherited genetics.[5] Environmental, as used by cancer researchers, means any cause that is not inherited genetically, such as lifestyle, economic and behavioral factors, and not merely pollution.[28] Common environmental factors that contribute to cancer death include tobacco (25–30%), diet and obesity (30–35%), infections (15–20%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity, and environmental pollutants.[5]

It is nearly impossible to prove what caused a cancer in any individual, because most cancers have multiple possible causes. For example, if a person who uses tobacco heavily develops lung cancer, then it was probably caused by the tobacco use, but since everyone has a small chance of developing lung cancer as a result of air pollution or radiation, then there is a small chance that the cancer developed because of air pollution or radiation. Excepting the rare transmissions that occur with pregnancies and only a marginal few organ donors, cancer is generally not a transmissible disease.[29]

Chemicals
Further information: Alcohol and cancer and Smoking and cancer

The incidence of lung cancer is highly correlated with smoking.
Exposure to particular substances have been linked to specific types of cancer. These substances are called carcinogens. Tobacco smoking, for example, causes 90% of lung cancer.[30] It also causes cancer in the larynx, head, neck, stomach, bladder, kidney, esophagus and pancreas.[31] Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons.[32] Tobacco is responsible for about one in three of all cancer deaths in the developed world,[33] and about one in five worldwide.[32] Lung cancer death rates in the United States have mirrored smoking patterns, with increases in smoking followed by dramatic increases in lung cancer death rates and, more recently, decreases in smoking rates since the 1950s followed by decreases in lung cancer death rates in men since 1990.[34][35]

In Western Europe, 10% of cancers in males and 3% of all cancers in females are attributed to alcohol exposure, especially cancer of the liver and of the digestive tract.[36] Cancer related to substance exposures at work is believed to represent between 2–20% of all cases.[37] Every year, at least 200,000 people die worldwide from cancer related to their workplaces.[38] Millions of workers run the risk of developing cancers such as lung cancer and mesothelioma from inhaling tobacco smoke or asbestos fibers on the job, or leukemia from exposure to benzene at their workplaces.[38]

Diet and exercise
Main article: Diet and cancer
Diet, physical inactivity, and obesity are related to up to 30–35% of cancer deaths.[5][39] In the United States excess body weight is associated with the development of many types of cancer and is a factor in 14–20% of all cancer deaths.[39] Correspondingly, a UK study including data on over 5 million people showed higher body mass index to be related to at least 10 types of cancer, and responsible for around 12,000 cases each year in that country.[40] Physical inactivity is believed to contribute to cancer risk, not only through its effect on body weight but also through negative effects on the immune system and endocrine system.[39] More than half of the effect from diet is due to overnutrition (eating too much), rather than from eating too few vegetables or other healthful foods.

Some specific foods are linked to specific cancers. A high-salt diet is linked to gastric cancer.[41] Aflatoxin B1, a frequent food contaminate, causes liver cancer.[41] Betel nut chewing causes oral cancer.[41] The differences in dietary practices may partly explain differences in cancer incidence in different countries. For example, gastric cancer is more common in Japan due to its high-salt diet[42] and colon cancer is more common in the United States. Immigrants develop the risk of their new country, often within one generation, suggesting a substantial link between diet and cancer.[43]

Infection
Main article: Infectious causes of cancer
Worldwide approximately 18% of cancer deaths are related to infectious diseases.[5] This proportion varies in different regions of the world from a high of 25% in Africa to less than 10% in the developed world.[5] Viruses are the usual infectious agents that cause cancer but cancer bacteria and parasites may also have an effect.

A virus that can cause cancer is called an oncovirus. These include human papillomavirus (cervical carcinoma), Epstein–Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), Kaposi's sarcoma herpesvirus (Kaposi's sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma), and human T-cell leukemia virus-1 (T-cell leukemias). Bacterial infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced gastric carcinoma.[44] Parasitic infections strongly associated with cancer include Schistosoma haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis viverrini and Clonorchis sinensis (cholangiocarcinoma).[45]

Radiation
Main article: Radiation-induced cancer
Up to 10% of invasive cancers are related to radiation exposure, including both ionizing radiation and non-ionizing ultraviolet radiation.[5] Additionally, the vast majority of non-invasive cancers are non-melanoma skin cancers caused by non-ionizing ultraviolet radiation, mostly from sunlight. Sources of ionizing radiation include medical imaging and radon gas.

Ionizing radiation is not a particularly strong mutagen.[46] Residential exposure to radon gas, for example, has similar cancer risks as passive smoking.[46] Radiation is a more potent source of cancer when it is combined with other cancer-causing agents, such as radon gas exposure plus smoking tobacco.[46] Radiation can cause cancer in most parts of the body, in all animals, and at any age. Children and adolescents are twice as likely to develop radiation-induced leukemia as adults; radiation exposure before birth has ten times the effect.[46]

Medical use of ionizing radiation is a small but growing source of radiation-induced cancers. Ionizing radiation may be used to treat other cancers, but this may, in some cases, induce a second form of cancer.[46] It is also used in some kinds of medical imaging.[47]

Prolonged exposure to ultraviolet radiation from the sun can lead to melanoma and other skin malignancies.[48] Clear evidence establishes ultraviolet radiation, especially the non-ionizing medium wave UVB, as the cause of most non-melanoma skin cancers, which are the most common forms of cancer in the world.[48]

Non-ionizing radio frequency radiation from mobile phones, electric power transmission, and other similar sources have been described as a possible carcinogen by the World Health Organization's International Agency for Research on Cancer.[49] However, studies have not found a consistent link between cell phone radiation and cancer risk.[50]

Heredity
Main article: Cancer syndrome
The vast majority of cancers are non-hereditary ("sporadic cancers"). Hereditary cancers are primarily caused by an inherited genetic defect. Less than 0.3% of the population are carriers of a genetic mutation that has a large effect on cancer risk and these cause less than 3–10% of all cancer.[51] Some of these syndromes include: certain inherited mutations in the genes BRCA1 and BRCA2 with a more than 75% risk of breast cancer and ovarian cancer,[51] and hereditary nonpolyposis colorectal cancer (HNPCC or Lynch syndrome), which is present in about 3% of people with colorectal cancer,[52] among others.

Physical agents
Some substances cause cancer primarily through their physical, rather than chemical, effects on cells.[53] A prominent example of this is prolonged exposure to asbestos, naturally occurring mineral fibers that are a major cause of mesothelioma, which is a cancer of the serous membrane, usually the serous membrane surrounding the lungs.[53] Other substances in this category, including both naturally occurring and synthetic asbestos-like fibers, such as wollastonite, attapulgite, glass wool, and rock wool, are believed to have similar effects.[53] Non-fibrous particulate materials that cause cancer include powdered metallic cobalt and nickel, and crystalline silica (quartz, cristobalite, and tridymite).[53] Usually, physical carcinogens must get inside the body (such as through inhaling tiny pieces) and require years of exposure to develop cancer.[53]

Physical trauma resulting in cancer is relatively rare.[54] Claims that breaking bones resulted in bone cancer, for example, have never been proven.[54] Similarly, physical trauma is not accepted as a cause for cervical cancer, breast cancer, or brain cancer.[54] One accepted source is frequent, long-term application of hot objects to the body. It is possible that repeated burns on the same part of the body, such as those produced by kanger and kairo heaters (charcoal hand warmers), may produce skin cancer, especially if carcinogenic chemicals are also present.[54] Frequently drinking scalding hot tea may produce esophageal cancer.[54] Generally, it is believed that the cancer arises, or a pre-existing cancer is encouraged, during the process of repairing the trauma, rather than the cancer being caused directly by the trauma.[54] However, repeated injuries to the same tissues might promote excessive cell proliferation, which could then increase the odds of a cancerous mutation.

It is controversial whether chronic inflammation can directly cause mutation.[54][55] It is recognized, however, that inflammation can contribute to proliferation, survival, angiogenesis and migration of cancer cells by influencing the microenvironment around tumors.[56][57] Furthermore, oncogenes are known to build up an inflammatory pro-tumorigenic microenvironment.[58]

Hormones
Some hormones play a role in the development of cancer by promoting cell proliferation.[59] Insulin-like growth factors and their binding proteins play a key role in cancer cell proliferation, differentiation and apoptosis, suggesting possible involvement in carcinogenesis.[60]

Hormones are important agents in sex-related cancers, such as cancer of the breast, endometrium, prostate, ovary, and testis, and also of thyroid cancer and bone cancer.[59] For example, the daughters of women who have breast cancer have significantly higher levels of estrogen and progesterone than the daughters of women without breast cancer. These higher hormone levels may explain why these women have higher risk of breast cancer, even in the absence of a breast-cancer gene.[59] Similarly, men of African ancestry have significantly higher levels of testosterone than men of European ancestry, and have a correspondingly much higher level of prostate cancer.[59] Men of Asian ancestry, with the lowest levels of testosterone-activating androstanediol glucuronide, have the lowest levels of prostate cancer.[59]

Other factors are also relevant: obese people have higher levels of some hormones associated with cancer and a higher rate of those cancers.[59] Women who take hormone replacement therapy have a higher risk of developing cancers associated with those hormones.[59] On the other hand, people who exercise far more than average have lower levels of these hormones, and lower risk of cancer.[59] Osteosarcoma may be promoted by growth hormones.[59] Some treatments and prevention approaches leverage this cause by artificially reducing hormone levels, and thus discouraging hormone-sensitive cancers.[59]

Pathophysiology
Main article: Carcinogenesis

Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
Genetics
Cancer is fundamentally a disease of tissue growth regulation failure. In order for a normal cell to transform into a cancer cell, the genes that regulate cell growth and differentiation must be altered.[61]

The affected genes are divided into two broad categories. Oncogenes are genes that promote cell growth and reproduction. Tumor suppressor genes are genes that inhibit cell division and survival. Malignant transformation can occur through the formation of novel oncogenes, the inappropriate over-expression of normal oncogenes, or by the under-expression or disabling of tumor suppressor genes. Typically, changes in many genes are required to transform a normal cell into a cancer cell.[62]

Genetic changes can occur at different levels and by different mechanisms. The gain or loss of an entire chromosome can occur through errors in mitosis. More common are mutations, which are changes in the nucleotide sequence of genomic DNA.

Large-scale mutations involve the deletion or gain of a portion of a chromosome. Genomic amplification occurs when a cell gains many copies (often 20 or more) of a small chromosomal locus, usually containing one or more oncogenes and adjacent genetic material. Translocation occurs when two separate chromosomal regions become abnormally fused, often at a characteristic location. A well-known example of this is the Philadelphia chromosome, or translocation of chromosomes 9 and 22, which occurs in chronic myelogenous leukemia, and results in production of the BCR-abl fusion protein, an oncogenic tyrosine kinase.

Small-scale mutations include point mutations, deletions, and insertions, which may occur in the promoter region of a gene and affect its expression, or may occur in the gene's coding sequence and alter the function or stability of its protein product. Disruption of a single gene may also result from integration of genomic material from a DNA virus or retrovirus, leading to the expression of viral oncogenes in the affected cell and its descendants.

Replication of the enormous amount of data contained within the DNA of living cells will probabilistically result in some errors (mutations). Complex error correction and prevention is built into the process, and safeguards the cell against cancer. If significant error occurs, the damaged cell can "self-destruct" through programmed cell death, termed apoptosis. If the error control processes fail, then the mutations will survive and be passed along to daughter cells.

Some environments make errors more likely to arise and propagate. Such environments can include the presence of disruptive substances called carcinogens, repeated physical injury, heat, ionising radiation, or hypoxia.[63]

The errors that cause cancer are self-amplifying and compounding, for example:

A mutation in the error-correcting machinery of a cell might cause that cell and its children to accumulate errors more rapidly.
A further mutation in an oncogene might cause the cell to reproduce more rapidly and more frequently than its normal counterparts.
A further mutation may cause loss of a tumor suppressor gene, disrupting the apoptosis signalling pathway and resulting in the cell becoming immortal.
A further mutation in signaling machinery of the cell might send error-causing signals to nearby cells.
The transformation of normal cell into cancer is akin to a chain reaction caused by initial errors, which compound into more severe errors, each progressively allowing the cell to escape the controls that limit normal tissue growth. This rebellion-like scenario becomes an undesirable survival of the fittest, where the driving forces of evolution work against the body's design and enforcement of order. Once cancer has begun to develop, this ongoing process, termed clonal evolution, drives progression towards more invasive stages.[64] Clonal evolution leads to intra-tumour heterogeneity that complicates designing effective treatment strategies.

Characteristic abilities developed by cancers are divided into a number of categories. Six categories were originally proposed, in a 2000 article called "The Hallmarks of Cancer" by Douglas Hanahan and Robert Weinberg: evasion of apoptosis, self-sufficiency in growth signals, insensitivity to anti-growth signals, sustained angiogenesis, limitless replicative potential, and metastasis. Based on further work, the same authors added two more categories in 2011: reprogramming of energy metabolism and evasion of immune destruction.[24][25]

Epigenetics

The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
Classically, cancer has been viewed as a set of diseases that are driven by progressive genetic abnormalities that include mutations in tumor-suppressor genes and oncogenes, and chromosomal abnormalities. However, it has become apparent that cancer is also driven by epigenetic alterations.[65]

Epigenetic alterations refer to functionally relevant modifications to the genome that do not involve a change in the nucleotide sequence. Examples of such modifications are changes in DNA methylation (hypermethylation and hypomethylation) and histone modification[66] and changes in chromosomal architecture (caused by inappropriate expression of proteins such as HMGA2 or HMGA1).[67] Each of these epigenetic alterations serves to regulate gene expression without altering the underlying DNA sequence. These changes may remain through cell divisions, last for multiple generations, and can be considered to be epimutations (equivalent to mutations).

Epigenetic alterations occur frequently in cancers. As an example, Schnekenburger and Diederich[68] listed protein coding genes that were frequently altered in their methylation in association with colon cancer. These included 147 hypermethylated and 27 hypomethylated genes. Of the hypermethylated genes, 10 were hypermethylated in 100% of colon cancers, and many others were hypermethylated in more than 50% of colon cancers.

While large numbers of epigenetic alterations are found in cancers, the epigenetic alterations in DNA repair genes, causing reduced expression of DNA repair proteins, may be of particular importance. Such alterations are thought to occur early in progression to cancer and to be a likely cause of the genetic instability characteristic of cancers.[69][70][71][72]

Reduced expression of DNA repair genes causes deficient DNA repair. This is shown in the figure at the 4th level from the top. (In the figure, red wording indicates the central role of DNA damage and defects in DNA repair in progression to cancer.) When DNA repair is deficient DNA damages remain in cells at a higher than usual level (5th level from the top in figure), and these excess damages cause increased frequencies of mutation and/or epimutation (6th level from top of figure). Mutation rates increase substantially in cells defective in DNA mismatch repair[73][74] or in homologous recombinational repair (HRR).[75] Chromosomal rearrangements and aneuploidy also increase in HRR defective cells.[76]

Higher levels of DNA damage not only cause increased mutation (right side of figure), but also cause increased epimutation. During repair of DNA double strand breaks, or repair of other DNA damages, incompletely cleared sites of repair can cause epigenetic gene silencing.[77][78]

Deficient expression of DNA repair proteins due to an inherited mutation can cause an increased risk of cancer. Individuals with an inherited impairment in any of 34 DNA repair genes (see article DNA repair-deficiency disorder) have an increased risk of cancer, with some defects causing up to a 100% lifetime chance of cancer (e.g. p53 mutations).[79] Germ line DNA repair mutations are noted in a box on the left side of the figure, with an arrow indicating their contribution to DNA repair deficiency. However, such germline mutations (which cause highly penetrant cancer syndromes) are the cause of only about 1 percent of cancers.[80]

In sporadic cancers, deficiencies in DNA repair are occasionally caused by a mutation in a DNA repair gene, but are much more frequently caused by epigenetic alterations that reduce or silence expression of DNA repair genes. This is indicated in the figure at the 3rd level from the top. Many studies of heavy metal-induced carcinogenesis show that such heavy metals cause reduction in expression of DNA repair enzymes, some through epigenetic mechanisms. In some cases, DNA repair inhibition is proposed to be a predominant mechanism in heavy metal-induced carcinogenicity. In addition, there are frequent epigenetic alterations of the DNA sequences coding for small RNAs called microRNAs (or miRNAs). MiRNAs do not code for proteins, but can "target" protein-coding genes and reduce their expression.

Cancers usually arise from an assemblage of mutations and epimutations that confer a selective advantage leading to clonal expansion (see Field defects in progression to cancer). Mutations, however, may not be as frequent in cancers as epigenetic alterations. An average cancer of the breast or colon can have about 60 to 70 protein-altering mutations, of which about three or four may be "driver" mutations, and the remaining ones may be "passenger" mutations.[81]

As pointed out above under genetic alterations, cancer is caused by failure to regulate tissue growth, when the genes that regulate cell growth and differentiation are altered. It has become clear that these alterations are caused by both DNA sequence mutation in oncogenes and tumor suppressor genes as well as by epigenetic alterations. The epigenetic deficiencies in expression of DNA repair genes, in particular, likely cause an increased frequency of mutations, some of which then occur in oncogenes and tumor suppressor genes.

Metastasis
Main article: Metastasis
Metastasis is the spread of cancer to other locations in the body. The new tumors are called metastatic tumors, while the original is called the primary tumor. Almost all cancers can metastasize.[82] Most cancer deaths are due to cancer that has spread from its primary site to other organs (metastasized).[83]

Metastasis is very common in the late stages of cancer, and it can occur via the blood or the lymphatic system or both. The typical steps in metastasis are local invasion, intravasation into the blood or lymph, circulation through the body, extravasation into the new tissue, proliferation, and angiogenesis. Different types of cancers tend to metastasize to particular organs, but overall the most common places for metastases to occur are the lungs, liver, brain, and the bones.[82]

Diagnosis

Chest x-ray showing lung cancer in the left lung
Most cancers are initially recognized either because of the appearance of signs or symptoms or through screening. Neither of these lead to a definitive diagnosis, which requires the examination of a tissue sample by a pathologist. People with suspected cancer are investigated with medical tests. These commonly include blood tests, X-rays, CT scans and endoscopy.

Most people are distressed to learn that they have cancer. They may become extremely anxious and depressed. The risk of suicide in people with cancer is approximately double the normal risk.[84]

Classification
Further information: List of cancer types and List of oncology-related terms
Cancers are classified by the type of cell that the tumor cells resemble and is therefore presumed to be the origin of the tumor. These types include:

Carcinoma: Cancers derived from epithelial cells. This group includes many of the most common cancers, particularly in the aged, and include nearly all those developing in the breast, prostate, lung, pancreas, and colon.
Sarcoma: Cancers arising from connective tissue (i.e. bone, cartilage, fat, nerve), each of which develops from cells originating in mesenchymal cells outside the bone marrow.
Lymphoma and leukemia: These two classes of cancer arise from hematopoietic (blood-forming) cells that leave the marrow and tend to mature in the lymph nodes and blood, respectively. Leukemia is the most common type of cancer in children accounting for about 30%.[85]
Germ cell tumor: Cancers derived from pluripotent cells, most often presenting in the testicle or the ovary (seminoma and dysgerminoma, respectively).
Blastoma: Cancers derived from immature "precursor" cells or embryonic tissue. Blastomas are more common in children than in older adults.
Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ or tissue of origin as the root. For example, cancers of the liver parenchyma arising from malignant epithelial cells is called hepatocarcinoma, while a malignancy arising from primitive liver precursor cells is called a hepatoblastoma, and a cancer arising from fat cells is called a liposarcoma. For some common cancers, the English organ name is used. For example, the most common type of breast cancer is called ductal carcinoma of the breast. Here, the adjective ductal refers to the appearance of the cancer under the microscope, which suggests that it has originated in the milk ducts.

Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma (the common name of this frequently occurring benign tumor in the uterus is fibroid). Confusingly, some types of cancer use the -noma suffix, examples including melanoma and seminoma.

Some types of cancer are named for the size and shape of the cells under a microscope, such as giant cell carcinoma, spindle cell carcinoma, and small-cell carcinoma.

Pathology
The tissue diagnosis given by the pathologist indicates the type of cell that is proliferating, its histological grade, genetic abnormalities, and other features of the tumor. Together, this information is useful to evaluate the prognosis of the patient and to choose the best treatment. Cytogenetics and immunohistochemistry are other types of testing that the pathologist may perform on the tissue specimen. These tests may provide information about the molecular changes (such as mutations, fusion genes, and numerical chromosome changes) that have happened in the cancer cells, and may thus also indicate the future behavior of the cancer (prognosis) and best treatment.


An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue
 

An invasive colorectal carcinoma (top center) in a colectomy specimen
 

A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen
 

A large invasive ductal carcinoma in a mastectomy specimen
Prevention
Main article: Cancer prevention
Cancer prevention is defined as active measures to decrease the risk of cancer.[86] The vast majority of cancer cases are due to environmental risk factors, and many, but not all, of these environmental factors are controllable lifestyle choices. Thus, cancer is considered a largely preventable disease.[87] Between 70% and 90% of common cancers are due to environmental factors and therefore possibly preventable.[88]

Greater than 30% of cancer deaths could be prevented by avoiding risk factors including: tobacco, overweight / obesity, an insufficient diet, physical inactivity, alcohol, sexually transmitted infections, and air pollution.[89] Not all environmental causes are controllable, such as naturally occurring background radiation, and other cases of cancer are caused through hereditary genetic disorders, and thus it is not possible to prevent all cases of cancer.

Dietary
Main article: Diet and cancer
While many dietary recommendations have been proposed to reduce the risk of cancer, the evidence to support them is not definitive.[9][90] The primary dietary factors that increase risk are obesity and alcohol consumption; with a diet low in fruits and vegetables and high in red meat being implicated but not confirmed.[91][92] A 2014 meta-analysis did not find a relationship between fruits and vegetables and cancer.[93] Consumption of coffee is associated with a reduced risk of liver cancer.[94] Studies have linked excessive consumption of red or processed meat to an increased risk of breast cancer, colon cancer, and pancreatic cancer, a phenomenon that could be due to the presence of carcinogens in meats cooked at high temperatures.[95][96] This was confirmed in 2015 by the IARC of the World Health Organization, which determined that eating processed meat (e.g., bacon, ham, hot dogs, sausages) and, to a lesser degree, red meat was linked to some cancers.[97][98]

Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruit, whole grains, and fish, and an avoidance of processed and red meat (beef, pork, lamb), animal fats, and refined carbohydrates.[9][90]

Medication
The concept that medications can be used to prevent cancer is attractive, and evidence supports their use in a few defined circumstances.[99] In the general population, NSAIDs reduce the risk of colorectal cancer, however due to the cardiovascular and gastrointestinal side effects they cause overall harm when used for prevention.[100] Aspirin has been found to reduce the risk of death from cancer by about 7%.[101] COX-2 inhibitor may decrease the rate of polyp formation in people with familial adenomatous polyposis, however it is associated with the same adverse effects as NSAIDs.[102] Daily use of tamoxifen or raloxifene has been demonstrated to reduce the risk of developing breast cancer in high-risk women.[103] The benefit versus harm for 5-alpha-reductase inhibitor such as finasteride is not clear.[104]

Vitamins have not been found to be effective at preventing cancer,[105] although low blood levels of vitamin D are correlated with increased cancer risk.[106][107] Whether this relationship is causal and vitamin D supplementation is protective is not determined.[108] Beta-Carotene supplementation has been found to increase lung cancer rates in those who are high risk.[109] Folic acid supplementation has not been found effective in preventing colon cancer and may increase colon polyps.[110] It is unclear if selenium supplementation has an effect.[111]

Vaccination
Vaccines have been developed that prevent infection by some carcinogenic viruses.[112] Human papillomavirus vaccine (Gardasil and Cervarix) decreases the risk of developing cervical cancer.[112] The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases the risk of liver cancer.[112] The administration of human papillomavirus and hepatitis B vaccinations is recommended when resources allow.[113]

Screening
Main article: Cancer screening
Unlike diagnosis efforts prompted by symptoms and medical signs, cancer screening involves efforts to detect cancer after it has formed, but before any noticeable symptoms appear.[114] This may involve physical examination, blood or urine tests, or medical imaging.[114]

Cancer screening is currently not possible for many types of cancers, and even when tests are available, they may not be recommended for everyone. Universal screening or mass screening involves screening everyone.[115] Selective screening identifies people who are known to be at higher risk of developing cancer, such as people with a family history of cancer.[115] Several factors are considered to determine whether the benefits of screening outweigh the risks and the costs of screening.[114] These factors include:

Possible harms from the screening test: for example, X-ray images involve exposure to potentially harmful ionizing radiation.
The likelihood of the test correctly identifying cancer.
The likelihood of cancer being present: Screening is not normally useful for rare cancers.
Possible harms from follow-up procedures.
Whether suitable treatment is available.
Whether early detection improves treatment outcomes.
Whether the cancer will ever need treatment.
Whether the test is acceptable to the people: If a screening test is too burdensome (for example, being extremely painful), then people will refuse to participate.[115]
Cost of the test.
Recommendations
The U.S. Preventive Services Task Force (USPSTF) strongly recommends cervical cancer screening in women who are sexually active and have a cervix at least until the age of 65.[116] They recommend that Americans be screened for colorectal cancer via fecal occult blood testing, sigmoidoscopy, or colonoscopy starting at age 50 until age 75.[117] There is insufficient evidence to recommend for or against screening for skin cancer,[118] oral cancer,[119] lung cancer,[120] or prostate cancer in men under 75.[121] Routine screening is not recommended for bladder cancer,[122] testicular cancer,[123] ovarian cancer,[124] pancreatic cancer,[125] or prostate cancer.[126]

The USPSTF recommends mammography for breast cancer screening every two years for those 50–74 years old; however, they do not recommend either breast self-examination or clinical breast examination.[127] A 2011 Cochrane review came to slightly different conclusions with respect to breast cancer screening stating that routine mammography may do more harm than good.[128]

Japan screens for gastric cancer using photofluorography due to the high incidence there.[19]

Genetic testing
See also: Cancer syndrome
Gene   Cancer types
BRCA1, BRCA2   Breast, ovarian, pancreatic
HNPCC, MLH1, MSH2, MSH6, PMS1, PMS2   Colon, uterine, small bowel, stomach, urinary tract
Genetic testing for individuals at high-risk of certain cancers is recommended.[113][129] Carriers of these mutations may then undergo enhanced surveillance, chemoprevention, or preventative surgery to reduce their subsequent risk.[129]

Management
Main articles: Management of cancer and oncology
Many treatment options for cancer exist, with the primary ones including surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy and palliative care. Which treatments are used depends on the type, location, and grade of the cancer as well as the person's health and wishes. The treatment intent may be curative or not curative.

Chemotherapy
Chemotherapy is the treatment of cancer with one or more cytotoxic anti-neoplastic drugs (chemotherapeutic agents) as part of a standardized regimen. The term encompasses any of a large variety of different anticancer drugs, which are divided into broad categories such as alkylating agents and antimetabolites.[130] Traditional chemotherapeutic agents act by killing cells that divide rapidly, one of the main properties of most cancer cells.

Targeted therapy is a form of chemotherapy that targets specific molecular differences between cancer and normal cells. The first targeted therapies to be developed blocked the estrogen receptor molecule, inhibiting the growth of breast cancer. Another common example is the class of Bcr-Abl inhibitors, which are used to treat chronic myelogenous leukemia (CML).[131] Currently, there are targeted therapies for breast cancer, multiple myeloma, lymphoma, prostate cancer, melanoma and other cancers.[132]

The efficacy of chemotherapy depends on the type of cancer and the stage. In combination with surgery, chemotherapy has proven useful in a number of different cancer types including: breast cancer, colorectal cancer, pancreatic cancer, osteogenic sarcoma, testicular cancer, ovarian cancer, and certain lung cancers.[133] The overall effectiveness ranges from being curative for some cancers, such as some leukemias,[134][135] to being ineffective, such as in some brain tumors,[136] to being needless in others, like most non-melanoma skin cancers.[137] The effectiveness of chemotherapy is often limited by toxicity to other tissues in the body. Even when it is impossible for chemotherapy to provide a permanent cure, chemotherapy may be useful to reduce symptoms like pain or to reduce the size of an inoperable tumor in the hope that surgery will be possible in the future.

Radiation
Radiation therapy involves the use of ionizing radiation in an attempt to either cure or improve the symptoms of cancer. It works by damaging the DNA of cancerous tissue leading to cellular death. To spare normal tissues (such as skin or organs, which radiation must pass through to treat the tumor), shaped radiation beams are aimed from several angles of exposure to intersect at the tumor, providing a much larger absorbed dose there than in the surrounding, healthy tissue. As with chemotherapy, different cancers respond differently to radiation therapy.[138][139][140]

Radiation therapy is used in about half of all cases and the radiation can be from either internal sources in the form of brachytherapy or external radiation sources. The radiation is most commonly low energy x-rays for treating skin cancers while higher energy x-ray beams are used in the treatment of cancers within the body.[141] Radiation is typically used in addition to surgery and or chemotherapy but for certain types of cancer, such as early head and neck cancer, may be used alone.[142] For painful bone metastasis, it has been found to be effective in about 70% of people.[142]

Surgery
Surgery is the primary method of treatment of most isolated solid cancers and may play a role in palliation and prolongation of survival. It is typically an important part of making the definitive diagnosis and staging the tumor as biopsies are usually required. In localized cancer surgery typically attempts to remove the entire mass along with, in certain cases, the lymph nodes in the area. For some types of cancer this is all that is needed to eliminate the cancer.[133]

Palliative care
Palliative care refers to treatment that attempts to make the person feel better and may or may not be combined with an attempt to treat the cancer. Palliative care includes action to reduce the physical, emotional, spiritual, and psycho-social distress experienced by people with cancer. Unlike treatment that is aimed at directly killing cancer cells, the primary goal of palliative care is to improve the person's quality of life.

People at all stages of cancer treatment should have some kind of palliative care to provide comfort. In some cases, medical specialty professional organizations recommend that people and physicians respond to cancer only with palliative care and not with cure-directed therapy.[143] This includes:[144]

people with low performance status, corresponding with limited ability to care for themselves[143]
people who received no benefit from prior evidence-based treatments[143]
people who are not eligible to participate in any appropriate clinical trial[143]
people for whom the physician sees no strong evidence that treatment would be effective[143]
Palliative care is often confused with hospice and therefore only involved when people approach end of life. Like hospice care, palliative care attempts to help the person cope with the immediate needs and to increase the person's comfort. Unlike hospice care, palliative care does not require people to stop treatment aimed at prolonging their lives or curing the cancer.

Multiple national medical guidelines recommend early palliative care for people whose cancer has produced distressing symptoms (pain, shortness of breath, fatigue, nausea) or who need help coping with their illness. In people who have metastatic disease when first diagnosed, oncologists should consider a palliative care consult immediately. Additionally, an oncologist should consider a palliative care consult in any person they feel has less than 12 months of life even if continuing aggressive treatment.[145][146][147]

Immunotherapy
Main article: Cancer immunotherapy
A variety of therapies using immunotherapy, stimulating or helping the immune system to fight cancer, have come into use since 1997, and this continues to be an area of very active research.[148]

Alternative medicine
Complementary and alternative cancer treatments are a diverse group of health care systems, practices, and products that are not part of conventional medicine.[149] "Complementary medicine" refers to methods and substances used along with conventional medicine, while "alternative medicine" refers to compounds used instead of conventional medicine.[150] Most complementary and alternative medicines for cancer have not been rigorously studied or tested. Some alternative treatments have been investigated and shown to be ineffective but still continue to be marketed and promoted. Cancer researcher Andrew J. Vickers has stated: "The label 'unproven' is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been 'disproven'."[151]

Prognosis
See also: List of cancer mortality rates in the United States and Cancer survivor
Cancer has a reputation as a deadly disease. Taken as a whole, about half of people receiving treatment for invasive cancer (excluding carcinoma in situ and non-melanoma skin cancers) die from cancer or its treatment.[19] Survival is worse in the developing world,[19] partly because the types of cancer that are most common there are at present harder to treat than those associated with the lifestyle of developed countries.[152] However, the survival rates vary dramatically by type of cancer, and by the stage at which it is diagnosed, with the range running from the great majority of people surviving to almost no one surviving as long as five years after diagnosis. Once a cancer has metastasized or spread beyond its original site, the prognosis normally becomes much worse.

Those who survive cancer are at increased risk of developing a second primary cancer at about twice the rate of those never diagnosed with cancer.[153] The increased risk is believed to be primarily due to the same risk factors that produced the first cancer, partly due to the treatment for the first cancer, and potentially related to better compliance with screening.[153]

Predicting either short-term or long-term survival is difficult and depends on many factors. The most important factors are the particular kind of cancer and the patient's age and overall health. People who are frail with many other health problems have lower survival rates than otherwise healthy people. A centenarian is unlikely to survive for five years even if the treatment is successful. People who report a higher quality of life tend to survive longer.[154] People with lower quality of life may be affected by major depressive disorder and other complications from cancer treatment and/or disease progression that both impairs their quality of life and reduces their quantity of life. Additionally, patients with worse prognoses may be depressed or report a lower quality of life directly because they correctly perceive that their condition is likely to be fatal.

People with cancer, even those who are walking on their own, have an increased risk of blood clots in veins. The use of heparin appears improve survival and decrease the risk of blood clots.[155]

Epidemiology
Main article: Epidemiology of cancer
See also: List of countries by cancer rate

Death rate adjusted for age for malignant cancer per 100,000 inhabitants in 2004[156]
  no data
  ≤ 55
  55–80
  80–105
  105–130
  130–155
  155–180
  180–205
  205–230
  230–255
  255–280
  280–305
  ≥ 305
In 2008, approximately 12.7 million cancers were diagnosed (excluding non-melanoma skin cancers and other non-invasive cancers),[19] and in 2010 nearly 7.98 million people died.[157] Cancers as a group account for approximately 13% of all deaths each year with the most common being: lung cancer (1.4 million deaths), stomach cancer (740,000 deaths), liver cancer (700,000 deaths), colorectal cancer (610,000 deaths), and breast cancer (460,000 deaths).[158] This makes invasive cancer the leading cause of death in the developed world and the second leading cause of death in the developing world.[19] Over half of cases occur in the developing world.[19]

Deaths from cancer were 5.8 million in 1990[157] and rates have been increasing primarily due to an aging population and lifestyle changes in the developing world.[19] The most significant risk factor for developing cancer is old age.[159] Although it is possible for cancer to strike at any age, most people who are diagnosed with invasive cancer are over the age of 65.[159] According to cancer researcher Robert A. Weinberg, "If we lived long enough, sooner or later we all would get cancer."[160] Some of the association between aging and cancer is attributed to immunosenescence,[161] errors accumulated in DNA over a lifetime,[162] and age-related changes in the endocrine system.[163] The effect of aging on cancer is complicated with a number of factors such as DNA damage and inflammation promoting it and a number of factors such as vascular aging and endocrine changes inhibiting it.[164]

Some slow-growing cancers are particularly common. Autopsy studies in Europe and Asia have shown that up to 36% of people have undiagnosed and apparently harmless thyroid cancer at the time of their deaths, and that 80% of men develop prostate cancer by age 80.[165][166] As these cancers did not cause the person's death, identifying them would have represented overdiagnosis rather than useful medical care.

The three most common childhood cancers are leukemia (34%), brain tumors (23%), and lymphomas (12%).[167] In the United States cancer affects about 1 in 285 children.[168] Rates of childhood cancer have increased by 0.6% per year between 1975 to 2002 in the United States[169] and by 1.1% per year between 1978 and 1997 in Europe.[167] Death from childhood cancer have decreased by half since 1975 in the United States.[168]

History
Main article: History of cancer

Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689
Cancer has existed for all of human history.[170] The earliest written record regarding cancer is from circa 1600 BC in the Egyptian Edwin Smith Papyrus and describes cancer of the breast.[170] Hippocrates (ca. 460 BC – ca. 370 BC) described several kinds of cancer, referring to them with the Greek word καρκίνος karkinos (crab or crayfish).[170] This name comes from the appearance of the cut surface of a solid malignant tumor, with "the veins stretched on all sides as the animal the crab has its feet, whence it derives its name".[171] Galen stated that "cancer of the breast is so called because of the fancied resemblance to a crab given by the lateral prolongations of the tumor and the adjacent distended veins".[172]:738 Celsus (ca. 25 BC – 50 AD) translated karkinos into the Latin cancer, also meaning crab and recommended surgery as treatment.[170] Galen (2nd century AD) disagreed with the use of surgery and recommended purgatives instead.[170] These recommendations largely stood for 1000 years.[170]

In the 15th, 16th and 17th centuries, it became acceptable for doctors to dissect bodies to discover the cause of death.[173] The German professor Wilhelm Fabry believed that breast cancer was caused by a milk clot in a mammary duct. The Dutch professor Francois de la Boe Sylvius, a follower of Descartes, believed that all disease was the outcome of chemical processes, and that acidic lymph fluid was the cause of cancer. His contemporary Nicolaes Tulp believed that cancer was a poison that slowly spreads, and concluded that it was contagious.[174]

The physician John Hill described tobacco snuff as the cause of nose cancer in 1761.[173] This was followed by the report in 1775 by British surgeon Percivall Pott that chimney sweeps' carcinoma, a cancer of the scrotum, was a common disease among chimney sweeps.[175] With the widespread use of the microscope in the 18th century, it was discovered that the 'cancer poison' spread from the primary tumor through the lymph nodes to other sites ("metastasis"). This view of the disease was first formulated by the English surgeon Campbell De Morgan between 1871 and 1874.[176]

Society and culture
Though many diseases (such as heart failure) may have a worse prognosis than most cases of cancer, cancer is the subject of widespread fear and taboos. The euphemism "after a long illness" is still commonly used (2012), reflecting an apparent stigma.[177] This deep belief that cancer is necessarily a difficult and usually deadly disease is reflected in the systems chosen by society to compile cancer statistics: the most common form of cancer—non-melanoma skin cancers, accounting for about one-third of all cancer cases worldwide, but very few deaths[178][179]—are excluded from cancer statistics specifically because they are easily treated and almost always cured, often in a single, short, outpatient procedure.[180]

Cancer is regarded as a disease that must be "fought" to end the "civil insurrection"; a War on Cancer has been declared. Military metaphors are particularly common in descriptions of cancer's human effects, and they emphasize both the parlous state of the affected individual's health and the need for the individual to take immediate, decisive actions himself, rather than to delay, to ignore, or to rely entirely on others caring for him. The military metaphors also help rationalize radical, destructive treatments.[181][182]

In the 1970s, a relatively popular alternative cancer treatment was a specialized form of talk therapy, based on the idea that cancer was caused by a bad attitude.[183] People with a "cancer personality"—depressed, repressed, self-loathing, and afraid to express their emotions—were believed to have manifested cancer through subconscious desire. Some psychotherapists said that treatment to change the patient's outlook on life would cure the cancer.[183] Among other effects, this belief allows society to blame the victim for having caused the cancer (by "wanting" it) or having prevented its cure (by not becoming a sufficiently happy, fearless, and loving person).[184] It also increases patients' anxiety, as they incorrectly believe that natural emotions of sadness, anger or fear shorten their lives.[184] The idea was excoriated by the notoriously outspoken Susan Sontag, who published Illness as Metaphor while recovering from treatment for breast cancer in 1978.[183] Although the original idea is now generally regarded as nonsense, the idea partly persists in a reduced form with a widespread, but incorrect, belief that deliberately cultivating a habit of positive thinking will increase survival.[184] This notion is particularly strong in breast cancer culture.[184]

One idea about why people with cancer are blamed or stigmatized, called the just-world hypothesis, is that blaming cancer on the patient's actions or attitudes allows the blamers to regain a sense of control. This is based upon the blamers' belief that the world is fundamentally just, and so any dangerous illness, like cancer, must be a type of punishment for bad choices, because in a just world, bad things would not happen to good people.[185]

Economic effect
In 2007, the overall costs of cancer in the U.S. — including treatment and indirect mortality expenses (such as lost productivity in the workplace) — was estimated to be $226.8 billion. In 2009, 32% of Hispanics and 10% of children 17 years old or younger lacked health insurance; "uninsured patients and those from ethnic minorities are substantially more likely to be diagnosed with cancer at a later stage, when treatment can be more extensive and more costly."[186]

Research
Main article: Cancer research
Because cancer is a class of diseases,[187][188] it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases.[189] Angiogenesis inhibitors were once thought to have potential as a "silver bullet" treatment applicable to many types of cancer, but this has not been the case in practice.[190] It is more likely that angiogenesis inhibitors and other cancer therapeutics will be used in combination to reduce cancer morbidity and mortality.[191]

Experimental cancer treatments are treatments that are being studied to see whether they work. Typically, these are studied in clinical trials to compare the proposed treatment to the best existing treatment. They may be entirely new treatments, or they may be treatments that have been used successfully in one type of cancer, and are now being tested to see whether they are effective in another type.[192] More and more, such treatments are being developed alongside companion diagnostic tests to target the right drugs to the right patients, based on their individual biology.[193]

Cancer research is the intense scientific effort to understand disease processes and discover possible therapies.

Research about cancer causes focuses on the following issues:

Agents (e.g. viruses) and events (e.g. mutations) that cause or facilitate genetic changes in cells destined to become cancer.
The precise nature of the genetic damage, and the genes that are affected by it.
The consequences of those genetic changes on the biology of the cell, both in generating the defining properties of a cancer cell, and in facilitating additional genetic events that lead to further progression of the cancer.
The improved understanding of molecular biology and cellular biology due to cancer research has led to a number of new treatments for cancer since U.S. President Nixon declared the "War on Cancer" in 1971. Since then, the U.S. has spent over $200 billion on cancer research, including resources from the public and private sectors and foundations.