Which of the following is a canonical hallmark of cancer?

• A. Sustained proliferative signaling
• B. Evading growth suppressors
• C. Activating invasion and metastasis
• D. Resisting cell death

Answer: (D)

Cancer cells' ability to resist programmed cell death is a canonical hallmark. In healthy tissue, cells that incur severe damage or stress undergo apoptosis to prevent malignant transformation. Cancer cells often disable this safeguard—through p53 loss, upregulation of anti-apoptotic proteins like Bcl-2, or constant survival signaling—so they survive where normal cells would die. This survival under stress lets them accumulate more mutations and makes them harder to kill with therapies that rely on triggering cell death. While other listed traits are also hallmarks, resisting cell death directly embodies the persistence and treatment resistance that define cancerous cells.