1 Childhood Cancer Overview

Question 1

What are the cellular changes that cause DNA mutation –> cancer?

Answer 1

Lack of cell differentiation
Loss of contact inhibition
Unregulated growth
Cellular immortality

Question 2

List 5 genetic predispositions to cancer (fragile chromosomes)

Answer 2

• Down Syndrome
• Li-Fraumeni
• Retinoblastoma gene (the inherited form, lacking one pair of tumor suppressor geners making it more likely to develop)
• Immunodeficiency (immune system plays protective role against cancer, AIDS or imunosuppressive drugs could predispose)
• History of cancer or cancer tx

Question 3

Three germ cell layers of a developing embryo

Answer 3

Ectoderm, mesoderm, endoderm. All body tissues come from these.

Question 4

Most childhood cancer originates form which germ cell layer? Most adult cancers come from which later?

Answer 4

Childhood - ecto and mesoderm. (brain, adrenal, blood, bone, kidney, pleura, etc.)
Adult- endo (tissues most exposed to the environment such as epithelial cells, GI tract, thyroid)

Question 5

Which childhood cancers are associated with peak growth periods

Answer 5

Infancy and early childhood: wilms, retinoblastoma

Adolescence: hodgkins, osteosarcoma

Question 6

Reasons for improved survival w/ pediatric cancer?

Answer 6

high rates of participation with clinical trials, using multimodal therapy and intensive supportive care.

Question 7

Teenagers: what did the study stay about treating on pediatric trials vs adult trials?

Answer 7

64% event free survival vs 34%. Same disease but different eras - adolscnets do better when treated on peds protocols