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Unit 1 > 9/26a Cancer (Biomedical Sciences) > Flashcards

9/26a Cancer (Biomedical Sciences) Flashcards

1
Q

Define Neoplasm

A

Tumor, new tissue growth

-spectrum of disease characterized by abnormal growth of cells resulting in distorted tissue architecture

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2
Q

Classification of cancer systems

A

Benign vs malignant
Tissue of origin
Anatomic location

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3
Q

Define Dysplastic

A

abnormal cells that are not cancerous - often precursor to cancerous lesions

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4
Q

different kinds of dysplastic cells

A
  • precursor cancer stage
  • Skin - dysplastic nevi = moles
  • monitor for progression/growth
  • can be seen on pap-smears and colonoscopies
  • don’t typically cause cancer until there are greater than 1 billion of those cells
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5
Q

Define in situ

A

neoplasm that has not invaded adjacent structures

  • ex: breast cancer
  • Isolated!!
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6
Q

Define malignant

A

cancerous, abnormal cells

  • capable of invasion and local/distant spread (metastasis)
  • fast growing
  • invasive, infiltrative
  • anaplastic, undifferentiated, and/or immature cells
  • NOT NORMAL CELLS
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7
Q

Define benign

A

non-cancerous, normal cells, organized and localized

  • non-invasive
  • does not spread
  • slow growing
  • encapsulated
  • well-differentiated cells
  • not harmless, BUT you may have a benign tumor in the brain and if it gets larger you will still have the neurologic deficits if the tumor is pushing on the brain
  • NORMAL CELLS
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8
Q

Classifying cancer

A

Epithelial Tissue (skin glands, GI/GU, reproductive)
-Benign: adenoma
-Malignant: carcinoma
Connective Tissue (bone, fat, muscle, cartilage)
-Bengin: tissue type + “-oma” - lipoma
-Malignant: Sarcoma

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9
Q 
Benign tumor of fat cells: 
Malignant tumor of squamous cells: 
Malignant tumor of basal cells:
Malignant tumor of breast glandular cells: 
Benign tumor of bone: 
Malignant tumor of bone:
A 
lipoma
squamous cell carcinoma
basal cell carcinoma
breast adenocarcinoma
osteoma
Osteosarcoma
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10
Q

Epidemiology and pathophysiology of cancer

A
  1. approximately 40% of americans will be diagnosed with cancer in their lifetime
    - Males most common: prostate, lung, colorectal
    - Females most common: breast, lung, colorectal
  2. second most common cause of death in US, though decreasing
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11
Q

why are cancer survival rates increasing?

A

Prevention, Detection, and Treatment

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12
Q

Why is health poor even after survival of cancer?

A
  • there are emotional considerations

- significantly less likely for people to return to work in comparison with other disorders

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13
Q

how are physical therapists and healthcare providers to help cancer patients after survival

A

help them become more functional in society

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14
Q

how does cell growth and maturation occur?

A

throughout embryogenesis, growth, tissue repair, and remodeling

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15
Q

what are necessary components of healthy cell growth?

A
  • recognize DNA damage or errors in replication
  • activate checkpoints to stop further/unnecessary replication
  • implement corrective measures or induce apoptosis
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16
Q

what are reasons for loss of control of cell growth?

A
  • genetic: hereditary predisposition (inactivation of tumor suppressor gene - stops and gives negative FB to cell or overactivation of oncogenes)
  • epigenetic: chronic inflammation from environmental situations (poor diet, inactivity, hormones)
  • abnormal signaling: RAS pathway, positive and negative FB that is signaling uncontrolled cell proliferation
17
Q

Normal cell growth cycle

A

mitosis > 2 homologous pairs > G1 cell growth > oncogenes > tumor suppressor genes > synthesis > DNA repair genes > G2

–Need good cell repair processes

18
Q

Loss of normal growth control

A

Inactivation > normal cell growth > cell damage/no repair > cell suicide or apoptosis
Overactivation > cancer cell division > first mutation > second mutation > third mutation > fourth mutation > uncontrolled growth

19
Q

Tumor suppressor genes (most common)

A

first checkpoint in cell growth - stops and gives negative FB to cell growth

20
Q

oncogenes

A

give positive FB to cell growth

21
Q

Viruses that introduce foreign genetic material

A

HPV (most common/well known), Herpes virus, t-cell leukemia virus all introduce cancerous material to the host cell

22
Q

Overactication of ras pathway leads to:

A

another factor that leads to uncontrolled proliferation in cell growth

23
Q

abnormal signaling

A
  1. hormone receptors (estrogen) - hormone replacemet for menopause increases the rate for certain cancers (uteran and breast)
  2. angiogenesis (VEGF) - vascular endothelial growth factor, collection of new tumor cells are becoming vascularized. Most common route of spreading is through tumors in the blood stream that spread to distant sites
24
Q

Neoplasia hallmarks of cancer

A
  1. Proliferation (ability and speed + uncontrolled)
  2. invasion of nearby tissues and structures through the basement membrane
  3. metastatic potential primarily through angiogenesis through BVs
25
Q

Common sites of metastasis

A

Bone, liver, brain, lungs and sometimes adrenal glands

26
Q

Cancer risk factors

A
  • tobacco (most common) - When a healthcare provider talks to a patient about smoking, they are around 10-20% successful in helping them quit
  • Nutrition - not eating enough fruits and veggies
  • physical activity - living a sedentary life, direct relationship between exercise and physical activity
  • alcohol
  • excess sun exposure
  • weight
  • genetics
  • environmental exposure
  • viruses/prior infections
  • immunocompromised state
27
Q

Diagnosing cancer

A
  1. screening - the more up to date, the better
  2. genetic testing
  3. diagnostic imaging (often incidental)
  4. clinical manifestations/symptoms and systemic effects
  5. ultimately need biopsy for tissue sample to confirm
28
Q

Cancer Screening Guideliens

A

Colorectal - colonoscopy starting at age 50
Breast - mammogram starting at age 40-50
cervical - pap smear starting at age 21
prostate - PSA test + rectal exam starting at age 50, but no longer recommended bc of USA preventative task force
lung - low dose CT starting at age 55 for those with >30 pack year smoking history

29
Q

Signs and symptoms concerning for cancer

A 
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump (in breast or elsewhere)
Inability to swallow food easily
Obvious change in a wart or mole
Nagging cough or hoarseness
30
Q

Grading and staging cancer

A

-higher the grade, the more abnormal the cells were
-staging - TNM: TUmor, Number of lymph nodes affected, Metastasis
Stage I: small, local tumor; Stage IV: widespread metastatic disease

31
Q

when do PTs get involved with cancer patients?

A
  • Curative Intent: 5 year disease free survival
  • Palliative: improve symptom burden and quality of life
  • Hospice Care: expected survival <6 months, focus on QOL
32
Q

Role of PT in cancer treatment?

A
  1. Prevention/Improved QOL: anti-inflammatory benefits of physical activity/exercise; promotion of a healthy lifestyle
  2. Functional Status - ability to receive treatment; cardiovascular, metabolic and immune function
  3. Anti-inflammatory benefits: improved survival in physically active patients
33
Q

ECOG - eastern cooperative oncology group

A

Used for treatment, patients must be 0-2 to be candidates for chemotherapy
ECOG 4 - often consider hospice care

34
Q

Treatment-associated comorbidities

A

Post-operative deconditioning and mobility
Cancer-related fatigue
Chemotherapy-related cognitive impairment
Lymphedema
Radiation Fibrosis

35
Q

when to refer a patient to ER

A

sudden change, unstable, shortness of breath, muscle pain weakness, worsening of mental status

Unit 1 (28 decks)

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