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Block 7 Week 1 > Barsky: Cancer > Flashcards

Barsky: Cancer Flashcards

1
Q

Men have the highest incidence of which cancer?

Women have the highest incidence of which cancer?

Both men and women have the highest death rates from which cancer?

A

prostate; breast; lung

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2
Q

Two factors leading to tumor progression?

A

genetic: mutations, rearrangements in proto-oncogenes

epigenetics

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3
Q

It’s important to know that cancer is a multi-hit event. Why does this help explain why cancer is a disease of aging?

A

It takes years to accumulate “hits” - this is why neonates don’t get cancer

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4
Q

Why is it important to catch cancer when it is “in situ” vs. invasive?

A

To become metastatic/invasive, cancer must break through the epithelial barriers of the blood or lymph vessels and spread through the circulation. If it is still contained within its barriers, the cancer cells can be surgically removed and rid of before it spreads systemically.

**once you have invasion, it doesn’t take much to develop micrometastasis

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5
Q

4 properties of cancer

A

disease of uncontrolled growth
disease of invasion and metastasis
clonal dominance
loss of differentiation

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6
Q

What is clonal dominance?

A

cells in a cancer have come from one single ancestral cancer cell

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7
Q

What is tumor heterogeneity?

A

as tumors grow, mutant subclones are derived - as the tumor grows, it acquires other traits through tumor heterogeneity

**this makes it hard to treat cancer (too many different types of cells)

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8
Q

4 types of cancer therapy

A

surgery
radiotherapy
chemotherapy
immunotherapy

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9
Q

List 3 limitations in treating cancer

A
  1. lack of tumor specific antigen
  2. tumor cell heterogeneity
  3. micrometastasis
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10
Q

List some causes of human cancer

A 
environmental carcinogens
UV radiation
ionizing radiation
viruses
lifestyle, diet, immune status
hereditary factors or genes
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11
Q

How do chemical carcinogens cause cancer?

A

bind to DNA (electrophile) and form DNA adducts which give rise to mutations; if the mutations occur in “hot spot” genes, then they can be carcinogenic

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12
Q

How does UV/ionizing radiation cause cancer?

A

chromosome breakage, translocations and point mutations; ACTION IS SIMILAR TO CHEMICAL CARCINOGENS - FORMATION OF DNA ADDUCTS

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13
Q

What genes in HPV are important? What do they do?

A

E6 and E7; they inactivate tumor suppressors p53 and pRb

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14
Q

How is UV/ionizing radiation different from other chemical carcinogens?

A

can cause single and double stranded DNA breaks

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15
Q

4 cancers associated with Epstein Bar Virus?

A

Burkitt’s lymphoma
B cell lymphoma in AIDS pts
Hodgkin’s disease
Nasopharyngeal cancer

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16
Q

Why do immunodeficient hosts have a higher rate of certain cancers, esp virally-induced cancers?

A

they lack the proper antigen recognition of the viral cells

**immunocompromised pts not necessarily more susceptible to cancers like breast cancer that don’t have an antigenic marker

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17
Q

T/F: Nuns (women who are nulliparous) have a high rate of breast cancer

A

True

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18
Q

Men who are obese have a higher rate of this cancer

A

esophageal

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19
Q

Women who eat fatty foods have a higher rate of this cancer

A

breast

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20
Q

People who eat red meat have a higher incidence of this cancer

A

colon

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21
Q

Do more cancers have a familial component or inherited component?

A

familial

**certain cancers run in families

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22
Q

What is the cause of MOST cancers?

A

spontaneous and sporadic - UNKNOWN CAUSE

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23
Q

List two key properties of cancers

A
  1. growth in an uncontrolled manner

2. invasion and metastasis

24
Q

Genes that code for products associated with neoplastic transformation

A

oncogenes

25
Q

NORMAL genes that affect growth and differentiation

A

Protooncogenes

26
Q

What activates protooncogenes to oncogenes?

A

point mutations
chromosomal translocation
gene amplification

27
Q

T/F: Some cancers are caused by a gain of function mutation, while others are due to loss of function mutation (tumor suppresors)

A

True

28
Q

One of the most commonly mutated genes seen in virtually all types of human cancers;
Multiple complex functions involving antiproliferation and apoptosis

A

p53

29
Q

This syndrome is caused by one mutant p53 allele

A

Li Fraumeni syndrome

30
Q

Certain DNA viruses can inactivate this tumor suppressor

A

p53

31
Q

What is unique about the retinoblastoma hypothesis?

A

two hits - both Rb genes must be inactivated by somatic mutation, but FAMILIAL cases only require one hit

32
Q

T/F: Cancer is characterized by methylation and histone deacytylation imbalance

A

True

33
Q

Active migration of neoplastic cells out of their tissue or origin and across host tissue boundaries

A

cancer invastion

34
Q

A secondary tumor colony discontinuous from the primary tumor

A

metastasis

35
Q

How do sarcomas tend to spread?

A

Through the blood vessels

36
Q

How do carcinomas tend to spread?

A

Through the lymph

37
Q

3 routes of metastasis

A

blood
lymph
transcoelomic (seeding by body cavities) *Peritoneal, pleural, pericardial and subarachnoid spaces

38
Q

Grading is measure of the degree of differentiation. What are the categories of GRADING?

A

1-4; well differentiated - moderately - poorly differentiated - undifferentiated

39
Q

Grading of cancer tells us about (blank)

A

prognosis

40
Q

Staging is a degree of invasion and metastasis. What system is used for staging?

A

T: tumor size (ex: T1, T2, T3…)
N: nodes (how many nodes involved ex: N0, N1…)
M: metastasis present or no

41
Q

Compare grading and staging

A

grading: differentiation
staging: invasion and metastasis

grading: 1-4
staging: TNM

42
Q

What happens to tumor cells when they become carcinogenic?

A

they become less cohesive and lose their attachment to matrix components (more motility); they degrade the ECM via metalloproteinases and migrate

43
Q

What is the soil seed hypothesis of paget?

A

cancers tend to grow in certain organs

44
Q

Is systemic metastasis an early event?

A

yes, circulating tumor cells are found in the blood early on in cancer; disseminated cells are found in organs early, too

45
Q

Why do many cancers recur?

A

cancer stem cells

46
Q

3 properties of all stem cells

A

self-renewal
symmetrical and asymmetrical cell division
pluripotent

47
Q

Propeties of cancer stem cells

A

Exist in a resting or dormant state

Resist chemotherapy and radiotherapy

Express embryonic stem cell pathways

Replenish the dividing cell population of the tumor

48
Q

What must be present in order for metastases to occur?

A

cancer stem cells

49
Q

Why might tumor recurrence occur?

A

stem cells are repopulating the tumor

**tumor treatments need to not only target tumor cells, but stem cells as well

50
Q

Any gene or gene product altered in tumor progression

A

tumor marker

51
Q

weight loss, weakness, anorexia, and anemia associated with cancers

A

cachexia

52
Q

Can tumor markers be used for definitive diagnosis?

A

no; but can be used for staging, detecting recurrences, and monitoring effectiveness and therapy

53
Q

GIVE US INFORMATION ABOUT PROGNOSIS: DISEASE-FREE SURVIVAL, OVERALL SURVIVAL, LENGTH OF LATENCY

A

prognostic markers

54
Q

What are some examples of prognostic markers?

A

ER (estrogen receptor) in breast cancer; p21 and p27 in prostate cancer

55
Q

GIVE US INFORMATION REGARDING THE EFFECTIVENESS OF A CHEMOPREVENTIVE OR THERAPEUTIC STRATEGY BEFORE DIRECT TUMORAL MEASUREMENTS CAN BE ASSESSED.

A

surrogate end point markers (intermediate markers)

**used in clinical trials as a marker or how effective treatments are

56
Q

Why do we need predictive markers?

A

to guide therapy

Block 7 Week 1 (9 decks)

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