Biology of Cancer Lecture Powerpoint Flashcards
Cancer is a disease of the…
…genome
Caretaker genes
Genes that function to maintain the integrity of the genome
Oncogenes in a healthy individual are in a state of ___, while tumor suppressor genes are ___
inactivity, active
Over 400 tumor suppressor genes exist in this animal causing prevalence of cancer to be near zero.
What is the difference between acquired and inherited somatic mutations?
Elephant, acquired are received thruout the lifetime due to spontaneous mutation and make up the majority of mutations, while inherited are those that an individual receives from parents
2 hallmarks of solid tumor malignancy
- anorexia
- cachexia (muscle wasting)
Cancers associated with selected genetic mutations (Philadelphia chromosome, P210, ALK, BRCA)
CML, Myeloid expansion in bone marrow, lung cancer, breast/ovary
2 types of cancers that almost never metastasize
Basal cell carcinoma and squamous cell carcinoma on the skin
2 serotypes of HPV that are associated with cervix cancer
16 and 18
Organism agent promoting cancer development
Helicobacter pylori
Common chemoprotective agents (5)
Tamoxifen Oral contraceptives Topical sunscreen Lycopene (prostate) aspirin (colon and breast cancer)
Family history screen 7 for BRCA1/2 risk assessment
A questionnaire of 7 questions where one positive response initiates referral for screening
If a breast is too dense for x ray mammography, 2 alternatives are…
…ultrasound and MRI
Once an individual has a positive screen, they are referred to…..
…A respective specialist who will then take a sample which after being sent to pathology is diagnosed
Once a single lymph node is involved in a cancer….
….survival rate drops substantially, it is considered stage II at least at that point
TNM system for stage 0, I, II, IIIA,B,C, and IV
Stage 0 T0N0M0 Stage I T1N0M0 Stage II T1-2N1M0 Stage IIIA T1-3,N2,M0 Stage IIIB T4NanyM0 Stage IIIC TanyN2M0 Stage IV TanyNanyM1
5 year survival rate for cancer is determined by…
…what stage it is at, regardless of what type
Li fraumeni syndrome
A collection of cancers that are related to the defective tumor suppressor gene TP53 including breast, leukemia, brain, etc
Lynch (hereditary nonpolyposis colon cancer) syndrome
A collection of cancers that are related to the defective tumor suppressor genes MSH2 causing colon cancer without polyps which is unique
Lung cancer in someone who has never smoked or exposed to smoke is most likely due to…
…radon exposure
Signs that would indicate referral for woman with pelvic mass to gynecologic oncologist
- elevated CA 125 level
- ascites
- abdominal or fixed pelvic mass
- evidence of abdominal or distant metastases
Most ovarian cancers are what type? What are 2 concerns regarding ovarian cancer?
Serous carcinoma of the surface epithelium of the ovary, although all tissue in the ovary can become cancerous and they are free in the peritoneum meaning they can spread thru that space and potentially distantly metastasize
Superficial spreading melanoma
A very treatable form of melanoma that grows outward opposed to deep and with large excision can be easily detected and treated fully
Condition of “stuck on lesions” that many confuse with malignant nodular melanoma
Seborrheic keratoses
ABCDE of melanoma
Asymmetry (unbalanced) Border (not smooth) Color (more than one) Diameter (thicker than pencil eraser) Evolving (progressing)
4 pattern subtypes of melanoma
- Superficial spreading
- lentigo maligna melanoma (moles that become cancer)
- Acral lentiginous melanoma (on far off surfaces such as under the nail)
- nodular melanoma (raised and firm)
Sentinal lymph node dissection
Proedure where radioactive blue dye is injected into the tumor area, then a geigar counter traces it to the sentinal node then potentially dissects out that and the closest 2 or 3 to ensure that the cancer has not spread
Upon visualization of mass on mammogram + follow up confirmatory ultrasound, what technique is often employed to then confirm the suspected diagnosis?
-Fine needle aspiration from the breast tissue
Risks of colon cancer increase dramatically after age…
…50
Colonoscopy scheduling
Once every 10 years, if detected malignancy then every 2-3 years then 5 then back to 10
Small cell lung cancer
Contains neuro and endocrine components, no surgery will help (treatment is chemo therapy and radiation) that FREQUENTLY metastases to the brain
Coin lesions
Common name for finding on an x ray that is a solid pulmonary lesion that is often asymptomatic. Can be a small or non small cell lung cancer or benign that requires biopsy for further diagnosis
Pancoast tumor and treatment options
A rare form high lying tumor in the lung in the upper lobe near the clavicle that can put pressure on the brachial plexus resulting in horner syndrome, treated with wedge resection
Mesothelioma
Occupational cancer, pleural based malignancy caused by exposure to asbestos, cannot be dealt with surgically as it is diffuse in the pleura and doesn’t respond to any chemotherapy yet devised
Examples of oncologic emergencies (4)
- spinal cord compression
- tumor lysis syndrome
- hypercalcemia
- superior vena cava (obstruction syndrome)
Superior vena cava syndrome
Occurs when blockage due to lump in upper right chest limits blood return to the heart causing facial and upper extremity edema, shortness of breath, distended neck veins, dyspnea, and cough
If prostate cancer spreads to the bone, you have what type of cancer in the bone?
Prostate cancer
Prostate cancer staging
Stage I - small and only in prostate
II - may be in both lobes
III - spread byeond to close lymph nodes or sseminal vesicles
IV - metastatic
A Gleason score that requires some form of intervention beyond watchful waiting
> 6
Brachytherapy for prostate cancer is limited to those with a gleason score below…
…6
Space OAR
a hydrogel that protects the rectum during radiation from prostate cancer lasting approx 3 months done via a needle that inserts between the rectum and prostate
Androgen deprivation therapy agents for prostate cancer (2)
- leuprolide
- flutamide
