Bolded Cancer Flashcards
loss of cellular differentiation, irregularities of size and shape of nucleus, loss of normal tissue structure
anaplasia
*cells become pleomorphic - meaning they are variable sizes and shapes
tumor =
new growth (neoplasm)
preinvasive epithelial MALIGNANT tumors of glandular or epithelial origin that have not broken through the basement membrane or invaded the surrounding stroma
recognized in? main type (probably)
carcinoma in situ (CIS)
recognized in cervix, skin, oral cavity, esophagus, and bronchus
glandular epithelial in situ lesions - stomach, breast, endometrium, large bowel
DCIS - ductal carcinoma in situ in breast
- fills mammary ducts, but not progressed to local tissue invasion
- readily treatable
*abnormal cells grown in normal place
substances produced by cancer cells or that are found on plasma cell membranes, in the blood, CSF, or urine
examples?
tumor cell markers
- produced by benign or malignant cells
- hormones, enzymes, genes, antigens, antibodies
- liver tumor - alpha fetoprotein (AFP) blood
- PSA in blood = prostate tumor
If tumor marker, itself, has biologic activity what occurs? Example of this?
symptoms are expressed
- this phenomenon AKA paraneoplastic syndrome
- a type of this is pheochromocytoma = usually benign tumor of the adrenal medulla that causes production of epinephrine and adrenaline (epinephrine) in excess (both considered hormones). This leads to SNS activation - sweating, increased BP, increased HR, h/a
The process by which a normal cell becomes a cancer cell
TRANSFORMATION - CARCINOGENESIS
Transformation/carcinogenesis involves
*all cancers involve malfunction of genes that regulate cell growth and devision
- autonomy - independent control
- lack of contact inhibition - not limited by crowding
- has anchorage independence - normal cells will not grow unless attached to firm surface
- are immortal
cancer metabolism
cancer cells always perform ______?
cancer can grow in hypoxic & acidic environment
glycolysis, even in presence of O2 - allows for more rapid cell growth
cancer stem cells do what? and are what?
self-renew, and are multi-potent meaning they can differentiate into many cell types
cancer causing mutations turn on what?
telomerase and new blood vessel growth
cancer causing mutations…
- prevent apoptosis
- turn on telomerase and new blood vessel growth
- allow tissue invasion and distant metastasis
- activate growth-promotion pathways
- block antigrowth signals
normal genes that direct protein synthesis and cellular growth
proto-oncogenes (non-mutant genes)
*a normal gene that when it undergoes mutation becomes an oncogene
encode proteins in their normal state that positively regulate proliferation
oncogenes (mutant genes)
encode proteins that in their normal state negatively regulate proliferation
anti-oncogenes or TUMOR suppressor genes
encode for proteins that are involved in repairing damaged DNA - responsible for the maintenance
*inherited mutations of these genes can lead to?
caretaker genes
HNPCC (hereditary non-polyposis colorectal cancer) - small area of insertions and deletions that lead to high rate of colon cancer
chromosomal instability in cancer can result in…
a high rate of chromosomal loss, as well as loss of heterozygosity and chromosomal amplification; each of these events can ACCELERATE THE LOSS OF TUMOR-SUPPRESSOR GENES AND THE OVER EXPRESSION OF ONCOGENES
chromosome instability may result in the over expression of
oncogenes
protective caps on each chromosome that blocks cell division and prevents immortality
TELOMERES
*remember that telomeres become smaller and smaller with each cell division and eventually die
cancer cells can activate ______ which leads to unlimited division and proliferation
telomerase - this restores and maintains telomeres
tumor spread by 3 mechanisms
1- direct invasion of contiguous organs known as local spread
2- metastases to distant organs through lymph and blood circulation
3- direct transportation - carried on surgical instrument
a prerequisite for metastasis and the FIRST step in the metastatic process
INVASION: LOCAL SPREAD
- cancer often spreads first to regional lymph nodes and then to distant organs through the blood - can do this through angiogenesis
- invasion then requires that the cancer attach to specific receptors and survive in that environment
what do cancer cells secrete that helps them move through extracellular matrix and basement membranes?
protease
what is EMT
epithelial-mesenchymal transition - increases migratory capacity (decreased adherence), increases resistance to apoptosis, and causes dedifferentiation to a stem cell-like state to favor growth in new environment
Cancer Stages
stage 1- confined to its organ of origin
stage 2- locally invasive (contiguous)
stage 3- advanced to regional structures (nodes)
stage 4- has spread to distant sites
TNM
tumor, node involvement, metastasis
Pain - how much in early stage, later stage? influenced by? Mechanisms?
- little or no pain is associated with early stages of malignancy; usually associated with later stages of cancer
- influenced by fear, anxiety, sleep loss, fatigue, and overall physical deterioration
- mechanisms: pressure, obstruction, invasion of sensitive structures, stretching of visceral surfaces, tissue destruction, inflammation
Most reported symptom of cancer and cancer tx?
fatigue
syndrome of cachexia
includes?
loss of appetite, progressive weight loss, and malnutrition
- MOST severe form of malnutrition
- present in 80% of cancer patients AT DEATH
- includes anorexia, early satiety, weight loss, anemia, asthenia (weak), taste alterations, and altered protein, lipid, and carb metabolism
clinical manifestations of cancer
*anemia - associated w/tx, malignancy (blood-forming organs), chronic bleeding, severe malnutrition
- leukopenia, thrombocytopenia d/t chemo or malignancy in DM
- infection d/t low wbc count is the most common cause of complication and death
*stomatitis, malabsorption, diarrhea, hair loss
change in genetic expression (phenotype) without DNA mutation
influenced by?
usually involve?
epigenetics - involve gene silencing or lack of gene silencing (genes are switched on and off)
-influenced by environment/lifestyle including in utero
leading in # of cancer dx in men and women
men - prostate; women - breast
leading cause of cancer death in men & women?
lung for both
Tobacco increased r/f what types of cancer?
- lung, lower urinary tract, upper aero-digestive tract, liver, kidney, pancreas, cervix, uterus
- pipe smoker: lung, throat, esophagus, larynx, pancreas, colon
- myeloid leukemia
study of nutrigenomics
study of how nutrition on the phenotypic variation of individuals, based on genomic differences
foods that cause cancer
foods cooked in fat, meat, and alkaloids or mold byproducts (cheese?)
dietary factors can alter what and cause cancer?
alters micro-ribonucleic acid (miRNA)
foods that improve DNA repair and help prevent cancer
cooked carrots, kiwi, co-enzyme Q10
other foods that decrease cancer risk?
fruit/veggie, fiber; vitamins A, B6, C, D, E, and folate; whole grains; lycopene; legumes/nuts
foods that increase r/f cancer?
fat (omega-6 fatty acids), high-glycemic carbs, preservatives, alcohol, grilled/blackened, fried, HIGH levels of calcium >2000mg, refined grain products
Obesity causes insulin-resistance which causes hyper insulinemia - this does what?
increases the r/f cancer of the CE KP - colon, endometrium, kidney, pancreas
+ prostate b/c insulin promotes secretion of insulin-like growth factor which increases r/f prostate cancer
*also remember that adipose tissue secretes adipokines which increase inflammation
remember that alcohol consumption can increase r/f
breast, colon, esophageal, liver, pharynx, oral cavity cancers
EBV connected to what type of cancer?
cancers of the nasopharynx, Hodgkin disease, and non-Hodgkin lymphoma
HIV r/t what type of cancer?
lymphoma and Kaposi sarcoma
Human t-cell lymphotrophic virus type 1 linked to what types of cancer?
leukemia and lymphoma
most common STI
HPV
which HPV types cause the majority of cancers?
16, 18 - think ages when you have SEX
HPV can cause cancers of…infect epithelial cells
cervix, anus, penis, oropharynx (base of tongue, soft palate, tonsils)
ionizing radiation sources and what does it cause?
x-ray, radiation - causes deposition of energy into tissue and can lead to oncogene activation, DNA damage, etc.
*could also come from background radiation from soil, rocks, radon (come from homes or other buildings)
UV radiation cause gene mutations that cause skin cancer
UVA UVB in sunlight - promotes inflammation and ROS
Occupational carcinogenic agents
- asbestos - mesothelioma and lung cancer
- dyes, rubber, paint - bladder cancer
- explosives, rubber, cement, benzol, and dyeing materials - leukemia
- heavy metals
*can accumulate in body fat and remain there for years
indoor pollution
considered worse than outdoor
smoking and radon cause lung cancer
inorganic arsenic - bladder, skin and lung cancer
cancer in children
leading cause of death d/t disease in children, but relatively rare
most common types of childhood cancer
MOST COMMON
most common type of solid tumors
leukemias and brain tumors
ALL - acute lymphoblastic leukemia
Central nervous system tumors
most childhood cancers originate from
mesodermal germ layer - this layer gives rise to connective tissue, bone, cartilage, muscle, blood, blood vessels, gonads, kidneys, and lymphatic system (as child grows these things do too)
- childhood cancers often diagnosed during peak growth periods
- usually fast growing and metastasize before dx
- boys>girls
trisomy 21 can lead to what type of cancer
acute leukemia - down syndrome is the most common genetic abnormality linked to the development of this cancer
genetic factors familial risk - cancer of the kidneys
Wilms tumor AKA nephroblastoma - usually responsive to tx
genetic factors familial risk - genetic defect that causes immature cells of the retina to proliferate and causes cancer
retinoblastoma - almost all children survive, but will have loss of vision in that eye
diethylstilbestrol (DES)
if mother took while pregnant increased r/f cervical and vaginal cancer
