Cancer 1 Flashcards
What is role of gate keepers [5] and care taker genes [1]
Gate keepers:
* Directly supresses growth/restricts proliferation
* Cell cycle/cell division regulator genes
* Check point control genes
* Apoptosis - related genes
Care takers:
* Maintains genetic stability: DNA repair proteins
At which stages in cell cycle are checkpoints where cell cycle can be arrested? [2]
G2 / M [1]
G1 / S [1]
Explain how Retinoblastoma occurs (and compare to normal functioning gene) [2]
Unphosphorylated form of Rb: binds to GF E2F - cannot bind the DNA and transcription is blocked
Phosphorylated form of Rb: cannot bind to GF E2F - bind the DNA and transcription goes on uncontrolled growth
Explain how normal proto-oncogenes cause normal cell signalling
- growth factor binds to receptor. two receptors interact (dimerization)
- intracelllar side: phosphorylation of tyrosine
- signalling proteins bind to P-tyrosine
- causes cascade of phosphorylation events
- activates two pathways: MAPK pathway and PI3 Kinase Pathway
- once pathways are activated, activate gene expression and transcription factors occur.
State whether oncogenes and tumour supressor genes are activated by a single or double mutation [2]
Oncogene: single mutation
Tumour supressor genes: double mutation
Explain what happens when p53 becomes mutated [2]
- Mutated p53 does not inhibit cyclin B/ CDK1 complex so cell cycle arrest at G2/M does not occur
- Mutated p53 does not inhibit cyclin E/ CDK2 complex so cell cycle arrest at G1/S does not occur
Explain the role of BRCA1 [1]
Explain the role of BRCA2 [2]
BRCA2:
* Upregulates RAD51
* Causes repair by homologous recombination
BRCA1:
* Broader role upstream of BRCA2, participating in various cellular processes in response to DNA damage.
BRCA1 & BRCA2 are involved in repairing dsDNA crosslinks at which cell cycle check point? [1]
G2/M checkpoint
Which gene increases the amount of telomerase? [1]
What happens if this is upregulated? [1]
Telomerase reverse transcriptase(TERT)
If gene upregulated allows the cancer cell to have unlimited replication
Malignant neuroectodermal tumours are called what? [1]
Glioma/ neuroblastoma
Grading of cancer is based on which two factors? [2]
- Degree of anaplasia (degree of differentiation)
- Rate of growth
Staging of cancer is based on which two factors? [2]
1 Size of tumour
2 Extent of growth (or spread)
Explain TNM staging of tumours [3]
T- size of the cancer and how far it has spread into nearby tissue
* T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T’s may be further divided to provide more detail, such as T3a and T3b.
N refers to whether the cancer has spread to the lymph nodes – it can be between 0 (no lymph nodes containing cancer cells) and 3 (lots of lymph nodes containing cancer cells)
* N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer.
M refers to whether the cancer has metastasised – it can either be 0 (no spread) or 1 (the cancer has spread)
Metastatic breast cancer:
Which genes are downregulated? [2]
Which genes are upregulated? [1]
Downregulated:
* BRCA1
* E-cadherin
Upregulated:
* VEGF
Which cancers do we screen for in the UK? [4]
Retinoblastoma
Bowel-FiT
Cervical
Breast
Name 5 red flags in a patient that would indicate cancer in patients [5]
Weight Loss
Lumps:
* Anywhere
* Throat/mouth/neck
* Primary or secondary
Symptoms of Anaemia and/or Infections
Unexpected Bleeding:
PU, PV, PR, Resp, Bruises
Changes: voice; stamina/SOB; moles; back pain, bone pain, swallowing; bowels; complexion (jaundice/pallor); itching
What are the different types of biopsy? [6]
- Transcutaneous
- Endoscopic Biopsy
- Laparoscopic Biopsy
-
Image-directed (with fine-needle aspiration or
cutting needle)
–Ultrasonography
–Computerized tomography
–Magnetic resonance imaging - Open incisional ( portion of the tumor)
- Open excisional (all tumor mass removed)
What are the 5 types of surgical treatment? [5]
- Local resection
-
Radical resection with en-bloc resection of
lymph nodes - Supra-radical resections = LN+Organs
- Surgery for metastasis/recurrence
- Surgical management of complications
Name a classification type for bowel cancer [1]
Dukes Classification
What are the 3 categories of surgery? [3]
1. Open Surgery
2. Minimally Invasive Surgery (MIS)
Hand Assisted (MIS)
Laparoscopic Surgery
Robot Assisted Surgery
Surgery thru natural orifice (NOTES)
3. Image Guided Surgery