Cancer Flashcards
1
Q
What is important about basal cell carcinoma?
A
Never spreads to other parts of the body
2
Q
What happens if you carry out a complete local excision of a basal cell carcinoma?
A
The patient is completely cured.
3
Q
Leukaemia definition
A
Malignant cancer of both bone marrow and other blood-forming organs. Usually involves WBC.
4
Q
Why can’t you treat leukaemia with surgery?
A
Because it’s in your blood- all over your body.
5
Q
What often happens to lymph nodes during breast cancer?
A
Lymph nodes drain the site of the carcinoma, and become cancerous themselves.
6
Q
Can carcinomas spread to bone?
A
Yes. Carcinomas can spread through the blood to bone.
7
Q
What are the cancers that commonly spread to bone?
A
Breast, prostate, lung, thyroid and kidney.
8
Q
How do you confirm that someone has breast cancer?
A
A core needle biopsy.
9
Q
After you confirm someone has breast cancer, where do you check next?
A
The axilla. If it has spread, node clearance is needed.
10
Q
What are micro metastases?
A
Metastases that may still be present even if a tumour is completely excised.
11
Q
How do you remove micro metastases?
A
Adjuvant radiotherapy.
12
Q
What are recovered breast cancer patients often prescribed?
A
Anti-oestrogens.
13
Q
What is the name of neoplasms starting in epithelial tissue or the skin?
A
Carcinomas.
14
Q
What is the name of neoplasms starting in bones or soft tissues?
A
Sarcomas.
15
Q
What is the most common type of cancer?
A
Carcinomas.
16
Q
What is the name of neoplasms starting in plasma cells?
A
Myeloma.
17
Q
What is the name of neoplasms most linked to WBCs?
A
Leukaemia.
18
Q
What is the name of neoplasms starting in the lymphatic system?
A
Lymphoma.
19
Q
What are the 3 classes of neoplasms based on their behaviour?
A
Benign, borderline and malignant.
20
Q
What is a tumour?
A
Any mass or lump of tissue that may resemble swelling. A tumour may be: a neoplasm, an inflammation, hypertrophy or a hyperplasia.
21
Q
Neoplasm definition
A
An abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should.
22
Q
What are 4 characteristics of neoplasia?
A
AN autonomous, abnormal, persistent new growth.
23
Q
What is the suffix of all neoplasms?
A
‘-oma’
24
Q
What are the 2 main types of benign epithelial neoplasms?
A
Papillomas and adenomas.
25
What is a papilloma?
Benign tumour of non-glandular, non-secretory epithelium.
26
What is an adenoma?
Benign tumour of glandular or secretory epithelium.
27
What is a malignant epithelial neoplasm known as?
Carcinoma
28
How do you name benign connective tissue neoplasms?
According to the cell of origin, suffixed by '-oma'. E.g. lipoma: adipocytes.
29
What is the prefix referring to adipocytes?
'Lip-'
30
What is the prefix referring to cartilage?
'Chondr-'
31
What is the prefix referring to bone?
'Oste-'
32
What is the prefix referring to vascular?
'Angi-'
33
What is the prefix referring to striated muscle?
'Rhabdomy-'
34
What is the prefix referring to smooth muscle?
'Leiomy-'
35
What is the prefix referring to nerves?
'Neur-'
36
What is a malignant connective tissue neoplasm?
Sarcoma
37
How are sarcomas named?
'-sarcoma' prefixed with by cell type of origin.
38
What is the definition of anaplastic?
Cancer cells that divide rapidly and have little or no resemblance to normal cells.
39
Where do neoplastic cells derive from?
Nucleated cells.
40
What is the definition of monoclonal?
Forming a clone which is derived asexually from a single individual or cell. Neoplasms are usually monoclonal.
41
How does the parent cell affect the growth pattern of the neoplasm?
Synthetic activity is related to the the parent cell.
42
How does the stroma support the development of the neoplasm.
Connective tissue framework. Mechanical support and nutrition.
43
What is tumour angiogenesis?
The growth of new blood vessels that tumours need to grow.
44
What is the name of striated muscle cancer?
Rhabdomyosarcoma
45
What is a cancer in situ?
Cancer that has not broken through the basement membrane.
46
What cancer does Hep C cause?
Hepatocellular carcinoma
47
What is the name of a benign tumour of fat cells?
Lipoma
48
What is the name of malignant tumour of glandular epithelium?
Adenocarcinoma
49
Does ovarian cancer commonly spread to the peritoneum?
Yes
50
Definition of carcinogenesis
The transformation of normal cells to neoplastic cells through permanent genetic alterations or mutations.
51
Does carcinogenesis apply to benign neoplasms, malignant neoplasms or both?
Malignant neoplasms
52
Does oncogenesis apply to benign neoplasms, malignant neoplasms or both?
Both benign and malignant neoplasms.
53
Is carcinogenesis a single or multistep process?
A multistep process.
54
What is a carcinogen?
Agents known or suspected to cause tumours.
55
What is the difference between carcinogenic and oncogenic?
Carcinogenic is cancer causing. Oncogenic is tumour causing?
56
Definition of mutagenic
Inducing or capable of inducing genetic mutation.
57
What percentage of cancer risks are environmental?
85%
58
What are the problems with identifying carcinogens?
Latent interval may be decades. Complexity of environment. Ethical constraints (can't just give people cancer)
59
What is hepatocellular carcinoma?
Most common type of primary liver cancer. Uncommon in UK/USA. Common in areas with high hep B/C and mycotoxins.
60
How does thorotrast provide direct evidence of carcinogenesis?
Colloidal suspension of thorium.
Radiographic contrast medium 1930-1950.
Irreversibly ingested by phagocytes.
61
Evidence linked to thyroid irradiation?
Chernobyl nuclear reactor explodes.
Release of radioactive iodine isotopes.
Increased incidence of thyroid cancer in Ukrainian children.
62
How do you ethically collect evidence for carcinogens?
Incidence of tumours in laboratory animals.
Cell/tissue cultures.
Mutagenicity testing in bacterial cultures.
63
What are the problems with cancer research on animals and cultures.
Animals / cultures may metabolise agents differently to humans. Bacterial mutation may not mean carcinogenicity.
64
What are the classes of carcinogens?
Chemical, viral, ionising and non-ionising radiation, hormones parasites and mycotoxins and miscellaneous.
65
Are there common features of chemical carcinogens?
There are no common structural features.
66
How many of the chemical carcinogens act directly?
Some act directly, but most require metabolic conversion from pro-carcinogens to ultimate carcinogens.
67
Where does alcohol cause cancer?
Oropharynx, larynx, oesophagus, liver, breast, colorectal
68
How does cancer assist other cancer development?
Makes it easier for cells in oropharynx to absorb other carcinogens. Also increases oestrogen levels.
69
What cancers does UV light (UVA and UVB) increase the risk of?
BCC, melanoma and SCC. The risk is increased in xeroderma pigmentosum.
70
What is radiant energy and what time frame does the effect have?
Ionising radiation. Long term effect.
71
What cancers is increased oestrogen associated with?
Increase in mammary/endometrial cancer.
72
What cancer is anabolic steroids associated with?
Increased risk of hepatocellular carcinoma.
73
What are 2 examples of miscellaneous carcinogens?
Asbestos and metals.
74
What host factors affect the risk of cancer?
Race, diet, premalignant lesions, transplacental exposure and constitutional factors (age, gender etc.)
75
What are identifiable local abnormalities associated with an increased risk of malignancy at the site?
Colonic polyps, cervical dysplasia (CIN), ulcerative colitis, undescended testis.
76
Why can't carcinoma in situ spread anywhere?
The cancer is enclosed by the basement membrane.
77
What is an invasive carcinoma?
When the cancer leaves the basement membrane and escapes somewhere with blood and lymph vessels.
78
What is a micro-invasive carcinoma?
Carcinomas that have not invaded very far.
79
How does the tumour break through the basement membrane?
Proteases - matrix metalloproteinases, collagenase, cathepsin D, urokinase-type, plasminogen activator, cell motility.
80
What are the first 4 steps of metastasis?
Cross the basement membrane. Get through the connective tissue. Enter a small vessel (blood or lymph). Avoid WBC's.
81
What are the last 4 steps of metastasis?
Lodge somewhere in the vessel. Cross the basement membrane again. Lodge itself in the connective tissue (metastatic site). Develop its own blood supply.
82
What is tumour cell motility?
Tumour derived motility factors, often derived by the tumour cells often breakdown the products of extracellular matrices.
83
How do spreading cancers evade host immune defence?
Aggregation with platelets. Shedding of surface antigens. Adhesion to other tumour cells.
84
What is needed for growth of the metastatic site?
Growth factors. The cancers often produce their own.
85
What is angiogenesis?
The formation of new blood vessels.
86
What growth factors promote angiogenesis?
Vascular endothelial growth factor.
87
What inhibits angiogenesis?
Angiostatin, endostatin and vasculostatin.
88
Where do cancers first formed in the heart commonly metastasise?
In the lungs.
89
Where do cancers first formed in the colon often metastasise?
In the liver via the portal vein. Other cancers that commonly metastasis in the liver are Colon, stomach, pancreas, carcinoid tumours of intestine.
90
Which tumours commonly metastasise to bone?
Prostate, breast, thyroid lung and kidney.
91
Definition of chemotherapy
The treatment of disease by the use of chemical substances, especially the treatment of cancer by cytotoxic and other drugs
92
What type of cells does conventional chemotherapy act on?
Dividing cells
93
How does conventional chemotherapy work?
It prevents microtubules pulling DNA apart to stop cell division. Cross links DNA to prevent replication
94
Why does chemotherapy cause side effects?
It doesn't just target cancer cells; targets all cells that are dividing
95
What are side effects of conventional chemotherapy?
Fatigue, hair loss, myelosuppression (anaemia), nausea and vomiting and changes to bowel movements
96
What 2 factors result in the increase in tumour size?
Cell division. Lack of cell death (apoptosis)
97
What sort of tumour is conventional chemotherapy good for?
Fast dividing tumour e.g. germ cell tumours of testis, acute leukaemia, lymphomas, embryonal paediatric tumours, choriocarcinoma
98
How does targeted chemotherapy work?
Exploits some difference between cancer cells and normal cells to target drugs to the cancer cells
99
How can differences between cancer cells and normal cells be found?
Gene arrays, proteomics and tissue microarrays
100
How are the differences between cancer cells and normal cells be exploited?
Make a monoclonal antibody against growth factor A receptor. Binds to the outside of the growth factor. No activation because the receptor is blocked by the antibody.
101
What is cetuximab?
Monoclonal antibody against epidermal growth factor receptor (EGFR).
