Cancer

Question 1

What are benign tumors?

Answer 1

Benign tumors are not considered cancerous.They do not spread locally or to distant sites, which means they are well encapsulated. Additionally, they are
slow-growing. They are named after the tissue of origin with the suffix “-oma”. The pathologic effects of benign tumors are from the space they occupy. While they do not invade tissues they may become large and compress normal tissue and inhibit blood. If they are located in the head and growing, the patient may have issues with increased intracranial pressure.

Question 2

What is the main biological characteristic of malignant tumors?

Answer 2

One of the many biological characteristics of malignant cells is anaplasia, which is the loss of cellular differentiation. They are also pleomorphic which means that have variable shapes and sizes. Malignant tumors are named after the cell of origin but in addition to the “oma” they have the root words “carcino” or “sarco”.Tumors involving epithelial tissue usually have “carcinoma” plus the organ of origin.

Question 3

What is carcinoma in situ?

Answer 3

Carcinoma in Situ is a very early and preinvasive carcinoma of the glandular or squamous epithelial tissue. It has not broken thru the basement membrane. The basement membrane is a very thin layer of tissue that separates the epithelium (skin, respiratory tract, GI tract, etc.), mesothelium (pleural cavity, peritoneal cavity, pericardial cavity etc), and the endothelium (blood vessels, lymph vessels) from the underlying connective tissue.

Question 4

What is a neuroblastoma?

Answer 4

Malignant tumors of nervous tissues are named based on the nerve cell type plus “blastoma”. A neuroblastoma is a malignancy of the nerve cell. A neuroma is a benign growth of a nerve cell.

Question 5

How do you describe malignant tumors of the muscle?

Answer 5

Malignant tumors of the muscle are named using the specific muscle type “sarcoma” and “myo”. Uterine leiomyosarcoma is a malignancy of the smooth muscle of the uterus. Rhabdomyosarcoma is a malignancy of the skeletal muscle.

Question 6

What are the exceptions to this rule?

Answer 6

Lymphoma is a malignancy of the lymphatic system, i.e. Hodgkin’s Lymphoma. Leukemia is a cancer of the WBCs or leukocytes

Question 7

What are oncogenes?

Answer 7

Proto-oncogenes produce proteins that regulate cellular proliferation. Cancer cells contain what is referred to as oncogenes which are proto-oncogenes that have mutated. Oncogenes function independently of normal regulator cellular mechanisms, thus the cancer cell proliferates.

Question 8

What is autocrine stimulation?

Answer 8

Oncogenes also provide cancer cells with the ability to secrete growth factors that stimulate their own growth. This process is known as autocrine stimulation.

Question 9

How do oncogenes work in breast cancer?

Answer 9

In breast cancer, the oncogene human epidermal growth factor receptor 2 (HER2) is responsive to low levels of epidermal growth factor and this stimulates breast cancer growth. This receptor is the target of some drugs used to treat breast cancer known as HER2 receptor inhibitors

Question 10

How does tumor-suppressing work in normal physiology?

Answer 10

In normal physiology, they are responsible for controlling cellular proliferation. They stop cell division in damaged cells and prevent mutations. There are two tumor suppressor genes in each cell and for their effects to be halted both genes must be turned off by the cancer. Tumor suppressor genes are known as anti-oncogenes.

Question 11

What is the p53 tumor suppressor gene?

Answer 11

The p53 tumor suppressor gene produces the p53 protein that is responsible for monitoring cellular stress and activating the caretaker genes. These genes maintain the integrity of the genome. They produce proteins that repair damaged or mutated DNA. The p53 protein also controls the initiation of
3 cellular senescence, apoptosis, and suppresses cell division until DNA is repaired. The loss of function in this tumor suppressor gene and the caretaker genes increases genetic mutations and cancer. Tumor suppressor genes may mutate and be passed on in the sperm and egg, thus contributing to the transmission of cancer-causing genes.

Question 12

What are telomeres?

Answer 12

Telomeres are protective end caps on each chromosome and are maintained by the enzyme
telomerase. This enzyme is normally only active in germ cells (ovaries and testes) and stem cells. When cancer cells reach a certain age they activate telomerase, which restores and maintains the cancer cells’ telomeres, thus allowing unregulated cellular division.

Question 13

What is EMT?

Answer 13

The epithelial-mesenchymal transition (EMT) is the process by which a cancer cell changes to one that can metastasize. In order for a cancer cell to spread to distant sites it must obtain a significant degree
of dedifferentiation from the tissue of origin, which allows it to break away from this tissue. Until this happens it can only have local invasion. IL-8 is a potent stimulus for cancer cells to undergo EMT.

Question 14

Where does lung cancer metastasize?

Answer 14

Brain and many other organs

Question 15

Where does colorectal cancer metastasize?

Answer 15

liver and lungs

Question 16

Where does testicular cancer metastasize?

Answer 16

lungs, liver, and brain

Question 17

Where does prostate cancer metastasize?

Answer 17

Bone (especially the lumbar vertebrae) and liver

Question 18

Where does breast cancer metastasize?

Answer 18

bones, lungs, liver, and brain

Question 19

Where does head and neck cancer metastasize?

Answer 19

lymphatics, liver, and bone

Question 20

Where does ovarian cancer metastasize?

Answer 20

Peritoneal surfaces, diaphragm, omentum,
liver

Question 21

Where does sarcoma metastasize?

Answer 21

lungs

Question 22

where does melanoma metastasize?

Answer 22

Lymphatics, lung, liver, brain, GI tract

Question 23

What is carcinoid syndrome?

Answer 23

Carcinoid tumors may release serotonin into the circulation and cause flushing, diarrhea, wheezing, and a rapid heartbeat. These types of tumors are most commonly found in the lungs or GI tract.

Question 24

What are the common side effects of cancer and cancer therapies?

Answer 24

anemia, osteoporosis, cachexia, cardiac and pulmonary damage, fatigue, hair loss, N/V, diarrhea, infection, infertility, pancytopenia, lymphedema, and pain.

Question 25

What is cachexia?

Answer 25

Cachexia is an imbalance between the amount of energy intake versus the energy used. In cancer, metabolism is increased thus causing this imbalance. Cachexia is a catabolic process and results in a wasting syndrome. Persons who are experiencing cachexia have an increase in apoptosis and an impaired ability to regenerate cells.

Question 26

What are the symptoms of cachexia?

Answer 26

Individuals experience a loss of appetite, cardiac atrophy, and dysfunction, gut barrier dysfunction, the release of proinflammatory mediators, the release of acute phase reactants, increased lipolysis, the release of fatty acids, reduced albumin synthesis, thermogenesis, weight loss, and muscle wasting.

Question 27

What is TNM?

Answer 27

T refers to the tumor size, N refers to the degree of lymph node involvement and M represents distant metastasis. The higher the number for each category
the more severe the cancer.

Question 28

What are tumor markers?

Answer 28

They are substances produced by the cancer cells that are found on tumor plasma membranes or in the
blood, spinal fluid, or urine. They are used to help diagnose, detect, or manage some cancers. A decrease in tumor marker levels may mean the cancer is responding to treatment and a resurgence of the marker may mean recurrence of the cancer. No change in the marker may mean the cancer is not responding to treatment.

Question 29

What does the AFP marker check?

Answer 29

Alpha-fetoprotein (AFP) is elevated in tumors of
the liver or germ cell.

Question 30

What does the beta HCG marker check?

Answer 30

Beta HCG is elevated in germ cell cancers or choriocarcinoma.

Question 31

What does a carcinoembryonic antigen marker check?

Answer 31

Carcinoembryonic antigen (CEA) is elevated in GI, pancreatic, lung, and breast cancers.