Cancer Flashcards
The main reason that people get cancer is due to _____________ (cancer starts in the body as ________)
inflammation
Ex: Jimmy smoking 3 packs of cigarettes a day. He’s smoking an irritant. That smoke enters his lungs and the trachea and causes inflammation
Inflammation = release of __________ markers, release of ______ which triggers ______ _____and a release of ____.
The ROS stimulates genetic changes and genetic ______.
The genetic instability triggers the changes that happen inside the cell. The cell becomes _____ and start to proliferate, developing into _______ _____ _____.
Ex: Jimmy smoking 3 packs of cigarettes a day. He’s smoking an irritant. That smoke enters his lungs and the trachea and causes inflammation
Inflammation = release of proinflammatory markers, release of cytokines which triggers oxidative stress and a release of ROS.
The ROS stimulates genetic changes and genetic instability.
The genetic instability triggers the changes that happen inside the cell. The cell becomes abnormal and starts to proliferate, developing into rapidly reproducing cells.
Why do we get Cancer?
The main reason that people get cancer is due to inflammation (cancer starts in the body as inflammation). You start to have an alteration of cell which stimulates the release of ROS, those free radicals stimulate _______ to the cellular structure of our lungs and any of the tissues related to inhalation. That’s how you get cancer from smoking (Lung Cancer). In addition to inhaling ______ that are sticking to your lungs.
changes
carcinogens
Three ways we can treat cancer
Chemotherapy
Radiation
Immunotherapy
Chemotherapy –> is poison that kills ______ ______ _____. Cancer is ______ _____ _____! Chemo targets rapidly reproducing cells and kills them. This is why we see patients lose their ____, they will experience changes to their ____ & ____ and will begin to have ___ upset b/c these are the places in our bodies that have rapidly reproducing cells that the chemo is also targeting.
Chemotherapy –> is poison that kills rapidly reproducing cells. Cancer is RAPIDLY REPRODUCING CELLS! Chemo targets rapidly reproducing cells and kills them. This is why we see patients lose their hair, they will experience changes to their skin & nails and will begin to have GI upset b/c these are the places in our bodies that have rapidly reproducing cells that the chemo is also targeting.
Areas of rapidly reproducing cells we have in our body:
Hair
Skin
GI tract (Chemo = nausea and vomiting)
Side effects of cancer
- Hair loss
- Weight loss/Cachexia
- Weakness
Cancer is not a ____. Cancer is an _____ growth resulting from uncontrolled ______.
It’s also referred to as _____, which means “new growth”
Cancer is not a tumor. Cancer is an abnormal growth resulting from uncontrolled proliferation
It’s also referred to as neoplasm (new growth)
Characteristics of a benign tumor:
Grows _____
______ _____ ____(doesn’t move around very much)
Not _____
_____ ________ (still kind of looks like the cells where they came from)
____ ____ _____ (slow replication)
Does not ________
Grows slowly
Well defined capsule (doesn’t move around very much)
Not invasive
Well differentiated (still kind of looks like the cells where they came from)
Low mitotic index (slow replication)
Does not metastasize
Malignant tumor:
Grows ____
Not ________
______
_____ differentiated (_____)
____ mitotic index (____ replication)
Can spread _____(metastasis)
Grows rapidly
Not encapsulated
Invasive
Poorly differentiated (anaplasia)
High mitotic index (rapid replication)
Can spread distantly (metastasis)
Benign tumors are named according to the tissues from which they arise and include the suffix -oma
What are some examples of benign tumors?
Lipoma- fat tissue
Leiomyoma- uterine tissue (smooth muscle)
Chondroma- cartilage tissue
Giloma- brain and spine tissue
Malignant tumors are also named according to the tissues from which they arise:
Malignant ______ tumors are referred to as _______
Adenocarcinoma means it arises from the ____ or _____
Malignant epithelial tumors are referred to as carcinomas
Adenocarcinoma means it arises from the ducts or glands
More malignant tumor classifications:
Malignant connective tissue tumors are called _____
Cancers of lymphatic tissue? ______
Cancers of blood forming cells? _______
Malignant connective tissue tumors are called sarcomas
Cancers of lymphatic tissue? lymphomas
Cancers of blood forming cells? leukemias
Almost all sarcomas are..
malignant
Benign tumors may progress to _____, but usually stay..
Benign tumors may progress to cancer, but usually stay benign
- Carcinoma in situ (CIS) – anything above the muscle layer (ex. breast, skin)
They are ___-_____ malignant tumors of glandular or epithelial origin that have not ______ through the ________ membrane or invaded the surrounding ____ (benign)
This means it doesn’t have access to the______ or _____, so it can’t metastasize yet
- Carcinoma in situ (CIS) – anything above the muscle layer (ex. breast, skin)
They are pre-invasive epithelial malignant tumors of glandular or epithelial origin that have not broken through the basement membrane or invaded the surrounding stroma (benign)
This means it doesn’t have access to the blood or lymph, so it can’t metastasize yet
Carcinoma in situ (CIS) is..
not malignant
3 prognoses of Carcinoma in situ:
- Can remain stable for a long time
- Can progress to invasive and metastatic cancers
- Can regress and disappear
Cancer cells are characterized by..
Anchorage independent
Immortal
Anaplasia
Pleomorphic
Autonomy
Anchorage independent
can stack on top of each other and grow and push off the agar plate (don’t have to sit on top of a food source. They just keep growing & spreading & eventually push off the plate).
they don’t need to be anchored to anything
Immortal
because they just DIVIDE DIVIDE DIVIDE without apoptosis
Anaplasia
Poorly differentiated cells
Pleomorphic
Cells vary in size and shape
Autonomy
Independent- they’re allowed to not respond to normal cell signals that your body would normally produce to get rid of those types of tumors
It takes more than one “hit, more than one ______ to trigger a cancer cell to develop
change
- Cancer is predominantly a disease of _____
Aging
_____ _____ are required before cancer (malignant cell) can develop, this is why it develops usually in older adults b/c they have been living long enough to have their cells go through multiple mutations. It also takes multiple exposures to the carcinogenic agent before a cancerous cell forms.
Multiple mutations
o Approximately ___ to ____ specific “hits” (mutations) have to occur for full blown cancer.
o “Step-wise” accumulation of alterations occurs in specific genes
four to seven
Three Key Genetic Mechanisms have a role in Human Carcinogenesis
- ________ of __________, resulting in ________of growth-related gene products (called _______).
- Activation of proto-oncogenes, resulting in hyperactivity of growth-related gene products (called oncogenes).
Three Key Genetic Mechanisms have a role in Human Carcinogenesis
- ________ of genes, resulting in the ____ or ______ of gene products that would normally _____ ______ (called ______-______ genes – Rb gene).
- Mutation of genes, resulting in the loss or inactivity of gene products that would normally inhibit growth (called tumor-suppressor genes – Rb gene).
Three Key Genetic Mechanisms have a role in Human Carcinogenesis
- ______ of genes, resulting in an ________ of products that _______ normal cell death or apoptosis, thus allowing ________ growth of tumors (Tp53 gene (suicide gene –> promotes apoptosis of cells)
- Mutation of genes, resulting in an overexpression of products that prevent normal cell death or apoptosis, thus allowing continued growth of tumors (Tp53 gene (suicide gene –> promotes apoptosis of cells)
Metastasis usually only occurs through the
blood or through the lymph nodes
Who is the first to respond to initial proliferation
T lymphocytes and macrophages
1st hallmark of cancer is sustained ______ _______ which means…
Ex?
Sustained Proliferative Signaling:
RAPIDLY REPRODUCING CELLS
Ex: RAS (oncogene)- stimulates more cell growth and it mutated to never turn off
Oncogenes & Tumor Suppressor Genes (The Drivers)
* Oncogenes (Tells the cells to ____!!!) – This is BAD!!! These stimulate the development of cancer
o ______ genes that in their nonmutant state direct ______ ______ and cellular _____; promotes ______
Must be active for cancer to occur
Oncogenes & Tumor Suppressor Genes (The Drivers)
* Oncogenes (Tells the cells to GO!!!) – This is BAD!!! These stimulate the development of cancer
o MUTANT genes that in their nonmutant state direct protein synthesis and cellular growth; promotes proliferation
Oncogenes & Tumor Suppressor Genes (The Drivers)
- Tumor-suppressor genes (Tells the cells to _____!!) – __ gene negatively regulates suppressor genes
o Encode proteins that in their normal state ______ ______ ______ (must be INACTIVE for cancer to occur)
o Also referred to as anti-oncogenes
- Tumor-suppressor genes (Tells the cells to STOP!!) – Rb gene negatively regulates suppressor genes
o Encode proteins that in their normal state negatively regulate proliferation
o Also referred to as anti-oncogenes
Oncogenes & Tumor Suppressor Genes (The Drivers)
- Proto-oncogene – causes cellular growth to occur _____ ______
o A normal, _______gene that codes for cellular growth
o Epithelial Growth Factor (EGF) –> allows epithelial cells to replicate more frequently
- Proto-oncogene – causes cellular growth to occur more rapidly
o A normal, NONMUTANT gene that codes for cellular growth
o Epithelial Growth Factor (EGF) allows epithelial cells to replicate more frequently
2nd hallmark of cancer- Evading ____ Supressors
Evading Growth Suppressors:
Inactivation of Tumor Suppressor Genes (BRCA1 BRCA2)
Inactivation of Rb tumor suppressor
Mutation in p53 gene- inactivation leads to increased mutation rates and cancer
If there’s an abnormality of BRCA 1 or 2 (normally occurring tumor-suppressor genes), then the risk for breast or ovarian cancer ______ significantly
increases
Telomeres and Immortality
* Body cells are not immortal, except for ___ cells, & can only divide a limited number of times, then they undergo apoptosis.
* _______ are protective caps on each chromosome, held in place by telomerase, and are important for cellular replication signaling.
* Telomeres become smaller and smaller with each cell division and eventually become so small they signal the cell to ____ ______
* Cancer cells _______ and _____ telomerase which helps preserve the telomere on the cancer cell chromosome, so they never get smaller. This allows for ______ ______
* Telomeres play a role in immortality (protective caps that sit at the end of chromosomes) unimportant cells they eventually fall off and die; cancer cells generate _______ that keeps these telomeres for a longer time and allows cancer cells to divide indefinitely (immortality).
Telomeres and Immortality
* Body cells are not immortal, except for germ cells, & can only divide a limited number of times, then they undergo apoptosis.
* Telomeres are protective caps on each chromosome, held in place by telomerase, and are important for cellular replication signaling.
* Telomeres become smaller and smaller with each cell division and eventually become so small they signal the cell to stop replication.
* Cancer cells ACTIVATE and SUSTAIN telomerase which helps preserve the telomere on the cancer cell chromosome, so they never get smaller. This allows for continued replication.
* Telomeres play a role in immortality (protective caps that sit at the end of chromosomes) unimportant cells they eventually fall off and die; cancer cells generate telomerase that keeps these telomeres for a longer time and allows cancer cells to divide indefinitely (immortality).
Angiogenesis is the
growth of new vessels, AKA neovascularization
- Cancer cells can stimulate _______ (growth of new vessels) which brings them more blood so that they can continue to function and replicate (since the blood delivers oxygen & nutrients to the cell).
- Advanced cancers can secrete angiogenic factors
o _______ _______ Growth Factor so they can create their own blood supply.
- angiogenesis
- Vascular Endothelial Growth Factor
The vessels are way more..
porous and fragile so they are prone to hemorrhage
Cancer _____, so when you think of a tumor, think _____
BLEEDS
think bleeding
Gene Changes that Occur in Cancer Mutation of Normal Cells
- Point Mutations – changes to the _____ _____ (_______ _____ ____ GCA) can stimulate abnormal cellular _______ causing someone to get cancer
o Changes in one or a few nucleotide base pairs Ex: Mutation in Epithelial Growth Factor
- Point Mutations – changes to the DNA structure (nucleotide base pairs GCA) can stimulate abnormal cellular development causing someone to get cancer
Gene Changes that Occur in Cancer Mutation of Normal Cells
Chromosome Translocation
o A piece on one ________ is transferred to ______ (pieces of one chromosome is transferred somewhere else can that can cause you to get cancer).
Chromosome Translocation:
o A piece on one chromosome is transferred to another (pieces of one chromosome is transferred somewhere else can that can cause you to get cancer).
Gene Changes that Occur in Cancer Mutation of Normal Cells
Gene Amplification:
o Duplication of a small piece of ________ ____ and _____ (if there is a specific place on a gene that causes you to get cancer, that particular place can be amplifiec and increase your chance at developing cancer).
o Results in an increased expression of an oncogene
Gene Amplification:
o Duplication of a small piece of chromosome over and over (if there is a specific place on a gene that causes you to get cancer, that particular place can be amplifies and increase your chance at developing cancer).
o Results in an increased expression of an oncogene
Mutagen Exposure & Mutation
If in somatic cells, ____ _______ to offspring
If in germ cells (germline mutant allele), ___ __ transferred to future generations; it may not
o Usually in tumor suppressor gene
o Retinoblastoma (RB gene)
o Neurofibromatosis (NF1 gene)
o Breast cancer (BRCA1 gene)
o Polyposis coli/colon cancer (APC gene)
Somatic = NOT transferred to offspring
Germ = May be transferred
Mutation of Normal Cells
* _______ genes _____
o Encode for proteins that are involved in repairing damaged DNA
- _________ _______
o Increased in malignant cells
o Results in chromosome loss, loss of heterozygosity, and chromosome amplification
Caretaker genes decrease
Chromosome instability
Viruses & Cancer – so whenever there is an inflammatory state in our bodies then we are susceptible to developing cancer.
- Hepatitis B and C viruses – very common causes of hepatic cancers (liver cancers) b/c of that _____ ________ in our liver. Hep B is largely preventable (vaccine for it and is treatable) 90% of Hep C is treatable now and chances are patients will get cured. These illnesses cause long standing chronic inflammation which is one of the biggest causes of ____
- Epstein-Barr virus (EBV)
- Kaposi sarcoma herpesvirus (KSHV)
- Human Papillomavirus (HPV) – increases risk for developing _____ cancer
- Human T cell leukemia – lymphoma virus (HTLV)
- Hepatitis B and C viruses – very common causes of hepatic cancers (liver cancers) b/c of that chronic inflammation in our liver. Hep B is largely preventable (vaccine for it and is treatable) 90% of Hep C is treatable now and chances are patients will get cured. These illnesses cause long standing chronic inflammation which is one of the biggest causes of Cancer
- Epstein-Barr virus (EBV)
- Kaposi sarcoma herpesvirus (KSHV)
- Human Papillomavirus (HPV) – increases risk for developing cervical cancer
- Human T cell leukemia – lymphoma virus (HTLV)
Bacterial Cause of Cancer
*________ ______ – bacteria that burrows down into the stomach; more common in low socioeconomic status
Bacterial Cause of Cancer
* Helicobacter pylori – bacteria that burrows down into the stomach; more common in low socioeconomic status
- Bacteria can cause gastric irritability & cause _____ _______ in the stomach & GI tract.
- Helicobacter pylori (H. pylori)
- H. pylori –> gastric inflammation –> gastric cancer
chronic inflammation
- What is the leading cause of death in the USA?
Heart Disease
- What is the most common cancer in women?
1st Breast cancer, then 2nd lung cancer, then 3rd ovarian uterine, the 4th colon cancer
- What is the most common cancer in men?
1st Prostate, then 2nd lung cancer, then 3rd colon cancer
Cancer Epigenetics (huge umbrella term that studies many different things)
The ____ of changes in gene ______ or cellular phenotype, caused by mechanisms other than changes in the underlying _____ _____
The study of changes in gene expression or cellular phenotype, caused by mechanisms other than changes in the underlying DNA sequence.
Ultraviolet Radiation - UV Radiation From The Sun
- Causes basal cell carcinoma, squamous cell carcinoma, and melanoma –> the most _______ cancer he’s even seen in his career, you need to use sun protection, reapply throughout the day
- Principal source is sunlight
- Ultraviolet A (UVA) and ultraviolet B (UVB) – don’t need to go higher than spf of 35 on your sun screen (absorbs 97% of UVA & UVB rays) -> spray sunscreen – rub it in, it will wear off and fall off, so you must reapply (it will expire so buy a new one once it expires)
- Promotes skin inflammation and release of free radicals
aggressive
Sexual Reproductive Behavior – All of these increase the risk of developing cancer!
- Carcinogenic types of human papillomavirus
- High-risk HPV
- HIV
Physical Activity
* Reduces _____ risk
* Decreases _____ and insulin-like growth factors
* Decreases _____ (excessive fat cells lead to the release of ______ hormone, & when there is an excessive number of hormones in the body, that causes _________ which can then lead to the development of cancer)
* Decreases inflammatory mediators and free radicals
* Increased gut motility
- Reduces cancer risk
- Decreases insulin and insulin-like growth factors
- Decreases obesity (excessive fat cells lead to the release of estrogen hormone, & when there is an excessive number of hormones in the body, that causes inflammation which can then lead to the development of cancer)
- Decreases inflammatory mediators and free radicals
- Increased gut motility
Air pollution is linked to
lung cancer
Outdoor Pollution:
Ozone and particle pollution
o Ozone: Is the principle component of smog.
* Particle pollution: Causes pulmonary inflammation, oxidative stress and oxidation of DNA, proliferative response, tissue remodeling with fibrosis, and tumor development.
Indoor pollution is considered
worse than outdoor
Indoor pollution:
Cigarette smoke, radon = lung cancer
Inorganic arsenic = bladder, skin, and lung cancers
What cancers are associated with obesity
endometrial, colorectal, kidney, esophageal, breast (postmenopausal), and pancreatic cancers
Obesity:
- Energy balance may affect: (1) _____ instability, (2) _______ growth ______ and cellular energetics, (3) _______ of ______ and immune surveillance, and (4) _______
- Energy balance may affect: (1) genomic instability, (2) dysregulated growth signaling and cellular energetics, (3) inhibition of apoptosis and immune surveillance, and (4) angiogenesis.
Obesity increases ____ resistance, producing
insulin - producing hyperinsulinemia
Obesity:
Adipose tissue secretes adipokines - increases inflammation
Steps of metastasis (important)
- Direct or continuous extension
- Penetration into lymphatics, blood vessels, or body cavities
- Transport into lymph or blood –” seeding”
- Transport to secondary sites
- Entry and growth in secondary sites
Distant Metastases
* Metastasis often occurs in the first capillary bed encountered by circulating cells
* Organ tropism – (preferential growth of cancer cells to different organs) Often times this organ tropism follows the blood circulation.
o Preferential growth of cancerous cells in certain organs
Growth factors, chemokines, hormones, tissue-selective homing receptors, and chemotactic factors
preferential growth of cancer cells to different organs
There are different ways that we stage cancer. All cancers are staged VERY SPECIFICALLY by a physician!
- Involves the size of the primary tumor, degree to which it has invaded, and the extent to which it has spread.
1. Stage 1 – isn’t so bad -> Cancer is _______ to its organ of ____
2. Stage 2 -> ______ ______ (right sided lung cancer in right middle and right lateral)
3. Stage 3 -> ________ structures (right lung and left lung)
4. Stage 4 – really bad -> metastasized to ______ _____
- Stage 1 – isn’t so bad -> Cancer is confined to its organ of origin
- Stage 2 -> Locally invasive (right sided lung cancer in right middle and right lateral)
- Stage 3 -> Regional structures (right lung and left lung)
- Stage 4 – really bad -> metastasized to Distant sites
