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Hawk Tuah > CANCER > Flashcards

CANCER Flashcards

1
Q

Define neoplasm.

A

Uncontrolled cell growth
ie tumour

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2
Q

Define cancer.

A

Malignant neoplasm

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3
Q

Carcinomas are defined as…

A

Malignant epithelium neoplasms

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4
Q

Sarcomas are defined as…

A

Malignant mesenchymal neoplasms

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5
Q

What are adenocarcinomas?

A

Malignant epithelium neoplasms of glandular origin

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5
Q

What are adenomas?

A

Benign neoplasms of glandular origin

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6
Q

What are fibroadenomas?

A

Benign neoplasms of fibrous and glandular origin

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7
Q

Most benign neoplasms end with -oma except…

A

Lymphoma
Leukaemia
Hepatoma
Melanoma
Myeloma

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8
Q

What is teratoma?

A

A tumour with tissue or organ components resembling normal derivatives of more than one germ layer

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9
Q

What is a blastoma?

A

A type of cancer caused in malignant precursor cells

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9
Q

Describe 7 microscopic features of malignant tumours.

A

Hyperchromatic nuclei
High mitosis
High nucleo-cytoplasmic ratio
Pleomorphism
Irregular outline
Prominent nucleolus
Enlarged

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9
Q

How do you describe benign tissue?

A

Cells resemble normal tissue
Few mitosis
No invasion
Highly differentiated

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9
Q

What are the histopathological features of squamous cell carcinoma?

A

Keratin pearls
Pavementing
Intercellular bridges

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10
Q

What are the methods of cancer metastasis?

A

Local infiltration
Cavities
Lymphatic spread (Carcinomas)
Hematogenous spread (Sarcomas)

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10
Q

Based on what factors do you stage cancer?

A

T = Tumour size (T1-4)
M = Presence of distant metastasis (M0/1)
N = Presence of regional lymph node metastasis (N0-2)

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10
Q

What are the histopathological features of glandular cancers?

A

Mucin

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11
Q

What does T4 mean?

A

Invasion of other organs by tumours

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11
Q

What is the difference between N1 and N2?

A

N1 = 1-3 lymph nodes involved
N2 = 4 lymph nodes involved

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12
Q

What does Tis mean?

A

No infiltration past the basement membrane

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12
Q

How is stage III cancer diagnosed?

A

N1 required (involvement of 1-3 regional lymph nodes)

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12
Q

What are the different gradings of cancer?

A

Grade 1 = well differentiated (normal cells)
Grade 2 = moderately differentiated (resemble normal cells)
Grade 3 = poorly differentiated

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13
Q

How is stage IV cancer diagnosed?

A

M1 required (presence of distant metastasis)

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13
Q

List the 9 tumour markers and their associated cancers.

A

HCG - Trophoblastic/ Non-seminomatous testicular tumours
Calcitonin - Thyroid medullary carcinoma
Caltechoamines - Pheochromocytoma
AFP - Liver cancer
CEA - Colon cancer
Prostatic acid phosphatase - Prostate cancer
CA-125 - Ovarian cancer
CA-19-9 - Colon/ Pancreatic cancer
CA-15-3 - Breast cancer

13
Q

What are the 10 hallmarks of cancer?

A

Established:
Growth signal autonomy
Evasion of inhibitory growth signals
Evasion of apoptosis
Unlimited replicative potential
Angiogenesis
Invasion & metastasis

Emerging:
Avoiding immune destruction
Reprogramming energy metabolism

Enabling characteristics:
Genome instability
Tumour-promoting inflammation

14
List the broad ways growth autonomy affects the cell.
Excessive production of growth factors w/o appropriate stimulus eg PDGF in glioblastomas Growth factor receptor amplification eg HER2 in breast cancer Growth factor receptor constitutive activation eg EGFR for lung adenocarcinoma Signalling molecules activated without receptor eg mutated KRAS => constant MAPK signalling pathway activation => uncontrolled proliferation Auto transcription by MYC producing proteins/factors that aid replication eg Burkitt lymphoma; starry sky appearance; IgH t(8:14) translocation
14
Name 2 tumour supression genes.
p53 and Retinoblastoma
14
How does p53 exert its effect?
Safeguards genomic stability Cell cycle arrest Cellular senescence DNA repair Apoptosis Inhibit angiogenesis
14
What are the activators of p53?
Hypoxia Damaged DNA Inappropriate oncogene signalling
15
How does Retinoblastoma exert its effect?
Inhibits cell division (no apoptosis capabilities) Acts on G1/S transition phase of cell cycle
15
How is Retinoblastoma inactivated by cancer cells?
Inactivated via hyperphosphorylation Cancer gene amplification of cyclin D and CDK4 gene / mutate both Rb alleles
16
What is the intrinsic pathway of apoptosis?
DNA damage triggers p53 Upregulation of apoptotic factors BAX/BAK Egression of cytochrome C & capase production Apoptosis
16
How do tumour cells overcome intrinsic apoptosis pathways?
Upregulation of BCL2 Lose p53
16
What does TP53 mutation cause?
Li-Fraumeni syndrome
16
What gene is activated and what translocation occurs in follicular lymphoma?
BCL2 gene due to t(14,18) translocation in B cells
16
What allows for unlimited replicative potential in tumour cells?
Telomerase reactivation causing evasion of hayflick limit and divide infinitely
16
What are the anti-angiogenic factors?
p53 producing TSP-1
16
What are the pro-angiogenic factors?
PDGF EGF VEGF (from hypoxia producing HIF-a / oncogenes ras, myc)
16
How does invasion and metastasis occur?
Detachment of tumour cells by inactivating E-cadherin function Mobilised by epithelial-mesenchymal transition Breach basement membrane via secretion of proteolytic enzymes Circulate as emboli => extravasate => angiogenesis
16
How do tumour cells evade immune destruction?
Downregulate MHC Secrete inhibitory cytokines TGF-B Engage inhibitory receptors PD1 Lose expression of tumour antigens Promote Tregs
16
How do tumour cells reprogram energy metabolism?
Aerobic glycolysis Lactic acid fermentation causes diversion of glycolytic intermediates, which enable synthesis of macromolecules and organelles for cell growth
16
How does genomic instability affect tumour cell?
Loss of MMR protein (eg MLH1) leads to high levels of macrosatellite instability causing the cell to be more prone to mutations
16
How does loss of MMR protein occur?
Gene deletion LOF mutation
16
How does inflammation enhance tumours?
Inflammation provides growth factors, pro-angiogenic factors, ECM modifying enzymes
16
Name 2 classes of anti-cancer drugs.
Cell cycle specific and cell cycle non-specific
16
What are the 3 cell cycle specific drugs?
Anti-metabolites Microtubule inhibitors Topoisomerase I/II inhibitors
16
What are the 3 cell cycle non-specific drugs?
Alkylating agents Platinating agents Cytotoxic antibiotics
16
Name 2 anti-metabolite anti-cancer drugs and what they inhibit.
Methotrexate inhibits dihydrofolate reductase 5-flourouracil inhibits thymidylate synthase
16
Name 2 microtubule inhibitors and state their functions.
Vinblastine (binds polymerising ends preventing elongation) Paclitaxel (stabilise microtubules prevents depolymerisation)
16
Name an alkylating agent and state its function.
Cyclophosphamide (Crosslink DNA and prevent transcription and translation)
16
Name 2 platinizing agents and state their functions.
Cisplatin and Carboplatin (Crosslink DNA and prevent transcription and translation)
16
Name 2 cytotoxic antibiotic anti-cancer drugs and state their functions.
Anthracyclie and Doxorucibin (crosslink and damage DNA)
16
What are the adverse effects of alkylating agents?
Haemorrhagic cystitis
16
What are the adverse effects of Platinating agents?
Nephro/Ototoxicity
16
What are the adverse effects of cytotoxic antibiotics?
Cardiotoxicity
16
What are the general adverse effects of anti-cancer drugs?
Alopecia GI toxicity Myelosupression
17
What is associated with Hodgkin’s lymphoma?
Reed-sternberg cells
18
What is an effective treatment for MMR deficient tumour cells with micro satellite instability?
Anti-PD1 therapy

Hawk Tuah (12 decks)

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