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DEN 2027 - Disease Mechanisms > Cancer 3 > Flashcards

Cancer 3 Flashcards

1
Q

What is a carcinogen?

A

Any substance or agent directly involved in causing cancer

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2
Q

Name 2 ways a carcinogen may increase cancer risk

A
  1. Altering cellular metabolism

2. Directly damaging cellular DNA

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3
Q

Name 6 risk factors contributing to cancer

A
  1. Age
  2. Hormones
  3. Infections
  4. Radiation
  5. Lifestyle
  6. Genetics
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4
Q

What does the “Hit and Run” theory detail?

A

Causative agent not usually found in tumour as it is a multi step process so the causation of the first change is not likely to be found in eventual proliferation

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5
Q

Name 2 exceptions to the “Hit and Run” theory

A
  1. Viruses

2. Insoluble materials

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6
Q

Why are viruses exceptions to the “Hit and Run” theory?

A

The viral genome can often be found in the DNA of the tumour

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7
Q

Name 3 types of carcinogens

A
  1. Chemical substances
  2. Physical agents
  3. Biological agents
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8
Q

What 3 ways may carcinogens be taken into the body?

A
  1. Inhalation
  2. Absorption through the skin
  3. Ingestion
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9
Q

What is the major difference between direct-acting and indirect-acting chemical carcinogens?

A
  • Direct acting carcinogens require no chemical transformation
  • Indirect acting carcinogens require chemical transformation i.e. metabolism and it is a metabolite which is carcinogenic
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10
Q

Name a direct acting chemical carcinogen

A

Alkylating agents (cyclophosphamide)

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11
Q

Describe the carcinogenic properties of direct acting chemical carcinogens

A
  • highly reactive

- Direct DNA damage leading to mutations

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12
Q

Name 3 examples of indirect acting chemical carcinogens

A
  1. Aromatic amines and azo dyes
  2. Beta-naphthylamine
  3. Polycyclic hydrocarbons
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13
Q

What are 3 stages of chemical carcinogenesis?

A
  1. Initiation
  2. Promotion
  3. Progression
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14
Q

Describe the initiation and promotion stages of chemical carcinogenesis

A
  • Application of initiator
  • Mutational activation of oncogene
  • Application of promoters leads to clonal expansion of initiated cells
  • Forced proliferation
  • Clone of mutated cells accumulates additional mutations
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15
Q

What is the most common type of physical carcinogen?

A

Radiant energy

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16
Q

Name 3 types of skin cancers caused by UV light

A
  1. Melanoma
  2. Squamous cell carcinoma
  3. Basal cell carcinoma
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17
Q

Name a type of cancer caused by ionising radiation

A

Leukaemia

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18
Q

Name 4 work environments where exposure to radiation is possible

A
  1. Healthcare facilities
  2. Research institutions
  3. Nuclear reactors
  4. Nuclear weapon production facilities
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19
Q

_____ are the most prominent biological agent for the causation of cancer

A

Viruses

20
Q

Name 4 cancers and viral infection associated with them

A
  1. Cervical Cancer (HPV)
  2. Burkitt’s Lymphoma (EBV)
  3. Nasopharyngeal Cancer (EBV)
  4. Hepatocellular Carcinoma (Hep B / Hep C)
21
Q

Name 3 cancers and non-viral biological agents associated with them

A
  1. Hepatocellular Cancer (Aspergillus in grains)
  2. Gastric Cancer (Helicobacter pylori)
  3. Bladder Cancer (Schistosoma haematobium)
22
Q

Name 5 ways carcinogens are identified

A
  1. Epidemiological studies
  2. Environmental linkage
  3. Direct exposure
  4. Laboratory tests
  5. Assessment of families
23
Q

Name 2 complications in identifying carcinogens

A
  1. Cofactors

2. Latency between exposure and detection

24
Q

What is the main body for carrying out epidemiological studies?

A

International Agency for Research on Cancer based in Lyon

25
Q

Describe the function of epidemiological studies

A
  • Association factors (casual / spurious)
  • Population studies
  • Identify precursor lesions
  • Comparisons of lifestyle / diet / occupation
26
Q

What is the criteria used to identify a true carcinogen?

A

Bradford Hill Criteria

27
Q

Describe 4 environmental links with regards to cancer

A
  1. Lung carcinoma - Cigarette smokers
  2. Cervical carcinoma - Prostitutes (HPV infection)
  3. Bladder carcinoma - Dye (Beta-naphthylamine)
  4. Scrotal carcinoma - Chimney sweeps (polycyclic aromatic hydrocarbons in soot)
28
Q

Name 3 types of laboratory tests carried out to identify carcinogens

A
  1. Cell culture studies
  2. Laboratory animal studies
  3. Tissue analyses
29
Q

What is the function of cancer screening?

A
  • Identification of potential signs for cancers developing

- Extend life expectancy

30
Q

What is one caution of cancer screening?

A

Over-diagnosis

31
Q

Why is over-diagnosis of cancers dangerous?

A
  • Particular cancer may be very slow or non-progressive
  • Person will die of other causes regardless of tumour
  • Patient shouldn’t be treated as uneconomic and unnecessary
32
Q

What does the “stage” of a tumour refer to?

A

Extent of spread of a tumour

33
Q

Name 2 things which inform stage of a tumour

A
  1. Clinical and radiological assessment

2. Pathological examination of surgical specimens

34
Q

Name the most common staging system

A

TMN (Tumour Node Metastases)

35
Q

Name 4 staging systems which are organ specific

A
  1. Dukes
  2. Ann Arbor
  3. Breslow Depth
  4. Clarke Level
36
Q

Name 5 benefits of a cancer staging system

A
  1. Determine treatment and prognosis
  2. Guide follow-ups
  3. Evaluate response to treatment
  4. Accurate communication between treatment centres
  5. Comparison between outcomes
37
Q

What is the major difference between clinical and pathological staging?

A

Pathological is accurate as it is tests whereas clinical staging is simply guestimation

38
Q

What is a positive tumour?

A

A tumour which moves beyond the surgical margins

39
Q

What is the major complication of tumours in the head and neck?

A

Spread to lymph nodes and metastases

40
Q

Name 2 clinical significances of staging

A
  1. Enable clinician to make some prediction of likely prognosis
  2. Essential information for the logical planning of treatment
41
Q

What are 5 major modalities for cancer treatment?

A
  1. Surgery
  2. Radiation therapy
  3. Chemotherapy
  4. Hormonal therapy
  5. Immunotherapy
42
Q

Why does hormonal therapy not tend to be used for tumours in the head and neck region?

A

Tissues in the head and neck region tend not to release hormones

43
Q

What is a cancer biomarker?

A

A characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacologic response to a therapeutic intervention

44
Q

Name 5 types of biomarkers found in cancer

A
  1. Genetic
  2. Epigenetic
  3. Proteomic
  4. Glycomic
  5. Imaging
45
Q

Name 3 uses of cancer biomarkers

A
  1. Diagnosis
  2. Prognosis
  3. Epidemiology
46
Q

What is precision medicine?

A

Personalised treatment so the right patient receives the right treatment at the right time

47
Q

Name 3 typical modalities of treatment for head and neck cancer

A
  1. Surgery
  2. Surgery +/- radiotherapy
  3. Radiotherapy +/- chemotherapy

DEN 2027 - Disease Mechanisms (20 decks)

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