Cancer Flashcards
Why are cancer trends changing?
Increase in lung cancer due to smoking
Increase in breast cancer due to delayed childbirth
Increasing obesity and diet changes affects risk of cancer
How are politics involved in cancer today?
Can’t afford to treat someone if it increase lifespans by 6months
Can afford to treat if it increases lifespan by 5 years
Circumstances- mother with 2 kids likely to get correct treatment compared to single middle aged male
If smoking was stopped how would cancer incidence change?
Incidence would reduce by 25% worldwide
Why are 90% of cancers of epithelial origin?
Proliferating tissues have increased risk of mutation
Exposure to uv light, diet and smoking which can enter blood and cause cancer anywhere
What factors increase the likelihood of a cell turning cancerous?
6-10 mutations in same cell
Live longer - more likely to accumulate mutations
Weak immune system
Changes in gene expression
Shape of nucleus changes with age - can have impact on gene expression
Genetic predisposition in young people
What gene is involved in bowel cancer?
Adenomatous polyposis coli APC gene
Tumour suppressor gene
Inherit one mutant copy - 100% risk bowel cancer
What are the key events in colorectal tumorigenesis?
- Mutated APC causes early adenoma
- Mutated K-ras proto-oncogene and overexpression of epidermal growth factor ….. Late adenoma
- Mutated p53 causes carcinoma
What is cancer?
Breakdown in the control of proliferation, differentiation and cell death Movement of cancerous cells to invade other tissues
What is the role of Bcl-2 in the colonic crypt?
Protects from apoptosis
Found in the base of the crypt
What is the role of TGFB in the colonic crypt?
Inhibits epithelial cell growth
Found at the top of the crypt
What is the role of Bax in the colonic crypt?
Gene involved in apoptosis
Found at the top of the crypt
As well as increased cell growth, what must there also be for tumours to develop?
Decreased cell death
What pathway is affected in colon cancer?
Apoptotic pathway
Bcl-2 overexpression
Baxmutated
Number of cells increases
How might some genetic changes that uncouple growth also confer resistance to current therapies for cancer?
Bcl-2 can protect against chemotherapy as it prevents programmed cell death
How does aspirin reduce the risk of bowel cancer?
Chronic inflammation increases risk
Aspirin is an NSAID so decreases inflammation
What do cancer cells behave like?
Embryonic cells
Display retrodifferentiation and revert back to embryonic phenotype
What behaviour do tumours acquire?
Evading apoptosis Self sufficiency in growth signal Insensitivity to anti growth signals - resistance to TGFB Tissue invasion and metastasis Limitless replication potential Sustained angiogenesis
How do carcinogens cause cancer?
Mutate growth control genes (TSG and Proto-oncogenes)
Alter gene expression
Does where you live affect your risk of developing cancer?
Yes
People who migrate from low to high incidence places, within one generation their cancer risk increases
Proof lifestyle is a factor in cancer development
What is a proto-oncogene?
Normal gene involved in normal growth control and differentiation.
Often involved in controlling the cell cycle- if they mutate or overexpress they become an oncogene
Single base change of c-ras turns it into oncogene
Overexpression of c-myc means it is an oncogene but still has normal function
What is an oncogene?
Gene whose product can act in a dominant fashion to make a normal cell cancerous
Mutant form of a proto-oncogene
2 alleles - mutate one - becomes oncogene
What are compete carcinogens?
Produce tumours on their own
Don’t need extra chemicals such as tumour promotors
E.g. Radiation at high dose
What is an incomplete carcinogen?
Sometimes called initiating agents
Require subsequent exposure of the treated cells to tumour promoting agents
Damage cells in such a way that if it comes into contact with another chemical it will turn cancerous
What is a papilloma?
Benign skin tumour caused by initiation followed by tumour promotion
Some undergo tumour progression
Most regress
(Similar to adenoma in colorectal cancer)