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Pathology > Cancer > Flashcards

Cancer Flashcards

1
Q

3 types of external causes of cancer

A
  1. toxins
  2. infections
  3. radiation
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2
Q

4 types of internal causes of cancer

A
  1. inherited (only 5% are strongly hereditary)
  2. Hormonal imbalance
  3. Autoimmune disease
  4. Metabolic disorders
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3
Q

neoplasm

A

“New growth” or “Tumor”
An uncontrolled growth of new cells
May be benign or malignant

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4
Q

what does benign mean?

what does malignant mean?

A

A neoplasm not capable of metastasizing, NOT CAPABLE OF CAUSING DEATH

“Cancer”, Neoplasm capable of metastasizing; CAPABLE OF CAUSING DEATH

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5
Q

Chemical or physical agent that causes a change in the DNA of a cell

A

mutagens

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6
Q

Any substance that contributes to the development of cancer
Changes DNA or metabolic processes
Causes nonlethal genetic damage

A

carcinogen

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7
Q

2 types of carcinogen

A
  1. Initiator (causes genetic damage)

2. Promoter (promotes tumor growth)

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8
Q

what things are possibly carcinogenic?

A 
Insecticides
Cisplatin (used to treat cancer, but can cause it in other tissues)
Nitrates or nitrites
Hairdresser or barber
Shift work
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9
Q

what things are definitely carcinogenic?

A 
Plutonium
Benzene
HPV
Alcoholic beverages
Tobacco smoke
Tanning beds
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10
Q

how is cancer caused by VIRUSES?

A

Inserting genetic material into infected cells

Initiating a chronic inflammatory response

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11
Q

**Hepatitis B and C viruses are associated with which cancer?
Epstein-Barr virus is associated with which cancer?Herpes virus is associated with which cancer?
**Human papillomavirus is associated with which cancer Lymphoma virus is associated with which cancer?

**only really mentioned these in class…but who knows what he will ask!

A

hepatic

burkitts lymphoma
kaposi sarcoma
cervical
human t cell keukemia

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12
Q

chronic infections of ___ ___ are associated with of peptic ulcer disease, stomach carcinoma, and mucosa-associated lymphoid tissue lymphomas

A

Helicobacter pylori

bacteria leads to CHRONIC INFLAMMATION and IMMUNE RESPONSES over time

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13
Q

what are three types of mutations of normal genes

A

point mutations:: example:: sickle cell disease
gene amplification
chromosomal translocation

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14
Q

chromosome translocation and give an example

A

Piece of one chromosome is transferred to another and leads to excess production of a normal protein or a novel protein

Chronic Myeloid Leukemia and Philadelphia chromosome

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15
Q

gene amplification

A

Duplication of a small piece of chromosome over and over that results in an increased expression of an oncogene

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16
Q

proto-oncogene

A

normal gene that controls cell division

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17
Q

oncogene

A

Mutant version of a proto-oncogene that promotes abnormal proliferation

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18
Q

epigenetics

A

Reversible chemical modification of DNA; controls transcrption
Heritable from mother to daughter cell BUT also
affected by EXTERNAL stimuli

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19
Q

Abnormal silencing of tumor-supressor genes leads to ___.

Loss of silencing for oncogenes also leads to ___

A

cancer

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20
Q

tumor-suppressor gene

A

Negatively regulate cell proliferation or induce apoptosis

“Anti-oncogenes”

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21
Q

both copies of the ___ ___ ___ must be inactivated for progression of cancer and unregulated growth

A

tumor-suppressor gene

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22
Q

___ Tumor Suppressor Gene inhibits cell cycling, and is the source of the most common tumor-suppressor gene defect

A

p53

>½ of all types of human tumors lack functional p53

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23
Q

how do chemo or radiation use p53/

A

Triggers p53-mediated cell death

May be ineffective in cancer cells lacking functional p53

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24
Q

___ is the most common intraocular malignant neoplasm of childhood

A

retinoblastoma

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25
Q

Retinoblastoma is initiated by mutations/deletions of gene ___ which is located on chromosome ___

A

RB1;13

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26
Q

what are caretaker genes and what happens if they are lost?

A

Maintain genomic integrity

Loss of genes leads to increased mutations

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27
Q

when does chromosome instability occur and what does it cause?

A

Occurs during mitosis
Chromosome loss
Loss of heterozygosity
Chromosome amplification

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28
Q

telomeres

A

Protective caps on each chromosome that become smaller and smaller with each cell division

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29
Q

___ maintains telomeres in stem cells and plays a role in keeping them active in cancer cells

A

telomerase

30
Q

___ ___ are hereditary, largely associated with tumor-suppressor genes but rarely with oncogenes. Usually heterozygous initially

A

germ-line mutations

31
Q

Germ-line mutations cause great risk for cancer resulting from ___ __ ___ or ___ ___

A

loss of heterozygosity and gene silencing

32
Q

in what ways are cancer cells autonomous?

A 
Anchorage independent
Immortal
Anaplastic
Undifferentiated
Pleomorphic
33
Q

___ is the late stage of tumor growth initiated by secretion of angiogenic factors. It deprives neighboring tissues of adequate oxygen and nutrients.

what is goal of cancer medications?

A

angiogenesis

goal of cancer medications is to inhibit angiogenesis

34
Q

___ ___ are self-renewing cells found in many tissues and may give rise to most or all cancers

A

stem cells

35
Q

how is cancer named?

A

according to the tissue of origin

36
Q

Malignant tumors of epithelial origin are called ____
Malignant tumors of connective tissue origin are called
Malignant tumors of lymphatic origin
Malignant tumors of blood-forming cell origin

A

carcinomas
sarcoma
lymphoma
leukemia

37
Q

what 5 events allow cancer to SPREAD and INVADE other tissues?

A
  1. cellular multiplication
  2. mechanical pressure
  3. release of lytic enzymes
  4. decreased cell-to-cell anhesion
  5. increased motility
38
Q

4 steps in the metastatic process

NOTE: occurs colon to liver, liver to lung, lung to brain

A
  1. Direct or continuous extension–local
  2. Penetration into lymphatics blood vessels, or body cavities
  3. Transport into lymph or blood
  4. Entry and growth in secondary sites
39
Q

tumour cell markers: help detect AND monitor progression of cancer

what are characteristic substances produced by cancer cells?

A 
Hormones (catecholemines)
Enzymes
Genes
Antigens (alpha-fetoprotein, prostate-specific antigen)
Antibodies
40
Q

___ ___ may be first signs of malignancy, include

symptoms not directly associated with the tumor, and usually a result of tumor-produced hormones

A

paraneoplastic syndrome

41
Q

manifestations of paraneoplastic syndrome

A 
Mental aberration
Neurologic disease
Hypercalcemia
Gynecomastia
Cushing disease
Electrolyte imbalances
42
Q

cancers associated with paraneoplastic syndrome

A

Lung carcinoma
Renal cell carcinoma
Tumors of endocrine glands

43
Q

what actions are usually the cause of pain from cancers?

A 
Pressure
Obstruction
Invasion of sensitive structures
Tissue destruction
Inflammation
44
Q

suggested cause of fatigue from cancer

A

Sleep disturbance
Biochemical changes from disease and treatment
Psychosocial factors
Level of activity
Nutritional status and environmental factors

45
Q

what is cachexia and what does it have to do with cancer?

A

Most severe form of malnutrition
Present in 80% of cancer patients at death

(anorexia/weight loss, anemia, altered protein, lipid, and carbohydrate metabolism)

46
Q

2 clinical manifestations of cancer

A
  1. anemia
    due to chronic bleeding (wounds), severe malnutrition, medical therapies, AND malignancy in blood-forming organs
  2. leukopenia and thrombocytopenia
    increased risk of infection!!
    causes:: invasion of bone marrow AND chemo :(
47
Q

___ is the primary cause of death in most patients with malignancies

A

infection

48
Q

why is someone with cancer at increased risk for infection?

A

Low neutrophil and lymphocyte counts
Disrupted epithelial barriers–entry routes
Surgery
Nosocomial infections–irritation due to treatment, may be due to long hospital stays….

49
Q

currrent tx for cancer

A 
WELL, prevention if possible!! 
But also::
Chemotherapy:: target rapidly dividing cells
Radiation therapy:: apoptosis goal
Surgery:: solid tumours
Drug therapy:: treat symptoms
50
Q

emerging tx for cancer

A

Immunotherapy:: manufactured cytokines, interluekins and interferons
Targeted molecular therapies:: mAB
Stem cell transplantation:: maybe for bone marrow cancer

51
Q

effects of cancer TX on GI, hair and skin, and reproductive tract

A 
GI: Mucositis
Malabsorption
Nausea
Diarrhea
hair: Alopecia
Thinned and dry skin
reproductive: varies
52
Q

ocular effects of cancer txs

A 
Conjunctivitis
Dry eyes
Epiphora
Photophobia
Corneal deposits
Cataracts
Pigmentary retinopathy
Macular edema
Retinal ischemia
Optic neuritis
53
Q

cancer treatments associated with ocular side effects

A

Tamoxifen (causes retinopathy)
Interferon
Radiation
Methotrexate (causes corneal whorls)

54
Q

what are some characteristics of cancer cells?

A 
associated with altered genetic expression
can be fatal
invasive or metastasizing in nature
grows rapidly
angiogenic (blood vessels)
anaplastic (undifferentiated)
55
Q

____ survival rate for all cancers

A

67%

56
Q

what are preventable types of cancer

A

tobacco use
obesity, physical inactivity, and poor nutrition

Other: HPV (vaccine), HIV behavior change, H. pylorii (antibiotics–part of normal flora), skin cancer (behavior)

57
Q

what is the two causes of metastatic cancer to the eye?

A

breast (1)
lung (2)

95% are metastatic to the eye

58
Q

how do inflammatory cells play a role in cancer progression?

A

ongoing production of CYTOKINES (pro-inflammation and pro-growth)
free radical production (damaging to cells)
Mutation promotion (result of pro-inflammatory, hyper-proliferative environment)

59
Q

Progression of normal tissue

A

dysplasia: atypical hyperplasia, pre-cancerous
in-situ neoplasm: cancerous BUT limited toTISSUE OF ORIGIN (hasn’t gone through membrane)
INVASIVE neoplasm: it starts to invade

60
Q

Pinguecula is a _____ in response to chronic irritation while Conjunctival Intraepithelia Neoplasia is ______ that looks like frog eggs due to angiogenic factors

A

HYPERPLASIA

IN-SITU NEOPLASM

61
Q

what are tumor specific antigens?

A

they are found only on tumour cells and they arise by GENETIC MUTATION and VIAL ANTIGENS in the affected cell

62
Q

what are tumor associated antigens?

A

NORMAL proteins with increased expressions;

examples: oncofetal antigens AND differentiation antigens

63
Q

what are types of tumour associated antigens

A

HCD: preg women, AFP: oncofetal antigens, CEA, and PSA: prostrate

64
Q

what are immunologic response to tumours (cytotoxicity)

A

T cell
NK
macrophage
Complement

65
Q

what are ways of immune evasion?

A

Antigenic changes:
low immunogencitiy: downregulate surface antigens
antigen masking: glycocalyx to prevent access
antigen modulation: different unrecognizable antigen
antigen release: release into environment to overload our immune response (tricky!)
Immunosuppression: anti-inflammatory cytokines
Speed of growth: quick suckers!

66
Q

BENIGN VS MALIGNANT

A

BENIGN: slow, well-defined, not invasive, well differentiated, low mitotic, do not mestastasize

MALIGNANT: RAPID, not encapsulated, invasive, poor differentiation, high mitotic, mestastasis**deadly

67
Q

How does WHO grade/state cancers?

A

T: how big tumour is and if it has invaded locally
N: lymph node involvement
M: metastases

the higher the stage, the more malignant!!

68
Q

As cells get more malignant, they get ____ (size) AND ___(differentiation) AND doubling time becomes ____

A

bigger and less differentiated; SHORTER (quickly spreading!!)

69
Q

what are characteristics of retinoblastoma

A

unilateral or bilateral
75% unilateral
if BILATERAL, then INHERITED

70
Q

what are clinical manifestations of retinoblastoma

A

leukocoria
strabismus
loss of vision
usually confined to eye:: can spread to brain though!

71
Q

what are two ways to LOSE HETEROZYGOSITY in retinoblastoma?

A

missegregation:: intial division fine, but on subsequent division, one has mutant allele and one has normal
mitotic recombination:: homologous chromosomes

Pathology (13 decks)

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