Cancer Flashcards
What cells in the body can Cancer originate from?
Almost any cell in the body.
A diverse group of diseases in which some of the body’s cells become defective and multiply out of control is known as…..
Cancer
Cells which are damaged , aged, or are no longer needed undergo…….
Apoptosis
The orderly cellular process which causes the cell to shrink, condense and disassemble is known as……..
Apoptosis
During the normal cell cycle, there are two main stages from cell formation to cell reproduction.
What are they?
- Interphase
2. Mitotic phase
What occurs during Interphase of the cell cycle?
G1-(Gap 1) main phase, active growth and production of proteins.
S- (Synthesis) DNA is replicated.
G2- (Gap 2) proteins and enzymes needed for cell division are produced.
What occurs during the Mitotic phase of the cell cycle?
Mitosis: division of nucleus to form two identical daughter cells.
During the cell cycle, ‘Checkpoints’ are reached. What are the two checkpoints called?
G1/S checkpoint
G2/M checkpoint
What occurs at G1/S checkpoint?
Cell cycle progresses into S phase only if; Fully prepared to complete cycle and, DNA damage has been repaired.
What occurs at G2/M checkpoint?
Cell cycle progresses into M phase only if; DNA replication is completed and, chromosomes are intact.
A _________ (neoplasm) is a mass or growth which can arise from normal tissue.
Tumour
_______ ________ are non-invasive and do not spread.
Benign Tumours
________ _________ have the capacity to invade and infiltrate surrounding tissue, so extend beyond the tissue of origin and can metastasise or spread to other sites.
Malignant Tumours
Benign tumours are composed of _____ ___________ cells (mature cells that resemble the tissue of origin).
Well differentiated.
Malignant tumours are _______________. (the cells lack the ability to undertake mature cellular function, as they are ‘immature’).
Undifferentiated.
Benign tumours have ______ growth and Malignant tumours usually have ______ growth.
Slow
Rapid
A main difference between benign and malignant tumours is the presence/lack of a capsule. Describe the capsule status of each tumour.
Benign tumours have a well defined capsule and malignant tumours lack a capsule.
Can benign tumours metastasise?
No, only malignant tumours metastasise.
Carcinomas arise from _______ and ________ tissues, such as hepatocellular carcinoma.
Endothelial and Epithelial
Sarcomas arise from _______ tissues, such as osteogenic sarcoma.
Connective.
A benign tumour arising from the glandular or ductal epithelium is known as _______.
Adenoma
Describe Cancer
Cancer is a chronic disease, characterised by the uncontrolled, unregulated and uncoordinated proliferation of cells; with the ability to metastasise or spread.
Cancer arises to due _______ ________ (damage to DNA).
Genetic mutations.
Cancer’s likely cause is due to _______ and _________ factors, and less likely can be due to inheritance of _______ ______.
Lifestyle and Environmental factors.
Mutated genes.
Carcinogens causes______ _______, which causes _______.
Genetic mutations.
Cancer.
Inheritance of mutated genes only occurs in _____ % of cancer cases.
5
Cancer cells may stimulate their own growth by:
- Secreting growth factors.
2. Increasing number of growth factor receptors.
Our bodies have normal regulatory genes, such as Proto-oncogenes and Tumour suppressor genes (eg. p53 gene). What are their roles?
Proto-oncogenes regulate cell growth and division.
Tumour Suppressor genes slow down proliferation and direct cell repair when DNA is damaged.
What is the role of Caretaker genes?
Help repair DNA and induce Apoptosis when repair not completed.
Outcomes triggered by p53 activation on cells include…….
Cell cycle arrest
DNA repair
Apoptosis
Senescence (old age of the cell)
During mutations to regulatory genes, Proto-oncogenes become _____ _______ which ………
Active oncogenes which promote cell differentiation and tumour growth! (in other words, these go faulty and say….. Grow everything! Healthy or not!!) 😳
During mutations to regulatory genes, Tumour suppressor genes become _______ ______.
What happens then?
Inactive Tumour Suppressor genes.
They lose their normal ‘brake’ on cell proliferation and allow tumour growth.
When other regulatory genes mutate (eg. Caretaker genes), what happens?
Apoptosis does not occur.
Damaged genes are not repaired.
Cancer cells _____ and ______ independently of normal cell controls.
Grow and multiply
(All the usual mechanisms that say… Slow down! Make sure it’s all correct… Are not working).
Cancer growths have the ability to undertake Angiogenesis.
What is this?
Formation of new blood vessels.
Specifically to grow cancer bigger!!!
The ability of cancer to spread to other distant tissues or organs is known as ______.
Metastasis
During cancer growth, the cells have an increased nucleus size and an increase in Mitotic activity (cell division).
True or False?
True!!
Angiogenesis mainly occurs in more ________ _______. The tumour develops it’s own _______ ______.
Advanced tumours.
Blood supply.
The most common sites for metastasis include:
Liver
Lungs
Bone
Brain
(Differing for each primary type of cancer).
The original site of cancer is the ……
Primary cancer.
Secondary cancer is ……..
Cancer which has spread to another site.
Production of new formed elements (blood cells) occurs in the _____ _______ and are derived from _____ _____.
Bone Marrow
Stem Cells
Mature blood cells divide.
True or False?
False! They do not divide.
The lysis of cancer cells occurs by a type of lymphocyte known as …………..
Natural killer (NK) cells.
What cells release chemicals to enhance the inflammatory response?
Natural killer (NK) cells.
Chronic inflammation increases the risk of cancer.
Why?
Inflammatory cells release cyclo-oxygenase 2 (COX-2) (enzyme involved in the chronic inflammation process).
COX-2 is associated with some cancers, eg. Colerectal cancer.
How is stress and immunity related to cancer growth?
Excess cortisol (from stress) suppresses some functions of the immune system, which is linked with the development of cancer. Also, in cancer patients, stress can increase growth and spread of cancer.
Carcinogens are made up of:
Infectious agents.
Environmental factors.
Lifestyle factors.
Infectious agents (viruses/bacteria) can cause cancer. List some example.
Human papillomavirus (HPV) can cause cancer of the cervix.
Human Immunodeficiency virus (HIV) can cause Lymphoma.
Hepatitis virus can cause cancer of the liver.
Helicobacter pylori can cause stomach cancer.
Environmental factors such as ionising radiation and iatrogenic exposure can cause cancer.
Explain these.
Ionising radiation can occur through medical imaging, fallout from nuclear radiation or UV radiation from the sun or tanning booths.
Iatrogenic exposure is caused due to medical diagnostics and treatments, eg. Chemotherapeutic drugs, hormone replacement therapy.
(Treatments can create further cancers).
Obesity increases the risk of _______ cancers………
Endometrial Renal Breast Oesophageal Colorectal Gallbladder Pancreatic Prostate
Excessive alcohol consumption increases risk of _______ cancers
Hepatic Oropharyngeal Laryngeal Oesophageal Breast Colorectal Ovarian Pancreatic
By increasing physical activity, the risk of ________ cancers is decreased.
Breast
Colorectal
Pancreatic
Lung
Dietary factors which can decrease cancer risk include……
Fruit, vegetables, dietary fibre. Legumes: flavonoids and phyto-oestrogens. Vitamins C and E Vitamin D Calcium, selenium Folate
In diagnosis and evaluation of cancer, early detection is important because……
Smaller size, easier to remove.
Less invasion of surrounding tissues.
Organ function may still be normal.
Before metastasis to other organs.
Describe the TNM classification system of Tumour Staging.
T: Tumour; size of local tumour and degree of invasion.
N: Nodes; involvement of lymph nodes.
M; Extent of metastasis.
List some clinical features of the advanced stages of cancer.
Pain Fatigue Cachexia Anorexia Anaemia Thrombocytopenia Infection
Ways in which cancer can be diagnosed include…..
Screening
Blood tests
Biopsy
Medical imaging (including X-Ray, CT scans).
Check for lumps or sores that don’t heal.
In well-advanced cancer, why might there be pain?
Direct pressure of tumour on sensory receptors.
Obstruction due to tumour.
Inflammation.
Tissue damage.
Fatigue is the most common symptom in advanced cancer. This could be from………
Sleep disturbances. Alterations in cytokines. Psychosocial factors. Nutritional status. Level of physical activity.
What is Cachexia?
Severe tissue wasting (fat and muscle).
Can also cause fatigue and weakness, Anorexia and pain.
Explain Anorexia (as opposed to Anorexia Nervosa).
Anorexia is a loss of appetite due to various factors including; altered taste sensation, nausea and vomiting, and psychological concerns.
Some of these can be due to cancer treatments.
Oxygen-carrying capacity is low due to; inadequate food intake, chronic bleeding and iron loss.
What is this referring to?
Anaemia
Anaemia can be caused by….
Cancer in bone marrow or depression of bone marrow during cancer treatments.
Cancer in bone marrow or depression of bone marrow via cancer treatment can cause insufficient number of platelets.
What is this called?
Thrombocytopenia
Cancer in bone marrow or depression of bone marrow via cancer treatments can cause insufficient numbers of leucocytes.
What might happen?
Infections can develop and often be fatal due to the immune system becoming weakened.
Treatments available for cancer include…..
Surgery Radiation therapy Immunotherapy Chemotherapy Anti-angiogenesis drugs Monoclonal antibodies Immune system modulators Hormonal therapy Palliative care
What happens in the cancer surgery process?
Removal of the tumour including a margin of healthy tissue that surrounds the growth.
Removal of nearby lymph nodes.
Radiation therapy is….
Destructive X-Ray or gamma radiation.
Immunotherapy boosts the immune defences against cancer cells. It can activate immune system components such as………..
Interferons
Natural killer (NK) cells
Cytotoxic T cells.
Immunotherapy in cancer treatment includes ________ against some viruses that cause cancer.
Vaccination
Cytotoxic or antineoplastic drugs that target rapidly dividing cells are known as……
Chemotherapy
Chemotherapy drugs can be used ______ surgery to destroy any remaining cells, or _________ surgery to decrease tumour size.
After
Before
What is the role of Anti-angiogenesis agents?
Prevent formation of new blood vessels.
What is the role of Monoclonal antibodies in cancer treatment?
Targeted therapy whereby monoclonal antibodies attach to specific cancer cells.
(Makes the cancer cell more ‘visible’ to the immune system).
Some cancers of the reproductive system are hormone dependant. Drugs that block activity or production of hormones may be used.
This describes…….
Hormonal therapy.
Treating a patient’s cancer symptoms, including pain management, when other treatment options are not suitable, is known as…….
Palliative Care
Tissue fluid is normally returned to lymphatic vessels, then empties into venous circulation.
What may occur due to the surgical removal or damage of lymph nodes during cancer treatment?
Secondary lymphoedema.
- if lymph channels are blocked or removed, fluid gets trapped in tissues, leading to oedema.
Rapidly dividing cells are vulnerable to side effects of cancer therapies.
Which areas might be affected?
Hair follicles - Alopecia, usually temporary.
Gastrointestinal Tract - causing nausea, vomiting, anorexia and diarrhoea.
Skin and mucous membranes - resulting in infections.
Leucopenia, thrombocytopenia and Anaemia are side effects from cancer treatment which occur in the ______ ______.
This can be treated with ________ and ___________.
Bone marrow.
Transfusions and EPO (Erythropoietin)
Cancer patients seeking treatment may like to do sperm or embryo banking.
Why?
Cancer treatment can cause decreased fertility or early menopause.
Indigenous Australians have a higher incidence of ______________ cancer and a lower incidence of _______________ cancer.
Higher - cervical and lung cancer.
Lower - colorectal, breast, prostate and melanoma cancers.
National Cancer Screening Programs exist in Australia for……
Breast Cancer
Bowel (Colorectal) Cancer
Cervical Cancer
Colorectal Cancer mostly develops from benign growths called ______.
Risk factors for Colorectal Cancer include ___________ and _________.
Polyps.
Low dietary fibre and high fat intake.
Symptoms for Colorectal cancer can include…..
Change in bowel habits.
Abdominal pain, bloating.
Bleeding.
Unexplained tiredness.
(Few symptoms until advanced stage).
The National Bowel Screening Program uses a _____________
Faecal occult blood test.
Breast Cancer usually arises from the _________ _________ lining the small ducts involved in milk production.
Risk Factors include……..
Epithelial Cells.
Early menarche and late menopause.
No pregnancy, or first pregnancy late in life, little breastfeeding.
Family history/genetics.
Hormone replacement therapy.
Women should self-examine for breast cancer. What else can women do?
Women over 40 should have mammograms, and younger women in high risk groups should have an MRI.
Clinical features of Breast Cancer include…….
Painless Lump.
Breast skin dimpling.
Changes to nipples.
Palpable nodes in axilla.
Most Prostate Cancers are ___________.
Risk factors include……….
Adenocarcinomas.
Family history/genetics.
Dietary factors eg. High fat intake.
Advanced Prostate cancer can cause dysuria, urinary infection, frequent urination.
Why?
The tumour can compress the urethra causing urinary symptoms.
Prostate cancer diagnosis can occur through……..
Digital rectal examination.
Prostate serum antigen (PSA) levels in the blood.
Biopsy.
Melanoma is a malignant tumour arising from _________.
It has a very rapid ________ and is __________ to chemotherapy.
Melanocytes.
Metastasis, Resistant.
Risk factors for Melanoma include………
Recurring exposure to UV light.
Sunburn in childhood.
Fair skin.
Family history.
In Melanoma detection... What does A B C D E Stand for?
Asymmetry. Border irregularity. Colour variation. Diameter >6mm. Evolving over time, or elevation.
