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Pathology 2210 > Cancer > Flashcards

Cancer Flashcards

1
Q

Define Cancer:

A

A class of diseases characterised by uncontrollable cell division and the ability of these cells to be able to invade other tissues by invasion or metastasis

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2
Q

Define Invasion:

A

The direct growth of cancer into an adjacent tissue

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3
Q

Define Metastasis:

A

The migration of cancer cells to distant sites

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4
Q

Define Neoplasm:

A

A new and abnormal tissue growth

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5
Q

For Benign Tumours, what is their;

Growth Rate:
Character of Growth:
Tumour Spread:
Cell Differentiation:

A

Slow
Expansion
Remains localised
Well Differentiated (It’s structure mimics normal tissue)

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6
Q

For Malignant Tumours, what is their;

Growth Rate:
Character of Growth:
Tumour Spread:
Cell Differentiation:

A

Fast
Infiltration (Can send processes into other tissues)
Metastasises
Can range from well to poorly differentiation

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7
Q

In general prefix + oma means that the tumour is________

A

Benign

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8
Q 
What do these prefixes mean?
Adeno-
Angio-
Chondro-
Haemangio-
Lymphangio- 
Fibro-
A 
Adeno = Has a glandular structure
Angio = Vessels
Chondro = Cartilage 
Haemangio = Blood vessels 
Lymphangio = Lymph vessels
Fibro = Fibrous tissue
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9
Q

Is a Papilloma/Polyp benign or malignant?

A

Benign

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10
Q

What is a Carcinoma?

A

A malignant tumour that arises from the epithelial cells

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11
Q

What is a Sarcoma?

A

A malignant tumour that arises from non-epithelial cells

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12
Q

What some exceptions to the prefix + oma = benign rule?

A

Melanoma

Lymphoma

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13
Q

Colon/rectal, breats and prostate cancers are believed to be linked with ______________________

A

Diet and lifestyle choices

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14
Q

Liver cancer is associated with ________________

A

The Hepatitis virus

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15
Q

Cervix/Uterine cancer is associated with ____________

A

Human Papilloma Virus

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16
Q

How do we deal with benign tumours?

A
  1. Ignore it if it isn’t affecting function (e.g. Lipoma)
  2. Remove it if it is large or in the way
  3. Remove it if it could cause damage to surrounding tissues/organs (e.g. benign brain tumour)
  4. Remove it due to malignant potential (colon polyps)
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17
Q

How common are Breast Fibroadenomas

A
  • Very common especially in young women

- May be left or removed (due to pain or other symptoms or patient concern)

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18
Q

What is a Breast Fibroadenoma?

A

Characteristically well-circumscribed benign tumour of the breast fibrous and glandular tissue

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19
Q

Breast Fibroadenomas usually present as __________________________ that is _______, ______, _______ and not _______

A

Single Discrete mass

Smooth, rubbery, mobile and not tender

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20
Q

Breast Fibroadenomas respond to __________ and _________ and therefore can change in size over the _____________.

A

Oestrogen and Progesterone

Ovarian/Menstrual Cycle

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21
Q

Breast Fibroadenomas _______ progress to malignancy

A

Do not

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22
Q

How do we diagnose Breast Fibroadenomas?

A

Ultrasound
Biopsy
Fine Needle Aspiration (FNA)

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23
Q

How do we treat Breast Fibroadenomas?

A

Can be left or removed (due to symptoms {pain} or patients wishes)

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24
Q

What is a Meningioma?

A

A generally benign tumour of the meninges that cover the brain and spinal cord

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25
Q

Meningiomas are unlikely to _________. They are removed due to the ____________________________

A

Metastasise

Damage they cause the brain due to increased pressure

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26
Q

Colon Polyps are ________ tumours of the colon and are usually _________

A

Benign

Asymptomatic

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27
Q

Colon polyp incidence _________ with age and is screened for by using a ____________

A

Increases

Colonoscopy

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28
Q

Cancer is a multi-step process that results from the accumulation of ___________ and __________ alterations

A

Genetic and Epigenetic

29
Q

What genetic factors can affect cancer developent?

A

Gain/Loss of Chromosomes or Chromosome pieces

Presence of oncogenes

30
Q

What is an oncogene?

A

A gene whose activation by mutation or inappropriate expression leads to an increased ikelihood of cancer

31
Q

Carcinoma In Situ (CIN) is a pathway leading to ________ cancer development. It is characterised by the ___________________ and __________________

A

Colorectal cancer
Loss of tumour suppressor genes
Mutation of oncogenes (K-RAS)

32
Q

What is a tumour suppressor gene?

A

A gene whose partial or complete inactivation either in germ line or somatic cells leads to an increased likelihood of cancer

33
Q

What is a microsatellite?

A

A region of the DNA where you have multiple repeats

Repeating regions is normally 1-6 nucleotides long

34
Q

______________ enzymes repair microsatellite regions whose structure has been affected during ___________

A

Mismatch repair enzymes

Cell division

35
Q

If there is a mutation or lack of expression of _____________________ then we get variable alterations in length of the microsatellite regions. This is called _______________

A

Mismatch repair enzymes

Microsatellite instability

36
Q

A microsatellite located in the coding region that has mutated will alter _____________ and therefore the ___________

A

Amino acids sequence

Protein structure

37
Q

A microsatellite located in the regulatory region that has mutated will alter ___________

A

Gene Expression

38
Q

CpG Island Methylator Phenotype (CIMP) is a pathway leading to ________ cancer characterised by the ______________ of CpG islands

A

Colorectal cancer

Hypermethylation

39
Q

CpG islands are often found in the ________ region of DNA, therefore hypermythlation of these islands ________________________ which can lead to ______

A

Promoter
Silences important genes
Cancer

40
Q

Cancer Treatment is dependent on:

A

Cancer type
Cancer stage
Pathological features e.g. size
The patient e.g. age, other illnesses, patient choice

41
Q

What are the 4 types of cancer treatment?

A

Chemotherapy
Radiotherapy
Surgery
Targeted treatments

42
Q

_________ is often the first line of treatment for solid tumours

A

Surgery

43
Q

In order to prepare the patient for surgery they often have to undergo ______________ to _______ the tumour

A

Chemotherapy to shrink the tumour

44
Q

After surgery patients may require _______________ to destroy remaining cancer cells

A

Radiation therapy

45
Q

What must surgeons consider before surgery?

A
  • Accessibility of the tumour
  • Tumour size
  • Has it metastasised?
  • Age and health of patient
  • Likelihood of success
46
Q

What is radiation therapy?

A

The use of high energy radiation to kill tumour cells by damaging their DNA and preventing them from dividing

47
Q

Radiation treatment is usually _________ (dose is divided up into smaller ones) so that __________ have time to _________

A

Fractionated
Healthy Tissues
Repair

48
Q

What are some common cancers treated with radiation therapy?

A 
Breast
Prostate
Lung
GI
Skin
49
Q

What are the advantages of Radiotherapy?

A
  • Treats cancers in situ without anaesthetic (Surgery) or systemic side effects (Chemo)
  • Effectively controls symptoms and improves quality of life
  • Effective in managing severe conditions associated with malignancy
50
Q

What are the side effects of Radiotherapy?

A
  • Usually limited to the area treated e.g. hair loss or skin reactions
  • Fatigue
  • Symptoms associated with damage to certain tissues
51
Q

What is chemotherapy?

A

The treatment of disease via chemical substances

52
Q

How does chemotherapy work?

A
  • Inhibits normal cell function (metabolism, DNA synthesis, cell division)
53
Q

Chemotherapy affects ________ but affects __________ the most due to their ______________

A

All cells
Cancer cells
Increased activity

54
Q

What are anti-metabolites?

A
  • Structurally related to naturally occurring substances (Vitamins, AAs, Nucleotides) that interfere with nucleotide production
  • Inhibit key enzymes or substitute for normal purine/pyrimidines
  • Decrease DNA synthesis and interfere with cell growth
55
Q

Methotrexate is an analogue of ________ that inhibits the enzyme _____________. It inhibits _____________

A

Folic Acid
Dihydrofolate Reductase (DHFR)
DNA synthesis

56
Q

Methotrexate is toxic to the cells of the __________, ________ and _________ as these cells ___________

A

Bone Marrow
Oropharynx
GI Tract
Rapidly divide

57
Q

Methotrexate is used to treat _________________ and _____________________

A

Acute Lymphoblastic Leukaemia

Burkitt’s Lymphoma

58
Q

Alkylating Drugs a form of highly reactive electrophillic that _________________. This affects __________ and ___________.

A

Covalently bind to DNA

Transcription and Replication

59
Q

What are some examples of Alkylating Drugs?

A

Cyclophophamide and Cisplatin

60
Q

Platinum compounds like _______ cause DNA _________ and _____________. It is ____ specific and therefore ______ be used to treat many cancers.

A 
Cisplatin
Cross-Links
Interstrand adducts
Not-specific
can
61
Q

Inhibitors of chromatin function like _______ and ______ deplete __________ and promote ______________________ and ___________

A

Paclitaxel and Taxol
Soluble tubulin
Microtubule polymerisation
Apoptosis

62
Q

Inhibitors of Chromatin function are used to treat ___________________ like _________, _____________________ and _________

A

Aggressively growing tumours
Ovarian Cancer
Advanced breast cancer
Lung cancer

63
Q

Due to the lack of specificity of chemotherapy __________ that are _____________ or _________________ are affected

A

Normal cells
Rapidly dividing
Have high energy needs

64
Q

What are targeted treatments?

A

Treatments that affect cancer cells but are less toxic to non malignant cells

65
Q

What are Steroid Receptor Antagonists?

A

Compounds that are structurally similar to steroids that compete with them at the receptor but don’t trigger the receptors

66
Q

Steroid Receptor Antagonists can be used to treat ___________ as these cancer cells __________ oestrogen receptor production and they are _____________________. __________ is most commonly used for this cancer.

A

Breast Cancer
Up-regulate
Dependent on Oestrogen for growth
Tomoxifen

67
Q

Many reactions in the body are regulated by _______ enzymes. In cancer cells the activity of these enzymes is ________. To prevent this we use __________

A

Kinase enzymes
Increased
Kinase Inhibitors

68
Q

About 10% of ____________________ carry mutations in the __________________. This causes constant _______________ which causes cancer cell proliferation

A

Non-Small Cell Lung Cancer (NSCLC)
Epidermal Growth Factor Receptor (EGFR)
Activation of the receptor

69
Q

If the patient has a ______ mutation then they are given a ___________________

A

EGFR

EGFR tyrosine kinase inhibitor

Pathology 2210 (20 decks)

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