Cancer Flashcards
Define Cancer:
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
Define Invasion:
The direct growth of cancer into an adjacent tissue
Define Metastasis:
The migration of cancer cells to distant sites
Define Neoplasm:
A new and abnormal tissue growth
For Benign Tumours, what is their;
Growth Rate:
Character of Growth:
Tumour Spread:
Cell Differentiation:
Slow
Expansion
Remains localised
Well Differentiated (It’s structure mimics normal tissue)
For Malignant Tumours, what is their;
Growth Rate:
Character of Growth:
Tumour Spread:
Cell Differentiation:
Fast
Infiltration (Can send processes into other tissues)
Metastasises
Can range from well to poorly differentiation
In general prefix + oma means that the tumour is________
Benign
What do these prefixes mean? Adeno- Angio- Chondro- Haemangio- Lymphangio- Fibro-
Adeno = Has a glandular structure Angio = Vessels Chondro = Cartilage Haemangio = Blood vessels Lymphangio = Lymph vessels Fibro = Fibrous tissue
Is a Papilloma/Polyp benign or malignant?
Benign
What is a Carcinoma?
A malignant tumour that arises from the epithelial cells
What is a Sarcoma?
A malignant tumour that arises from non-epithelial cells
What some exceptions to the prefix + oma = benign rule?
Melanoma
Lymphoma
Colon/rectal, breats and prostate cancers are believed to be linked with ______________________
Diet and lifestyle choices
Liver cancer is associated with ________________
The Hepatitis virus
Cervix/Uterine cancer is associated with ____________
Human Papilloma Virus
How do we deal with benign tumours?
- Ignore it if it isn’t affecting function (e.g. Lipoma)
- Remove it if it is large or in the way
- Remove it if it could cause damage to surrounding tissues/organs (e.g. benign brain tumour)
- Remove it due to malignant potential (colon polyps)
How common are Breast Fibroadenomas
- Very common especially in young women
- May be left or removed (due to pain or other symptoms or patient concern)
What is a Breast Fibroadenoma?
Characteristically well-circumscribed benign tumour of the breast fibrous and glandular tissue
Breast Fibroadenomas usually present as __________________________ that is _______, ______, _______ and not _______
Single Discrete mass
Smooth, rubbery, mobile and not tender
Breast Fibroadenomas respond to __________ and _________ and therefore can change in size over the _____________.
Oestrogen and Progesterone
Ovarian/Menstrual Cycle
Breast Fibroadenomas _______ progress to malignancy
Do not
How do we diagnose Breast Fibroadenomas?
Ultrasound
Biopsy
Fine Needle Aspiration (FNA)
How do we treat Breast Fibroadenomas?
Can be left or removed (due to symptoms {pain} or patients wishes)
What is a Meningioma?
A generally benign tumour of the meninges that cover the brain and spinal cord
Meningiomas are unlikely to _________. They are removed due to the ____________________________
Metastasise
Damage they cause the brain due to increased pressure
Colon Polyps are ________ tumours of the colon and are usually _________
Benign
Asymptomatic
Colon polyp incidence _________ with age and is screened for by using a ____________
Increases
Colonoscopy
Cancer is a multi-step process that results from the accumulation of ___________ and __________ alterations
Genetic and Epigenetic
What genetic factors can affect cancer developent?
Gain/Loss of Chromosomes or Chromosome pieces
Presence of oncogenes
What is an oncogene?
A gene whose activation by mutation or inappropriate expression leads to an increased ikelihood of cancer
Carcinoma In Situ (CIN) is a pathway leading to ________ cancer development. It is characterised by the ___________________ and __________________
Colorectal cancer
Loss of tumour suppressor genes
Mutation of oncogenes (K-RAS)
What is a tumour suppressor gene?
A gene whose partial or complete inactivation either in germ line or somatic cells leads to an increased likelihood of cancer
What is a microsatellite?
A region of the DNA where you have multiple repeats
Repeating regions is normally 1-6 nucleotides long
______________ enzymes repair microsatellite regions whose structure has been affected during ___________
Mismatch repair enzymes
Cell division
If there is a mutation or lack of expression of _____________________ then we get variable alterations in length of the microsatellite regions. This is called _______________
Mismatch repair enzymes
Microsatellite instability
A microsatellite located in the coding region that has mutated will alter _____________ and therefore the ___________
Amino acids sequence
Protein structure
A microsatellite located in the regulatory region that has mutated will alter ___________
Gene Expression
CpG Island Methylator Phenotype (CIMP) is a pathway leading to ________ cancer characterised by the ______________ of CpG islands
Colorectal cancer
Hypermethylation
CpG islands are often found in the ________ region of DNA, therefore hypermythlation of these islands ________________________ which can lead to ______
Promoter
Silences important genes
Cancer
Cancer Treatment is dependent on:
Cancer type
Cancer stage
Pathological features e.g. size
The patient e.g. age, other illnesses, patient choice
What are the 4 types of cancer treatment?
Chemotherapy
Radiotherapy
Surgery
Targeted treatments
_________ is often the first line of treatment for solid tumours
Surgery
In order to prepare the patient for surgery they often have to undergo ______________ to _______ the tumour
Chemotherapy to shrink the tumour
After surgery patients may require _______________ to destroy remaining cancer cells
Radiation therapy
What must surgeons consider before surgery?
- Accessibility of the tumour
- Tumour size
- Has it metastasised?
- Age and health of patient
- Likelihood of success
What is radiation therapy?
The use of high energy radiation to kill tumour cells by damaging their DNA and preventing them from dividing
Radiation treatment is usually _________ (dose is divided up into smaller ones) so that __________ have time to _________
Fractionated
Healthy Tissues
Repair
What are some common cancers treated with radiation therapy?
Breast Prostate Lung GI Skin
What are the advantages of Radiotherapy?
- 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
What are the side effects of Radiotherapy?
- Usually limited to the area treated e.g. hair loss or skin reactions
- Fatigue
- Symptoms associated with damage to certain tissues
What is chemotherapy?
The treatment of disease via chemical substances
How does chemotherapy work?
- Inhibits normal cell function (metabolism, DNA synthesis, cell division)
Chemotherapy affects ________ but affects __________ the most due to their ______________
All cells
Cancer cells
Increased activity
What are anti-metabolites?
- 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
Methotrexate is an analogue of ________ that inhibits the enzyme _____________. It inhibits _____________
Folic Acid
Dihydrofolate Reductase (DHFR)
DNA synthesis
Methotrexate is toxic to the cells of the __________, ________ and _________ as these cells ___________
Bone Marrow
Oropharynx
GI Tract
Rapidly divide
Methotrexate is used to treat _________________ and _____________________
Acute Lymphoblastic Leukaemia
Burkitt’s Lymphoma
Alkylating Drugs a form of highly reactive electrophillic that _________________. This affects __________ and ___________.
Covalently bind to DNA
Transcription and Replication
What are some examples of Alkylating Drugs?
Cyclophophamide and Cisplatin
Platinum compounds like _______ cause DNA _________ and _____________. It is ____ specific and therefore ______ be used to treat many cancers.
Cisplatin Cross-Links Interstrand adducts Not-specific can
Inhibitors of chromatin function like _______ and ______ deplete __________ and promote ______________________ and ___________
Paclitaxel and Taxol
Soluble tubulin
Microtubule polymerisation
Apoptosis
Inhibitors of Chromatin function are used to treat ___________________ like _________, _____________________ and _________
Aggressively growing tumours
Ovarian Cancer
Advanced breast cancer
Lung cancer
Due to the lack of specificity of chemotherapy __________ that are _____________ or _________________ are affected
Normal cells
Rapidly dividing
Have high energy needs
What are targeted treatments?
Treatments that affect cancer cells but are less toxic to non malignant cells
What are Steroid Receptor Antagonists?
Compounds that are structurally similar to steroids that compete with them at the receptor but don’t trigger the receptors
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.
Breast Cancer
Up-regulate
Dependent on Oestrogen for growth
Tomoxifen
Many reactions in the body are regulated by _______ enzymes. In cancer cells the activity of these enzymes is ________. To prevent this we use __________
Kinase enzymes
Increased
Kinase Inhibitors
About 10% of ____________________ carry mutations in the __________________. This causes constant _______________ which causes cancer cell proliferation
Non-Small Cell Lung Cancer (NSCLC)
Epidermal Growth Factor Receptor (EGFR)
Activation of the receptor
If the patient has a ______ mutation then they are given a ___________________
EGFR
EGFR tyrosine kinase inhibitor
