Cancer

Question 1

What is the second leading cause of death?

Answer 1

Cancer (> 1 million diagnosed ea. year, >500,000 deaths per year)

Question 2

What is a tumor and what is it also referred as?

Answer 2

• an abnormal growth of cells that serves no purpose or swelling that is caused by inflammation
• Neoplasm (new growth)

Question 3

What are the characteristics of benign (non-cancerous) tumors?

Answer 3

• grow slowly
• cells have a well-defined capsule
• Non-invasive(doesn’t spread or invade other tissue)
• well differentiated cells
• slow mitosis
• localized(don’t metastasize)

Question 4

What are the characteristics of malignant(cancerous) tumors?

Answer 4

• grow rapidly
• cells not encapsulated
• invasive
• poorly differentiated cells
• rapid mitosis
• Spreads rapidly(metastasis)

Question 5

How are benign tumors classified?

Answer 5

they are named from the tissues that they are originated from

-Benign tumors can progress into cancer-

Question 6

How are malignant or cancerous tumors classified?

Answer 6

• Anaplasia: loss of differentiation

- Pleomorphic: cells are variable in sizes and shape

Question 7

Where do most cancers originate from?

Answer 7

In tissues with cells that replicate faster (ex: skin, respiratory tract, reproductive tract, bone marrow, GI tract, bone; from areas where cells naturally grow and divide rapidly

Question 8

What is the difference between carcinomas and adenocarcinomas?

Answer 8

• Carcinomas: malignant epithelial tumors

- Adenocarcinomas: malignant tumors from ductal or glandular tissue

Question 9

What is Carcinoma in situ (CIS)?

Answer 9

• Pre-invasive epithelial tumors
• A tumor that does not invade surrounding tissue
• Pre-cancerous(non-malignant)

Question 10

Cancer is predominantly a disease of aging.

True/False

Answer 10

True

Question 11

An individual acquires multiple mutations or genetic ‘hits’ over time, causing cancer to develop.
True/False

Answer 11

True

Question 12

What are mutations in the environment that are cancer causing(or alter genetic makeup?

Answer 12

• Smoking

- UV Radiation(sunlight; damages epithelial cells over time with exposure)

Question 13

Clonal Proliferation or Expansion?

Answer 13

• Is a result of mutations, allows cells to acquire characteristics of a cancer cell and have a selective advantage over its neighboring cells
• increased growth rate or decreased apoptosis of cells

Question 14

What are transformed cells?

Answer 14

-transformed cells are cancer cells that can be created from normal cells in a lab setting

Question 15

Characteristics of transformed cells

Answer 15

• decreased need for growth factors to multiply
• lack contact inhibition(cells jus pile up on each other)
• anchorage-independent(continue to divide in a soft-gel growing environment)
• immortal

Question 16

Proto-oncogenes vs. Oncogenes vs. Tumor-Supressor Genes

Answer 16

• Proto-oncogenes: genes that regulate normal cell growth and proliferation; it is an oncogene in it’s normal, non-mutant state
• Oncogenes: over-expressed/mutated proto-oncogene
• Tumor-Supressor Genes(Anti-oncogenes): genes that encode proteins that inhibit proliferation of cancer genes; they are growth inhibiting genes(act like a brake pedal)

Question 17

Gene Silencing

Answer 17

Turning off genes w/o mutations

-whole regions of a chromosome are shut off while the same regions in other cells remain active

Question 18

what is chromosome instability?

Answer 18

• chromosomes are unstable, such that either whole chromosomes or parts of chromosomes are duplicated or deleted.
• an increase in malignant cells
• Results in chromosome loss, loss of heterozygosity, and chromosome amplification

Question 19

Mutagens

Answer 19

any agent that causes a mutation

Question 20

How can a mutation be passed onto future generations?

Answer 20

If the mutation occurs in germline cells or in other words gametes. This does not happen if it occurs in somatic cells.

Question 21

Metastasis

Answer 21

• spread of cancer from a primary site of origin to a distant site
• it is highly inefficient; meaning it is not efficient or controlled
• usually occurs in later stages of cancer

Question 22

True/False

Signs and Symptoms of a tumor vary according to its origin and size

Answer 22

True
Manifestations of tumor include:
-physical pressure 
-obstructions 
-loss of normal function
-compression of nerves

Question 23

What is a biopsy?

Answer 23

Consists of obtaining tumor tissue to confirm a diagnosis and to see whether the tumor is benign or malignant

Question 24

What are the steps involved in determining the stage of a tumor? (3 total)

Answer 24

• Size
• the degree to which it has locally invaded
• the degree to which it has spread(metastasized)

Question 25

What are the different stages?

Answer 25

Stage I: No metastasis Stage II: Local Invasion Stage III: Spread to regional structures(lymph nodes) Stage IV: Distant metastasis

Question 26

What is the World Health Organization's TNM system for staging cancer?

Answer 26

T--> tumor spread(primary tumor) N--> node involvement(regional lymph nodes) M-->presence of distant metastasis *When lymph nodes are involved in cancer that is not a good thing along with the increasing size of tumor and degree of metastasis* staging may also alter the choice of therapy

Question 27

What are substances produced by benign or malignant cells that are present either in or on tumor cells or found in blood, cerebrospinal fluid, or urine. And what do they include?

Answer 27

Tumor (Cell) Markers or Biological Markers Includes: Hormones, Enzymes, Genes, antigens, and Antibodies

Question 28

What are tumor markers used for? and what problem do thay pose?

Answer 28

- Screen and identify individuals at high risk for cancer - Diagnose specific types of tumors - Observe clinical course of cancer -Problem: false positives and negatives

Question 29

Pain, Fatigue, Anemia, Leukopenia,Thrombocytopenia, Infection, Gastrointestinal Problems, Hair(alopecia) and Skin Problems are all a result of what?

Answer 29

These are all clinical manifestations of cancer.

Question 30

Pain and Cancer | How does the pain occur?

Answer 30

- Little or no pain is associated with early stages of malignancy - Most feared complication of advanced cancer - Influenced by fear, anxiety, sleep loss, fatigue, and overall physical deterioration Mechanisms of pain: Direct pressure, Obstruction, Invasion of sensitive structures, Stretching of visceral surfaces, Tissue destruction, Inflammation

Question 31

Fatigue and Cancer

Answer 31

-Subjective clinical manifestation *Tiredness, weakness, lack of energy, exhaustion, lethargy, inability to concentrate, depression, sleepiness, boredom, and lack of motivation -Causes *Sleep disturbances, treatment, psychosocial factors, nutritional status (syndrome of cachexia)

Question 32

Cachexia

Answer 32

- Severe form of malnutrition - Present in 80% of cancer patients at death - Includes anorexia, early satiety, weight loss, anemia, asthenia (lack of energy), taste alterations, and altered protein, lipid, and carbohydrate metabolism

Question 33

Anemia and Cancer | What is the anemia in cancer patients caused by?

Answer 33

Anemia is the decrease of hemoglobin in the blood. Caused by: Chronic bleeding resulting in iron deficiency, Severe malnutrition, Medical therapies (chemotherapy), Malignancy in blood-forming organs

Question 34

Leukopenia/Thrombocytopenia as a Clinical Manifestation of Cancer Cause and Risk

Answer 34

-Leukopenia: decrease of white blood cells -Thrombocytopenia: decrease in the number of platelets Cause: -Direct tumor invasion to the bone marrow causes leukopenia (decreased total WBC) and thrombocytopenia (decreased total platelets) -Chemotherapy drugs are toxic to the bone marrow Risk: Infection risk increases when the absolute neutrophil and lymphocyte counts fall

Question 35

Gastrointestinal Manifestations with Cancer

Answer 35

-Oral ulcers caused by decreased cell turnover from chemotherapy and radiation, Malabsorption, Diarrhea, Therapy-induced nausea

Question 36

Hair and Skin Manifestations with Cancer

Answer 36

- Alopecia from chemotherapy: usually temporary | - Skin breakdown and dryness

Question 37

Effects of Chemo

Answer 37

Chemotherapy is very toxic: affects the gut, bone marrow, causes sores in the mouth(resulting in the inability to eat), burns, alopecia(side effect; hair will grow back)