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MBC > Cancer > Flashcards

Cancer Flashcards

1
Q

What are cancer cells?

A

Dysfunctional cells that do not respond to extracellular/intracellular signals that control cellular growth and death

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2
Q

Which process do cancer cells evade?

A

Apoptosis

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3
Q

What occurs during the later phase of cancer?

A

Cells traverse through typical tissue boundaries and metastasize to new sites.

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4
Q

Which two classes of enzymes are responsible for intercellular signalling?

A

Cyclins and protein kinases

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5
Q

Which molecular cascade results in the promotion of transcription factors?

A

RAF-MERK-Erk cascade

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6
Q

Which types of genes encode for growth factor receptors?

A

Proto-oncogenes

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7
Q

Which types of genes become superactive within cancer cells?

A

Due to direct mutations of various genes that control cell proliferation. Growth promoting genes (protoncogenes) become super-active and produce cells that are strongly stimulated by growth receptors

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8
Q

Which of the main type of genes are inactivated within cancer cells?

A

Tumour-suppressor genes

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9
Q

Which common tumor suppressor gene is inactivated?

A

p53

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10
Q

Why does an acquired mutation results in cancerous changes?

A

Acquired mutation can result in a growth advantage, that increased cellular proliferation and mitotic division compared to a normal cell- offspring outperforms non-cancerous counterparts in the competition for resources
The second mutation May provide the cancer cell with a reproductive advantage-intensifies competitive advantage.

Omitted checkpoints and suppressed repair genes contribute to the rate of damage accumulation

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11
Q

What are benign tumours?

A

Tumours are confined within the normal boundaries of tissues

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12
Q

What is a malignant tumour?

A

Tumour gains the ability to break through the specific tissue boundary and invasively adjoin to neighbouring tissues.

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13
Q

Which types of enzymes are secreted by malignant cancer cells?

A

Proteases, enabling the degradation of the extracellular matrix at a tissue boundary
Proteases form a pathway for cancer cells to traverse (break down cell junctions and adhesive proteins)

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14
Q

What is metastasis?

A

Cancerous cells enter circulation or the lymphatic system, traveling to a new location of the body, beginning to divide and establish the foundation of new secondary tumour formation.

N.B: Cancer cells must have the ability to penetrate normal barriers of the body to enter and leave the blood/lymph vessels

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15
Q

What is cancer?

A

Cancer is unchecked cell growth directed by genic mutations that cause cancer by accelerating cell division rates or inhibiting normal controls on the system (cell cycle arrest or apoptosis)
Mass of cancer cells can develop into a tumour
Malignancy occurs when cancer cells become invasive and invade adjacent tissues
Secondary tumours form during metastasis

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16
Q

Which types of drugs can be used to treat cancer?

A

Chemotherapy drugs: Counteract by blocking the action of growth signaling proteins

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17
Q

What is the mechanism of Herceptin?

A

Blocks over-active receptor tyrosinase kinases (RTKs)

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18
Q

What is the mechanism of Gleevec?

A

Bocks a mutant signaling kinase

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19
Q

What are the two main types of tumours?

A

Benign

Malignant

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20
Q

What are polyps?

A

Occur due to unregulated growth of healthy unmutated cells (Non-neoplastic tumours)

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21
Q

What is a neoplasm?

A

Refers to the formation of a mass due to abnormal cell or tissue growth
Autonomous (independent of stimuli), growth of tissue which has escaped the normal constraints of cell proliferation

22
Q

What are the characteristic features of benign neoplasms?

A

Typically moveable and are not fixed

23
Q

What is a hamartoma?

A

Localized benign overgrowths of multiple mature cell types.
Composed of abnormal mixture of cells in a disorganized manner typically found at the tissue site
Express architectural but no cytological abnormalities
Grows at the same rate of neighboring tissue

24
Q

What is heterotopia?

A

The presence of a particular tissue type at a non-physiological site co-existing with another anatomically correct tissue type

25
Q

What is an adenoma?

A

Benign glandular tumor

26
Q

What is the term used to describe a malignant glandular tumor?

A

Adenocarcinoma

27
Q

What is a chondroma?

A

Benign cartilage tumour

28
Q

What is melanoma?

A

Malignant skin cancer

29
Q

What is teratoma?

A

A germ tumour, containing tissue derived from three major types; forming 3 germ cell layers.
Teratomas contain mature tissue (benign), immature teratomas are malignant.

Multiple tissues: Hair, teeth, muscle or bone

30
Q

What is invasion of malignant tumours?

A

Direct invasive expansion into adjacent connective tissue and other structures (blood vessels).
Increase cell proliferation of transformed cells in addition to the progressive increase in tumour size eventually leads to breaching the tissue boundaries, resulting in tumour extension

31
Q

What distinguishes dysplasia/carcinoma in situ from cancer?

A

Dysplasia = non invasive

32
Q

What is metastasis?

A

Development of secondary malignant growths at a distance from the primary site of cancer.
Separation from the primary tumour, followed by the invasion through tissues around the initial lesion and penetration of their basement membranes (protease enzyme activity), leads to entry into the circulatory system
Cancer cells spread via blood/lymph vessels (hematogenous spread)

33
Q

What term is used to describe cancer spread via circulation and lymph vessels?

A

Hematogenous spread

34
Q

What are the characteristic cytological features of tumour cells?

A

Larger nuclei
Therefore larger nuclear-cytoplasmic ratio
Loss of distinctive features (variation in nuclear size & shape)

35
Q

Why do abnormal mitoses occur?

A

Aberrant centrosome amplification results in multipolar spindle contributing to aneuploidy
Mark unclear pleomorphism

36
Q

What score parameter is used to evaluate qualitatively how much cancer from biopsy resembles that of a healthy tissue?

A

Gleason score

37
Q

What is a direct extension?

A

Concerns primary tumour growth into adjacent structures & tissues
The direct extension is associated with a stromal response to the tumor
Includes fibroblastic proliferation (desmoplastic response)
Vascular proliferation and an immune response

38
Q

What is another term for vascular proliferation?

A

Angiogenesis

39
Q

What is hematogenous?

A

Metastasis and movement of cancerous growths through blood vessels (sarcomas) and lymphatics (carcinomas)
Vessels typically invaded are the venules & capillaries considering the respective walls are thin, thereby extravasation and intravasation are easier.

40
Q

How is the pattern of the spread of cancer cells dictated within the lymphatic system to lymph nodes?

A

Dictated by normal lymphatic drainage of associated organs.

41
Q

How do epithelial cancers metastasise first?

A

Via the lymphatic system, through this system tumor cells penetrate the basement membrane of the epithelium through this mechanism they arise carried partly by the hydrostatic pressure

42
Q

What is transcoelomic?

A

Across the body cavities (most common example is the pleural cavities)
Metastasis refers to the dissemination of malignant tumours throughout the surfaces and organs of the abdominal and pelvic cavity covered by the peritoneum (intra-abdominal cancers) and pleural cavities

43
Q

What is perineural cancer?

A

Spread of cancer through nerves

44
Q

What is the TNM system? (Describes the spread of tumours)

A

Tumour, Nodes, metastases

45
Q

What is T is the TNM system?

A

T= Tumour size of extent of local invasion

46
Q

What is N for the TNM system?

A

N= Nodes, number of lymph nodes involved

47
Q

What is M for the TNM system?

A

M: Metastases: Presence of distant metastases.

48
Q

What are the differences between benign and malignant tumours? Describe them

A

Invasion: Direct extension into the adjacent connective tissue/ other structures e.g. blood vessels. This is what distinguishes dysplasia/carcinoma in situ (most severe degree of dysplasia) from cancer

Metastasis: Spread via blood vessels to other parts of the body

Differentiation: How much do the cells of the tumour resemble the cells of the tissue it came from.
Tumour cells tend to have larger nuclei (and a higher nuclear-cytoplasmic ratio) and more mitoses than the normal tissue they are derived from.
They may have abnormal mitoses (e.g. tripolar) and marked nuclear pleomorphism (variability in nuclear size and shape).

Growth: How much does the architecture of the tumour resembles the architecture of the tissue it is came from.
Tumours have less well defined architecture than the tissue they are derived from

49
Q

What are the ways that tumours spread?

A 
Direct extension. 
Haematogenous.
Lymphatic 
Transcoelomic
Perineural
50
Q

How are tumour spread assessed?

A

Clinically
Radiologically
Pathologically

51
Q

How is tumour prognosis determined?

A 
Grade = how differentiated is the tumour (see Differentiation, above)?
Stage = how far as the tumour spread (see TNM above)?

(Stage is more important than grade)

MBC (4 decks)

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