Cancer basics Flashcards
what fraction of cancer in england can be prevented?
4/10
What is cancer?
uncontrolled growth/proliferation of abnormal cells.
cancerous cells invade and destroy healthy tissue including organs
what are the five broad stages of cancer?
histologically
cell with mutation
hyperplasia
dysplasia
in situ cancer
invasive cancer
how does the intratumour heterogenity help survival of the cancer
selection pressures won’t elimintate all the cells
survival of resistant clones help repopulate the tumour making it more likely to spread
whats the difference between intratumour heterogeneity, intertumour heterogeneity and intercancer heterogeneity
Intratumor heterogeneity - the presence of more than one clone of cancer cells within a given tumor mass
Intertumor heterogeneity - the presence of different genetic alterations in different metastatic tumors from a single patient
Intercancer heterogeneity - heterogeneity between cancer from different anatomical locations
what are the two paths to cancer formation?
genetic origin
acquisition of a series of DNA mutations in the genome
but progression is influenced by cancer cell extrinsic factors (soluble
what are the main points in tumour progression and metastatis?
8
- carcinogeneis/tumourigenesis
- angiogensis
- detachment/invasion
- intravasation
- migration/transport
- extravasation
- micrometastasis
- macrometastasis
what type of cell intrinsic factors promote cancer?
- altered tumour suppressor or oncogene function
- deregulation of cell cycle proteins
- dysregulated signallign pathways
- chromosomal instability - leads to deletions or duplications within genes
what type of cell extrinsic factors promote cancer?
- soluble factors
- immune cells
- angiogenesis
- extracellular matrix
- altered environmental conditions
what ways can cancer be treated?
(5)
in terms of disrupting their mechanisms
- surgical removal or radiation directed at primary tumour
- limit spread of disease (chemotherapy, antiangiogenics)
- circumvent immune evasion (immunotherapy)
- correct dysregulated signlling pathways (targetted antibodies, small molecule)
- prevention of cell proliferation (chemotherapy, small molecule approaches, antibodies)
what targetted therapies are used for HER2 breast cancer
Herceptin, monoclonal antibodies
What targetted therapies are used in EGFR lung cancer?
Iressa, smallmolecule EGFR inhibitor
what is the average cost and time frame that it taes to bring a drug to market
10-15 years
$1.3 - 2.8 billion
give some evidence as to why cancer is a genetic disease
- most carcinogens are also mutagens
- no mini epidemics, not contagious (but see viral oncogenes)
- incidence increases with age as does damage to DNA
- some cancers segregate in families
- chromosomal instability is a common feature
- defects in DNA repair increase the probability of cancer
(>50 forms have some degree of inherited predisposition)
what are the types of mutations that can occur?
(6)
- substitution (point mutations)
- insertions
- deletions
- duplication
- inversions
- translocations
Is cancer a inherited disease if it is genetic?
all cancer arises from mutations in genes but not all cancer is inherited
most is not inherited, only 5-10% are due to inherited mutations (germline)
what are germline mutations?
mutation in every cell of the body, including the reproductive cells (starting from a mutation in germline cells)
passed directly from a parent to a child
associated with inherited and familial forms of cancer - less common cau
what are germline mutations?
mutation in every cell of the body, including the reproductive cells (starting from a mutation in germline cells)
passed directly from a parent to a child
associated with inherited and familial forms of cancer - less common cau