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NYCC Physiopathology > Cancer Epidemiology and Special Cases > Flashcards

Cancer Epidemiology and Special Cases Flashcards

1
Q

What is epidemiology?

A
  • study of identifying common factors which contribute to the spread, growth, or development of a disease
  • evaluation of these factors in the context of current biological understanding
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2
Q

What is a carcinogen?

A

A cancer-causing agent

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3
Q

Lung cancer is ____ greater in the US than Japan?

A

2x

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4
Q

Skin cancer deaths are (Greater/Lesser) in New Zealand than in Iceland?

A

Greater (6x)

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5
Q

Upper esophageal cancers (nasopharyngeal, esophageal) are more prevalent in Asia and Iran (TRUE/FALSE)?

A

TRUE (consume more hot tea)

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6
Q

Lower esophageal cancers at the gastroesophageal junction are most prevalent in the US (TRUE/FALSE)?

A

TRUE

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7
Q

Acute leukemia and brain neoplasms present more commonly in older patients (TRUE/FALSE)?

A

FALSE

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8
Q

What is the most common cancer in males?

A

Prostate

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9
Q

What is the most common cancer in females?

A

Breast

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10
Q

What is the most common cause of cancer death in both males and females?

A

Lung and bronchus

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11
Q

What is the second most common cause of cancer death in males?

A

Prostate

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12
Q

What is the third most common cause of cancer death in both males and females?

A

Colon and rectum

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13
Q

What is the second most common cause of cancer death in females?

A

Breast

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14
Q

What cancer has dropped rapidly in the US upon the advent of antibiotic therapy?

A

Stomach

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15
Q

In general, as age increases, the incidence of cancers increases. What are 2 examples of exceptions to this trend?

A
  • Hodgkin’s disease (bimodal: young and old)
  • Testicular cancer (peak age 30)
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16
Q

What are inherited cancer syndromes?

A

Well-defined malignancies in which the inheritance of a single mutant gene (must be identified) greatly increases the risk of developing a neoplasm

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17
Q

What are examples of inherited cancer syndromes?

A

Childhood retinoblastoma
Familial adenomatous polyposus coli
Li-Fraumeni syndrome

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18
Q

What gene is mutated in a familial adenomatous polyposis coli patient?

A

APC

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19
Q

What gene is mutated in an inherited childhood retinoblastoma patient?

A

Rb

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20
Q

What gene is mutated in a patient with Li-Fraumeni syndrome?

A

P53

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21
Q

Cancer incidence is increased in genetic relatives who have had that cancer in the past (TRUE/FALSE)?

A

TRUE

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22
Q

With familial cancers there is no consistent link to a specific genetic mutation (TRUE/FALSE)?

A

TRUE

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23
Q

What are examples of known or suspected carcinogens?

A
  • Tobacco smoke
  • Dietary carcinogens/insufficiencies
  • Alcohol
  • Chemicals
  • Radiation
  • Viruses
  • Bacteria
  • Therapeutic drugs
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24
Q

What is an example of a patient presentation of a “low-risk” strain of HPV?

A

Papilloma (warts)

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25
Q

What can “high-risk” strains of human papilloma virus (HPV) cause?

A

Cervical carcinoma; Oral carcinoma

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26
Q

What are examples of “high-risk” strains of HPV?

A

HPV 16
HPV 18

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27
Q

What is the mechanism in which “high-risk” HPV strains such as HPV 16 and 18 cause cancer?

A

High-risk viral protein products degrade p53 gene products

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28
Q

What virus is responsible for causing infectious mononucleosis and potentially lymphomas and leukemias?

A

Epstein-Barr virus (EBV)

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29
Q

What cells does the Epstein-Barr virus infect?

A

Epithelial cells and B lymphocytes

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30
Q

What gene is overexpressed in Burkitt’s lymphoma?

A

Bcl-2

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31
Q

Bcl-2 is a(n) (Pro-apoptotic/Anti-apoptotic) gene?

A

Anti-apoptotic

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32
Q

What virus is implicated in cases of Hodgkin’s lymphoma?

A

Epstein-Barr virus (EBV)

33
Q

What virus has a strong association with hepatocellular carcinoma?

A

Hepatitis B virus (HBV)

34
Q

How does hepatitis B virus cause hepatocellular carcinoma?

A

Chronic liver damage leads to regenerative hyperplasia and an increased amount of spontaneous mutations

35
Q

What bacteria is associated with chronic gastritis?

A

Helicobacter pylori

36
Q

What bacteria is linked to gastric carcinomas and B-cell lymphomas of the stomach?

A

Helicobacter pylori

37
Q

Birth control generally (Increases/Decreases) cancer rates?

38
Q

What are the primary risk factors associated with breast, cervical, and uterine cancers?

A
  • increasing age
  • increased length of reproductive life
  • decreased number of children
  • obesity
  • genetics
39
Q

What is the early detection method for cervical cancer?

40
Q

What are the early detection methods for breast cancer?

A

Mammogram and breast self-exam

41
Q

Earlier menstruation and later menopause (longer reproductive life) is linked to a reduced chance of cancer (TRUE/FALSE)?

42
Q

What are the general steps of anti-estrogen therapy?

A
  • Inject Her2/Neu receptors into an animal
  • Animal makes Ab (Herceptin) against Her2/Neu receptor
  • Reinject Herceptin Ab into patient to shut down the mutated receptor
43
Q

What antibody is formed during anti-estrogen Ab therapy?

44
Q

What are MABs?

A

Monoclonal antibodies against one thing

45
Q

What is the function of Herceptin?

A

Intercept and shut down the Her2/Neu receptor to treat breast carcinoma (if this is the specific mutation)

46
Q

What is an important side effect of anti estrogen Ab therapy?

A

Triggers early menopause

47
Q

What population is chiefly affected by prostate carcinoma?

A

Elderly men 50+ years of age

48
Q

What is a normal PSA range?

49
Q

What PSA number indicates benign prostatic hypertrophy or prostate carcinoma?

A

Greater than 4 ng/ml

50
Q

Patient presents with frequent urination at night and dribbling from the penis. A blood test is performed for the presence of prostate specific antigen. Results demonstrate a PSA of 6 ng/ml? What are two possible diagnoses?

A

Benign prostatic hypertrophy or prostate carcinoma

51
Q

What is the function of dihydrotestosterone (DHT)?

A

Maintains the prostate (growth factor for prostatic epithelium)

52
Q

What are potential treatment methods for prostate carcinoma?

A

Watchful waiting (active surveillance)
Surgery
Brachytherapy (Bradytherapy)
External radiation
Hormone therapy
TURP
5-a-reductase inhibitor

53
Q

What are common complications of prostate surgery?

A

Impotence and incontinence

54
Q

What is brachytherapy? What cancer is it used to treat?

A

Internal radiation where radioactive beads are placed into the prostate to destroy epithelium and decrease tumor size

55
Q

What is a TURP?

A

Transurethral resection of the prostate from the inside out

56
Q

What are potential adjunct therapies for prostate carcinoma?

A

Saw palmetto
Genistein
Lycopenes

57
Q

What is the function of saw palmetto? What neoplasm can it help prevent?

A

Inhibition of DHT synthesis to prevent prostate carcinoma

58
Q

What is genistein a derivative of?

59
Q

What is the function of genistein? What neoplasm can it treat?

A
  • Decrease angiogenesis and epithelium cell cycles
  • Blocks DHT growth factor receptor and acts as an antioxidant
  • Treats prostate cancer
60
Q

What is the function of lycopenes? What neoplasm can it help prevent?

A

Antioxidant used to help prevent prostate carcinoma

61
Q

What are examples of pre-neoplastic disorders (and benign neoplasms) which have a well-defined association with malignancy?

A

Bronchial metaplasia
Endometrial hyperplasia
Esophageal metaplasia
Liver cirrhosis
Chronic atrophic gastritis
Ulcerative colitis
Colon adenoma

62
Q

What lifestyle habit predisposes you to bronchial metaplasia?

A

Smoking (inhaling harmful substances)

63
Q

What are potential etiologic agents of liver cirrhosis?

A

Alcohol
Hepatitis B and C
Autoimmune conditions such as Wilson’s disease
(cause reactive hyperplasia)

64
Q

What is endometrial hyperplasia?

A

Thickening of the endometrium due to heightened levels of estrogen

65
Q

The endometrial walls should be (Thin/Thick) at day 3 of a woman’s menstrual cycle?

66
Q

The endometrial walls should be (Thin/Thick) at day 24 of a woman’s menstrual cycle?

67
Q

What is chronic atrophic gastritis?

A

Autoimmune disorder against the parietal cells of the stomach that causes epithelial inflammation and a heightened risk of stomach cancer

68
Q

What is ulcerative colitis?

A

Ulcerative inflammation of the epithelium in the distal colon that can lead to colon carcinoma

69
Q

What gene is mutated in a patient with a colon adenoma?

70
Q

What is initiation in regards to chemical carcinogens?

A

Exposure of cells to an appropriate dose of a carcinogenic agent (trigger/initiator) which elicits a permanent DNA mutation

71
Q

What are promoters in regards to chemical carcinogens?

A

Triggering of the cell cycle and division by exposure to a second carcinogen (promoter)

72
Q

What are common groups of carcinogenic initiators?

A

Direct alkylating agents
Polycyclic aromatic hydrocarbons
Aromatic amines and azo dyes
Naturally occurring; Aflatoxin (black mold)
Nitrosamines and amides

73
Q

What are examples of direct alkylating agents?

A

Nitrogen mustard
Doxyrubicin
(Chemotherapy)

74
Q

How are polycyclic aromatic hydrocarbons produced? What is its function?

A

Fatty acid exposed to high heat (BBQ) that stabilizes free radicals

75
Q

What is an example of an aromatic amine? What profession is at increased risk of exposure to this amine?

A

Aniline (varnish/stain); carpenter

76
Q

What cancer can amiline predispose a person to?

A

Liver carcinoma

77
Q

What is aflatoxin?

A

Toxin produced by aspergillus (black mold)

78
Q

What is an example of a nitrosamine? What foods is it in?

A
  • Sodium nitrate
  • fermented and cured foods such as deli meats, cured meats

NYCC Physiopathology (28 decks)

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