Cancer genetics 25/10/22 Flashcards

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1
Q

What are the main features of a tumor?

A

Growth signal autonomy
Uncontrolled growth
Insensitivity to anti-growth signals
Invasion and metastasis
Unlimited replicative potential
Sustained angiogenesis
Evading apoptosis

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2
Q

What is anchorage-independent growth?

A

This is when tumor cells can grow without a surface to anchor to. Normal cells have an absolute requirement for tethering to a solid substrate before they would grow and were therefore considered to be anchorage-dependent. Anchorage-independent cells in vitro are good predictors of their ability to form tumors in vivo.

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3
Q

What is loss of sensitivity to contact-inhibition of growth?

A

In normal cells high cell density or contact with neighbors causes these cells to stop dividing. In tumor cells they have clearly lost contact (density) inhibition and consequently continued to proliferate, piling up on top of one another and creating multilayered clumps of cells so thick that they could often be seen with the naked eye.

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4
Q

What are telomeres in cancer?

A

Telomere regeneration can be done through the actions of the telomerase enzyme. Telomerase activity is detectable in 85 to 90% of human tumor cell samples but is present at very low levels in most types of normal human cells.

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5
Q

What is telomerase?

A

Telomerase is a ribonucleoprotein containing human telomerase reverse transcriptase activity.
This maintains telomere length in certain cell types, such as stem cells. Telomerase transforms normal fibroblasts into cancer cells in vitro (tumourigenesis) and several oncogenes have been demonstrated to regulate the expression of telomerase.

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6
Q

What is the invasion-metastasis cascade?

A

Step 1 - cancer cells invade through the basement membrane and migrate through the tumor stroma.
Step 2 - intravasation into vasculature.
Step 3 - survival in the circulation is characterized by circulating tumor cells in the bloodstream undergoing shear stress and evading clearance by the immune system before reaching distant organs. After attaching to blood vessels around secondary sites, tumor cells enter.
Step 4 - extravasation through the endothelial barrier.
Step 5 - Colonization in the metastatic target organ. (Hapach, L.A., et al, 2019).

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7
Q

What is Boveri’s somatic mutation theory?

A

Carcinogens interact with and cause damage to
DNA. If not repaired, the damage is fixed as mutations. Mutations involving genes controlling growth can result in neoplastic transformation. The cancer cell has inherited mutations and is immortal.

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8
Q

How are cancer mutations inherited?

A

Genes associated with cancers are 90% somatic mutations and 20% are germline mutations. Germline cancers can be passed on while somatic mutations can not.

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9
Q

What is rhabdomyosarcoma?

A

Rhabdomyosarcoma is a malignant tumor of the muscles that are attached to the bones. This cancer mostly affects children.

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10
Q

What is alveolar rhabdomyosarcoma?

A

This is the cause of around 20% of RMS cases. They are small, round, and undifferentiated cells and result in a worse prognosis. The mutation is a translocation.

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11
Q

What is embryonal rhabdomyosarcoma?

A

This is the cause in around 60% of RMS cases. They are small, round cells with variable degrees of differentiation. This is a favorable prognosis. The mutation is a chromosomal gain in 2,8,12, and 13, or a chromosomal loss in 9 and 16.

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12
Q

Where is the chromosomal location of the Rb gene?

A

The Retinoblastoma gene (RB1), located on chromosome 13, is a tumor suppressor gene that was discovered in genetic studies of hereditary retinoblastoma.

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13
Q

What is the function of the Rb protein?

A

Growth suppression:
-E2F is a transcription factor that mediates growth-dependent activation of genes required to make the transition into and through the S phase
-Rb binds and inactivates E2F under conditions of growth suppression
-There are several ways to alleviate growth suppression resulting in controlled or uncontrolled cell growth
Relief of growth suppression:
*G1 phase phosphorylation releases E2F
*Adenovirus E1A oncoprotein binding releases E2F
*Gene mutation affecting binding pocket releases E2F

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14
Q

What is Knudson’s ‘two-hit’ theory?

A

This is the hypothesis that most tumor suppressor genes require both alleles to be inactivated, either through mutations or by epigenetic silencing, to cause a phenotypic change. It was first formulated by Alfred G. Knudson in 1971 and led indirectly to the identification of tumor suppressor genes.

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15
Q

What was Knudson’s theory with retinoblastoma?

A

Alfred Knudson Jr. studied the kinetics with which
bilateral and unilateral retinoblastomas appeared in children. He calculated that the bilateral cases (tumors in both eyes) arose with one-hit kinetics, whereas the unilateral tumors (affecting only one eye) arose with two-hit kinetics. Each of these hits was presumed to represent a somatic mutation. The fact that the two-hit kinetics involved two copies of the Rb gene was realized only later.

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16
Q

What is Knudson’s theory about tumour suppressor genes?

A

The inactivating mutation of one copy of a TSG (tumour suppressor gene) usually creates a recessive null allele whose presence is not felt by the cell because of the activities of the surviving wild-type allele. Only when the 2nd gene copy is inactivated or eliminated, then the cell will be free from the inhibitory actions of the gene.

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17
Q

What is Knudson’s theory about tumour suppressor genes?

A

The inactivating mutation of one copy of a TSG (tumour suppressor gene) usually creates a recessive null allele whose presence is not felt by the cell because of the activities of the surviving wild-type allele. Only when the 2nd gene copy is inactivated or eliminated, then the cell will be free from the inhibitory actions of the gene.

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18
Q

Who named oncogenes?

A

Huebner-Todaro (1969).

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19
Q

How were oncogenes discovered?

A

Viral mRNA particles in vertebrate cells. Viruses induce cancers in experimental animals. Normal cells have the capacity to activate latent tumour viruses. This led to the identification of retroviral oncogene src (Rous sarcoma in chicken) and the realization that these viral genes were derived
from functional cellular genes or proto-oncogenes.
The identification of cellular proto-oncogenes as
precursors of transforming cancer genes.

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20
Q

How do oncogenes play a role in cancer?

A

In normal cells, proto-oncogenes increase cell growth and proliferation, and tumor suppressor genes will decrease cell growth and proliferation. In cancer cells, mutated or activated oncogenes lead to a massive increase in cell growth and proliferation which results in a malignant transformation, and the tumor suppressor gene is mutated so it’s function is lost.

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21
Q

What is an oncogene?

A

Oncogene - mutated forms of proto-oncogenes that promote abnormal growth and cell division.

Oncogenes are described by a three-letter code usually derived from their first discovery. Oncogenes are usually dominant (gain of function) whose activities are increased as a consequence of genetic alteration. The gain of function can be due to qualitative or quantitative changes in the protein products.

A group of cellular genes includes -
*DNA viruses
*Homologous to the transforming genes of RNA viruses (retroviruses)
*Normal cellular genes actively transcribed in a variety of neoplasm: such as growth factor genes and genes for cyclins.

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22
Q

What is a proto-oncogene?

A

Proto-oncogenes are normal genes that can become oncogenes, they are found in many animals and code for growth factors that stimulate cell division. For a proto-oncogene to become an
oncogene, a mutation must occur in the cell’s DNA.

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23
Q

Different processes of a proto-oncogene becoming an oncogene?

A
  1. Proto-oncogene has a mutation within the gene which causes a hyperactive growth-stimulating protein to be produced.
  2. Multiple copies of the gene result in normal growth-stimulating protein becoming excessive.
  3. A gene is moved to a new DNA locus and is under new control which results in a normal growth-stimulating protein becoming excessive.
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24
Q

What are oncogene products?

A

Growth factors
– Epidermal growth factor (EGF)
– Fibroblast growth factor (FGF), PDGF-b encoded by SIS
* Growth factor receptors
– EGF receptors encoded by ERBB1, HER2/NEU, MET
* Signal transduction proteins
– G-protein encoded by RAS
– Tyrosine kinase encoded by ABL
* Nuclear transcription factors
– MYC, MYB, JUN, FOS
* Cyclins and cyclin-dependent kinases
– CDK4, CDKN2A, cyclin D

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25
Q

What are the growth factors and their receptors?

A

PDGFa - PDGF-R (Platelet-derived growth factor) EGFb - EGF-Rc (Epidermal growth factor)
NGF - Trk (Nerve growth factor)
FGFd - FGF-Re (Fibroblast growth factor)
HGF/SF - Met (Hepatocyte growth factor/Scatter factor)
VEGFf - VEGF-R9 (Vascular endothelial growth factor)
IGFh - IGF-R1 (Insulin-like growth factor)
GDNF - Ret (Glial cell derived neurotrophic factor)
SCF - Kit (Stem cell factor)
VSMC (Vascular smooth muscle cell)

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26
Q

What is the cell signaling growth factor to receptor cascade?

A
  1. Secreted growth factor
  2. Growth factor receptors
  3. Cytoplasmic Signal Transduction proteins
  4. Nuclear proteins - transcription factors - cell growth genes
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27
Q

How is autocrine signaling changed in cancer cells?

A

In many types of cancer, tumor cells acquire the ability to make a ligand for a growth factor receptor that they also display. This creates an auto-stimulatory or autocrine signaling loop.

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28
Q

How is autocrine signaling changed in cancer cells?

A

In many types of cancer, tumor cells acquire the ability to make a ligand for a growth factor receptor that they also display. This creates an auto-stimulatory or autocrine signaling loop.

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29
Q

What are autocrine growth factors (ligands) and their receptors?

A

HGF - Met (endocrinal tumors, breast, lung, and osteosarcoma)
IGF-2 - IGF-1R (colorectal)
IL-6 - IL-6R (myeloma, HNSCC)
IL-8 - IL-8RA (bladder cancer)
NRG - ErbB2a/ErbB3 (ovarian carcinoma)

30
Q

What are the most highly expressed autocrine growth factors?

A

Hepatocyte growth factor (HGF) and c-MET are the most highly expressed in a variety of carcinomas. For example, the lung is c-MET (40%) and HGF (50%), and the breast is c-MET (17%) and HGF (91%).

31
Q

What is a hepatocyte growth factor receptor?

A

The c-MET receptor is a tyrosine kinase. It is expressed by epithelial cells and is also found in endothelial cells, neurons, hepatocytes, hematopoietic cells, and melanocytes. Its ligand, hepatocyte growth factor (HGF) regulates multiple cellular processes: cell
proliferation, invasion, survival, and angiogenesis.
This is essential for embryonic development and wound healing. The overexpression of c-MET is a poor
prognostic factor.

32
Q

What is a hepatocyte growth factor receptor?

A

The c-MET receptor is a tyrosine kinase. It is expressed by epithelial cells and is also found in endothelial cells, neurons, hepatocytes, hematopoietic cells, and melanocytes. Its ligand, hepatocyte growth factor (HGF) regulates multiple cellular processes: cell
proliferation, invasion, survival, and angiogenesis.
This is essential for embryonic development and wound healing. The overexpression of c-MET is a poor prognostic factor.

33
Q

What is tyrosine kinase?

A

A tyrosine kinase is an enzyme that can transfer a phosphate group from ATP to the tyrosine residues of specific proteins inside a cell. It functions as an “on” or “off” switch in many cellular functions.

34
Q

What is the epidermal growth factor receptor?

A

Overexpression or activation of EGFR is in tumors of epithelial origin. Expression of EGFR is associated with metastasis, poor prognosis, and resistance to chemotherapy.

35
Q

What is an oncoprotein?

A

Oncoproteins are proteins encoded by oncogenes that are involved in the regulation or synthesis of proteins associated with the growth of cancer tumor cells.

36
Q

What is the deregulation of receptor firing?

A

Normal functioning growth factor receptors emit cytoplasmic signals in response to binding ligands. However, mutations in the genes encoding the receptor molecules can cause subtle alterations in protein structure that cause ligand-independent firing. More drastic alterations in receptor structure, including
truncation of the ectodomain, may also yield such deregulated signaling. In many human tumors,
receptor proteins are overexpressed. Excessive
numbers of normally structured receptor molecules can also drive ligand-independent receptor firing by causing these molecules to frequently collide and thereby spontaneously dimerize and release signals.

37
Q

What is the type of alterations in GF receptors in tumors?

A

EGF-R/ErbB1 - alteration is overexpression
EGF-R/ErbB1 - alteration is the truncation of ectodomain
ErbB2/HER2/Neu - alteration is overexpression
ErbB3,4 - alteration is overexpression

38
Q

What is HER2 and how it is detected?

A

HER2 is a protein called human epidermal growth factor receptor 2 (HER2). This protein promotes the growth of cancer cells. This test for HER2 detects if HER2 is positive or negative in several ways. These are southern blot, northern blot, and western blot, these are all immunohistochemistry tests.

39
Q

What was seen in the expression of HER2/ERBB2 oncogene?

A

In breast cancer, it was seen that in 30% of cases HER2/ERBB2 is amplified. It was also seen that a number of co-amplified genes close to the HER2/ERBB2 gene may be collaborating to orchestrate the malignant phenotype of human breast cancer cells, and it becomes difficult to ascribe specific cancer cell phenotypes to the elevated expression of only a single gene, such as the erbB2/neu/HER2.

40
Q

What is transfection?

A

Transfection is the process of deliberately introducing naked or purified nucleic acids into eukaryotic cells.

This done by chemically transforming mouse fibroblast, the DNA from this undergos transfection using the calcium phosphate co-precipitation procedure. Normal mouse fibroblast then recieves this tranfected DNA which forms a focus of morphologically transformed cells which are then injected into the mouse host and this forms a tumor on the mouse.

41
Q

What is the RAS protein?

A

It is a oncoprotein.

42
Q

What are the RAS family proteins?

A

The c-RAS family contains three genes: H-RAS, K-RAS, and NRAS. The RAS proteins are small G-proteins (guanosine-nucleotide-binding proteins, or GTPase). The RAS proteins are activated by binding GTP and the proteins are inactivated by GTP to GDP hydrolysis. The proteins transmit growth signals from cell surface receptors (receptor tyrosine kinases) to the MAP kinase pathway. Mutations in the RAS genes inhibit the GTPase activity and lock the protein in the active GTP-bound conformation. Mutated RAS proteins are constitutively active and this constitutively active RAS protein results in uncontrolled cell growth.

43
Q

What are tumor supressor genes?

A

A tumor suppressor gene, or anti-oncogene, is a gene that regulates a cell during cell division and replication. If the cell grows uncontrollably, it will result in cancer. When a tumor suppressor gene is mutated, it results in a loss or reduction in its function.

44
Q

What is the dominance and recessiveness of cancer?

A

When you have a normal cell and a mutated tumor suppressor gene that does not work. With this, you can either have a hybrid cell that is tumorigenic and the cancer alleles are dominant or have a hybrid cell that is non-tumorigenic and the cancer alleles are recessive.

45
Q

How do tumor suppressor genes work?

A

Their protein products suppress tumour formation. Mutant alleles of TSGs are recessive and therefore as long as the cell contains one normal allele, tumour suppression continues.

If one allele of TSG is mutated at birth, then the person has increased susceptibility to develop cancer at an early age. Tumour suppressor proteins function in many key cellular processes:
– plays a role in keeping cell division in check (serves at cell cycle checkpoints control cell growth)
– regulating DNA repair, gene transcription, and cell-cell communication

46
Q

What can cause a tumor suppressor gene to be inactivated?

A

*Deletion
* Point mutation
* Mutation followed by duplication
* Loss of heterozygosity
* DNA methylation
* Post-translational mechanism-binding to DNA
viral oncoproteins

47
Q

What is the loss of heterozygosity (LOH)?

A

When the genomic copies derived from each parent have different bases the region is heterozygous, however, one parental copy of a region can sometimes be lost which results in the region having just one copy- loss of heterozygosity (LOH).

LOH due to the loss of one parental copy in a region is also called hemizygosity in that region. The LOH is a common occurrence in cancer, where it indicates the
absence of a functional TSG in the lost region. Loss of heterozygosity exposes the recessive mutant allele of TSG in a hemizygous state. Loss of heterozygosity does not imply a reversal to the homozygous state.

48
Q

What is the mechanism of LOH?

A

Deletion of:
– the normal allele
– the chromosome arm containing the normal allele
– the entire chromosome containing the normal
allele (resulting in aneuploidy)

49
Q

What is the mechanism of LOH?

A

Deletion of:
– the normal allele
– the chromosome arm containing the normal allele
– the entire chromosome containing the normal
allele (resulting in aneuploidy)

50
Q

What are cytoplasmic tumor suppressor proteins?

A

-Adenomatous polyposis coli protein (APC) (colon and stomach cancers)
-Deleted in pancreatic carcinoma, locus 4 (DPC4) or called Mothers against decapentaplegic homolog 4 (SMAD4) (pancreatic cancer)

51
Q

What are nuclear tumor supressor proteins?

A

-Retinoblastoma protein (RB), master brake on cell cycle (retinoblastoma, bone, bladder, lung, and breast cancer)
-p53, halts the cell cycle in G1 and induces cell suicide (many cancers)
-p16, inhibits cyclin D-dependent kinase activity
-WT1 (Wilms tumor of the kidney)
-BRCA1 functions in the repair of damage to DNA (breast and ovarian cancers)
-BRCA2 functions in the repair of damage to DNA (breast cancer)

52
Q

What do tumor suppressor genes function as?

A

They act like a brake pedal on all cell functions if at any point a cell process goes wrong.

53
Q

What is p53?

A

p53 (Tp53) is the “guardian of the genome”. The p53 protein functions as a transcription factor that regulates the cell cycle and DNA repair genes. UV irradiation causes cell-cycle arrest in G1 which is dependent on p53. Cells that contain a mutated p53 cannot arrest and go into the S phase and replicate damaged DNA.
p53 is frequently found mutated in human tumors and p53 loss-of-function mutations result in the replication of cells with damaged DNA and the further accumulation of other mutations affecting oncogenes and tumor suppressor genes, and to an increased likelihood of cancer, germline p53 mutations are found in Li-Fraumeni syndrome.

54
Q

What is the role of p53?

A

*Regulates DNA damage, cell cycle abnormalities, and hypoxia
*Controls cell cycle arrest, DNA repair, and cell cycle restart
*Controls apoptosis

55
Q

What is the role of p53?

A

*Regulates DNA damage, cell cycle abnormalities, and hypoxia
*Controls cell cycle arrest, DNA repair, and cell cycle restart
*Controls apoptosis

56
Q

What is the role of p53?

A

*Regulates DNA damage, cell cycle abnormalities, and hypoxia
*Controls cell cycle arrest, DNA repair, and cell cycle restart
*Controls apoptosis

57
Q

What is Li-Fraumeni syndrome (LFS)?

A

It is caused by a mutation in the p53 gene. Some LFS families have a mutation in the CHK2 gene. CHK2 is involved in the control of the cell cycle.

Inheriting the abnormal variant of CHK2 doubles the risk of a woman developing breast cancer.

Characteristics:
– Several kinds of cancer are involved (cancers of the breast, brain, bone (sarcoma), adrenal cortex (adrenal cortical carcinoma) as well as leukemia
– Cancer often strikes at a young age (half of the patients with LFS present before the age of 45)
– Cancer often strikes several times throughout the life of an affected person (children who survive initial cancer have a high risk of developing a second one)

58
Q

What factors are involved in cancer induction and development?

A

*Genetic (inborn zygotic mutations, somatic mutations)
– Oncogenes
– Tumour suppressor genes

*Viruses (RNA viruses, DNA viruses)
– HPV (human papillomavirus) cervical cancer
– Epstein-Barr virus - Burkitt’s lymphoma
– Hepatitis B and C viruses - liver cancer
– Abl virus - leukaemia

  • Chemicals
  • Radiation
  • Others: age, lifestyle, etc.
59
Q

What is HPV?

A

The majority of types of HPV do not cause symptoms or health problems. High-risk types of HPV play an important etiological role in cancers of the cervix, vagina, and anus. HPV proteins E6 and E7 are
associated with cancers. Pap smear screening. HPV vaccination

60
Q

What mechanisms cause HPV to become cancer?

A

Human papillomaviruses (HPV) have two proteins known as E6 and E7 which turn off some tumor suppressor genes, such as p53 and Rb. This may allow the cells lining the cervix to grow too much and to develop changes in additional genes, which in some cases can lead to cancer.

61
Q

What is Epstein-Barr infection?

A

The Epstein–Barr virus, formally called Human gammaherpesvirus 4, is one of the nine known human herpesvirus types in the herpes family and is one of the most common viruses in humans. EBV is a double-stranded DNA virus. It is best known as the cause of infectious mononucleosis. Epstein–Barr Virus (EBV) can transform B cells and contributes to the development
of Burkitt lymphoma.

62
Q

What are hep B and C infections?

A

These increase the risk of developing liver cancer. Hep B and C are liver infections caused by a virus and are transmitted through body fluids with an infected person.

Hepatocellular carcinoma (HCC) aetiology:
* viral hepatitis
* liver cirrhosis
* alcoholic liver disease
* metabolic-related fatty liver disease
* aflatoxin infection

63
Q

How are hep B and C prevented?

A

Vaccination and blocking of the transmission route.

64
Q

What is adenomatous poluposis coli (APC)?

A

-APC gene is a tumor suppressor gene that encodes for the APC protein which plays a critical role in several cellular processes.
-The APC protein is a negative regulator that controls beta-catenin concentrations and interacts with E-cadherin which is involved in cell adhesion.
-Mutations in the APC gene cause both classic and attenuated familial adenomatous polyposis. These mutations affect the ability of the cell to maintain normal growth and function.

65
Q

What are chemical carcinogens?

A

-The targets for chemical carcinogens often are the
proto-oncogenes and the tumor suppressor genes.
-Cancers can be generated by environmental chemicals.
-Diet is also a major determinant of human carcinogenesis and a change in lifestyle can reduce the risk of cancer.
-Traditional tests for carcinogenicity have relied on the
use of laboratory animals, though this has obvious
ethical implications.

66
Q

What is an example of some carcinogenic chemicals?

A

Aflatoxin - source is aspergillus flavus and aspergillus
parasiticum growing on crops such as corn and peanuts, can cause cancer of the liver.
Arsenic - source is insecticides and herbicides, which can cause cancer of the lung and skin.
Asbestos - source is in mineral fibers used in fire insulation and brake lining, can cause mesothelioma.
Benzene - source is petrochemicals and dyes, which can cause bladder cancer.
Benzo(a)pyrene - source is the partial combustion of petroleum and tobacco smoke, which can cause lung cancer.
Diethylstilbestrol - source was it used to be used for abortions, can cause vaginal tumors in the offspring of treated women.
Vinyl chloride - source is industrial processes, which can cause liver cancer.

67
Q

What kinds of radiation can cause cancer?

A

UV light - source is sunlight, which can cause skin cancer.
X-ray - source is medical treatment, and can cause leukemia and thyroid cancer.
Atomic radiation - source is war and leaks from nuclear power station, can cause all types of cancer.
Radon - source is mining and geological seepage, which can cause lung cancer.

68
Q

What is cfDNA tests for?

A

This technology can detect microscopic levels of cancer tissue before, during, or after treatment.

69
Q

How is cell-free DNA (cfDNA) used in cancer care?

A

o Aiding diagnosis
o Identifying tumor molecular profiling
o Selecting a treatment strategy
o Tracking therapeutic response/resistance
o Evaluating tumor heterogeneity
o Monitoring disease burden/minimal residual disease

70
Q

How does the cfDNA test work?

A

Cancer patients with tumor tissue will have high levels of cell apoptosis, necrosis, and secretion which will lead to the release of cfDNA from lysed cells, therefore, cancer patients have higher levels of cfDNA in their blood serum or plasma. Whole blood is taken from a patient and a next-generation sequencing analyser is used and will identify targetable mutations to test for cancers.

71
Q

What are the future potential advantages of cfDNA liquid biopsy?

A

o Sample collection is less invasive than a conventional tissue biopsy
o The process is rapid and easy
o It can be taken when the primary tissue samples are not available or are difficult to obtain.
o ctDNA represents both tumour heterogeneity and spatially separated disease foci
o ctDNA testing can provide a snapshot of the current genetic makeup of the tumour. A repeat sample can be readily taken, facilitating longitudinal analysis e.g. tracking tumour clonal evolution and therapy resistance etc.