Cancer Overview and Staging Flashcards
Cancer is a group of many different diseases characterized by
Uncontrolled cellular growth, local tissue invasion, distant metastases
Cancer is the ________ leading cause of death in Americans.
Second
Carcinogenesis is a multistep process that includes
Initiation, Promotion, Conversion, and Progression
Vinblastine is which type of chemotherapy agent
Antimicrotubule, vinca alkaloid
Which cancer occurs most often in women?
Breast Cancer
Which cancer causes the most deaths in men and women?
Lung Cancer
Exposure of normal cells to carcinogens is which step in carcinogenesis?
Initiation
Carcinogens or other factors alter the environment to favor growth of the altered cell population is which step in carcinogenesis.
Promotion
Conversion is the step in carcinogenesis when?
The altered cell becomes cancerous
Genetic alterations that lead to increased cell proliferation
Progression
What three actions can activate a proto-oncogene into an oncogen?
Point mutation, chromosomal rearrangement, or gene amplification
A gene that regulates and inhibits inappropriate cellular growth and proliferation
Tumor Suppressor Gene
One of the most common genetic alterations associated with cancer is?
Mutation of TP53
The tumor suppressor genes primarily associated with breast cancer.
BRCA1, BRCA2
Unique traits of cancer cells include
Stimulate their own growth, resist inhibitory signals, avoid programmed cell death, grow new blood vessels, invade local tissues, spread to metastatic sites
What are the five phases of the cell cycle
DNA replication (S phase), cell division (M phase), two resting phases (G1, G2) and a nondividing state (G0)
Apotosis is
Programmed cell death or suicide
Angiogenesis is
Development of new blood vessels
Cellular Senescence is
Cell death following a preset number of doublings when growth stops.
Gompertzian growth curve illustrates
The growth of most cancers
Clinically detectable disease occurs at
10 to the 9th cells
The body can use its own immune system to eliminate what size tumor burden?
10 to the 4th cells
A benign tumor of fibrous tissue is called a
Fibroma
A malignant tumor of the bone is called a
Osteosarcoma
The most common tissue type of cancer is
Adenocarcinoma
The most common staging system for solid tumors is the
TNM system
Which type of chemotherapy agents are M phase specific in their mechanism of action?
Antimicrotubule agents, Topoisomerase II inhibitors
Which type of chemotherapy agents are S Phase specific in their mechanism of action?
Antimetabolites, Topoisomerase II inhibitors
Which type of chemotherapy agents affect multiple phases of the cell cycle?
Antitumor Antibiotics
Which type of chemotherapy agents are cell cycle independent in their actions?
Alkylating agents
What are the three main types of cancer treatment modalities?
Surgery, Radiation, Systemic anticancer agents
Systemic anticancer agents include
chemotherapy, targeted therapy, immunotherapy
Surgery is the treatment of choice for
Most early stage cancers
Surgery can be used to
Cure cancer, debulk cancer, remove isolated metastases, relieve symptoms associated with metastatic disease
Radiation can be used to
Cure localized cancer or cancer in a single radiation field, alleviate symptoms
Systemic therapy administered to eradicate micrometastatic disease after surgery or radiation.
Adjuvant therapy
The effectiveness of adjuvant therapy is evaluated by
Recurrence rates and survival
Systemic therapy given to patients before surgery or radiation therapy to reduce tumor burden and destroy micrometastases.
Neoadjuvant therapy
The goal of treatment when cancer is local or regional.
Cure
The goal of treatment when cancer is metastatic.
Palliation
A cell-cycle phase-specific chemotherapy agent is also termed?
Schedule dependent
A cell-cycle phase-nonspecific chemotherapy agens is called?
Not schedule dependent but dose dependent
Chemotherapy regimens are usually comprised of
Multiple agents given on a repeating schedule called a cycle.
Agents that stop cancer progression by blocking aberrant intracellular signaling pathways that govern cell responses, movement and division are called
Targeted anticancer agents
Agents classified as immunotherapies include
Cytokines, chimeric antigen receptor (CAR) T-cell therapies, immune checkpoint inhibitors, and therapeutic vaccines.
In which two ways does immunotherapy work
Training the immune system to attack the cancer directly, administering immune components that result in a more general stimulation of the immune system
Name the five potential types of responses to cancer treatment.
Cure, complete response (CR), partial response (PR), stable disease, progression
The response criteria for solid tumors is call
RECIST
A major weakness of RECIST is that it does not account for
Pseudoprogression from immunotherapy
Factors affecting anticancer therapy include
Tumor burden, cancer cell heterogeneity, drug resistance, dose intensity, and patient specific factors such as pharmacogenomics.
Dose intensity which three variables
Dose per course, the interval between doses, and the total cumulative dose.
Shortening of the usual interval between doses is called
Dose Density
A molecular characteristic of the tumor that influences prognosis or predicts response to a specific therapy
Molecular biomarker
A biomarker that predicts response to a specific therapeutic intervention
Predictive biomarker
A predictive biomarker for response to trastuzumab in breast cancer
HER2 over expression
Anticancer agents associated with myelosuppression can usually be given with the ANC and Platelet count are above
ANC 1500 cells/mm3
Platelet count of 100,000 cells/mm3
Cytotoxic chemotherapy is usually does based on
Body surface area (BSA)
CTCAE was developed by the National Cancer Institute to grade
Adverse reactions or toxicities
Used assess how a patient’s disease
is progressing, assess how the disease affects the daily living abilities of the patient, and
determine appropriate treatment and prognosis.
ECOG performance status
Cells that lose their ability to perform usual functions
Anaplasia
Consolidation therapy is given once a patient is in
Remission
Agent that can cause severe tissue damage when it escapes the vasculature.
Vesicant
A 30% decrease in sum diameters of target lesions
Partial Response
Cancer guidelines are published by at least three organizations. Those organizations are:
National Comprehensive Cancer Network (NCCN)
American Society of Clinical Oncology
Multinational Association of Supportive Case in Cancer