Ch. 7 Neoplasia Flashcards
[T/F] Cancer is the leading cause of death in the United States .
- False.
- Cancer is the second leading cause of death in the US.
- Heart Disease is the leading cause.
What does “cancer is not a single disease” mean?
- cancer can start anywhere and move anywhere
- it is not always contained in one organ.
Cancer growth is _______ and _________.
-autonomous and uncoordinated
How long do cancer cells live?
- forever
- they do not die off
- they do not go through apoptosis.
Cancers result from disorders of…..
3 things
- cell proliferation
- cell differentiation
- apoptosis
how does cell proliferation function in normal cells?
- cell proliferation is the replenishing of cells.
- Cell division
- cells that die is equal to those that are created (in size and number)
how does cell differentiation function in normal cells?
new cells have the same structures and function of the cells they replace.
how does apoptosis function in normal cells?
natural programmed cell death
-oma
suffix added to names of BENIGN tumors.
-could be malignant depending on position…ex:brain
-carcinoma
suffix added to MALIGNANT tumors of the epithelial cell origin (adenocarcinoma, squamous cell carcinoma)
papilloma
finger-like growths
sarcoma
malignant tumor of mesenchymal tissue
polyp
growth that projects from mucosal surface (GI tract, often in the colon). precursor to colon cancer
In Situ
localized pre-invasive lesion
if the cancer is localized in one area then…
it is often treatable and normally doesn’t have lymphoid involvement
cell growth/similar cells in tissue of origin ( clustered in a mass)
benign neoplasms
grows by expansion
benign neoplasms
slow growth
benign neoplasms
encapsulated (fibrous capsules)
benign neoplasms
do not metastasize
benign neoplasms
able to differentiate
benign neoplasms
do not cause death
benign neoplasms
autonomous growth (asymmetrical cell division)
malignant neoplasms
uncoordinated growth
malignant neoplasms
rapid rate of growth
malignant neoplasms
invade and destroy (metastasize)
malignant neoplasms
lack of differentiation
malignant neoplasms
compress blood vessels
malignant neoplasms
necrosis of tissues
malignant neoplasms
Invasion (Metastatic Spread of Tumor Cells)
- synthesize/secrete enzymes that break down proteins
- the crab-like tentacles of a neoplasms can crush surrounding tissue invading their space
- new blood vessel growth is triggered by tumor secreted growth factors
Metastasis
- development of a second tumor
- disseminate through lymph channels or blood vessels
- enzyme secretion aids in invasion and movement to tissues
lymphatic spread of malignant tumors
tumor cells lodge in the initial lymph node that receives drainage from the tumor site… will lead to hematogenous spread or can infect the lymph nodes
hematogenous spread of malignant tumors
cancer cells invade capillaries and venules, then eventually tissues (angiogenesis process)
angiogenesis process
tumor secreted growth factor that leads to development of new blood vessels
Proto-oncogenes
these encode for normal proteins used in cell division
Oncogenes
mutated proto-oncogenes
they still code for the proteins needed for cell division but they might produce….
- too much of the protein
- an abnormal protein (atypical)
- protein that turns on all by itself
- protein that is made when it is not needed
- protein that cannot turn cell division off
- protein that should be made by a different cell
carcinogenesis
the creation of cancer
what is the root of the problem in carcinogenesis?
changes in DNA
Carcinogenesis over a long period of time creates…
multiple mutations.
-it is related to combination of several factors or repeated exposure to a single agent
initiating factors (related to carcinogenesis)
cause 1st changes in DNA but don’t actually cause the cancer to start growing. it causes the chain of events to start.
“ initiation involves the exposure of cells to appropriate dose of a carcinogenic agent that makes them susceptible to malignant transformation”
promoters (related to carcinogenesis)
repeated exposure causes more changes/mutations of cell DNA. 1st visible signs of changes occurring in cells. promotion can be reversible depending
risk factors for carcinogenesis
genetics viruses radiation exposure chemical exposure chronic irritation inflammation age diet hormones
what are the body defenses set in place to prevent carcinogenesis?
cancer suppressor genes, T-cells, NK cells
immune system problems lead to these not working properly and for cancer to form
what is the treatment for cancer?
chemotherapy, radiation, tumor removal
oncogenesis
- initiation- causes 1st changes in DNA
- promotion- causes cancer to start growing, cells are stimulated to divide
- progression- tumor cells compete w/each other to develop more mutation which makes them more aggressive
how can you get cancer?
heredity, hormones (can drive cell formation), obesity, immunologic mechanisms, chemical carcinogens, radiation, oncogenic viruses
What are two oncogenic viruses?
ebstin barr, herpes
What are the characteristics of cancer cells?
- genetic instability ( uncorrected mutations)
- faulty celltocell communication (contributes to growth and survival of cells)
- immortal (cells do not dies as normal cells do, no apoptosis)
[T/F] Cancer cellular growth responds to body commands sometimes.
False. Cancer cellular growth does not respond to body commands. Uncontrolled reproduction and consists of atypical immature cells.
oncology
the study of malignant tumors and cancers
benign neoplasms/ tumors characteristics
over growth of fairly normal cells. it is usually encapsulated. it grows but does not spread.
malignant neoplasms/tumors characteristics
rapid autonomous growth of undifferentiated, nonfunctional cells. they infiltrate surrounding tissue, and spread easily to other organs.
what are the warning signs of cancer.
- unusual bleeding/discharge
- change in bowel or bladder habits
- change in appearance of wart or mole
- sores that don’t heal
- unexplained weight loss
- anemia, low hemoglobin, persistent fatigue
- persistent cough or hoarseness w/o reason
- solid lump, usually painless, in breast, testes, or anywhere on the body
local effects of malignant tumors
pain, swelling, obstruction, tissue necrosis, organ size decreases (tumor cells getting bigger so normal cells are suppressed and get smaller), ulceration, infection, inflammation
systemic effects of malignant tumors
weight loss, anorexia, cachexia, fatigue and sleep disturbances, anemia, opportunistic infections, bleeding, paraneoplastic syndromes, decreased lymphatic flow
what are the 3 ways malignant tumors can spread?
- invasion
- metastasis
- seeding
how do you stage (determine the extent of the disease) malignant tumors?
TNM
- (T) size of primary tumor - bigger means increased mortality
- (N) extent of lymph node involvement
- (M) spread/metastasis of the tumor
explain the differences between Stage I and Stage IV cancer
Stage I - small, well localized, easily treatable, good prognosis
Stage IV - well advanced, spread to multiple sites, hard to treat, poor prognosis
Surgery to treat Cancer
dependent on staging,
removal of the tumor
Radiation to treat cancer
primary treatment method
preop/postop : with or without surgery and or other treatments like chemo
chemotherapy to treat cancer
to treat primary and distant sites
it is considered major systemic treatment modality
hormone therapy to treat cancer
for cancers that are dependent on hormones to grow
biotherapy to treat cancer
changes person’s own response to cancer cells
- using bacterium
- transferring cultured immune cells(NK, T, B cells) into a tumor bearing host
targeted therapy to treat cancer
targeting cancer cells and leaving normal cells alone
-developing drugs that do this
progression (in terms of carcinogenesis)
process whereby tumor cells acquire malignant phenotypic changes that promote invasiveness, metastatic competence, autonomous growth tendencies and karyotypic instability.
what are the manifestations of cancer cachexia?
- wasting away syndrome
- common manifestation of most solid tumors with the exception of breast cancer
- these patients respond less well to chemo and are more prone to toxic side effects
- the extent of weight loss and protein wasting cannot be explained in terms of diminished food intake alone
paraneoplastic syndromes
when cancer produces manifestations in sites that are not directly affected by the disease.
-caused by the elaboration of hormones by cancer cells and others can result from the production of circulating factors that produce hematopoietic, neurologic, and dermatologic malignancies
-may be the earliest indication that a person has cancer
Treatment
-involves concurrent treatment of the underlying cancer and suppression of the mediator causing the syndrome
Diagnostic method: Tumor Markers
tumor markers are antigens expressed on the surface of tumor cells or substances released from normal cells in response to the presence of a tumor
- limited, not in themselves specific enough to permit a diagnosis of a malignancy
- greatest value for tumor markers are monitoring therapy in people with widespread cancer
Diagnostic Method: Papanicolaou Test
microscopic examination of a properly prepared slide
-commonly used for cervical cancer, but can also be used for nipple drainage, pleural or peritoneal fluid, and gastric washings
Diagnostic Method: Tissue Biopsy
removal of tissue specimen for microscopic study
- needle aspiration : thyroid, breast and lymph nodes
- excisional biopsy: entire tumor removed
- if tumor is too large they can remove a wedge to examine
