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understanding human disease > chap 5 - neoplasm > Flashcards

chap 5 - neoplasm Flashcards

1
Q

neoplasm

A

uncontrolled growth of cells, benign or malignant
- new growth, doesn’t tell you if it is cancerous, just tells you that there is growth

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2
Q

tumor

A

a non-specific term meaning lump or swelling, often synonyms, for neoplasm

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3
Q

benign

A

mass of cells that remain confined to their site of origin, no spreading to a distal site

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4
Q

metastasis

A

discontinuous spread of a malignant neoplasm to distant sites
- spread by? blood, lymphatics, lymph nodes

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5
Q

cancer

A

any malignant neoplasm or tumor

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6
Q

benigh

A

growth rate: slow
growth character: expansion
tumor spread: remains localized
cell differentiation: well-differentiated cells

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7
Q

malignant

A

growth rate: rapid
growth character: infiltration
tumor spread: metastasis by bloodstream or lymphatic channels
cell differentiation: poorly differentiated

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8
Q

carcinoma

A

malignancy of epithelial cells

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9
Q

sarcoma

A

malignancy of connective tissue

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10
Q

melanoma

A

malignancy of skin

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11
Q

lymphoma

A

malignancy of lymphoid tissue

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12
Q

cancer statistics

A

most commonly diagnosed in women is breast cancer and most commonly diagnosed in men is prostate cancer
- the cancer that leads to the most deaths is lung cancer

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13
Q

age of cancer occurence

A

carcinomas are most common with age because everytime a cell divides there is a change for mutation

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14
Q

mutations

A

change in the dna

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15
Q

mutations occur

A

in germline or somatic cells

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16
Q

mutations can be

A

large or small scall

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17
Q

to be carcinogenic

A

genetic alteration must promote a growth advantage

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18
Q

transformation

A

normal cell is transformed into cancer cell, accumulating mutations that cause a growth advantage

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19
Q

categories of mutant genes

A

oncogenes and tumor suppressor genes

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20
Q

proto-oncogene

A

usually involved in cell growth and/or cell division, normal associated with growth and division,
- green light
growth factors, growth factor receptors, kinases

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21
Q

oncogene

A

proto-oncogene that has been mutated

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22
Q

oncogenes: RAS

A

mutation in RAS leads to constitutively activated protein
- important for signaling
- always “on” - the cell loses its ability to turn on and off

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23
Q

tumor suppressor genes

A

detect and repair defective DNA before cell can undergo mitosis, suppresses a tumor, act in the cell cycle and put the brakes on the cells ability to stop

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24
Q

p53

A

tumor suppressor gene, most commonly mutated
- over 50% of cancers have mutated p53
- halts the cell cycle

25
Q

carcinogenesis

A

creation of cancer

26
Q

cancer may be

A

hereditary or sporadic

27
Q

herditary

A

inherit copy of mutant gene
- first “hit”
-subsequent additional mutations
-5-10% of cancers

28
Q

sporadic

A

mutations are acquired
- majority of cancers

29
Q

familial adenomatous polyposis

A

first hit is inherited mutation in APC gene
- additional mutations over time develop as polyp
- if left in place, adenomatous polyps can undergo further genetic alteration and develop into cancer

30
Q

what can cause mutations?

A

chemicals, radiation, infectious agents, familial predisposition

31
Q

chemicals that can lead to mutation

A

initiating chemical causes mutation, additional chemical promotes growth, ex: tobacco smoke, asbestos, etc

32
Q

radiation causing mutation

A

ionizing radiation, effects are dose-dependent, ultraviolet

33
Q

infectious agents cause mutation

A

oncogenic viruses - hpv, epstein-barr virus, hep b and hep c

34
Q

familial predisposition causing mutation

A

increased risk of developing cancer at a younger age, inherited first hit

35
Q

inherited cancer predisposition

A

cancer predisposition, not necessarily inheritance of mutated gene, individual at risk has inherited set of genes that influence:
- differences in circulating hormone levels
- variations in which cells metabolize cancer causing chemicals
- variations in ability to repair DNA
- variations in efficiency of immune system

36
Q

natural history of cancer

A

malignancies develop through premalignancy
normal –> metaplasia –> dysplasia –> CIS

37
Q

dysplasia

A

premalignant state, tissue is atypical, usually epithelium, does not necessarily progress to malignancy

38
Q

carcinoma in situ (CIS)

A

cancer in place, not invasive as basement membrane intact, curable by complete excision, progression to invasion

39
Q

invasion

A

local breakthrough of basement membrane

40
Q

metastasis

A

occurs late in course of disease, major cause of morbidity and mortality

41
Q

staging of cancer

A

stage describes extent of spread of cancer
- tnm combines correspond to stages
Stage 0: CIS
Stage 1: not spread into surrounding tissues, but larger than stage 0
Stage 2: may extend to nearby tissue
Stage 3: spread to nearby lymph nodes, but not other parts of body
stage 4: spread to distant tissues and organs

42
Q

tnm system

A

T describes tumor
N describes extent of lymph node metastasis
M describes whether distant metastasis has occurred

43
Q

survival rate

A

measurement of 5 or 10 year survival is used for predicting behavior of cancers

44
Q

cancer prognosis

A

mutations lead to de-differentiation of cell
- cellular atypia
frequent mitotic figures - high level of mitosis
irregular nuclear placement - no longer in the right place
- cancer cell bears little resemblance to normal cell from which it originated
- basis of prognosis
grading - how differentiated or undifferentiated the tumor looks

45
Q

grade of tumor

A

microscopic assessment
assessment of how differentiated tumor appears
- degree of differentiation roughly estimate tumor’s malignant potential

46
Q

staging

A

behavioral assessment
- size and extent of metastasis
- helps plan the treatment
cancer cells are differentiated to a greater or lesser degree

47
Q

clinical detection of cancer

A

neoplasms come to clinical detection in a variety of ways
- producing symptoms related to local growth
- causing systemic manifestations
- producing hormones

48
Q

mass

A

cause pain, obstruction, palpable

49
Q

hormone production

A

some neoplasms secrete hormones that lead to specific clinical manifestations
- benign neoplasms of endocrine glands
- malignant endocrine gland neoplasms
- paraneoplastic syndromes
manifestations of aberrant and uncontrolled hormone production by malignant neoplasm

50
Q

systemic manifestations

A

many cancers metastasize to bone
- anemia, osteoporosis, pathologic feature

51
Q

cachexia

A
  • generalized wasting that occurs in terminal cancer patients
  • not specific to cancer, often seen in patients with AIDS or other terminal illnesses
    contributing factors
  • anorexia, lack of appetite
  • nutritional demands of rapidly growing neoplasm
52
Q

cancer treatment

A

depends on stage of disease
-surgery, radiation, chemotherapy, immunotherapy, hormone therapy, targeted therapy

53
Q

surgery

A

to prevent cancer
- cure *only if the cancer hasn’t metastasized yet
- biopsy for diagnosis and staging
- debulking surgery
- palliative surgery

54
Q

radiation

A

ionizing radiation
goals: eradicate cancer without excessive toxicity, avoid damage to normal structure, normal cells can repair the damage better than the cancer cells, ionizing radiation damages the cancer cell’s DNA

55
Q

chemotherapy

A

chemicals target rapidly dividing cells, its nonspecific so all cells will be targeted

56
Q

hormone therapy

A

receptor activation or blockage, interferes with cellular growth and signaling

57
Q

immunotherapy

A

stimulating own immune system to better recognize cancer cell
- tumor antibodies

58
Q

targeted therapy

A

“precision medicine”
- act on specific molecular targets = biopsying it first

59
Q

caution

A

Change in bowel/bladder habits or function
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Nagging cough or hoarseness

understanding human disease (25 decks)

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