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CSO Exam 2018 > Chapter 1: Overview of Cancer, Carcinogenesis, and the Role of Nutrition (2021) > Flashcards

Chapter 1: Overview of Cancer, Carcinogenesis, and the Role of Nutrition (2021) Flashcards

1
Q

What is the lifetime risk of developing cancer for men and women?

A

1 in 2 for men

A little more than 1 in 3 for women

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2
Q

The 5 most common cancer types for men?

A

Prostate, lung, colorectal, urinary bladder, melanoma

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3
Q

The 5 most common cancer types for women?

A

breast, lung, colorectal, uterine and thyroid

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4
Q

Cancer is the _____ most common cause of death in the US.

A

Second

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5
Q

What is the 5 year survival rate for all cancers?

A

69%

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6
Q

What is early cancer detection?

A

Identifying tumors before they become palpable

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7
Q

What are the different kinds of cancer screening tests?

A

Physical examination (palpation),
Blood tests,
Imaging procedures,
Molecular tests

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8
Q

Give examples of physical examination.

A

Breast or testicle self-exam, looking for changes in skin pigmentation that may be a sign of skin CA.

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9
Q

Which is the most common cancer screening test?

A

Physical examination

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10
Q

What are examples of imaging procedures?

A

Mammograms and colonoscopy

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11
Q

Give examples of molecular testing techniques?

A

Genotyping or gene expression assays which look for certain genetic mutations that are linked to some types of cancers.

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12
Q

T/F: When a cancer is detected by physical exam or palpation it is often fairly advanced?

A

True

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13
Q

What does a cancer screening blood test look for?

A

To determine certain levels of certain tumor cell metabolites, such as prostate specific antigen testing.

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14
Q

What is a false-positive test?

A

One that appears positive (to indicate cancer present), but is actually negative (no cancer).

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15
Q

What is a false negative?

A

A test result that shows no cancer, but cancer is present. It can delay treatment.

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16
Q

Why is cancer staging used?

A

To determine the appropriate treatment plan and to estimate prognosis at the time of diagnosis.

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17
Q

What does TNM stand for?

A

Tumor, Lymph Node, Metastasis

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18
Q

What does the T of TNM stand for?

A

Tumor size and/or extent of the tumor.

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19
Q

What does the N of TNM stand for?

A

The extent and spread to local lymph nodes.

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20
Q

What does the M of TNM stand for?

A

Indicates the presence or absense of distance metastasis.

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21
Q

What does the Histologic grade describe?

A

How “differentiated” the tumor cells appear. How “different” the tumor cells appear from normal cells in the same tissue.

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22
Q

What is the nuclear grade?

A

Grade is a measure of how abnormal the cancer cells look under the microscope, this is called differentiation.

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23
Q

Describe the Tumor grades.

A

Tx: Tumor can’t be evaluated
T0: No evidence of a tumor
Tis: Carcinoma in situ (CIS): abnormal cells are present but have not spread. CIS is not cancer, but may become cancer.
T1: Tumor not visible or palpable or visible by imaging
T2: Tumor confined to the primary cancer site
T3: Tumor extends to the neighboring tissue
T4: Metastatic disease

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24
Q

Describe the lymph Node grades.

A

Nx: Regional lymph nodes cannot be evaluated
N0: No regional lymph node involvement
N1, N2, N3: Involvement of regional lymph nodes (number of lymph nodes and/or extent of spread)

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25
Q

Expected medical cost of cancer care in 2020?

A

$173 billion.

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26
Q

The increase in projected cancer care costs will be from long term care from which two groups?

A

Female breast cancer and male prostate cancer survivors.

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27
Q

What is carcinogenesis?

A

The process by which normal cells transform into cancer cells, usually from accumulating genetic damage.

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28
Q

Describe the M grades.

A

Mx: Distant metastasis cannot be evaluated
M0: No distant metastasis
M1: Distant metastasis is present

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29
Q

What causes cancer?

A

Acquired factors, including internal factors such as hormones and the immune system and external factors including infection, environmental toxins, and behaviors such as smoking, sunlight exposure and unhealthy diet.

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30
Q

In carcinogenesis, what three things cause genetic damage of a normal healthy cell?

A

viruses, radiation, chemicals

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31
Q

How can nutrition protect against carcinogenesis?

A

Through cell growth cycle, apoptosis, DNA repair, cell differentiation, hormone regulation, carcinogen metabolism and inflammatory response.

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32
Q

Describe the process of carcinogenesis.

A

Normal cells develop damaged DNA which lead to an “initiated cell’. DNA repair or apoptosis may occur at this stage. If not, those damaged cells can replicate and lead to a malignant tumor.

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33
Q

Which vitamins may protect DNA from oxidative damage?

A

Vitamin C and E

34
Q

Which vitamins plays an important roll in DNA synthesis and repair?

A

Folate and selenium

35
Q

How do soy isoflavones effect carcinogenesis?

A

They are phytoestrogens which have hormonal effects and alter hormonal regulation.

36
Q

What is the best sources of curcumin?

A

Tumeric

37
Q

How does curcumin effects carcinogenesis?

A

Induces apoptosis and inhibit angiogenesis (which is the formation of blood supply to the tumor).

38
Q

How does cruciferous vegetables effect carcinogenesis?

A

Indole-3-carbinol has been showen to influence estrogen regulation, induce cell cycle arrest and apoptosis, inhibit angiogenesis and suppress inflammatory responses.

39
Q

Extremely high doses of _____ may promote the growth of undetected cancers.

A

Folate

40
Q

How does folate accelerate cancer cell growth?

A

Folate provides substrates for DNA synthesis and accelerates cancer cell proliferation and tumor expansion.

41
Q

What is Methotrexate?

A

An anti-folate chemotherapeutic agent which targets the metabolic process and inhibits folate-mediated DNA synthesis, thus stopping CA cell proliferation.

42
Q

What can “rescue” a patient from Methotrexate toxicity?

A

Folate in the form of calcium leucovorin.

43
Q

How is cancer treated?

A

surgery, radiation, chemotherapy, hormone therapy, immunotherapy, biological therapy, targeted therapy, transplantation or a combination of these.

44
Q

What factor determine which cancer treatment is used?

A

It depends on the cancer type, stage of disease, patient’s age, and comorbid conditions.

45
Q

Common side effects of chemotherapy. Why?

A

Loss of appetite, nausea, nucositis, diarrhea result when healthy cells are damaged by the chemotherapy drug.

46
Q

Nutrition intervention during cancer treatment is associated with…

A

fewer side effects, fewer hospitalizations, better quality of life.

47
Q

ECGC a compound found in green tea has been shown to….

A

modulate rates of cell differentiation, and suppress inflammatory responses.

48
Q

May protect cells from oxidative damage.

A

Vitamin C and E

49
Q

What are potential nutrition issues during initial treatment?

A

Side effects of treatment such as (N/V, diarrhea, mucositis, taste changes), fatigue, pain, anorexia, treatment-related cachexia, immunosuppression, body weight composition changes, drug-nutrient interactions.

50
Q

What are early post-treatment potential nutrition issues?

A

Fatigue, pain, endocrine disorders, weight body composition changes, cognitive deficits, dental caries.

51
Q

What are long-term cancer survivorship potential nutrition issues?

A

Weight changes, osteoporosis, endocrine disorders, cardiovascular complications, cognitive deficits, dental caries.

52
Q

What are potential nutrition issues for cancer prevention?

A

Obesity, energy-dense food intake, excessive micronutrient intake from dietary supplement, food contaminants (toxins, chemicals).

53
Q

What are some potential nutrition intervention outcomes during initial treatment?

A

Ability to adhere to scheduled treatment, fewer infectious complications, weight/body composition management, delay/prevent disease progression, improved survival, improved quality of life.

54
Q

What are some potential nutrition intervention outcomes during early post-treatment?

A

Less fatigue, improved functional status, more rapid recovery from treatment, weight/body composition management, decreased risk of cancer recurrence, improved survival, improved quality of life.

55
Q

What are some potential nutrition intervention outcomes for long-term cancer survivorship?

A

Fewer late-effects of treatment, improved functional status, weight/body composition management, decreased risk of cancer recurrence, improved survival, improved quality of life, lower health care costs.

56
Q

What does it mean when a cancer cell is poorly differentiated?

A

It looks less like normal cells (more abnormal) and they tend to grow and spread faster.

57
Q

Describe the tumor grading system.

A

Gx: Grade can’t be assessed (undetermined grade)
G1: Well-differentiated (low grade)
G2: Moderately differentiated (intermediate grade)
G3: Poorly differentiated (high grade)
G4: Undifferentiated (high grade)

58
Q

What are some diet-related factors that might increase the risk for developing cancer?

A

Cooking meats at high temperatures (grilling)
Aflatoxin (found in peanut butter)
PBA (found in plastic bottles and food containers)
Excessive doses of nutrients (>RDA) may enhance progression of initiated cancer cells.

59
Q

How is grilling meat on an open flame potentially carcinogenic?

A

It can precipitate the formation of heterocyclic amines and polycystic aromatic hydrocarbons which have been shown to form DNA adducts (a protein of DNA attached to cancer causing chemical)

60
Q

How might PBA found in plastic bottles be potentially carcinogenic?

A

It can stimulate the proliferation of estrogen-mediated cancers such as breast and ovarian cancers.

61
Q

What chemotherapeutic agent does folate enhance the effectiveness of?

A

5-FU (fluorouracil)

62
Q

Which nutrients detoxify carcinogens?

A

Isothiocynates and flavonoids

63
Q

Which nutrients protect DNA from oxidation?

A

A, C, D, E and selenium

64
Q

Which nutrients assist with DNA repair?

A

Folate, selenium, lycopene and retinoids

65
Q

Which nutrients assist with cell cycle regulation?

A

Polyphenols, retinoids, folate, selenium

66
Q

Which nutrients induce apoptosis in initiated cells?

A

Curcumin, polyphenols, sulforaphane, isothicynates, quercetin, lycopene

67
Q

Which nutrients promote cell differentiation?

A

Long-chain omega-3 fatty acids, Vitamin D, retinoic acid

68
Q

Which nutrients prevent angiogenesis?

A

Idol-3 carbonyl, curcumin

69
Q

Which nutrients suppress inflammation?

A

Omega-3 fatty acids, Indol-3 carbonyl

70
Q

Which nutrients regulate hormonal signals?

A

soy isoflavones, Vitamin D, carotenoids

71
Q

What is the harm in a ‘false positive’ test?

A

Increase patient anxiety and added tests and procedures that are unnecessary.

72
Q

What is the harm in a ‘false negative’ test?

A

Causes delays in treatment.

73
Q

What is carcinogenesis?

A

The process by which normal cells transform into cancer cells.

74
Q

What are the steps of carcinogenesis?

A

Initiation (normal cells get DNA damage)
Promotion (cells are stimulated to grow)
Progression (tumor grows rapidly and invades other tissue)

75
Q

What are internal factors associated with cancer development?

A

hormones and the immune system

76
Q

What are external factors associated with cancer development?

A

Infections, toxins, viruses, radiation

77
Q

What are examples of unhealthy behaviors that are associated with cancer development?

A

smoking, poor diet, sun exposure

78
Q

What are some factors that can cause DNA damage turning a normal cell into an initiated cell?

A 
Chemicals
Oxidation
Inflammation
Viruses
Radiation
79
Q

What are potential nutrition concerns for cancer prevention?

A 
Obesity, loss of muscle mass
Energy-dense food intake
Excessive micronutrient intake from dietary supplements
Food contaminants (toxins, chemicals
80
Q

What are potential outcomes of nutrition intervention for cancer prevention?

A

Improved weight and body composition
Improved blood glucose control
Improved immune surveillance

CSO Exam 2018 (32 decks)

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