Chapter 5 Flashcards
neoplasm
uncontrolled growth of cells, benign or malignant
tumor
nonspecific term meaning lump or swelling (synonym for neoplasm)
benign
mass of cells that remain confined to their site of origin
metastasis
discontinuous spread of malignant neoplasm to distant sites
malignant
capable of metastasis
cancer
any malignant neoplasm or tumor
metastasis is spread by..
lymphatic system, main cause of morbidity/mortality
benign characteristics
- slow growth rate
- growth rate character: expansion
- tumor spread remains localized
- cells are well differentiated
cancer
less differentiation of cells
malignant characteristics
- rapid growth rate
- growth character: infiltration
- tumor spreads, metastasis by bloodstream or lymphatic channels
- cells are poorly differentiated
carcinoma
malignancy of epithelial cells
sarcoma
malignancy of CT
melanoma
melanocytes, pigment of skin
lymphoma
malignancy of lymphoid tissue
which cancers were most commonly diagnosed in 2019?
prostate and breast
which cancer was the leading cause of death in 2019?
lung for males and females
carcinoma happens because of..
rapid division, high chance of error, more common in older individuals because of built up mutations
damaged DNA due to..
mutations (change in DNA)
to be carcinogenic (cancer causing)..
genetic alteration must promote a growth advantage
proto-oncogene
normal, green light to divide, usually involved in cell growth and/or cell division
oncogene
proto-oncogene that is mutated, abnormal, doesn’t respond to environment but still gives green light to divide
mutation in RAS leads to..
constantly activated protein, apart of signaling inside of cell which promotes growth
tumor suppressor genes
detect and repair defective DNA before cell can transition through cell cycle and undergo mitosis (can be deactivated by mutations)
p53
most commonly mutated tumor supresser gene, master regulator
over 50% of cancers have..
mutated p53
function of p53
- halt the cell
- review cell cycle
- G1/S checkpoint is where it acts
- guardian of the genome
- recruits enzyme for repair, if cell too damaged, tells it to die
carcinogenesis
creation of cancer, can metastasize
what is required to acquire a malignant phenotype?
multiple “hits” to genome
cancer may be..
- hereditary
- sporadic
hereditary cancer
inherit first copy of mutant gene gives first “hit”, then additional mutations occur (5-10%) of cancers
sporadic cancer
mutations are acquired from environment or random, majority of cancers
causes of DNA mutation
- chemicals
- radiation
- infectious agents
- familial predisposition
chemical cause
- environment
- initiating chemical causes mutation then additional chemicals promote growth
radiation cause
- xrays -> effects are dose dependent
- UV -> sunlight, increases risk for skin cancer
infectious agents
oncogenic viruses are integrated into DNA (HPV)
familial predisposition
- genetics
- increasing risk of developing cancer at younger age (inherited first “hit”)
individual at risk has inherited set of genes that influence (inherited cancer predisposition)
- differences in circulation hormone levels
- variations in which cells metabolize cancer causing chemicals
- variations in ability to repair DNA
- variations in efficiency of immune system
natural history of cancer
- cell -> metaplasia -> dysplasia -> CIS
- malignancies develop through pre-malignancy
dysplasia in cancer
- premalignant state
- tissue is atypical
- usually epithelium
- doesn’t necessarily progress to malignancies
carcinoma in situ (CIS)
- cancer in place
- not invasive as basement membrane intact
- curable by complete excision
- not broken through membrane yet, once it does it can spread
invasion
local breakthrough of basement membrane
stage describes..
extent of spread of cancer
TNM system
- t describes tumor
- n describes extent of lymph node metastasis
- m describes whether distant metastasis has occurred
TNM combinations correspond to stages
- stage 0: CIS
- stage 1: not spread to surrounding tissues, but larger than stage 0
- stage 2: may extend into nearby tissue
- stage 3: spread to nearby lymph nodes, but not to other parts of the body
- stage 4: spread to distant tissues and organs
measures of 5 or 10 year survival is used for..
predicting behavior of cancers
cancer prognosis
- grade of tumor (assessment of how differentiated tumor appears)
- degree of differentiation roughly estimate tymors malignant potential
grading is..
microscopic assessment (how abnormal)
staging is..
behavioral assessment (size and extent of metastasis, help plan treatment)
clinical detection of cancer
- producing symptoms related to local growth
- causing systemic manifestations
- producing produce hormones
mass
cause pain, obstruction, palpable
hormone production
some neoplasms secrete hormones that lead to specific clinical manifestations
- benign and malignant neoplasms of endocrine gland
paraneoplastic syndromes
manifestations of aberrant and uncontrolled hormone production by malignant neoplasm
systemic manifestations
- metastasis to bone
- become anemic
- osteoporosis
- pathologic fracture: bone replaced by cancer, more likely to fracture
cachexia
generalized wasting that occurs in terminal cancer patients
contributing factors to cachexia
- anorexia
- nutritional demands of rapidly growing tumor
cancer treatment
- surgery
- hormone therapy
- ionizing radiation
- chemo
- immunotherapy
- targeted therapy
surgery
- prevent or cure cancer
- biopsy for diagnosing/staging and lymph node sampling
- debulking surgery (used on big tumors when can’t get radiation to whole tumor)
- palliative surgery (removing some mass to make patient more comfortable before death)
hormone therapy
- receptor activation or blockage
- interferes with cellular growth and signaling
ionizing radiation
- eradicate cancer w/o excessive toxicity
- avoid damage to normal structures
- damages cancer cells DNA
chemotherapy
- chemicals target rapidly dividing cells
- not specific to cancer cells
immunotherapy
stimulating own immune system to better recognize cancer cell
targeted therapy
- precision medicine
- act on specific molecular targets (biopsy and look at mutations)
survival rates
- vary from 4-95%
- thyroid = 95% 5 yr rate
- pancreatic = 4% 5 yr rate
warning signs and symptoms (CAUTION)
- change in bowel/bladder habits or function
- a sore doesn’t heal
- unusual bleeding/discharge
- thickening/lump in breast or elsewhere
- indigestion or difficulty swallowing
- obvious change in wart or mole
- nagging cough or hoarseness
lifestyle choices to reduce risk of cancer
- don’t use tobacco products
- sun safety
- diet
- drink alcohol in moderation
- exercise regularly
- vaccination
- safe sex practices
- maintain healthy weight
- self exam
