chapter 6: Neoplasia Flashcards
1
Q
cancer
A
leading cause of death worldwide
most common are:
breast, lung, colon, and prostate
1/3 due to:
tobacco, obesity, lack of physical activity, etc.
2
Q
cancer
A
leading cause of death worldwide
most common are:
breast, lung, colon, and prostate
1/3 due to:
tobacco, obesity, lack of physical activity, etc.
3
Q
cancer (generic term for):
A
a large group of diseases that can affect any part of the body
4
Q
malignant tumor
A
tumor that is cancerous
5
Q
Benign tumor
A
tumor in which cancer is NOT present
6
Q
metastasis
A
rapid creation of abnormal cells that grow beyond usual boundaries, which then INVADE ADJOINING PARTS OF THE BODY AND SPREAD TO OTHER ORGANS (this happens in cancer)
7
Q
primary cause of death from cancer
A
widespread metastasis of cancer cells
8
Q
cell proliferation
A
process of cell division, it is an inherent adaptive mechanism for replacing body cells
9
Q
cell differentiation
A
process of specialization; new cells acquire the structure and function of the cells they replace
10
Q
apoptosis
A
a form of programmed cell death to eliminate unwanted cells
11
Q
the cell cycle is
A
intervals between each cell division; genetic information will be duplicated; checkpoints in cell cycle provide opportunities for monitoring the accuracy of DNA replication.
12
Q
Well-differentiated neurons and cells
A
unable to divide and reproduce (cells of the skeletal and cardiac muscle)
13
Q
parent or progenitor cells
A
continue to divide and reproduce - blood cells, skin cells, and liver cells
14
Q
undifferentiated stem cells
A
can be triggered to enter cell cycle and produce large numbers of progenitor cells when needed
15
Q
stem cells
A
reserve cells that remain quiet until there is a need for cell replenishment; during division one retains the stem cell characteristics, and then the other one becomes a progenitor cell that proceeds through to terminal differentiation to the end of specialization
16
Q
tumor
A
swelling caused by several conditions; including inflammation and trauma; mass of cells due to overgrowth
17
Q
neoplasm
A
abnormal new growth of tissue that grows by cellular proliferation more rapidly than normal; can be benign or malignant
18
Q
adenoma
A
benign tumor of glandular tissue
19
Q
osteoma
A
benign growth of bone
20
Q
carcinoma
A
malignancy that develops from epithelial cells
21
Q
adenocarcinoma
A
malignancy has glandular epithelial tissue
22
Q
sarcoma
A
malignant tumors of mesenchymal origin
23
Q
papilloma
A
benign microscopic or microscopic fingerlike projections growing on a surface
24
Q
oncology
A
Study of tumors and their treatment
25
anaplasia
The loss of the mature or specialized features of a cell or tissue, as in malignant tumors
26
carcinoma in situ
A group of abnormal cells that have not spread from the location where they first formed
27
benign neoplasms:
- abnormal noncancerous collection of cells;
- can form anywhere on or in the body;
- cells multiply more than they should or don’t die when they should;
- Do not spread to other parts of the body;
- Grow slowly and have distinct smooth regular borders ;
- Develop a fibrous capsule
- may not require treatment
28
malignant neoplasms
- cancerous
- develop when cell grow/divide more than they should
- spread to nearby tissues, and two distant parts of the body
- Treatment options include surgery, chemotherapy, or radiation therapy
- early detection is key
29
cancer cell characteristics include:
- grow and divide at abnormally rapid rate
- Poorly differentiated with abnormal morphology
- Disorder of altered cell differentiation and growth results in neoplasia (“new growth”)
- growth is uncoordinated and autonomous; lacks normal regulatory controls over cell growth and division; tends to increase in size and grow after stimulus ceases or of the organism are met
30
anaplasia
loss of differentiation (undifferentiation) of the cells and their orientation to each other
- characteristic of tumor cells
- structural or functional undifferentiation to the point where its lineage and/or tissue or origin cannot be determined
31
tumor grading
measure of the cell appearance in tumors and other neoplasms
- the closer the tumor cells resemble normal tissue cells, the lower the grade; ranges from 1-4
- grading and cancer is distinguished from staging, which is a measure of the extent to which the cancer has spread
32
cancer characteristics
- **genetic instability** where there is increased tendency of genetic alteration during cell division; cancer results from damage to multiple genes controlling cell division and tumors suppressors
- **growth factor independence** which is the ability to proliferate, even in the absence of growth factors
- **cell density-dependent inhibition** where they lose the ability to stop growth after cells reach a certain density
- **anchorage dependence** - cancer cells remain viable and multiply without normal attachments to other cells and extra cellular matrix
- **cell-to-cell communication** interferes with formation of intercellular connections, and responsiveness to membrane derived signals
- **unlimited life span**
- **antigen expression** antigens are immunologically identified as foreign
- **production of enzymes, hormones, and other substances** is abnormal compared to normal cells
33
what two ways can cancer spread?
lymphatic: through lymph nodes (e.g. breast cancer)
or
blood (hematological) spread
34
growth and normal and cancerous tissue depends on what three factors?
1. The number of cells that are actively dividing or moving through the cell cycle.
2. The duration of the cell cycle.
3. The number of cells that are being lost relative to the number of new cells being produced.
35
etiology (causes) of cancer are:
complex and multifactorial involving both genetic and environmental factors
36
cancer associated genes (three main types):
1. oncogenes
2. tumor suppressor genes
3. mismatch-repair genes
37
oncogenes are:
genes that regulate the normal growth of cells - become unable to control the normal growth of cells, allowing abnormal cancer cells to grow
38
tumor suppressor genes:
genes that recognize abnormal growth of cancer cells and can interrupt their reproduction until the defect is corrected; if mutated they do not function properly allowing tumor growth
39
mismatch-repair genes
genes that help recognize errors when DNA is copied; if these genes are not working properly, errors in DNA can be transmitted to new cells, causing them to be damaged
40
carcinogenesis
the transformation of normal cells into cancer cells
41
steps involved in carcinogenesis
1. initiation - sales exposed to doses of carcinogenic agents, making them susceptible to malignant transformation
2. Promotion - unregulated accelerated growth in already initiated cells caused by various chemicals and growth factors.
3. progression - tumor cells acquire, malignant phenotypic changes that promote invasiveness, metastatic, competence, autonomous growth, tendencies, and increased
karyotypic instability
42
hosts and environmental factors that lead to cancer include (8):
heredity
hormones
stem cells
angiogenesis
carcinogens
oncogenic viruses
immunologic mechanisms
microenvironmental effects
43
activation of oncogenes involved what three genetic changes to cellular protooncogenes?
1. mutation
2. gene amplification
3. chromosome rearrangements
44
tumor suppressor genes (TSG)
regulate orderly, cell growth and differentiation by sensing the surrounding environment, transmitting signals to the nucleus and directly affecting transcription transaction, survival or cell division
45
Two-Hit Hypothesis involves
loss of TSG function occurs via the deletion or inactivation of two alleles
two-hit = two alleles (both alleles of the gene)
46
epigenetic mechanisms
involve changes in the patterns of gene expression without a change in the DNA
“silence” genes, such as TSG, so that it is not expressed, and a cancer suppressing protein is not made
47
genes the increase susceptibility to cancer or facilitate cancer growth are:
- defects in DNA repair mechanisms
- Defects in growth factor signaling pathways
- evasion of apoptosis
- Avoidance of cellular senescence
- Development of sustained angiogenesis
- metastasis and invasion
48
DNA repair defects
DNA repair genes affect cell proliferation and survival indirectly through their ability to repair damage in proto-oncogenes, genes impacting apoptosis and tumor suppressor genes
49
defects in growth factor signaling pathways
common way in which cancer cells gain autonomous growth
50
evasion of apoptosis
cancer cells are characterized by long life because of high levels of telomerase that prevent cell aging and senescence (condition or process of deterioration with age)
51
development of sustained angiogenesis
tumors cannot enlarge unless angiogenesis occurs and supplies them with the blood vessels necessary for survival; required for continued tumor growth and for metastasis
52
invasion of metastasis
cancer stem cells enable cancer cells to detached cross tissue boundaries, escape death by detaching from tissue from which they belong (anoikis), and colonize new tissues
53
TME
Tumor Microenvironment (environment around a tumor)
include surrounding blood vessels, immune cells, fibroblasts, signaling molecules, and the extra cellular matrix ; tumor and micro environment are closely related and interact constantly; tumors influence the micro environment by releasing extra cellular signals promoting tumor angiogenesis and inducing peripheral immune tolerance
54
clinical manifestations of cancer
- All body functions are affected by the presence of cancer
- initial manifestations of cancer usually reflect the primary side of involvement
- tissue integrity: cancer compress on a road blood vessels, causing ulceration and necrosis, along with frank bleeding and hemorrhage
55
cancer can cause anorexia and cachexia
many cancers are associated with weight loss and wasting of food, fat and muscle tissue accompanied by profound weakness and anorexia and anemia
- Causes this syndrome is often referred to as cancer anorexia-cachexia syndrome
- Common manifestation of most solid tumors (except breast cancer)
56
cancer can cause fatigue and sleep disorders
most frequent side effects of cancer
-tiredness weakness, and lack of energy and is not relieved by rest or sleep
-early symptoms of malignant disease
57
anemia
common with various types of cancers and is related to blood loss, hemolysis, impaired red cell production or treatment effects
- caused by nutritional deficiencies, bone marrow failure and a blunted erythropoietin release to hypoxia
- inflammatory cytokines generated in response to tumors decrease erythropoietin production, resulting in a decrease in erythrocyte production
58
screening for cancer is a secondary prevention measure for early recognition of cancer and can be achieved through…
observation, palpitation and laboratory tests and procedures and requires a test that will specifically detect early cancers or pre-malignancies
59
diagnostic methods (determined by location and type of cancer) include:
blood test for tumor markers, psychology, and tissue biopsy endoscopy ultrasonography x-ray, CT, MRI, and PET (positron emitted technology) scans
60
screening for cancer: tumor markers are used to…
screening establishing prognosis, monitoring, treatment, and detecting, recurrent disease
markers that are most useful are human chorionic gonadotropin (hCG), cancer antigen 125, PSA, a Fetoprotein, carcinoembryonic antigen, and cluster of differentiation
61
screening: PAP (papanicolaou) test
cytologic method used for detecting cancer cells: microscopic examination of a properly prepared, slide for detection of abnormal cells; widely used as a screening test for cervical cancer
62
Microarray technology
use “gene chips” that can simultaneously perform miniature assays to detect and quantify the expression of large numbers of genes
63
immunohistochemistry
uses antibodies to facilitate the identification of cell products or surface markers, but it can also be used to determine the site of origin of metastatic tumors
64
grading
grading is going to be based according to the histologic or cellular characteristics of the tumor.
cancers are classified as grades 123 and four with increasing and plasia or lack of differentiation
65
staging
gonna be based according to the clinical spread of the disease
staging of cancer determines the extent and spread of the disease
66
staging and grading are used to determine what?
the course of the disease and to help in selecting treatment or management plans for the patient
67
the tumor, node, metastasis (TNM) system of the American joint committee on cancer (AJCC) is used by most cancer facilities and it:
classifies the disease into stages using three tumor components, which include:
T stands for the size and local spread of the primary tumor
N refers to the involvement of the regional lymph nodes
M describes the extent of the metastatic involvement
68
three categories of cancer treatment are:
curative, control, and palliative (treatment of discomfort, symptoms, and stress of terminal illness)
69
most common modalities of cancer treatment are…
surgery radiation therapy, chemotherapy, hormonal therapy, and biotherapy
70
the team involved in cancer treatment include…
medical surgical and radiation oncologists
nurses
Pharmacist
Ancillary personnel - x-ray technician & ultrasound technician
71
surgery is…
oldest treatment for cancer
- it’s used for diagnosis, staging, tumor removal, and palliation (palliative where we relieve the symptoms but we don’t hear the disease)
72
administration of radiation therapy
therapeutic radiation can be delivered in 3 ways: external beam or tele therapy (most common); beams generated at a distance and aimed at the tumor in a person or break the therapy and systemic therapy
73
effects of radiation therapy include:
primary systemic effect is fatigue
Anorexia, nausea, emesis and diarrhea are common with abdominal and pelvic irradiation - symptoms are controlled by medication and diet
most frequently affected tissue include skin, G.I. tract and bone marrow
74
chemotherapy
major systemic drug treatment for cancer that enables drugs to reach the site of the tumor as well as other distant sites
- primary treatment for most hematologic and some solid tumors
it can also be used as part of a multimodal treatment plan. For example, the patient can have radiation therapy and chemotherapy, and sometimes even patients have a radiation therapy, chemotherapy and surgery.
75
chemotherapy exerts its effects through:
lethal action by targeting processes that prevent cell growth and replication
Kills cancer cells by stopping DNA, RNA, and protein synthesis
eradicates cancer cells, but has toxic effects on normal cells
76
hormonal therapy is
administration of drugs designed to disrupt the hormonal environment of cancer cells
- deprives cancer cells of the hormonal signals that otherwise would stimulate them to divide
- tumors known to be responsive to hormonal therapy are those of the breast prostate and endometrium
77
biotherapy
use of immunotherapy and biologic response modifiers to change the immune response to cancer
78
immunotherapy (biotherapy)
effective treatment and has less toxicity than chemotherapy; uses one’s own immune system to treat cancer by either stimulating the immune system to attack cancer cells or improving the individuals immune system maybe used as a single agent treatment or adjunctive
79
childhood cancers are rare, but…
is the second leading cause of death among school-age children in the US
80
common childhood cancers include:
leukemia, non-Hodgkin and Hodgkin lymphoma, and bone cancers (osteosarcoma, and Ewing sarcoma)
81
the most common embryonal tumors during the first years of life are:
Wilms tumor, RB, and neuroblastomas
82
what cancers have a peak incidence in children 2 to 5 years of age?
embryonal tumors, along with acute leukemia, non-Hodgkin lymphoma, and gliomas
83
after puberty, what cancers are more common?
bone malignancies, Hodgkin, lymphoma, gonadal, germ, cell tumors, and various carcinomas
84
embryonal tumors
exhibit features of organogenesis similar to that of embryonic development; frequently designated with the suffix blastoma (nephroblastoma and neuroblastoma)
- infancy and early childhood
85
neuroblastoma
Second, most common solid malignancy in childhood after brain tumors; arise from the primordial neural crest tissue in the sympathetic nervous system and adrenal medulla
extremely malignant neoplasm
children, younger than two years, present with large abdominal masses, fever and possibly weight loss
bone pain suggest metastatic disease
86
nephroblastoma (Wilms Tumor)
most common primary renal tumor in children and most common pediatric abdominal cancer
due to genetic alterations that deal with the normal embryological development of the genitourinary tract
most commonly affects children between the ages of one and five with the most common presentation being at three years of age
87
childhood cancer biology
no single cause
biologic aspects of neoplasms:
two-hit theory
defects in DNA repair
histologic similarities between organogenesis and oncogenesis
88
warning signs of cancer in children include:
generalized symptoms in conjunction with persistent lymphadenopathy, unexplained weight loss, growing masses and abnormalities of the CNS function
89
generalized symptoms of cancer in children include:
prolonged fever, fatigue, bone pain
these symptoms typically delay diagnosis
90
diagnosis of childhood cancers involves:
Histologic exam
Accurate disease staging is especially beneficial
91
treatment of childhood cancers include:
chemotherapy, surgery, radiation therapy, and biologic agent therapy
92
radiation therapy (children)
- poses the risk of long-term effects for survivors of childhood cancer
- late effects depend on the organs and tissue exposed type of radiation administered daily fractional and cumulative radiation dose and the HP treatment
- increased risk of melanoma, squamous, cell carcinoma, and basal cell carcinoma
- side effects include pain and altered musculoskeletal function
93
chemotherapy (children)
poses the risk of long-term effects for survivors
- side effects include gonadal injury (hypogonadism, infertility and early menopause), AML, pulmonary fibrosis, kidney disease, bladder disorders, cardiomyopathy, CHF, nephrotoxicity, ototoxicity and neurotoxicity
