Disorders of Cell Growth

Question 1

What is a tumour?

Answer 1

An abnormal growing mass of tissue whose growth is not coordinated with that of the surrounding tissue.

Question 2

What is a malignant tumour?

Answer 2

A tumour what can invade into adjacent tissue to metastasise and grow at other sites within the body

Question 3

What are the top 5 overall cancers?

Answer 3

1. Breast
2. Lung
3. Prostate
4. Colon
5. Melanoma

Question 4

What are the top 5 male cancers?

Answer 4

1. Prostate
2. Lung
3. Colon
4. Bladder
5. Lymph node

Question 5

What are the top 5 female cancers?

Answer 5

1. Breast
2. Lung
3. Colon
4. Uterine
5. Ovarian

Question 6

How are tumours classified?

Answer 6

Benign vs malignant

Tissue of origin

Question 7

What is a benign tumour of the glandular epithelium called?

Answer 7

Adenoma

Question 8

What is a Benign tumour of squamous epithelium called?

Answer 8

Squamous papilloma

Question 9

What is a malignant tumour of glandular epithelium called?

Answer 9

Adenocarcinoma

Question 10

What is a malignant tumour of squamous epithelium called?

Answer 10

Squamous carcinoma

Question 11

What is a benign tumour of bone called?

Answer 11

Osteoma

Question 12

What is a benign tumour of fat called?

Answer 12

Lipoma

Question 13

What is a benign tumour of fibrous tissue called?

Answer 13

Fibroma

Question 14

What is a malignant tumour of bone called?

Answer 14

Osteosarcoma

Question 15

What is a malignant tumour of fat called

Answer 15

Liposarcoma

Question 16

What is a malignant tumour of fibrous tissue called?

Answer 16

Fibrosarcoma

Question 17

What is a malignant tumour of leukocytes called?

Answer 17

Leukaemia

Question 18

What is a malignant tumour of lymphoid tissue called?

Answer 18

Lymphoma

Question 19

What is a malignant tumour in the CNS called?

Answer 19

Astrocytoma

Question 20

What is a benign tumour in the PNS called?

Answer 20

Schwannoma

Question 21

What is a teratoma?

Answer 21

A tumour of the germ cells

Question 22

Are ovarian teratomas normally malignant or benign?

Answer 22

Benign

Question 23

Are testicular teratomas normally malignant or benign?

Answer 23

Malignant

Question 24

Note some of the properties of cancer cells

Answer 24

• Altered genetics 
		○ Loss of tumour suppressor genes
		○ Gain of function of oncogenes
	• Altered cellular function
		○ Tumour-related proteins
	• Abnormal morphology

• Cells are capable of independent growth

• Loss of cell-to-cell adhesion
• Altered cell-to-matrix adhesion
• Production of tumour-related proteins  Tumour biomarkers

Question 25

What are tumour biomarkers?

Answer 25

Tumour related proteins

Question 26

What is an oncofoetal protein?

Answer 26

A protein which shows expression in foetal cells, is switched off postnatal, and turned on in cancer.

Question 27

How can tumour biomarkers be used clinically?

Answer 27

For screening To aid in diagnosis For prognosis (i.e. predict likely outcomes) Prediction: identify patients who will respond to a particular therapy

Question 28

Give examples of specific biomarkers and the cancers they are associated with.

Answer 28

Alpha-foetoprotein - Testicular teratoma - Hepatocellular carcinoma Carcino-embryonic antigen (CEA) -Colorectal cancer Oestrogen receptor -Breast cancer Prostate specific antigen (PSA) -Prostate cancer

Question 29

How do cancer cells appear?

Answer 29

Have celllular and nuclear pleomorphism (variation in appearance) Mitoses present and often abnormal

Question 30

What are four modes of cancer spread?

Answer 30

``` Local spread Lymphatic spread Blood spread Trans-coelomic spread -(spread of cells across body cavity) ```

Question 31

Describe metastasis via lymphatics

Answer 31

Adherence of tumour cells to lymph vessels Invasion from lymphatics Invasion into lymph node Formation of mets in lymph node

Question 32

Describe metastasis via blood

Answer 32

Adherence of tumour cells to blood vessels Invasion from blood vessels Invasion into tissue Formation of mets

Question 33

List common sites of metastasis (5)

Answer 33

``` Liver Lung Brain Bone (axial skeleton) Adrenal gland ```

Question 34

What are the local effects of benign tumours?

Answer 34

Pressure | Obstruction

Question 35

What are the local effects of malignant tumours?

Answer 35

Pressure Obstruction Tissue destruction (ulceration/infection) Bleeding (anaemia, haemorrhage) Pain (pressure on nerves, perineural infiltration, bone pain from pathological fractures) Side effects of treatment

Question 36

What are the systemic effects of malignant tumours?

Answer 36

Secretion of hormones - Normal (produced by tumour of endocrine organ, abnormal control) - Abnormal (produced by tumour of a non-hormone producing organ) Weight loss (cachexia) Paraneoplastic syndromes Side effects of treatment

Question 37

How can cancer be detected at a pre-invasive stage?

Answer 37

Identification of dysplasia (enlargement)/intraepithelial neoplasia

Question 38

What are the features of dysplasia?

Answer 38

Disorganisation of cells - Increased nuclear size - Increase mitotic activity - Abnormal mitoses

Question 39

Describe the mechanism of action of alkylating agents

Answer 39

Covalently bonds with both strands of DNA preventing replication

Question 40

Describe resistance mechanisms in cells to alkylating agents

Answer 40

Decreased entry or increased exit of a drug into/out of cell Inactivation of drug Enhanced DNA repair

Question 41

Give an example of an alkylating agent

Answer 41

Cisplatin

Question 42

Describe the mechanism of action of antimetabolite drugs (NB two methods)

Answer 42

Similar structure to metbolites needed by cell, can be incorporated into new nuclear materia or bind irreversibly with enzymes to inhibit mitosis

Question 43

Give example(s) of antimetabolite drugs

Answer 43

Fluorouracil Methotrexate Mercaptopurine

Question 44

Describe the mechanism of action of vinca alkaloids

Answer 44

Prevent spindle formation

Question 45

Give an example of a vinca alkaloid

Answer 45

Vincristine

Question 46

Describe the mechanism of action of taxoids

Answer 46

Prevent disassembly of spindles

Question 47

How do certain antibiotics act against cancer?

Answer 47

Inhibit DNA/RNA synthesis

Question 48

Give an example of an anticancer antibiotic

Answer 48

Bleomycin

Question 49

Note two other anticancer chemotherapy options

Answer 49

Hormones (eg tamoxifen for breast cancer) | Immunotherapy