Intro to Oncology Flashcards
Top 3 types of cancer occurrences
Breast/Prostate
Lung
Colon
Top 3 types of cancer deaths
Lung
Breast/Prostate
Colon
Mature cells, resemble the normal cells from which they have arisen
Well-differentiated cells
Immature cells, have little resemblance to the tissue of origin
Undifferentiated cells
Characteristics of cancer
Clonality
Autonomy
Anaplasia
Characteristics of a benign tumor
Grow slowly Well-defined capsule Not invasive Well differentiated Low mitotic index Do not metastasize
Characteristics of a malignant tumor
Grow rapidly Not encapsulated Invasive Poorly differentiated High mitotic index Metastasize
Tumors of epithelial origin
Glandular/Ductal -Adenomas, adenocarcinomas Liver -Hepatocellular adenoma, carcinoma Renal -Renal tubular/cell adenoma, carcinoma
Tumors of Mesenchymal origin
Osteoma Chondroma...cartilage Myoma Glioma...NS Lymphoma Leukemia
- Pre-invasive epithelial malignant tumors
- Have not broken basement membrane or invaded surrounding stroma
- Applies to solid tumors
Carcinoma in situ (CIS)
Stages of Carcinogenesis
Initiation
Promotion
Conversion (transformation)
Progression
Reversible stages of Carcinogenesis
Promotion
Irreversible stages of Carcinogenesis
Initiation
Conversion (transformation)
Progression
Six Hallmarks of Carcinogenesis
- Self-sufficiency in growth signals (oncogenes)
- Insensitivity to Negative Signals (TSGs)
- Evasion of Apoptosis
- Limitless Proliferative Capacity
- Sustained Angiogenesis
- Tumor Invasion and Metastasis
Examples of oncogenes
Myc oncogene family
EGFR, HER-2
BCR-ABL
Examples of TSGs
p53
Retinoblastoma Gene (RB)
DNA Methylation
Length of the cell cycle
Doubling time
Tumor growth curve that describes the relationship between age and expected cell death
Gompertzian model
-Approximates tumor cell proliferation
Proportion of actively dividing cells
Growth fraction
Genetic damage that results in irreversible cellular mutations
Initiation
1st step, change in DNA
Carcinogens or other factors alter the environment to favor growth of the mutated cells over normal cells
Induces tumor development - a clonal population of neoplastic cells develops
Promotion
Reversible in early stages
When a mutated cell becomes cancerous
Conversion, transformation
variable timeline 5-20 years
irreversible
Final stage of increased cell proliferation and tumor invasion into local tissues and development of distant metastases
Progression
irreversible step
adenoma
aden means epithelial
oma means benign
Types of tumors that are usually malignant
From mesenchymal origin…
Gliomas
Lymphomas
Leukemias
Common oncogene
HER-2 is a normal proto-oncogene
It becomes cancerous when it is mutated and becomes an oncogene
Another is EGFR
Opposite of oncogenes
TSGs
50 to 73% of malignancies have this type of mutation
p53
Removes the checkpoint for repairs and causes mutations
Cell aging
senescence
each cell can only divide a limited number of times as the telomeres shorten with each replication
Enzyme that elongates telomeres
Telomerase
Prevents senescence and allows for infinite cell doublings
Drug that is an angiogenesis inhibitor
Bevacizumab, Brand is Avastatin
VEGF inhibitor
Which hallmark of carcinogenesis leads to increased amounts and overproduction of normal or abnormal cells?
Self-sufficiency in Growth Signals
What does a higher growth fraction mean?
It means that there are more cells that are actively dividing and replicating
Size below which a tumor is undetectable
10 to the 9th
A tumor is undetectable
most of its life
Describe the Gompertzian model
Initially high growth fraction and short doubling time until 10 to 9th. Then slows as it approaches 10 to 12th, which is lethal and because most of nutrients are used up
Below 10 to 5th tumor size
Our own immune system can do most of the killing and immunotherapy is of greatest benefit
Describes the number of cancer cells, size of tumor, and amount of cancer in the body
Tumor Burden
Cell Kill Hypothesis
Amount of cells killed is independent of tumor size. You will never reach 100% kill.
Chemo, at best, produces a ___ reduction in tumor burden
3 log reduction
ECOG Score…
Fully active, no restriction
Zero
ECOG score…
Restricted in physical strenuous activity, but ambulatory and able to carry out light work
1
ECOG score…
Ambulatory and capable of self-care, but unable to carry out work activities. Up and about more than 50% of waking hours.
2
ECOG score…
Capable of only limited self-care, confined to bed more than 50% of waking hours
3
ECOG score…
Completely disabled. Cannot carry on any self care. Confined to bed or chair.
4
ECOG score…
Death
5
Staging of cancer
Stage I Localized tumor Stage II and III Local and regional ext of dz Stage IV Presence of distance metastases M is 1
TNM staging
Tumor size 1-4
Node 0-3
Metastases 0-1
Drugs that affect M phase
Taxanes
Paclitaxel, docetaxel
Vinca Alkaloids
Vinorelbine, vincristine, vinblastine
Drugs that affect G2 phase
Topoisomerase inhibitors
Irinotecan, etoposide
Drugs that affect S phase
Antimetabolites
Analogs
Purine Analogs
6-MP, fludarabine
Pyrimidine Analogs
5-FU, cytarabine
FA Analogs
MTXDrugs that affect G1 phase
Steroids
L-asparaginase
Drugs that are Phase Non-Specific
Alkylating Agents
Cisplatin, ifosfamide
Antitumor Antibiotics
Doxorubicin, mitomycin
Cells spend the majority of their time in which phase?
S Phase
DNA Synthesis
HER-2 is a
Common oncogene
Enzyme the prevents scenescence and how?
Telomerase
-prevents the shortening of telomeres
Irinotecan
Etoposide
Telomerase inhibitors
Affect G2
6-MP, fludarabine
Purine Analogs
Affect S phase
5-FU, cytarabine
Pyrimidine Analogs
Affect S phase
MTX
Folic Acid Analog
Affects S Phase
Steroids affect which phase of the cell cycle?
G 1
L-asparaginase affects which phase of the cell cycle?
G-1
