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Heme/Onc > Intro to Oncology > Flashcards

Intro to Oncology Flashcards

1
Q

What is initiation in carcinogenesis?

A

Exposure of normal cells to carcinogenic substances

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2
Q

What is promotion in carcinogenesis?

A

Carcinogens or other factors create an environment that favors growth of mutated cells over normal cells

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3
Q

What is conversion or transformation of carcinogenesis?

A

Cell becomes cancerous

Could be years before diagnosis occurs

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4
Q

What is progression of carcinogenesis?

A

Tumor invasion into local and distal sites (metastasis)

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5
Q

Which process in carcinogenesis is reversible?

A

Promotion

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6
Q

What are RFs for carcinogenesis?

A 
Chemical
Physical agents
Biologic
Age/gender
Diet
Chronic irritation
FH
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7
Q

What are chemical RFs for carcinogenesis?

A

Aniline dye exposure (bladder cancer)
Benzene (leukemia)
Smoking
Drugs/hormones (BC, Hydroxyurea, GLP-1 agonists, AZA)

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8
Q

What are the physical agents RFs for carcinogenesis?

A

Radiation (free radicals)

UV (free radicals)

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9
Q

How is chronic irritation a RF for carcinogenesis?

A

Persistent cell damage and repair

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10
Q

What are the two major classes of genes in cancer?

A

Oncogenes

Proto-oncogenes

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11
Q

What are oncogenes?

A

Develop from normal genes called proto-oncogenes

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12
Q

What are proto-oncogenes?

A

Present in all cells to regulate cell cycle and function

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13
Q

How do proto-oncogenes become oncogenes?

A

Alterations lead to oncogenes by point mutations, chromosomal rearrangements, or gene amplification

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14
Q

What are some examples of oncogenes?

A 
ALK
EGFR
HER2
KRAS/NRAS
RET
BCR-ABL
BCL-2
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15
Q

What function is the oncogene ALK?

A

Kinase

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16
Q

What are the cancers associated with ALK?

A

Lung
Lymphoma
Ovarian

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17
Q

What function is the oncogene EGFR?

A

Growth factor receptor

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18
Q

What cancers are associated with EGFR?

A

Breast
Head/neck
Colon

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19
Q

What function is the oncogene HER2?

A

Growth factor receptor

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20
Q

What cancers are associated with HER2?

A

Breast
Ovarian
Bladder
Prostate

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21
Q

What is the function of the oncogene KRAS/NRAS?

A

Cytoplasmic protein in signaling pathway

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22
Q

What cancers are associated with KRAS/NRAS?

A

Colon
Lung
Acute leukemia

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23
Q

What is the function of the oncogene RET?

A

Growth factor receptor

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24
Q

What cancers are associated with RET?

A

Thyroid

Lung

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25
Q

What is the function of the oncogene BCR-ABL?

A

Cytoplasmic kinase

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26
Q

What cancers are associated with BCR-ABL?

A

Chronic myeloid leukemia

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27
Q

What is the function of BCL-2?

A

Blocks apoptosis

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28
Q

What cancers are associated with BCL-2?

A

Indolent B-cell lymphoma

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29
Q

How are tumor suppressor genes involved in cancer?

A

Regulate and inhibit inappropriate cell growth and cell proliferation

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30
Q

What does mutation or loss of the gene lead to?

A

Uncontrolled, unregulated, unchecked, and unimpeded cell growth

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31
Q

What are DNA repair genes classified as?

A

Tumor suppressor genes

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32
Q

Which tumor suppressor gene is thought to be mutated in 1/2 of all cancers?

A

p53

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33
Q

What are some Tumor suppressor genes?

A 
p53
BCRA1
BCRA2
APC
RB1
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34
Q

What is the function of p53?

A

Halts cell division

Induces apoptosis

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35
Q

What is the function of BRCA1 and BRCA2?

A

DNA repair

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36
Q

What cancers are associated with BRCA1 and BRCA2?

A

Breast

Ovarian

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37
Q

What is the function of APC?

A

Cytoplasmic signaling step

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38
Q

What cancers are associated with APC?

A

Colon

Gastric

39
Q

What is the function of RB1?

A

Cell cycle master brake

40
Q

Are single mutations sufficient enough to initiate cancer?

A

No, multiple mutations are necessary for carcinogenesis

41
Q

How do passenger mutations affect cancer?

A

They do not contribute to cancer development

42
Q

How do driver mutations affect cancer?

A

Support growth of the cancer

43
Q

How are cyclins and CDKs involved in cancers?

A

Promote entry into the cell cycle

Overexpressed in several cancers

44
Q

What happens to apoptosis in cancer cells?

A

Dysfunctional or non-existent

45
Q

What are the steps for cancer immunoediting?

A

Elimination
Equilibrium
Escape

46
Q

What is dysplasia?

A

The presence of cells of an abnormal type of tissue

47
Q

What is “in situ”?

A

Means in place - not malignant

48
Q

What is the log linear growth phase?

A

High growth fraction

Short doubling time

49
Q

Does chemotherapy affect actively dividing cells or cells at rest?

A

Actively dividing cells

50
Q

Does chemotherapy work better during the log linear growth phase or the plateau phase?

A

Log linear, the plateau is not dividing as much

51
Q

Why do we stop giving chemotherapy during the microstatic disease area of treatment?

A

In hopes the body’s own immune system will kick in and take care of the rest of the cancer

52
Q

Is there a specific number of cells killed through a chemotherapy course?

A

No, it is a percentage

53
Q

What is the benign term for a cancer originating from surface epithelium?

54
Q

What is the benign term for a cancer originating from glandular cells?

55
Q

What is the benign term for a cancer originating from fibrous tissue?

56
Q

What is the benign term for a cancer originating from bone?

57
Q

What is the benign term for a cancer originating from smooth muscle?

A

Leiomyeoma

58
Q

What is the benign term for a cancer originating from striated muscle?

A

Rhabdomyoma

59
Q

What is the benign term for a cancer originating from fat?

60
Q

What is the benign term for a cancer originating from glial tissue?

61
Q

What is the benign term for a cancer originating from Melanocytes

A

Pigmented nevus (mole)

62
Q

What is the benign term for a cancer originating from nerve sheath?

A

Neurofibroma

63
Q

What is the benign term for a cancer originating from gonadal tissue?

64
Q

What is the malignant term for a cancer originating from surface epithelium?

65
Q

What is the malignant term for a cancer originating from glandular cells?

A

Adenocarcinoma

66
Q

What is the malignant term for a cancer originating from fibrous tissue?

A

Fibrosarcoma

67
Q

What is the malignant term for a cancer originating from bones?

A

Osteosarcoma

68
Q

What is the malignant term for a cancer originating from smooth muscle?

A

Leiomyosarcoma

69
Q

What is the malignant term for a cancer originating from striated muscle?

A

Rhabdomyosarcoma

70
Q

What is the malignant term for a cancer originating from fat?

A

Liposarcoma

71
Q

What is the malignant term for a cancer originating from lymphoid tissue?

72
Q

What is the malignant term for a cancer originating from plasma?

A

Multiple myeloma

73
Q

What is the malignant term for a cancer originating from glial tissue?

A

Glioblastoma

Astrocytoma

74
Q

What is the malignant term for a cancer originating from melanocytes?

75
Q

What is the malignant term for a cancer originating from nerve sheath?

A

Neurofibrosarcoma

76
Q

What is the malignant term for a cancer originating from gonadal tissue?

A

Teratocarcinoma

77
Q

What are the ways cancer survives?

A 
Sustaining proliferative signaling
Evading growth suppressors
Resisting cell death
Activating invasion and metastasis
Inducing angiogenesis
Enabling replicative immortality
78
Q

What steps are necessary for invasion and metastasis?

A

Neoplastic transformation
Angiogenesis
Detachment and embolization (seeds)

79
Q

What are the 7 warning signs of cancer?

A 
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding/discharge
Thickening/presence of lump in breast/elsewhere
Indigestion/difficulty swallowing
Obvious change in wart/mole
Nagging cough/hoarseness
80
Q

What does TNM stand for?

A

Tumor: size and invasion (T1-T4)
Lymph node involvement (N0-N3)
Metastasis: (M0-M1)

81
Q

What are the stages of cancer based on the TNM system?

A

Stage 1: localized cancer
Stage 2-3: regional cancer invasion: N 1+
Stage 4: metastatic cancer: M must = 1

82
Q

What level of Karnofsky is chemotherapy eligibility?

83
Q

What ECOG score is chemotherapy eligibility?

A

less than or equal to 2

84
Q

Who is the Lansky score used for?

A

16 years and under

85
Q

What are the modalities of cancer treatment?

A

Surgery
Radiation
Chemotherapy
Biologic therapy

86
Q

What is the treatment of choice for solid tumors (if possible)?

87
Q

What are the AEs of surgery?

A

Surgical complications
Damage to surrounding tissue
Possible metastasis

88
Q

How does radiation affect cancer?

A

Helps eradicate cancer cells left behind by surgery

Aids in tumor size reduction prior to other therapies

89
Q

What are the AEs of radiation?

A

Irritation of the skin and tissue underneath
Fatigue
Infertility and secondary cancers are a possibility

90
Q

When is chemotherapy used?

A

Management and treatment of primary tumor and any metastatic disease

91
Q

What are the AEs of chemotherapy?

A 
N/V
Alopecia
Fatigue
Myelosuppresssion
Mucositis
Infertility
Extravasation
Cutaneous reactions
Secondary malignancies
92
Q

What is a neoadjuvant?

A

Chemotherapy administered before surgery or radiation (a primary treatment)

93
Q

What is an adjuvant?

A

Given after the primary therapy to enhance the possibility of a cure

94
Q

What is salvage therapy?

A

Administered after primary therapy has failed.

Usually a different regimen

Heme/Onc (20 decks)

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