Lecture 2 - Neoplasia

Question 1

What are the 3 tissue types?

Answer 1

Labile - continuously dividing, epithelial including skin, GI, urinary, endocrine and reproductive system
Stable - quiescent, dividing with inactive periods, epithelial including lung, liver, pancreas and kidneys
Permanent - non dividing, neurons, cardiac, and skeletal, no chance of cancer unless mutates at embryo-genesis

Question 2

What is proliferation and where can mutations begin?

Answer 2

Proliferation is the cell cycle reproducing, includes mitosis, cytokenisis, G0 or G1, S and G2
At G1 mutations can begin as the cellular contents are duplicated

Question 3

What is dysplasia and what are the stages to get to dyplasia?

Answer 3

Dysplasia is the abnormal, pre-malignant stage of of a cell where the genotype and phenotype are abnormal. cal be destroyed by immune system

Cycle:
Normal –> Metaplasia (reversible, cell adapting to different environment in order to survive –> dysplasia
Normal –> Hyperplasia (increased no. of cells) –> dysplasia

Question 4

What are mutations and what are the 2 types of mutations?

Answer 4

Mutation is a permanent change to the cell and must occur multiple times for cancer to occur

Germ cell mutation - transmitted progeny (descendants)

Somatic cell mutation - most cancer, spontaneous change, congenital malformations, not transmitted

Question 5

What is apoptosis?

Answer 5

Cell suicide or programmed cell death - immune system or internal by ATP

Question 6

What are mutagens and what are some examples and the increased risks?

Answer 6

Physical or chemical agent that causes change by causing damage or increase oxidant levels

Increased risk with age, lower number or anti-oxidants produced and/or exposure to carcinogens including asbestos, nickle compounds, chromium

Other increased risks include:
visceral fat, smoking, UV exposure, alcohol, genetics and chronic condition e.g. inflammation

Question 7

What are the particular targets for genetic damage by mutation ?

Answer 7

• proto-oncogenes
• tumor suppressing genes
• genes which regulate apoptosis
• DNA repair genes
• p53

Question 8

What are the 8 essential alterations for malignancy?

Answer 8

1-self sufficient in growth signals -proliferation without external stimuli
2-insensitivity to growth inhibitory signals
3-evasion of apoptosis
4-limitless replication process - maintains telemers
5-sustained angiogenesis - blood vessles
6-ability to invade and metastasize
7- defects in DNA repair
8-predilection for glycolosis even in presence of oxygen

Question 9

What is the order of gene hits to reach invasive cancer?

Answer 9

normal cell –> DNA damage –> repair or genetic instability –> if cannot repair –> progressive no. of mutations –> unregulated cell division and inability to undergo apoptosis –>invasive cancer

Question 10

Benign vs Malignant? What are the main differences?

Answer 10

• ability to metastasis
• differentiation
• homogeneous vs heterogeneous
• cytoplasmic ratio (malignant high 1:1)
• rate of growth

Question 11

What are the 3 ways that cancer can metastasize and what are the main types of metastatic cancer?

Answer 11

Blood, lymph and direct seeding into lining of organs

Lung, liver, kidney, brain and bone

Question 12

What is nomenclature and what are the suffixes?

Answer 12

Naming
Benign = oma
Connective= sarcoma
Epithelial = carcinoma

Question 13

What are the prefixes for connective tissue cancers?

Answer 13

Fibro = fibrous tissue
Leiomy = muscle
Chondr = cartilage 
Oste = bone
Lip = fat 
Hoemangi = endothelial

Question 14

What are the prefixes for epithelial tissue cancers?

Answer 14

Adeno = secreting 
Papill = finger like projections 
Cystadeno = cyst like 

Squamous
Renal

Question 15

What are other benign cancers?

Answer 15

Teratomas

Meniginoma

Question 16

What are other malignant cancers?

Answer 16

Sarcomas
Carcinomas
Melanoma
Leukemia
Lymphomas
Gliomas
Mesothelioma

Question 17

What are the 3 different types of pathogenesis?

Answer 17

1- normal tissue –> multiple mutations –> malignant cancers
2-normal tissue –> multiple mutations –> benign or further mutations –> malignant cancer (high tendency in certain body parts)
3- normal tissue –>sustained stress –> metaplasia –> dysplasia –> further mutations –> malignant cancer

Question 18

What are the common cancers that form through the different types of pathogenesis?

Answer 18

Type 1 - melenoma, ovaria teretoma, mesothelioma (multiple genetic hits NOT mutations)
Type 2 - colon (usually try to get to before progression)
Type 3 - lung and cervix

Question 19

What is prognosis? Grading and Staging?

Answer 19

Prognosis is the course of a medical conditions, radical or palliative
Grading - I to IV estimate on how aggressive cancer
Staging - TNM system, tumor, nodes, metastasis

Question 20

What are the treatments of cancer?

Answer 20

• surgery
• radiation therapy
• chemo
• hormone therapy
• immuno therapy

Question 21

What are the potential side effects of treatment?

Answer 21

• healthy cells lost
• mutations in healthy cells
• scars and RT burns