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Patho > Module 2 Neoplasia > Flashcards

Module 2 Neoplasia Flashcards

1
Q

What is cancer?

A

Cancer is the unregulated growth of abnormal cells

Cancer cells exhibit altered cell differentiation and growth patterns.

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2
Q

What does neoplasia mean?

A

Neoplasia means ‘new growth’

The new growth itself is referred to as a neoplasm.

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3
Q

What is a neoplasm?

A

A neoplasm is a new growth that lacks normal regulatory controls over cell growth and division.

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4
Q

How does neoplasm growth differ from normal tissue growth?

A

Neoplasm growth lacks regulatory controls and does not respond to cellular signaling stimuli.

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5
Q

What are the three requirements for normal tissue renewal and repair?

A
  1. Proliferation
  2. Differentiation
  3. Apoptosis
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6
Q

Define proliferation in the context of cell growth.

A

Proliferation is the process of cell division for new cell growth to replace old cells or when additional cells are needed.

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7
Q

What is differentiation?

A

Differentiation is the process by which cells become more specialized with each mitotic division.

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8
Q

What is apoptosis?

A

Apoptosis is the process of controlled cell death that eliminates senescent, damaged, or unwanted cells.

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9
Q

What regulates the beginning and end stages of a cell lifecycle?

A

The beginning (proliferation) and end stages (apoptosis) are carefully regulated.

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10
Q

What do proto-oncogenes do?

A

Proto-oncogenes encode proteins that signal for the cell to proliferate.

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11
Q

What role do tumor suppressor genes play?

A

Tumor suppressor genes encode proteins that inhibit cell growth and signal for apoptosis when necessary.

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12
Q

True or False: Dysregulation of proto-oncogenes and tumor suppressor genes can lead to cancer.

A

True

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13
Q

Fill in the blank: Neoplasms tend to have genetic abnormalities that cause excessive and uncontrolled _______.

A

proliferation

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14
Q

What happens if cell growth becomes unregulated?

A

Tumor suppressor genes will initiate apoptotic events to eliminate potential tumor cells.

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15
Q

What is the cell cycle?

A

The process by which a cell duplicates its genetic information and divides between two genetically identical daughter cells.

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16
Q

What are the four phases of the cell cycle?

A
  • G1 (gap 1) * S phase * G2 (gap 2) * M phase
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17
Q

What occurs during the G1 phase?

A

DNA synthesis stops, the cell enlarges, and both RNA and protein synthesis begins.

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18
Q

What happens during the S phase?

A

DNA synthesis occurs, producing two separate sets of chromosomes.

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19
Q

What is the function of cell cycle checkpoints?

A

To ensure the cell is ready to proceed to the next phase, halting the cycle if necessary for replication or DNA repair.

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20
Q

What occurs during the G2 phase?

A

DNA synthesis stops while RNA/protein synthesis continues.

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21
Q

What are the three phases referred to as interphase?

A
  • G1 * S phase * G2
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22
Q

What does the M phase consist of?

A

Mitosis and cytoplasmic division.

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23
Q

What characterizes cells that continually divide?

A

They continue to cycle from one mitotic division to the next.

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24
Q

What is the resting phase in the cell cycle called?

A

G0 phase.

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25
Q

When does a cell enter the G0 phase?

A

When nutrients or growth factors are unavailable or when highly specialized cells first leave the cell cycle.

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26
Q

Under what conditions can cells in G0 re-enter the cell cycle?

A

When nutrients become available or the cell receives stimuli via growth factors, hormones, or other signals.

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27
Q

Which cells may permanently stay in G0?

A

Highly specialized and terminally differentiated cells, like neurons.

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28
Q

What is cell proliferation?

A

The process of increasing cell numbers by mitotic cell division

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29
Q

How is tissue/organ structure and function maintained in normal tissues?

A

The number of new cells produced is equivalent to the number of cells dying or being shed

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30
Q

What happens to the balance of new vs old cells in most cases of cancer?

A

It becomes unregulated and unbalanced

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31
Q

What are the two major categories of human cells?

A
  • Gametes (ovum and sperm)
  • Somatic (non-reproductive) cells
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32
Q

What is the chromosome status of gametes?

A

Haploid, having only one set of chromosomes from one parent

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33
Q

What type of cells do gametes form after fusion?

A

Diploid cells containing both sets of chromosomes, which are somatic cells

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34
Q

How many various cell types can proliferate in the body?

A

Approximately 200

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35
Q

What are the three large groups of proliferating cells?

A
  • Well-differentiated neurons and muscle cells that rarely divide
  • Progenitor or parent cells that continue to divide
  • Undifferentiated stem cells that can produce progenitor cells
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36
Q

Which cells have high turnover rates and must be replaced continuously?

A

White blood cells and cells lining the GI tract

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37
Q

What typically stimulates increased cell reproduction in tissues?

A

Injury or loss of tissue

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38
Q

What is cell differentiation?

A

The process by which cells become more specialized in structure and function

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39
Q

What is an example of cell differentiation in the body?

A

Blood-forming cells in the bone marrow differentiate into specialized adult red blood cells

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40
Q

What factors influence how cells differentiate into various tissue and organ types?

A
  • Specific genes
  • Patterns of gene expression
  • Chemical and environmental stimuli
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41
Q

Why must the rate of cellular reproduction and differentiation be controlled?

A

To ensure appropriate numbers and types of cells are formed

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42
Q

What happens as cells become more specialized?

A

They lose the ability to develop characteristics of other cell types

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43
Q

Why is it important to maintain the integrity of developing organs?

A

To avoid the presence of differing (and unwanted) cell types

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44
Q

What do specialized cells rely on when they are unable to divide?

A

Progenitor or parent cells of the same lineage that can still divide

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45
Q

Fill in the blank: The process of differentiation must be tightly regulated to ensure that cells do not differentiate into _______ cell types.

A

[non-target]

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46
Q

What distinguishes stem cells from progenitor cells?

A

Stem cells remain incompletely differentiated and dormant until needed

Progenitor cells are more differentiated and committed to specific lineages.

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47
Q

What happens when a stem cell divides?

A

One daughter cell retains stem cell characteristics, the other becomes a progenitor cell

The progenitor cell will eventually reach terminal differentiation.

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48
Q

Define self-renewal in the context of stem cells.

A

The ability of a stem cell to undergo numerous mitotic divisions while maintaining an undifferentiated state.

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49
Q

What does potency refer to in stem cells?

A

The differentiation potential of stem cells.

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50
Q

What are pluripotent stem cells often referred to as?

A

Master cells.

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51
Q

What is the differentiation capability of multipotent stem cells?

A

Can differentiate into only a few select types.

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52
Q

What defines unipotent stem cells?

A

Restricted to a single cell type but can maintain self-renewal.

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53
Q

What role do embryonic stem cells play?

A

They give rise to the three main germ layers: endoderm, mesoderm, and ectoderm.

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54
Q

What is the significance of adult stem cells?

A

Contribute to tissue regeneration and replacement of cells lost to apoptosis.

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55
Q

Fill in the blank: The three main germ layers formed by embryonic stem cells are _______.

A

endoderm, mesoderm, and ectoderm.

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56
Q

2.2 Cancer Terminology

A
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57
Q

What does the term oncology derive from?

A

The Greek word onkos, meaning ‘swelling’

Oncology is the study or science of neoplasms.

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58
Q

What is a clinical oncologist responsible for?

A

Diagnosing and treating neoplasms in a clinical setting

Neoplasms refer to new cell growths.

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59
Q

What is the common term used to refer to a cancerous mass of cells?

A

Tumor

Neoplasm is the proper term, but tumor is commonly used.

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60
Q

What are the characteristics of benign neoplasms?

A
  • Well-differentiated cells
  • Resemble cells of tissues of origin
  • Slow, progressive rate of growth
  • Localized and not capable of metastasizing

They develop a fibrous capsule aiding in surgical removal.

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61
Q

How do benign tumors grow?

A

By expansion and remain localized to their site of origin

They can compress blood vessels or nerves, potentially interfering with vital functions.

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62
Q

What can benign tumors potentially interfere with?

A

Vital functions

For example, a benign brain tumor can cause death by compressing surrounding brain structures.

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63
Q

What are malignant neoplasms known for?

A

Invading and destroying tissue

They grow rapidly and can spread to other parts of the body.

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64
Q

How do malignant neoplasms typically spread?

A

Via the circulatory or lymphatic systems

They lack well-defined margins.

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65
Q

What is metastasis?

A

The process of cells detaching, invading surrounding tissue, and spreading to other sites

This is common in solid tumors.

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66
Q

What are the two broad categories of malignant neoplasms?

A
  • Solid tumors
  • Hematologic cancers

Solid tumors are initially confined to specific tissues; hematologic cancers involve blood and lymph cells.

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67
Q

What are the distinguishing traits between benign and malignant neoplasms?

A
  • Cell characteristics
  • Rate of growth
  • Manner of growth
  • Capacity to invade and metastasize
  • Potential for causing death

These traits help differentiate between benign and malignant tumors.

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68
Q

True or False: Benign neoplasms can metastasize.

A

False

Benign neoplasms remain localized and do not spread.

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69
Q

What type of cells do benign neoplasms consist of?

A

Well-differentiated cells that resemble cells in the tissue of origin

Benign neoplasms maintain a resemblance to the originating tissue, which is a key characteristic.

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70
Q

What type of cells do malignant neoplasms consist of?

A

Undifferentiated cells, atypical structure that don’t look like cells in tissue of origin

Malignant neoplasms have a more chaotic structure and do not resemble the original tissue.

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71
Q

How does the rate of growth compare between benign and malignant neoplasms?

A

Benign: Progressive and slow; may stop or regress
Malignant: Variable; greater undifferentiation, more rapid the rate of growth

The growth rate of malignant neoplasms can vary widely, often being more aggressive than benign neoplasms.

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72
Q

What is the mode of growth for benign neoplasms?

A

Grows by expansion without invading surrounding tissues; usually encapsulated

Benign neoplasms typically remain localized and do not invade adjacent tissues.

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73
Q

What is the mode of growth for malignant neoplasms?

A

Grows by invasion, infiltrating the surrounding tissues

Malignant neoplasms can spread into nearby tissues, making them more dangerous.

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74
Q

Do benign neoplasms spread by metastasis?

A

Does not spread by metastasis

This is a major distinguishing feature of benign neoplasms, as they do not invade other parts of the body.

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75
Q

Do malignant neoplasms spread by metastasis?

A

Gains access to blood and lymph channels to metastasize to other areas of body

This ability to spread through the bloodstream or lymphatic system is a critical factor in the severity of malignant neoplasms.

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76
Q

What suffix is typically added to the tissue type to name tumors?

A

-oma

This suffix indicates the origin of the tumor.

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77
Q

What is an adenoma?

A

A benign tumor of glandular epithelial tissues

Adenomas arise from glandular tissues.

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78
Q

What is an osteoma?

A

A benign tumor of bone tissue

Osteomas are typically slow-growing and asymptomatic.

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79
Q

Define papilloma.

A

A benign finger-like projection that grows on any surface

Papillomas can occur in various locations, including skin and mucosal surfaces.

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80
Q

What is a carcinoma?

A

A malignant tumor of epithelial tissue origin

Carcinomas are the most common type of cancer.

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81
Q

What is an adenocarcinoma?

A

A malignant tumor of glandular epithelial tissues

Adenocarcinomas can occur in many organs, including the breast and prostate.

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82
Q

What is a sarcoma?

A

A malignant tumor of mesenchymal (multipotent) origin

Sarcomas are less common than carcinomas.

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83
Q

What is a polyp?

A

A growth that projects from a mucosal surface, such as the intestine

Polyps can be benign or malignant.

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84
Q

What is carcinoma in situ?

A

A localized pre-invasive lesion

These lesions can typically be surgically removed or treated.

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85
Q

What is an example of carcinoma in situ?

A

Breast ductal carcinoma in situ

In this condition, the cells have not crossed the basement membrane.

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86
Q

What is the curability rate of carcinoma in situ of the cervix?

A

Essentially 100% curable

Early detection and treatment are key factors.

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87
Q

What is the benign tumor of surface epithelial tissue?

A

Papilloma

This type of tumor has a characteristic finger-like appearance.

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88
Q

What is the malignant tumor of surface epithelial tissue?

A

Squamous cell carcinoma

It arises from squamous cells, which are flat cells found in the skin and lining of organs.

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89
Q

What is the malignant tumor of glandular epithelial tissue?

A

Adenocarcinoma

Adenocarcinomas are often associated with organs like the pancreas and lungs.

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90
Q

What is the benign tumor of fibrous connective tissue?

A

Fibroma

Fibromas are usually slow-growing and may not cause symptoms.

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91
Q

What is the malignant tumor of fibrous connective tissue?

A

Fibrosarcoma

Fibrosarcomas can occur in various locations and tend to be aggressive.

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92
Q

What is the benign tumor of adipose tissue?

A

Lipoma

Lipomas are soft, movable masses under the skin.

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93
Q

What is the malignant tumor of adipose tissue?

A

Liposarcoma

Liposarcomas can develop in deep soft tissues and can be aggressive.

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94
Q

What is the benign tumor of smooth muscle?

A

Leiomyoma

Leiomyomas are commonly found in the uterus.

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95
Q

What is the malignant tumor of smooth muscle?

A

Leiomyosarcoma

Leiomyosarcomas can occur in the uterus or other organs.

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96
Q

What is the benign tumor of nerve cells?

A

Neuroma

Neuromas may cause pain or discomfort depending on their location.

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97
Q

What is the malignant tumor of nerve cells?

A

Neuroblastoma

Neuroblastoma is most commonly seen in children.

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98
Q

What is the benign tumor of glial cells?

A

Glioma

Gliomas can vary in aggressiveness.

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99
Q

What is the malignant tumor of glial cells?

A

Glioblastoma/astrocytoma

These tumors are aggressive and often have a poor prognosis.

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100
Q

What is the malignant tumor of granulocytic hematologic tissue?

A

Myelocytic leukemia

This condition affects the blood and bone marrow.

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101
Q

What is the malignant tumor of lymphocytic hematologic tissue?

A

Lymphocytic leukemia/lymphoma

These malignancies involve the lymphatic system and blood.

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102
Q

What is the benign tumor of blood vessels?

A

Hemangioma

Hemangiomas are often found in infants and may resolve on their own.

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103
Q

What is the malignant tumor of blood vessels?

A

Hemangiosarcoma

Hemangiosarcoma is aggressive and often requires extensive treatment.

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104
Q

2.3 Cancer Cell Characteristics

A
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105
Q

What does anaplasia mean?

A

To form backward

Anaplasia describes the loss of cell differentiation in cancerous tissue.

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106
Q

What is pleomorphism in cancer cells?

A

Variations in size and shape of cells and nuclei

Pleomorphism is a condition observed in undifferentiated cancer cells.

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107
Q

What are the characteristics of chromatin in anaplastic cells?

A

Coarse and clumped

This abnormal chromatin structure is a common feature in cancerous tissues.

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108
Q

What is the significance of nucleoli in anaplastic cells?

A

Often larger than normal and contain an abnormal number of chromosomes

Changes in nucleoli size and chromosome number are indicative of aggressive cancer.

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109
Q

What is observed due to the high rate of proliferation in anaplastic cells?

A

Greater number of cells in mitosis

This reflects the rapid growth characteristic of cancerous tissues.

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110
Q

How do highly anaplastic cells compare to normal tissue?

A

Resemble undifferentiated or embryonic cells

This lack of resemblance to the tissue of origin is a hallmark of anaplasia.

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111
Q

What is the purpose of the grading system in cancer classification?

A

To classify and track changes in tumors

The grading system helps in assessing the aggressiveness of the tumor.

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112
Q

What factors are considered in the cytologic/histologic grading of tumors?

A

Degree of differentiation and number of proliferating cells

These factors determine how well the tumor cells resemble normal tissue.

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113
Q

What does a lower grade in tumor classification indicate?

A

Tumor cells resemble normal tissue cells more closely

Lower grades indicate better differentiation and less aggressiveness.

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114
Q

What is the grading scale for tumors?

A

I to IV

Grade I neoplasms are well differentiated, while grade IV are poorly differentiated/anaplastic.

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115
Q

What is the characteristic of grade I neoplasms?

A

Well differentiated

These tumors maintain more resemblance to normal tissue compared to higher grade tumors.

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116
Q

What is the characteristic of grade IV neoplasms?

A

Poorly differentiated/anaplastic

These tumors show significant loss of differentiation and resemble embryonic cells.

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117
Q

What is considered a hallmark of cancer?

A

Genetic instability

Genetic instability refers to an increased tendency of the genome to acquire mutations.

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118
Q

What protects cells from genetic errors under normal conditions?

A

Cellular mechanisms

These mechanisms include DNA repair systems, cell cycle checkpoints, and apoptosis.

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119
Q

What is the effect of cancer on genetic errors?

A

High frequency of genetic errors

This dysregulation contributes to genetic instability.

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120
Q

How does genetic instability contribute to cancer?

A

Promotes development and progression of cancer

Genetic instability can lead to the evolution of cancer cells.

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121
Q

What is aneuploidy?

A

Chromosomes are lost or gained

Aneuploidy is a common type of genetic instability in cancer cells.

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122
Q

What does intrachromosomal instability involve?

A

Insertions, deletions, and amplifications

This type of instability occurs within a single chromosome.

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123
Q

What is microsatellite instability?

A

Short, repetitive sequences of DNA

This instability is often associated with certain types of cancer, such as colorectal cancer.

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124
Q

What are point mutations?

A

Specific mutations usually affecting only a single nucleotide

Point mutations can lead to changes in protein function and are a common mutation type in cancer.

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125
Q

What does growth factor independence refer to?

A

The ability of cancer cells to proliferate even in the absence of growth factors.

This contrasts with normal cells, which require growth factors for growth.

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126
Q

Under standard conditions, what is required for cells to grow in cell culture?

A

The addition of growth factors.

Normal cells cannot grow without these factors.

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127
Q

How do cancer cells differ in their growth compared to normal cells?

A

Cancer cells can rapidly divide without the binding of growth factor to its receptor.

This allows them to proliferate in conditions that would typically inhibit normal cells.

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128
Q

What might some cancer cells do regarding growth factors?

A

Some cancer cells may produce their own growth factors.

This self-sufficiency further supports their uncontrolled growth.

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129
Q

What abnormalities may cancer cells have that affect growth signaling?

A

Abnormal receptors or signaling proteins.

These abnormalities can activate growth signaling pathways in the cells.

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130
Q

True or False: Normal cells can grow without any growth factors.

A

False.

Normal cells require growth factors to grow.

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131
Q

What is cell density-dependent inhibition?

A

The cessation of growth after cells reach a certain density.

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132
Q

What is another term for cell density-dependent inhibition?

A

Contact inhibition.

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133
Q

How do normal cells behave in relation to contact inhibition?

A

They usually stop growing when they come into contact with each other.

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134
Q

What is an example of contact inhibition in action?

A

During wound healing, tissue growth stops at the point where the edges of the wound come together.

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135
Q

Do cancer cells exhibit cell density-dependent inhibition?

A

No, cancer cells often lose this ability.

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136
Q

How do cancer cells behave in relation to adjacent tissue?

A

They grow rampantly without regard for adjacent tissue.

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137
Q

Fill in the blank: Cell density-dependent inhibition is often lost in _______.

A

[cancer cells]

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138
Q

True or False: Cancer cells stop growing when they come into contact with each other.

A

False.

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139
Q

What is lost when cell cohesiveness and adhesion are compromised?

A

Cells do not stick together

This loss of cohesiveness can lead to various pathological conditions, including cancer metastasis.

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140
Q

What happens to the surface cells of a tumor when cell adhesion is lost?

A

They shed into the surrounding body fluids or secretions

This process can contribute to tumor spread and the formation of secondary tumors.

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141
Q

What is anchorage dependence?

A

Anchorage dependence refers to the requirement of normal epithelial cells to be anchored to neighboring cells or the underlying matrix for survival and growth.

This is a critical mechanism that prevents uncontrolled cell growth.

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142
Q

What happens to normal epithelial cells when they become detached?

A

They undergo a type of apoptosis called anoikis.

Anoikis is derived from the Greek word for ‘homeless.’

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143
Q

What is anoikis?

A

Anoikis is a type of apoptosis that occurs when normal epithelial cells detach from their surroundings.

This process helps prevent cells from surviving in inappropriate environments.

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144
Q

How do cancer cells differ from normal epithelial cells regarding anchorage dependence?

A

Cancer cells can remain viable and multiply without normal attachments to other cells or the extracellular matrix.

This ability contributes to the uncontrolled growth characteristic of tumors.

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145
Q

True or False: Normal epithelial cells can grow and survive without being anchored to other cells or a matrix.

A

False

Normal epithelial cells require anchorage to survive, while cancer cells do not.

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146
Q

How is cell-to-cell communication affected in cancer cells?

A

Diminished

This diminishment interferes with intercellular connections and responsiveness to membrane-derived signals.

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147
Q

What is the impact of altered gap junction proteins in cancer?

A

Negatively impacts cell-to-cell communication

This alteration contributes to the diminished intercellular connections in cancer cells.

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148
Q

Fill in the blank: In cancer cells, intercellular connections and responsiveness to membrane-derived signals are _______.

A

diminished

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149
Q

True or False: Cancer cells exhibit enhanced cell-to-cell communication.

A

False

Cancer cells exhibit diminished cell-to-cell communication.

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150
Q

What is the normal life span of a cell harvested from the body?

A

A normal cell can only divide a limited number of times.

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151
Q

What happens to normal cells as they age?

A

They fail to divide further.

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152
Q

How do cancer cells differ from normal cells in terms of division?

A

Cancer cells tend to divide an infinite number of times.

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153
Q

What are telomeres?

A

Protective ‘end-caps’ on chromosomes.

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154
Q

What typically happens to telomeres with each cell division?

A

They shorten.

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155
Q

What enzyme do most cancer cells maintain high levels of?

A

Telomerase.

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156
Q

What is the function of telomerase?

A

It prevents telomere shortening.

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157
Q

What do older and more error-prone cells continue to do?

A

They continue to replicate.

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158
Q

What is a consequence of the replication of older cells?

A

It gives rise to cell populations of increasing levels of dysfunction.

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159
Q

True or False: Cancer cells can achieve immortality.

A

True.

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160
Q

What are antigens in the context of cancer cells?

A

Cell surface molecules that are immunologically different from normal tissue counterparts

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161
Q

How do cancer cells differ in antigen expression compared to normal cells?

A

Cancer cells often revert to embryonic patterns of gene expression, producing different antigens

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162
Q

Why are tumor antigens clinically useful?

A

They serve as identification markers for the presence, recurrence, or progressive growth of cancer

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163
Q

Fill in the blank: Cancer cells produce antigens that are _______ from the cells of the original tissue.

A

[far different]

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164
Q

True or False: The presence of abnormal markers in cancer cells can indicate progressive growth.

A

True

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165
Q

What substances do cancer cells produce?

A

Enzymes, hormones, and other substances

Cancer cells can produce these substances in larger amounts compared to normal tissues.

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166
Q

How do cancer cells differ from normal tissues in terms of production?

A

Cancer cells can overcome restrictions on production and secrete substances in much larger amounts

Normal tissues may not produce these substances or do so in much smaller amounts.

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167
Q

What additional capability do cancer cells have regarding hormones and enzymes?

A

They can secrete hormones or enzymes that promote metastasis

This ability contributes to the spread of cancer to other parts of the body.

168
Q

What are cytoskeletal changes in cancerous cells?

A

Abnormal intermediate filament types or changes in actin filaments and microtubules

These changes play a role in enhancing the invasive capabilities of cancer cells.

169
Q

How do cytoskeletal changes affect cancer cells?

A

They enhance their ability for invasion and metastasis

This is critical for the progression of cancer.

170
Q

What is the growth characteristic of normal cells?

A

Regulated

171
Q

What is the growth characteristic of cancer cells?

A

Unregulated

172
Q

Fill in the blank: Normal cells have _______ differentiation.

A

High

173
Q

Fill in the blank: Cancer cells have _______ differentiation.

A

Low

174
Q

What is the genetic stability of normal cells?

A

Stable

175
Q

What is the genetic stability of cancer cells?

A

Unstable

176
Q

Fill in the blank: Normal cells are _______ on growth factors.

A

Dependent

177
Q

Fill in the blank: Cancer cells are _______ on growth factors.

A

Independent

178
Q

What is the density-dependent inhibition characteristic of normal cells?

A

High

179
Q

What is the density-dependent inhibition characteristic of cancer cells?

A

Low

180
Q

What is the cell-to-cell adhesion characteristic of normal cells?

A

High

181
Q

What is the cell-to-cell adhesion characteristic of cancer cells?

A

Low

182
Q

What is the anchorage dependence of normal cells?

A

High

183
Q

What is the anchorage dependence of cancer cells?

A

Low

184
Q

What is the cell-to-cell communication characteristic of normal cells?

A

High

185
Q

What is the cell-to-cell communication characteristic of cancer cells?

A

Low

186
Q

Fill in the blank: Normal cells have a _______ life span.

A

Limited

187
Q

Fill in the blank: Cancer cells have an _______ life span.

A

Unlimited

188
Q

What is the antigen expression characteristic of normal cells?

A

Absent

189
Q

What is the antigen expression characteristic of cancer cells?

A

May be present

190
Q

Fill in the blank: Normal cells produce substances like proteases and hormones in a _______ manner.

A

Normal

191
Q

Fill in the blank: Cancer cells produce substances like proteases and hormones in an _______ manner.

A

Abnormal

192
Q

What is the cytoskeletal composition and arrangement of normal cells?

A

Normal

193
Q

What is the cytoskeletal composition and arrangement of cancer cells?

A

Abnormal

194
Q

How do benign tumors grow?

A

By expansion, usually in a capsule.

195
Q

What are the ways cancer spreads?

A

By direct invasion and extension, seeding, and metastasis.

196
Q

What does the word ‘cancer’ mean in Latin?

A

Crablike.

197
Q

Why is surgical removal of cancer often challenging?

A

There is no good line of demarcation separating the good tissue from the bad.

198
Q

What do surgeons do to ensure cancer-free margins?

A

Remove margins beyond the tumor.

199
Q

What does the presence of cancer-free margins indicate?

A

That cancer was likely completely removed.

200
Q

What does ‘seeding’ of cancer cells refer to?

A

The process of shed tumor cells entering circulation and moving into body cavities.

201
Q

Where does seeding most often occur?

A

Into the peritoneal cavity.

202
Q

What is a common condition that follows seeding in the peritoneal cavity?

A

Fluid accumulation, such as ascites or pleural effusion.

203
Q

What can happen to cancerous cells during surgical removal?

A

They may migrate into new body cavities.

204
Q

Fill in the blank: Cancer spreads in _______ projections.

A

crablike.

205
Q

True or False: Benign tumors invade surrounding tissues.

A

False.

206
Q

What does the term metastasis describe?

A

The development of a secondary tumor in a location distant from the primary tumor

The secondary tumor retains many characteristics of the primary tumor, aiding in identifying the original site.

207
Q

How can the primary tumor site be determined?

A

By analyzing characteristics of the secondary tumor

Some tumors metastasize early while others do so later.

208
Q

What are the two main pathways through which metastasis occurs?

A

Lymph channels and blood vessels

Each pathway has distinct implications for the spread of cancer.

209
Q

What is the sentinel node?

A

The first lymph node to which the primary tumor drains

It is crucial for determining the extent of disease spread.

210
Q

How does breast cancer typically spread?

A

By way of the lymph nodes

This is important for staging and treatment planning.

211
Q

What technique is used to determine the first lymph node affected by cancer?

A

Lymphatic mapping and sentinel lymph node biopsy

Involves injecting a radioactive tracer or blue dye into the tumor.

212
Q

What is the common site for metastatic spread of cancers originating in the GI tract, spleen, and pancreas?

A

The liver

This is due to the venous blood flow from these organs through the portal vein.

213
Q

What is the process by which cancer cells spread via blood vessels?

A

Hematogenous spread

Cancer cells enter the venous system that drains the primary neoplasm site.

214
Q

What must cancer cells do after entering the bloodstream to metastasize successfully?

A

Emerge at a favorable location, invade surrounding tissue, and establish a blood supply

This is crucial for continued tumor growth.

215
Q

What is angiogenesis?

A

The development of new blood vessels within a tumor

It is essential for tumor growth at distant sites.

216
Q

Fill in the blank: The first evidence of metastatic disease may be found in the _______.

A

lymph nodes

These nodes drain the tumor area and can indicate the spread of cancer.

217
Q

True or False: A secondary tumor can sometimes be found before the primary tumor is detected.

A

True

This can occur with certain cancers, such as malignant kidney tumors.

218
Q

What happens to cancer cells after they shed from the primary tumor?

A

They invade the surrounding extracellular matrix and gain access to a blood vessel

This is part of the multistep process of metastasis.

219
Q

What are the three factors that influence tissue growth in normal and cancerous tissue?

A
  1. The number of cells actively dividing or moving through the cell cycle
  2. The duration of the cell cycle
  3. The number of cells being lost relative to new cells being produced
220
Q

True or False: Cancer cells go through the cell cycle at a faster rate than normal cells.

A

False

Recent studies indicate that cancer cells go through the cell cycle at approximately the same rate as normal cells.

221
Q

What is the growth fraction?

A

The ratio of dividing cells to resting cells

222
Q

What is doubling time?

A

The length of time it takes for the total mass of cells in a tumor to double

223
Q

Fill in the blank: As the growth fraction increases, doubling time ______.

A

decreases

224
Q

What happens in normal adult tissues regarding cell death and cell renewal?

A

Equilibrium is maintained between cell death and cell renewal

225
Q

What characterizes the growth of cancer cells in relation to blood supply and nutrients?

A

Cancer cells continue to divide until their blood supply and nutrients are gone

226
Q

What is the significance of identifying a tumor as soon as possible?

A

To prevent undeterred growth of cancer cells

227
Q

What is the smallest tumor size that current screening imaging can detect?

A

0.2 cm

228
Q

True or False: Cancer cells have a prolonged lifespan and frequently enter the G0 phase.

A

False

Cancer cells seldom enter G0, leading to a greater percentage of them actively dividing.

229
Q

2.4 Etiology

A
230
Q

What are the two classifications of cancer-associated genes based on gene activity?

A

Gene overactivity and gene underactivity

231
Q

What are proto-oncogenes?

A

Normal genes that become cancer-causing oncogenes if mutated

232
Q

What role do proto-oncogenes play in the cell?

A

They provide signals that lead to cell division and regulate apoptosis

233
Q

What is a point mutation?

A

A single nucleotide base change due to an insertion, deletion, or substitution

234
Q

What is an example of a gene that undergoes point mutation leading to cancer?

A

ras gene

235
Q

What effect does a point mutation in the ras gene have?

A

It often causes an increase in cell proliferation

236
Q

What is chromosomal translocation?

A

The unusual movement or rearrangement of a segment of chromosomal DNA

237
Q

In which types of cancer are chromosomal translocations common?

A

Burkitt lymphoma and chronic myelogenous leukemia (CML)

238
Q

What happens to the myc proto-oncogene in Burkitt lymphoma?

A

It is translocated from chromosome 8 to chromosome 14

239
Q

What is gene amplification?

A

An unusual increase in the number of copies of a certain gene

240
Q

What is the consequence of gene amplification?

A

Unwanted over-expression of the gene leading to increased cell proliferation

241
Q

Which gene is often amplified in many breast cancers?

A

HER-2/neu gene

242
Q

What does amplification of the HER-2/neu gene indicate?

A

An aggressive tumor with a poor prognosis

243
Q

What is the role of tumor suppressor genes?

A

Tumor suppressor genes slow down cell division, repair DNA mistakes, or tell cells when to die.

244
Q

What occurs if the function of tumor suppressor genes is removed?

A

Unregulated growth can occur.

245
Q

What is breast cancer type 1 (BRCA1)?

A

A tumor suppressor gene involved in repairing damaged DNA.

246
Q

What happens if the BRCA1 gene is damaged?

A

Mistakes in DNA are not repaired properly, promoting the growth of faulty (cancerous) cells.

247
Q

Name a well-known tumor suppressor gene associated with several cancers.

A

TP53 gene.

248
Q

Which types of cancer is the TP53 gene associated with?

A

Lung, breast, and colon cancer.

249
Q

What are some molecular and cellular mechanisms that facilitate the development of cancer?

A

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.

250
Q

Fill in the blank: Tumor suppressor genes inhibit the _______ of cells in a tumor.

A

proliferation

251
Q

True or False: The presence of defects in DNA repair mechanisms can increase susceptibility to cancer.

A

True

252
Q

Fill in the blank: If tumor suppressor genes are functioning normally, they help to _______ cell division.

A

slow down

253
Q

What happens if DNA repair genes are flawed?

A

Cancer can result due to unchecked damage in tumor suppressor or apoptotic genes

Failure to repair damaged genes may give rise to proto-oncogenes or other abnormal activities within a cell.

254
Q

What can cause genetic damage?

A

Genetic damage may be caused by:
* Chemicals
* Radiation
* Viruses
* Inheritance from parent cell

A single-gene mutation is often insufficient to transform normal cells into cancer cells.

255
Q

What is required for cancerous transformation?

A

Activation of multiple independently mutated genes

A single-gene mutation alone typically does not lead to cancer.

256
Q

How can cancer cell growth become unregulated?

A

Mutations in genes that control growth factor signaling pathways

This involves changes that bypass normal regulations of cell growth.

257
Q

Describe the normal process of cell proliferation.

A

Involves:
* Binding of a growth factor to its receptor
* Activation of the receptor
* Signal transfer to the nucleus
* Initiation of DNA transcription
* Entry into the cell cycle

Any changes that disrupt this process can lead to unregulated growth.

258
Q

What role does apoptosis play in cancer?

A

Failure of cancer cells to undergo apoptosis contributes to cancer

This may be due to altered signaling, mutations, or immune cell failure.

259
Q

What factors may lead to failure of apoptosis in cancer cells?

A

Examples include:
* Altered cell survival signaling
* Overly active Ras proteins
* TP53 mutations
* Down-regulation of death receptors
* Stabilization of mitochondria
* Inactivation of proapoptotic proteins
* Immune cell failure

The mitochondrial membrane is a crucial regulator of cell death and survival balance.

260
Q

What is cellular senescence?

A

The process where cells stop dividing in response to DNA damage

Cancer cells can often bypass this signaling.

261
Q

How does telomerase relate to cancer cell growth?

A

High levels of telomerase prevent telomere shortening and promote continual cell growth

This also prevents cellular senescence.

262
Q

What is necessary for cancer cells to survive?

A

Development of new blood vessels (angiogenesis)

The molecular basis for the angiogenic switch is not fully understood.

263
Q

What are the two potential mechanisms involved in the angiogenic switch?

A

Involves:
* Increased production of angiogenic factors
* Loss of angiogenic inhibitors

Anti-angiogenesis therapy is a key cancer treatment.

264
Q

What is involved in the processes of invasion and metastasis in cancer?

A

Multiple genes and molecular pathways

Genetic programs present in stem cells during embryonic development may become operative in cancer stem cells.

265
Q

What characteristic do cancer stem cells exhibit regarding cell growth?

A

Anchorage-independent cell growth

This allows them to detach, cross tissue boundaries, and colonize new tissues.

266
Q

What are the three stages of cancer transformation?

A
  1. Initiation
  2. Promotion
  3. Progression
267
Q

What occurs during the initiation stage of cancer transformation?

A

Exposure of cells to a carcinogenic agent leading to irreversible alterations in the cellular genome

268
Q

What types of agents can cause initiation in cancer transformation?

A

Physical, chemical, or biologic agents

269
Q

How does repeated exposure to carcinogenic agents affect cells?

A

It may achieve the same effects as a single exposure of the same total amount

270
Q

Which cells are most susceptible to mutagenic changes?

A

Cells actively synthesizing DNA

271
Q

What is the main effect of the promotion stage in cancer transformation?

A

Abundant growth of cells triggered by growth factors or chemicals

272
Q

Is the promotion stage reversible?

A

Yes, if the promoter substance is removed

273
Q

Can initiated cells be promoted after a latency period?

A

Yes, initiated cells may be promoted even after long latency periods

274
Q

What factors influence the latency period in cancer promotion?

A

Type of agent, dosage, and characteristics of the target cells

275
Q

What characterizes the progression stage of cancer transformation?

A

Tumor cells become malignant with increased invasiveness and metastasis

276
Q

What are the characteristics of malignant cells during progression?

A

Heightened invasiveness, ability to metastasize, unregulated growth, and increased genomic alterations

277
Q

What are the main categories of risk factors linked to cancer?

A

Heredity, obesity, hormonal factors, immunologic mechanisms, environmental agents

Environmental agents include chemicals, radiation, and cancer-causing viruses.

278
Q

What is the relationship between heredity and breast cancer?

A

Breast cancer is more frequent in women with a family history of the disease

This includes grandmothers, mothers, aunts, or sisters who have had breast cancer.

279
Q

Which two tumor suppressor genes are linked to an increased risk of breast and ovarian cancer?

A

BRCA1 and BRCA2

Carriers of these mutations have significantly higher lifetime risks for breast and ovarian cancer.

280
Q

What is the lifetime risk of developing breast cancer for BRCA mutation carriers by age 85?

A

80%

The lifetime risk for ovarian cancer is 40-60% with BRCA1 and 10-20% with BRCA2.

281
Q

What type of inheritance is linked to other cancers besides breast and ovarian cancer?

A

Autosomal dominant inheritance

This typically involves a point mutation in a single allele of a tumor suppressor gene.

282
Q

What must happen for cancer to develop in individuals with an inherited mutation?

A

The normal gene must be inactivated through a somatic mutation

This is often required for tumors to develop, such as in retinoblastoma and familial adenomatous polyposis.

283
Q

What types of cancer have been linked to obesity?

A

Breast, endometrial, and prostate cancer

The relationship is multifactorial involving metabolic and immunologic mechanisms.

284
Q

How does obesity contribute to cancer development?

A

Through insulin resistance, increased sex hormone levels, and chronic inflammation

These factors can stimulate cell proliferation and inhibit apoptosis.

285
Q

What is the role of hormones in cancer development?

A

Hormones may promote cell division of malignant phenotypes

This association is particularly noted in breast, ovary, endometrium, and prostate cancers.

286
Q

What is the relationship between immune mechanisms and cancer?

A

Impairment in immune surveillance is associated with cancer development

Immunotherapy aims to enhance immune responses to detect and destroy tumors.

287
Q

What are tumor antigens?

A

Molecular determinants on tumor cells recognized by immune cells or antibodies

They enable the immune system to target and potentially eliminate cancer cells.

288
Q

What types of T lymphocytes are involved in detecting and eliminating cancer cells?

A

CD4+ helper T cells and CD8+ cytotoxic T cells

CD4+ cells signal the presence of cancer cells, while CD8+ cells eliminate them.

289
Q

True or False: People with immunodeficiency diseases have a higher rate of cancer.

A

True

This includes those on immunosuppressant drugs due to organ transplants.

290
Q

Fill in the blank: The decline in the surveillance capacity of the immune system has been associated with _______.

A

cancer

This highlights the importance of immune mechanisms in cancer detection and treatment.

291
Q

What is a carcinogen?

A

An agent capable of causing cancer.

292
Q

What are the two types of chemical carcinogens?

A
  • Direct-reacting agents
  • Indirect-reacting agents (procarcinogens or initiators)
293
Q

What do both direct and indirect carcinogens form that can bind to DNA, RNA, or proteins?

A

Highly reactive species (like free radicals).

294
Q

What is the role of promoters in carcinogenicity?

A

They may enhance the carcinogenicity of some chemicals.

295
Q

Name three lifestyle risk factors associated with chemical carcinogens.

A
  • Smoking
  • Dietary factors
  • Alcohol consumption
296
Q

What type of cancer is caused by cigarette smoke?

A
  • Lung cancer
  • Laryngeal cancer
  • Mouth cancer
  • Esophageal cancer
  • Pancreatic cancer
  • Liver cancer
  • Kidney cancer
  • Uterine cancer
  • Bladder cancer
297
Q

What percentage of all cancer deaths in the U.S. is attributed to tobacco use?

A

About 30%.

298
Q

What is the classification of environmental tobacco smoke by the U.S. Environmental Protection Agency?

A

Group A carcinogen.

299
Q

What are aflatoxins?

A

Natural dietary carcinogens occurring in plants.

300
Q

What carcinogen is produced when foods are fried in reused fat?

A

Benzo[a]pyrene.

301
Q

What are polycyclic aromatic hydrocarbons?

A

Potent carcinogens found in charcoal-broiled meats, smoked meats and fish, and tobacco smoke.

302
Q

How are nitrosamines formed?

A

In foods that are smoked, salted, cured, or pickled using nitrites or nitrates.

303
Q

What effect do antioxidants like vitamin C have on nitrosamines?

A

They may reduce the effects of nitrosamines.

304
Q

What dietary factors are associated with colon cancer?

A
  • High dietary fat
  • Red meat intake
  • Low dietary fiber intake
  • Obesity
  • Low physical activity
305
Q

What is the most toxic metabolite of ethanol?

A

Acetaldehyde.

306
Q

What mutations can acetaldehyde cause?

A

Point mutations in some cells.

307
Q

How does alcohol consumption affect the carcinogenic effects of cigarette smoke?

A

It enhances them.

308
Q

What is the relationship between dose and cancer risk?

A

The larger the dose or longer the duration of exposure, the greater the risk of cancer.

309
Q

What can promote the effects of some chemical carcinogens?

A

Viruses or radiation exposure.

310
Q

How long can it take for cancer to develop after exposure to carcinogenic agents?

A

Anywhere from 5 to 30 years.

311
Q

What was diethylstilbestrol used for?

A

To prevent miscarriages.

312
Q

What health issues were linked to in utero exposure to diethylstilbestrol?

A
  • Vaginal adenosis
  • Adenocarcinoma in young women
313
Q

What are Polycyclic Hydrocarbons associated with?

A

Soots, tars, and oils; cigarette smoke

These substances are known human carcinogens.

314
Q

Name three industrial agents that are considered carcinogenic.

A
  • Aniline and azo dyes
  • Arsenic compounds
  • Asbestos

Other agents include B-naphthylamine, benzene, benzo[a]pyrene, carbon tetrachloride, insecticides, fungicides, nickel and chromium compounds, polychlorinated biphenyls, and vinyl chloride.

315
Q

Fill in the blank: _______ is a known carcinogenic compound found in smoked foods.

A

Aflatoxin B

316
Q

What dietary factors are associated with increased cancer risk?

A
  • Smoked foods
  • High fat/low fiber diet
  • Alcohol

These factors can contribute to higher cancer risk in humans.

317
Q

Which drugs are classified as anticancer agents that may also be carcinogenic?

A
  • Alkylating agents
  • Cyclophosphamide
  • Chlorambucil
  • Nitrosourea

These drugs, while used in cancer treatment, have carcinogenic potential.

318
Q

True or False: Benzene is considered a carcinogenic industrial agent.

A

True

Benzene is listed among various industrial agents known for their carcinogenic properties.

319
Q

What are some examples of food-related carcinogens?

A
  • Nitrosamines
  • Aflatoxin B
  • Smoked foods

These substances are linked to dietary habits that may increase cancer risk.

320
Q

Fill in the blank: _______ compounds are associated with cancer risk in industrial settings.

A

Nickel and chromium

321
Q

What type of radiation is well documented in relation to cancer development?

A

Ionizing radiation

Particularly with the atomic bomb survivors

322
Q

What types of cancer were diagnosed at high rates among atomic bomb survivors?

A

Malignant epitheliomas of the skin and leukemia

Death rate from leukemia climbed to 30 times the normal rate between 1950 to 1970

323
Q

What factors influence the type of cancer that develops from ionizing radiation exposure?

A

Dose of radiation, gender, age at exposure

Younger exposure leads to earlier cancer development

324
Q

What cancers showed increased rates due to ionizing radiation exposure?

A

Breast, lung, stomach, thyroid, salivary gland, gastrointestinal, lymphoid tissue cancer

Includes leukemia as well

325
Q

What is the latency period for cancer development after exposure to ionizing radiation?

A

2-3 years for in utero exposure, 5-10 years after birth, 20 years for some solid tumors

Example: Children exposed in utero have increased leukemia risk

326
Q

What type of radiation has been linked to skin cancer for over 100 years?

A

Ultraviolet radiation

Particularly from sunlight

327
Q

Where does skin cancer most commonly develop due to UV exposure?

A

Areas frequently exposed to sunlight: head, neck, arms, hands, legs

The incidence is higher in people with light complexion

328
Q

How does skin pigmentation affect the incidence of skin cancer?

A

People with less melanin have a higher incidence of skin cancer

Melanin helps filter out ultraviolet rays

329
Q

Which regions have higher rates of skin cancer due to UV exposure?

A

Australia and the American Southwest

Related to intensity of exposure

330
Q

What is the relationship between the intensity of UV exposure and skin cancer incidence?

A

Higher intensity of exposure correlates with higher incidence

Effects of UV radiation are additive

331
Q

What type of sun exposure is more likely to cause melanoma?

A

Intense, episodic exposure during childhood

Compared to prolonged low-intensity exposure

332
Q

What is an oncogenic virus?

A

Any virus that has been shown to cause cancer

333
Q

What are the four DNA viruses linked to cancer in humans?

A
  • Human papillomavirus (HPV)
  • Epstein-Barr virus (EBV)
  • Human herpesvirus-8 (HHV-8)
  • Hepatitis B virus (HBV)
334
Q

How many genetically different types does HPV consist of?

A

Over 100

335
Q

Which HPV types are strongly associated with cervical cancer?

A
  • Type 16
  • Type 18
336
Q

What percentage of oropharyngeal cancers are associated with high-risk HPV?

A

At least 20%

337
Q

Cervical cancer can be viewed as a _______.

A

[sexually transmitted disease]

338
Q

What virus primarily targets B cells and is linked to several human cancers?

A

Epstein-Barr virus (EBV)

339
Q

What four human cancers are associated with EBV?

A
  • Burkitt lymphoma
  • Nasopharyngeal cancer
  • B-cell lymphomas in immunosuppressed individuals
  • Some cases of Hodgkin lymphoma
340
Q

What condition may an infected individual experience due to EBV?

A

Infectious mononucleosis (mono)

341
Q

What is HHV-8 associated with?

A

Kaposi sarcoma (KS)

342
Q

What type of cells does Kaposi sarcoma develop from?

A

Endothelial cells

343
Q

In what population does Kaposi sarcoma most frequently occur?

A

Immunosuppressed individuals

344
Q

What is the causative agent of hepatitis B?

A

Hepatitis B virus (HBV)

345
Q

What percentage of individuals infected with HBV progress to chronic liver damage?

A

15-25%

346
Q

What is the most frequent malignancy related to HIV infection?

A

Kaposi sarcoma (KS)

347
Q

What liver condition can develop due to HBV infection?

A

Hepatocellular carcinoma

348
Q

What percentage of hepatocellular cancers worldwide are due to HBV or HCV infection?

A

70-85%

349
Q

What is likely the cause of cancer development associated with HBV?

A

Prolonged HBV-induced liver damage and regeneration

350
Q

2.5 Clinical Manifestations, Diagnostics, and Treatments

A
351
Q

What is the effect of cancer on tissues?

A

Cancer disrupts the integrity of tissues, leading to bleeding, ulceration, and necrosis.

Bleeding can sometimes be the first sign of cancer, as seen in colorectal cancer.

352
Q

What initial signs can indicate the presence of certain cancers related to fluid?

A

Unusual amounts of fluid in the pleural, pericardial, or peritoneal spaces may indicate cancer.

Lung, breast, and lymphomas often present with pleural effusions.

353
Q

What is cancer anorexia-cachexia syndrome?

A

A syndrome associated with weight loss, muscle tissue wasting, weakness, anorexia, and anemia in cancer patients.

It occurs mainly with solid tumors, except in cases of breast cancer.

354
Q

What are common symptoms associated with cancer-related fatigue?

A

Tiredness, weakness, and lack of energy.

Symptoms can persist for months post-treatment.

355
Q

What causes cancer-related anemia?

A

Blood loss, hemolysis, or impaired red blood cell production.

It can also be due to the effects of cancer treatment.

356
Q

What are paraneoplastic syndromes?

A

Symptoms produced in sites not directly affected by cancer, often due to hormones secreted by cancer cells.

They can occasionally be seen with lung, breast, and hematologic malignancies.

357
Q

Name three common endocrine syndromes related to paraneoplastic syndromes.

A
  • Syndrome of inappropriate ADH secretion
  • Cushing syndrome due to ectopic ACTH production
  • Hypercalcemia
358
Q

True or False: Cancer treatment side effects can be as severe as the symptoms of the disease itself.

A

True

359
Q

What are common clinical manifestations of cancer?

A
  • Disruption of tissues
  • Fluid accumulation
  • Wasting syndrome
  • Fatigue
  • Anemia
  • Paraneoplastic syndromes
360
Q

Fill in the blank: The wasting syndrome associated with cancer is called _______.

A

cancer anorexia-cachexia syndrome

361
Q

What is a common consequence of cancer-related anemia?

A

Decreased performance and quality of life.

It can also lead to increased mortality and blood transfusions.

362
Q

What is the purpose of screening in cancer prevention?

A

Early detection of cancer

Screening is a secondary prevention strategy that improves outcomes by identifying cancers early.

363
Q

Name three methods used for cancer screening.

A
  • Observation
  • Palpation
  • Laboratory tests and procedures

Examples include skin observation, breast palpation, and tests like Pap smear and mammography.

364
Q

What is the significance of detecting cancer early?

A

Better outcomes are achieved

The sooner cancer is detected, the more effective treatment can be.

365
Q

What is the screening criteria for lung cancer?

A

20-pack per year smoker and age 50 or older

Annual low dose chest CT scan is recommended for this group.

366
Q

Is there a screening test for pancreatic cancer?

A

No, it still does not exist

Not all forms of cancer have available screening tests.

367
Q

List methods used to diagnose and stage cancer.

A
  • Blood tests for tumor markers
  • Cytologic studies
  • Tissue biopsy
  • Endoscopic examinations
  • Ultrasonography
  • X-ray studies
  • MRI
  • CT
  • PET scans

These methods vary based on the location and type of suspected cancer.

368
Q

How do tumor markers present themselves?

A
  • Antigens expressed on the surface of tumor cells
  • Substances released from normal cells in response to a tumor

Tumor markers include hormones and enzymes that indicate the presence of cancer.

369
Q

What is the role of tumor markers in cancer management?

A
  • Establishing prognosis
  • Monitoring treatment
  • Detecting recurrent disease

Tumor markers can help assess response to therapy and monitor for recurrence.

370
Q

What is the most well-known tumor marker for prostate cancer?

A

Prostate specific antigen (PSA)

PSA levels can be screened via a blood test.

371
Q

True or False: Most tumor markers are elevated in early stages of malignancy.

A

False

Most markers are not elevated in the early stages of cancer.

372
Q

Describe histologic and cytologic studies.

A

Laboratory methodologies to examine tissues and cells

These studies include cytologic smears, tissue biopsies, and needle aspiration.

373
Q

What is the purpose of the Papanicolaou (Pap) test?

A

Detect cancer cells

Commonly used for cervical cancer screening.

374
Q

What is tissue biopsy?

A

Removal of a tissue specimen for microscopic study

Essential for diagnosing the correct cancer and histology.

375
Q

What are the methods to obtain a biopsy?

A
  • Needle
  • Endoscopic methods
  • Laparoscopic methods
  • Excisional biopsy
  • Fine-needle aspiration

Different methods are used based on the tumor site.

376
Q

What is immunohistochemistry?

A

Technique using antibodies to identify specific cell products or surface markers

Important for accurately identifying cancer types and guiding treatment.

377
Q

What does microarray technology analyze?

A

Expression levels of a large number of genes

It detects molecular changes in cancer cells to determine behavior patterns.

378
Q

What are the two main strategies for classifying cancers?

A
  • Grading
  • Staging

Grading assesses cellular characteristics, while staging assesses the clinical spread of the disease.

379
Q

What does tumor grading involve?

A

Microscopic examination of cancer cells to determine differentiation

Cancers are classified as grades I, II, III, or IV.

380
Q

What is the TNM system used for?

A

Classifying cancer stages

Developed by the American Joint Committee on Cancer (AJCC), it uses Tumor, Nodes, and Metastasis components.

381
Q

What does ‘Tx’ signify in the TNM Classification System?

A

Tumor cannot be adequately assessed

‘Tx’ indicates that the primary tumor’s status cannot be determined.

382
Q

What does ‘T0’ represent in the TNM Classification System?

A

No evidence of primary tumor

‘T0’ indicates that there is no detectable primary tumor.

383
Q

What does ‘Tis’ indicate in the TNM Classification System?

A

Progressive increase in tumor size or involvement

‘Tis’ refers to a tumor that is in situ, meaning it has not invaded surrounding tissues.

384
Q

What does ‘Nx’ signify in the context of lymph nodes in the TNM Classification System?

A

Regional lymph nodes cannot be assessed

‘Nx’ indicates that the status of regional lymph nodes is unknown.

385
Q

What does ‘N0’ mean in the TNM Classification System?

A

No evidence of regional node metastasis

‘N0’ indicates that there are no cancerous cells in the nearby lymph nodes.

386
Q

What does ‘N1-3’ denote in the TNM Classification System?

A

Increasing involvement of regional lymph nodes

‘N1-3’ refers to various levels of metastasis to regional lymph nodes, with higher numbers indicating greater involvement.

387
Q

What does ‘Mx’ represent in the TNM Classification System?

A

Not assessed

‘Mx’ indicates that the presence of distant metastasis has not been evaluated.

388
Q

What does ‘M0’ signify in the TNM Classification System?

A

No distant metastasis

‘M0’ indicates that there is no spread of cancer to distant sites.

389
Q

What does ‘M1’ indicate in the TNM Classification System?

A

Distant metastasis present, specify sites

‘M1’ indicates that cancer has spread to distant sites, which need to be identified.

390
Q

What does the ‘T’ in the TNM Classification System refer to?

A

The size and local spread of the primary tumor

‘T’ assesses the characteristics of the primary tumor.

391
Q

What does the ‘N’ in the TNM Classification System indicate?

A

The involvement of the regional lymph nodes

‘N’ evaluates whether cancer has spread to nearby lymph nodes.

392
Q

What does the ‘M’ in the TNM Classification System represent?

A

The extent of the metastatic involvement

‘M’ assesses whether cancer has spread to distant parts of the body.

393
Q

What are the three categories of goals in cancer treatment methods?

A

Curative, control, and palliative

394
Q

List the common methods used to achieve cancer treatment goals.

A
  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormonal therapy
  • Biotherapy
395
Q

What factors influence the type of surgery performed for cancer treatment?

A
  • Extent of disease
  • Location
  • Structures involved
  • Tumor growth rate and invasiveness
  • Surgical risk to the patient
  • Quality of life post-surgery
396
Q

What is the primary purpose of surgery in cancer treatment?

A

To remove cancer, diagnose, stage, and provide palliation

397
Q

What is palliative surgery?

A

Surgery performed to relieve symptoms when a cure is not possible

398
Q

True or False: Radiation therapy can only be used as a primary treatment method.

A

False

399
Q

What are the primary effects of radiation therapy on cancer cells?

A

It destroys or damages cancer cells by creating free radicals and interrupting the cell cycle

400
Q

What is the most common side effect of radiation therapy?

A

Skin irritation

401
Q

How does chemotherapy work?

A

It uses drugs to prevent cell growth and replication by halting protein, DNA, and RNA synthesis

402
Q

Chemotherapy drugs can be classified into which two major categories?

A
  • Direct DNA-interacting agents
  • Indirect DNA-interacting agents
403
Q

What is an example of a cell-cycle specific chemotherapy drug?

A

Methotrexate

404
Q

What are common side effects of chemotherapy?

A
  • Neutropenia
  • Anemia
  • Thrombocytopenia
  • Anorexia
  • Nausea
  • Vomiting
  • Alopecia
405
Q

What is the goal of hormonal therapy in cancer treatment?

A

To deprive cancer cells of hormonal signals that stimulate division

406
Q

Which cancers are typically responsive to hormonal therapy?

A
  • Breast
  • Prostate
  • Endometrium
407
Q

What is biotherapy in cancer treatment?

A

It uses immunotherapy and biologic response modifiers to enhance the immune response to cancer

408
Q

What are monoclonal antibodies (mAbs)?

A

Highly specific antibodies made from cloned cells

409
Q

What is the role of rituximab in cancer treatment?

A

Targets CD20 antigen on B cells to treat non-Hodgkin lymphoma

410
Q

Fill in the blank: Chemotherapy is a _______ treatment that uses drugs to reach the tumor site.

A

systemic

411
Q

What is the function of anti-hormone drugs in hormonal therapy?

A

They bind to hormone receptors without stimulating them, blocking future signaling

412
Q

True or False: Radiation therapy exclusively targets cancer cells.

A

False

413
Q

What is the purpose of administering hematopoietic growth factors during chemotherapy?

A

To combat bone marrow suppression and restore blood cell levels

414
Q

What is the primary role of hormonal therapy in prostate cancer treatment?

A

To suppress circulating hormone levels or alter hormone receptors

415
Q

What are the primary types of drugs used in chemotherapy?

A
  • Alkylating agents
  • Antitumor antibiotics
  • Topoisomerase inhibitors
  • Antimetabolites
  • Mitotic spindle inhibitors

Patho (2 decks)

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