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.
2
Q
What does neoplasia mean?
A
Neoplasia means ‘new growth’
The new growth itself is referred to as a neoplasm.
3
Q
What is a neoplasm?
A
A neoplasm is a new growth that lacks normal regulatory controls over cell growth and division.
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.
5
Q
What are the three requirements for normal tissue renewal and repair?
A
- Proliferation
- Differentiation
- Apoptosis
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.
7
Q
What is differentiation?
A
Differentiation is the process by which cells become more specialized with each mitotic division.
8
Q
What is apoptosis?
A
Apoptosis is the process of controlled cell death that eliminates senescent, damaged, or unwanted cells.
9
Q
What regulates the beginning and end stages of a cell lifecycle?
A
The beginning (proliferation) and end stages (apoptosis) are carefully regulated.
10
Q
What do proto-oncogenes do?
A
Proto-oncogenes encode proteins that signal for the cell to proliferate.
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.
12
Q
True or False: Dysregulation of proto-oncogenes and tumor suppressor genes can lead to cancer.
A
True
13
Q
Fill in the blank: Neoplasms tend to have genetic abnormalities that cause excessive and uncontrolled _______.
A
proliferation
14
Q
What happens if cell growth becomes unregulated?
A
Tumor suppressor genes will initiate apoptotic events to eliminate potential tumor cells.
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.
16
Q
What are the four phases of the cell cycle?
A
- G1 (gap 1) * S phase * G2 (gap 2) * M phase
17
Q
What occurs during the G1 phase?
A
DNA synthesis stops, the cell enlarges, and both RNA and protein synthesis begins.
18
Q
What happens during the S phase?
A
DNA synthesis occurs, producing two separate sets of chromosomes.
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.
20
Q
What occurs during the G2 phase?
A
DNA synthesis stops while RNA/protein synthesis continues.
21
Q
What are the three phases referred to as interphase?
A
- G1 * S phase * G2
22
Q
What does the M phase consist of?
A
Mitosis and cytoplasmic division.
23
Q
What characterizes cells that continually divide?
A
They continue to cycle from one mitotic division to the next.
24
Q
What is the resting phase in the cell cycle called?
A
G0 phase.
25
When does a cell enter the G0 phase?
When nutrients or growth factors are unavailable or when highly specialized cells first leave the cell cycle.
26
Under what conditions can cells in G0 re-enter the cell cycle?
When nutrients become available or the cell receives stimuli via growth factors, hormones, or other signals.
27
Which cells may permanently stay in G0?
Highly specialized and terminally differentiated cells, like neurons.
28
What is cell proliferation?
The process of increasing cell numbers by mitotic cell division
29
How is tissue/organ structure and function maintained in normal tissues?
The number of new cells produced is equivalent to the number of cells dying or being shed
30
What happens to the balance of new vs old cells in most cases of cancer?
It becomes unregulated and unbalanced
31
What are the two major categories of human cells?
* Gametes (ovum and sperm)
* Somatic (non-reproductive) cells
32
What is the chromosome status of gametes?
Haploid, having only one set of chromosomes from one parent
33
What type of cells do gametes form after fusion?
Diploid cells containing both sets of chromosomes, which are somatic cells
34
How many various cell types can proliferate in the body?
Approximately 200
35
What are the three large groups of proliferating cells?
* 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
36
Which cells have high turnover rates and must be replaced continuously?
White blood cells and cells lining the GI tract
37
What typically stimulates increased cell reproduction in tissues?
Injury or loss of tissue
38
What is cell differentiation?
The process by which cells become more specialized in structure and function
39
What is an example of cell differentiation in the body?
Blood-forming cells in the bone marrow differentiate into specialized adult red blood cells
40
What factors influence how cells differentiate into various tissue and organ types?
* Specific genes
* Patterns of gene expression
* Chemical and environmental stimuli
41
Why must the rate of cellular reproduction and differentiation be controlled?
To ensure appropriate numbers and types of cells are formed
42
What happens as cells become more specialized?
They lose the ability to develop characteristics of other cell types
43
Why is it important to maintain the integrity of developing organs?
To avoid the presence of differing (and unwanted) cell types
44
What do specialized cells rely on when they are unable to divide?
Progenitor or parent cells of the same lineage that can still divide
45
Fill in the blank: The process of differentiation must be tightly regulated to ensure that cells do not differentiate into _______ cell types.
[non-target]
46
What distinguishes stem cells from progenitor cells?
Stem cells remain incompletely differentiated and dormant until needed
## Footnote
Progenitor cells are more differentiated and committed to specific lineages.
47
What happens when a stem cell divides?
One daughter cell retains stem cell characteristics, the other becomes a progenitor cell
## Footnote
The progenitor cell will eventually reach terminal differentiation.
48
Define self-renewal in the context of stem cells.
The ability of a stem cell to undergo numerous mitotic divisions while maintaining an undifferentiated state.
49
What does potency refer to in stem cells?
The differentiation potential of stem cells.
50
What are pluripotent stem cells often referred to as?
Master cells.
51
What is the differentiation capability of multipotent stem cells?
Can differentiate into only a few select types.
52
What defines unipotent stem cells?
Restricted to a single cell type but can maintain self-renewal.
53
What role do embryonic stem cells play?
They give rise to the three main germ layers: endoderm, mesoderm, and ectoderm.
54
What is the significance of adult stem cells?
Contribute to tissue regeneration and replacement of cells lost to apoptosis.
55
Fill in the blank: The three main germ layers formed by embryonic stem cells are _______.
endoderm, mesoderm, and ectoderm.
56
2.2 Cancer Terminology
57
What does the term oncology derive from?
The Greek word onkos, meaning 'swelling'
## Footnote
Oncology is the study or science of neoplasms.
58
What is a clinical oncologist responsible for?
Diagnosing and treating neoplasms in a clinical setting
## Footnote
Neoplasms refer to new cell growths.
59
What is the common term used to refer to a cancerous mass of cells?
Tumor
## Footnote
Neoplasm is the proper term, but tumor is commonly used.
60
What are the characteristics of benign neoplasms?
* Well-differentiated cells
* Resemble cells of tissues of origin
* Slow, progressive rate of growth
* Localized and not capable of metastasizing
## Footnote
They develop a fibrous capsule aiding in surgical removal.
61
How do benign tumors grow?
By expansion and remain localized to their site of origin
## Footnote
They can compress blood vessels or nerves, potentially interfering with vital functions.
62
What can benign tumors potentially interfere with?
Vital functions
## Footnote
For example, a benign brain tumor can cause death by compressing surrounding brain structures.
63
What are malignant neoplasms known for?
Invading and destroying tissue
## Footnote
They grow rapidly and can spread to other parts of the body.
64
How do malignant neoplasms typically spread?
Via the circulatory or lymphatic systems
## Footnote
They lack well-defined margins.
65
What is metastasis?
The process of cells detaching, invading surrounding tissue, and spreading to other sites
## Footnote
This is common in solid tumors.
66
What are the two broad categories of malignant neoplasms?
* Solid tumors
* Hematologic cancers
## Footnote
Solid tumors are initially confined to specific tissues; hematologic cancers involve blood and lymph cells.
67
What are the distinguishing traits between benign and malignant neoplasms?
* Cell characteristics
* Rate of growth
* Manner of growth
* Capacity to invade and metastasize
* Potential for causing death
## Footnote
These traits help differentiate between benign and malignant tumors.
68
True or False: Benign neoplasms can metastasize.
False
## Footnote
Benign neoplasms remain localized and do not spread.
69
What type of cells do benign neoplasms consist of?
Well-differentiated cells that resemble cells in the tissue of origin
## Footnote
Benign neoplasms maintain a resemblance to the originating tissue, which is a key characteristic.
70
What type of cells do malignant neoplasms consist of?
Undifferentiated cells, atypical structure that don’t look like cells in tissue of origin
## Footnote
Malignant neoplasms have a more chaotic structure and do not resemble the original tissue.
71
How does the rate of growth compare between benign and malignant neoplasms?
Benign: Progressive and slow; may stop or regress
Malignant: Variable; greater undifferentiation, more rapid the rate of growth
## Footnote
The growth rate of malignant neoplasms can vary widely, often being more aggressive than benign neoplasms.
72
What is the mode of growth for benign neoplasms?
Grows by expansion without invading surrounding tissues; usually encapsulated
## Footnote
Benign neoplasms typically remain localized and do not invade adjacent tissues.
73
What is the mode of growth for malignant neoplasms?
Grows by invasion, infiltrating the surrounding tissues
## Footnote
Malignant neoplasms can spread into nearby tissues, making them more dangerous.
74
Do benign neoplasms spread by metastasis?
Does not spread by metastasis
## Footnote
This is a major distinguishing feature of benign neoplasms, as they do not invade other parts of the body.
75
Do malignant neoplasms spread by metastasis?
Gains access to blood and lymph channels to metastasize to other areas of body
## Footnote
This ability to spread through the bloodstream or lymphatic system is a critical factor in the severity of malignant neoplasms.
76
What suffix is typically added to the tissue type to name tumors?
-oma
## Footnote
This suffix indicates the origin of the tumor.
77
What is an adenoma?
A benign tumor of glandular epithelial tissues
## Footnote
Adenomas arise from glandular tissues.
78
What is an osteoma?
A benign tumor of bone tissue
## Footnote
Osteomas are typically slow-growing and asymptomatic.
79
Define papilloma.
A benign finger-like projection that grows on any surface
## Footnote
Papillomas can occur in various locations, including skin and mucosal surfaces.
80
What is a carcinoma?
A malignant tumor of epithelial tissue origin
## Footnote
Carcinomas are the most common type of cancer.
81
What is an adenocarcinoma?
A malignant tumor of glandular epithelial tissues
## Footnote
Adenocarcinomas can occur in many organs, including the breast and prostate.
82
What is a sarcoma?
A malignant tumor of mesenchymal (multipotent) origin
## Footnote
Sarcomas are less common than carcinomas.
83
What is a polyp?
A growth that projects from a mucosal surface, such as the intestine
## Footnote
Polyps can be benign or malignant.
84
What is carcinoma in situ?
A localized pre-invasive lesion
## Footnote
These lesions can typically be surgically removed or treated.
85
What is an example of carcinoma in situ?
Breast ductal carcinoma in situ
## Footnote
In this condition, the cells have not crossed the basement membrane.
86
What is the curability rate of carcinoma in situ of the cervix?
Essentially 100% curable
## Footnote
Early detection and treatment are key factors.
87
What is the benign tumor of surface epithelial tissue?
Papilloma
## Footnote
This type of tumor has a characteristic finger-like appearance.
88
What is the malignant tumor of surface epithelial tissue?
Squamous cell carcinoma
## Footnote
It arises from squamous cells, which are flat cells found in the skin and lining of organs.
89
What is the malignant tumor of glandular epithelial tissue?
Adenocarcinoma
## Footnote
Adenocarcinomas are often associated with organs like the pancreas and lungs.
90
What is the benign tumor of fibrous connective tissue?
Fibroma
## Footnote
Fibromas are usually slow-growing and may not cause symptoms.
91
What is the malignant tumor of fibrous connective tissue?
Fibrosarcoma
## Footnote
Fibrosarcomas can occur in various locations and tend to be aggressive.
92
What is the benign tumor of adipose tissue?
Lipoma
## Footnote
Lipomas are soft, movable masses under the skin.
93
What is the malignant tumor of adipose tissue?
Liposarcoma
## Footnote
Liposarcomas can develop in deep soft tissues and can be aggressive.
94
What is the benign tumor of smooth muscle?
Leiomyoma
## Footnote
Leiomyomas are commonly found in the uterus.
95
What is the malignant tumor of smooth muscle?
Leiomyosarcoma
## Footnote
Leiomyosarcomas can occur in the uterus or other organs.
96
What is the benign tumor of nerve cells?
Neuroma
## Footnote
Neuromas may cause pain or discomfort depending on their location.
97
What is the malignant tumor of nerve cells?
Neuroblastoma
## Footnote
Neuroblastoma is most commonly seen in children.
98
What is the benign tumor of glial cells?
Glioma
## Footnote
Gliomas can vary in aggressiveness.
99
What is the malignant tumor of glial cells?
Glioblastoma/astrocytoma
## Footnote
These tumors are aggressive and often have a poor prognosis.
100
What is the malignant tumor of granulocytic hematologic tissue?
Myelocytic leukemia
## Footnote
This condition affects the blood and bone marrow.
101
What is the malignant tumor of lymphocytic hematologic tissue?
Lymphocytic leukemia/lymphoma
## Footnote
These malignancies involve the lymphatic system and blood.
102
What is the benign tumor of blood vessels?
Hemangioma
## Footnote
Hemangiomas are often found in infants and may resolve on their own.
103
What is the malignant tumor of blood vessels?
Hemangiosarcoma
## Footnote
Hemangiosarcoma is aggressive and often requires extensive treatment.
104
2.3 Cancer Cell Characteristics
105
What does anaplasia mean?
To form backward
## Footnote
Anaplasia describes the loss of cell differentiation in cancerous tissue.
106
What is pleomorphism in cancer cells?
Variations in size and shape of cells and nuclei
## Footnote
Pleomorphism is a condition observed in undifferentiated cancer cells.
107
What are the characteristics of chromatin in anaplastic cells?
Coarse and clumped
## Footnote
This abnormal chromatin structure is a common feature in cancerous tissues.
108
What is the significance of nucleoli in anaplastic cells?
Often larger than normal and contain an abnormal number of chromosomes
## Footnote
Changes in nucleoli size and chromosome number are indicative of aggressive cancer.
109
What is observed due to the high rate of proliferation in anaplastic cells?
Greater number of cells in mitosis
## Footnote
This reflects the rapid growth characteristic of cancerous tissues.
110
How do highly anaplastic cells compare to normal tissue?
Resemble undifferentiated or embryonic cells
## Footnote
This lack of resemblance to the tissue of origin is a hallmark of anaplasia.
111
What is the purpose of the grading system in cancer classification?
To classify and track changes in tumors
## Footnote
The grading system helps in assessing the aggressiveness of the tumor.
112
What factors are considered in the cytologic/histologic grading of tumors?
Degree of differentiation and number of proliferating cells
## Footnote
These factors determine how well the tumor cells resemble normal tissue.
113
What does a lower grade in tumor classification indicate?
Tumor cells resemble normal tissue cells more closely
## Footnote
Lower grades indicate better differentiation and less aggressiveness.
114
What is the grading scale for tumors?
I to IV
## Footnote
Grade I neoplasms are well differentiated, while grade IV are poorly differentiated/anaplastic.
115
What is the characteristic of grade I neoplasms?
Well differentiated
## Footnote
These tumors maintain more resemblance to normal tissue compared to higher grade tumors.
116
What is the characteristic of grade IV neoplasms?
Poorly differentiated/anaplastic
## Footnote
These tumors show significant loss of differentiation and resemble embryonic cells.
117
What is considered a hallmark of cancer?
Genetic instability
## Footnote
Genetic instability refers to an increased tendency of the genome to acquire mutations.
118
What protects cells from genetic errors under normal conditions?
Cellular mechanisms
## Footnote
These mechanisms include DNA repair systems, cell cycle checkpoints, and apoptosis.
119
What is the effect of cancer on genetic errors?
High frequency of genetic errors
## Footnote
This dysregulation contributes to genetic instability.
120
How does genetic instability contribute to cancer?
Promotes development and progression of cancer
## Footnote
Genetic instability can lead to the evolution of cancer cells.
121
What is aneuploidy?
Chromosomes are lost or gained
## Footnote
Aneuploidy is a common type of genetic instability in cancer cells.
122
What does intrachromosomal instability involve?
Insertions, deletions, and amplifications
## Footnote
This type of instability occurs within a single chromosome.
123
What is microsatellite instability?
Short, repetitive sequences of DNA
## Footnote
This instability is often associated with certain types of cancer, such as colorectal cancer.
124
What are point mutations?
Specific mutations usually affecting only a single nucleotide
## Footnote
Point mutations can lead to changes in protein function and are a common mutation type in cancer.
125
What does growth factor independence refer to?
The ability of cancer cells to proliferate even in the absence of growth factors.
## Footnote
This contrasts with normal cells, which require growth factors for growth.
126
Under standard conditions, what is required for cells to grow in cell culture?
The addition of growth factors.
## Footnote
Normal cells cannot grow without these factors.
127
How do cancer cells differ in their growth compared to normal cells?
Cancer cells can rapidly divide without the binding of growth factor to its receptor.
## Footnote
This allows them to proliferate in conditions that would typically inhibit normal cells.
128
What might some cancer cells do regarding growth factors?
Some cancer cells may produce their own growth factors.
## Footnote
This self-sufficiency further supports their uncontrolled growth.
129
What abnormalities may cancer cells have that affect growth signaling?
Abnormal receptors or signaling proteins.
## Footnote
These abnormalities can activate growth signaling pathways in the cells.
130
True or False: Normal cells can grow without any growth factors.
False.
## Footnote
Normal cells require growth factors to grow.
131
What is cell density-dependent inhibition?
The cessation of growth after cells reach a certain density.
132
What is another term for cell density-dependent inhibition?
Contact inhibition.
133
How do normal cells behave in relation to contact inhibition?
They usually stop growing when they come into contact with each other.
134
What is an example of contact inhibition in action?
During wound healing, tissue growth stops at the point where the edges of the wound come together.
135
Do cancer cells exhibit cell density-dependent inhibition?
No, cancer cells often lose this ability.
136
How do cancer cells behave in relation to adjacent tissue?
They grow rampantly without regard for adjacent tissue.
137
Fill in the blank: Cell density-dependent inhibition is often lost in _______.
[cancer cells]
138
True or False: Cancer cells stop growing when they come into contact with each other.
False.
139
What is lost when cell cohesiveness and adhesion are compromised?
Cells do not stick together
## Footnote
This loss of cohesiveness can lead to various pathological conditions, including cancer metastasis.
140
What happens to the surface cells of a tumor when cell adhesion is lost?
They shed into the surrounding body fluids or secretions
## Footnote
This process can contribute to tumor spread and the formation of secondary tumors.
141
What is anchorage dependence?
Anchorage dependence refers to the requirement of normal epithelial cells to be anchored to neighboring cells or the underlying matrix for survival and growth.
## Footnote
This is a critical mechanism that prevents uncontrolled cell growth.
142
What happens to normal epithelial cells when they become detached?
They undergo a type of apoptosis called anoikis.
## Footnote
Anoikis is derived from the Greek word for 'homeless.'
143
What is anoikis?
Anoikis is a type of apoptosis that occurs when normal epithelial cells detach from their surroundings.
## Footnote
This process helps prevent cells from surviving in inappropriate environments.
144
How do cancer cells differ from normal epithelial cells regarding anchorage dependence?
Cancer cells can remain viable and multiply without normal attachments to other cells or the extracellular matrix.
## Footnote
This ability contributes to the uncontrolled growth characteristic of tumors.
145
True or False: Normal epithelial cells can grow and survive without being anchored to other cells or a matrix.
False
## Footnote
Normal epithelial cells require anchorage to survive, while cancer cells do not.
146
How is cell-to-cell communication affected in cancer cells?
Diminished
## Footnote
This diminishment interferes with intercellular connections and responsiveness to membrane-derived signals.
147
What is the impact of altered gap junction proteins in cancer?
Negatively impacts cell-to-cell communication
## Footnote
This alteration contributes to the diminished intercellular connections in cancer cells.
148
Fill in the blank: In cancer cells, intercellular connections and responsiveness to membrane-derived signals are _______.
diminished
149
True or False: Cancer cells exhibit enhanced cell-to-cell communication.
False
## Footnote
Cancer cells exhibit diminished cell-to-cell communication.
150
What is the normal life span of a cell harvested from the body?
A normal cell can only divide a limited number of times.
151
What happens to normal cells as they age?
They fail to divide further.
152
How do cancer cells differ from normal cells in terms of division?
Cancer cells tend to divide an infinite number of times.
153
What are telomeres?
Protective ‘end-caps’ on chromosomes.
154
What typically happens to telomeres with each cell division?
They shorten.
155
What enzyme do most cancer cells maintain high levels of?
Telomerase.
156
What is the function of telomerase?
It prevents telomere shortening.
157
What do older and more error-prone cells continue to do?
They continue to replicate.
158
What is a consequence of the replication of older cells?
It gives rise to cell populations of increasing levels of dysfunction.
159
True or False: Cancer cells can achieve immortality.
True.
160
What are antigens in the context of cancer cells?
Cell surface molecules that are immunologically different from normal tissue counterparts
161
How do cancer cells differ in antigen expression compared to normal cells?
Cancer cells often revert to embryonic patterns of gene expression, producing different antigens
162
Why are tumor antigens clinically useful?
They serve as identification markers for the presence, recurrence, or progressive growth of cancer
163
Fill in the blank: Cancer cells produce antigens that are _______ from the cells of the original tissue.
[far different]
164
True or False: The presence of abnormal markers in cancer cells can indicate progressive growth.
True
165
What substances do cancer cells produce?
Enzymes, hormones, and other substances
## Footnote
Cancer cells can produce these substances in larger amounts compared to normal tissues.
166
How do cancer cells differ from normal tissues in terms of production?
Cancer cells can overcome restrictions on production and secrete substances in much larger amounts
## Footnote
Normal tissues may not produce these substances or do so in much smaller amounts.
167
What additional capability do cancer cells have regarding hormones and enzymes?
They can secrete hormones or enzymes that promote metastasis
## Footnote
This ability contributes to the spread of cancer to other parts of the body.
168
What are cytoskeletal changes in cancerous cells?
Abnormal intermediate filament types or changes in actin filaments and microtubules
## Footnote
These changes play a role in enhancing the invasive capabilities of cancer cells.
169
How do cytoskeletal changes affect cancer cells?
They enhance their ability for invasion and metastasis
## Footnote
This is critical for the progression of cancer.
170
What is the growth characteristic of normal cells?
Regulated
171
What is the growth characteristic of cancer cells?
Unregulated
172
Fill in the blank: Normal cells have _______ differentiation.
High
173
Fill in the blank: Cancer cells have _______ differentiation.
Low
174
What is the genetic stability of normal cells?
Stable
175
What is the genetic stability of cancer cells?
Unstable
176
Fill in the blank: Normal cells are _______ on growth factors.
Dependent
177
Fill in the blank: Cancer cells are _______ on growth factors.
Independent
178
What is the density-dependent inhibition characteristic of normal cells?
High
179
What is the density-dependent inhibition characteristic of cancer cells?
Low
180
What is the cell-to-cell adhesion characteristic of normal cells?
High
181
What is the cell-to-cell adhesion characteristic of cancer cells?
Low
182
What is the anchorage dependence of normal cells?
High
183
What is the anchorage dependence of cancer cells?
Low
184
What is the cell-to-cell communication characteristic of normal cells?
High
185
What is the cell-to-cell communication characteristic of cancer cells?
Low
186
Fill in the blank: Normal cells have a _______ life span.
Limited
187
Fill in the blank: Cancer cells have an _______ life span.
Unlimited
188
What is the antigen expression characteristic of normal cells?
Absent
189
What is the antigen expression characteristic of cancer cells?
May be present
190
Fill in the blank: Normal cells produce substances like proteases and hormones in a _______ manner.
Normal
191
Fill in the blank: Cancer cells produce substances like proteases and hormones in an _______ manner.
Abnormal
192
What is the cytoskeletal composition and arrangement of normal cells?
Normal
193
What is the cytoskeletal composition and arrangement of cancer cells?
Abnormal
194
How do benign tumors grow?
By expansion, usually in a capsule.
195
What are the ways cancer spreads?
By direct invasion and extension, seeding, and metastasis.
196
What does the word 'cancer' mean in Latin?
Crablike.
197
Why is surgical removal of cancer often challenging?
There is no good line of demarcation separating the good tissue from the bad.
198
What do surgeons do to ensure cancer-free margins?
Remove margins beyond the tumor.
199
What does the presence of cancer-free margins indicate?
That cancer was likely completely removed.
200
What does 'seeding' of cancer cells refer to?
The process of shed tumor cells entering circulation and moving into body cavities.
201
Where does seeding most often occur?
Into the peritoneal cavity.
202
What is a common condition that follows seeding in the peritoneal cavity?
Fluid accumulation, such as ascites or pleural effusion.
203
What can happen to cancerous cells during surgical removal?
They may migrate into new body cavities.
204
Fill in the blank: Cancer spreads in _______ projections.
crablike.
205
True or False: Benign tumors invade surrounding tissues.
False.
206
What does the term metastasis describe?
The development of a secondary tumor in a location distant from the primary tumor
## Footnote
The secondary tumor retains many characteristics of the primary tumor, aiding in identifying the original site.
207
How can the primary tumor site be determined?
By analyzing characteristics of the secondary tumor
## Footnote
Some tumors metastasize early while others do so later.
208
What are the two main pathways through which metastasis occurs?
Lymph channels and blood vessels
## Footnote
Each pathway has distinct implications for the spread of cancer.
209
What is the sentinel node?
The first lymph node to which the primary tumor drains
## Footnote
It is crucial for determining the extent of disease spread.
210
How does breast cancer typically spread?
By way of the lymph nodes
## Footnote
This is important for staging and treatment planning.
211
What technique is used to determine the first lymph node affected by cancer?
Lymphatic mapping and sentinel lymph node biopsy
## Footnote
Involves injecting a radioactive tracer or blue dye into the tumor.
212
What is the common site for metastatic spread of cancers originating in the GI tract, spleen, and pancreas?
The liver
## Footnote
This is due to the venous blood flow from these organs through the portal vein.
213
What is the process by which cancer cells spread via blood vessels?
Hematogenous spread
## Footnote
Cancer cells enter the venous system that drains the primary neoplasm site.
214
What must cancer cells do after entering the bloodstream to metastasize successfully?
Emerge at a favorable location, invade surrounding tissue, and establish a blood supply
## Footnote
This is crucial for continued tumor growth.
215
What is angiogenesis?
The development of new blood vessels within a tumor
## Footnote
It is essential for tumor growth at distant sites.
216
Fill in the blank: The first evidence of metastatic disease may be found in the _______.
lymph nodes
## Footnote
These nodes drain the tumor area and can indicate the spread of cancer.
217
True or False: A secondary tumor can sometimes be found before the primary tumor is detected.
True
## Footnote
This can occur with certain cancers, such as malignant kidney tumors.
218
What happens to cancer cells after they shed from the primary tumor?
They invade the surrounding extracellular matrix and gain access to a blood vessel
## Footnote
This is part of the multistep process of metastasis.
219
What are the three factors that influence tissue growth in normal and cancerous tissue?
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
True or False: Cancer cells go through the cell cycle at a faster rate than normal cells.
False
## Footnote
Recent studies indicate that cancer cells go through the cell cycle at approximately the same rate as normal cells.
221
What is the growth fraction?
The ratio of dividing cells to resting cells
222
What is doubling time?
The length of time it takes for the total mass of cells in a tumor to double
223
Fill in the blank: As the growth fraction increases, doubling time ______.
decreases
224
What happens in normal adult tissues regarding cell death and cell renewal?
Equilibrium is maintained between cell death and cell renewal
225
What characterizes the growth of cancer cells in relation to blood supply and nutrients?
Cancer cells continue to divide until their blood supply and nutrients are gone
226
What is the significance of identifying a tumor as soon as possible?
To prevent undeterred growth of cancer cells
227
What is the smallest tumor size that current screening imaging can detect?
0.2 cm
228
True or False: Cancer cells have a prolonged lifespan and frequently enter the G0 phase.
False
## Footnote
Cancer cells seldom enter G0, leading to a greater percentage of them actively dividing.
229
2.4 Etiology
230
What are the two classifications of cancer-associated genes based on gene activity?
Gene overactivity and gene underactivity
231
What are proto-oncogenes?
Normal genes that become cancer-causing oncogenes if mutated
232
What role do proto-oncogenes play in the cell?
They provide signals that lead to cell division and regulate apoptosis
233
What is a point mutation?
A single nucleotide base change due to an insertion, deletion, or substitution
234
What is an example of a gene that undergoes point mutation leading to cancer?
ras gene
235
What effect does a point mutation in the ras gene have?
It often causes an increase in cell proliferation
236
What is chromosomal translocation?
The unusual movement or rearrangement of a segment of chromosomal DNA
237
In which types of cancer are chromosomal translocations common?
Burkitt lymphoma and chronic myelogenous leukemia (CML)
238
What happens to the myc proto-oncogene in Burkitt lymphoma?
It is translocated from chromosome 8 to chromosome 14
239
What is gene amplification?
An unusual increase in the number of copies of a certain gene
240
What is the consequence of gene amplification?
Unwanted over-expression of the gene leading to increased cell proliferation
241
Which gene is often amplified in many breast cancers?
HER-2/neu gene
242
What does amplification of the HER-2/neu gene indicate?
An aggressive tumor with a poor prognosis
243
What is the role of tumor suppressor genes?
Tumor suppressor genes slow down cell division, repair DNA mistakes, or tell cells when to die.
244
What occurs if the function of tumor suppressor genes is removed?
Unregulated growth can occur.
245
What is breast cancer type 1 (BRCA1)?
A tumor suppressor gene involved in repairing damaged DNA.
246
What happens if the BRCA1 gene is damaged?
Mistakes in DNA are not repaired properly, promoting the growth of faulty (cancerous) cells.
247
Name a well-known tumor suppressor gene associated with several cancers.
TP53 gene.
248
Which types of cancer is the TP53 gene associated with?
Lung, breast, and colon cancer.
249
What are some molecular and cellular mechanisms that facilitate the development of cancer?
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
Fill in the blank: Tumor suppressor genes inhibit the _______ of cells in a tumor.
proliferation
251
True or False: The presence of defects in DNA repair mechanisms can increase susceptibility to cancer.
True
252
Fill in the blank: If tumor suppressor genes are functioning normally, they help to _______ cell division.
slow down
253
What happens if DNA repair genes are flawed?
Cancer can result due to unchecked damage in tumor suppressor or apoptotic genes
## Footnote
Failure to repair damaged genes may give rise to proto-oncogenes or other abnormal activities within a cell.
254
What can cause genetic damage?
Genetic damage may be caused by:
* Chemicals
* Radiation
* Viruses
* Inheritance from parent cell
## Footnote
A single-gene mutation is often insufficient to transform normal cells into cancer cells.
255
What is required for cancerous transformation?
Activation of multiple independently mutated genes
## Footnote
A single-gene mutation alone typically does not lead to cancer.
256
How can cancer cell growth become unregulated?
Mutations in genes that control growth factor signaling pathways
## Footnote
This involves changes that bypass normal regulations of cell growth.
257
Describe the normal process of cell proliferation.
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
## Footnote
Any changes that disrupt this process can lead to unregulated growth.
258
What role does apoptosis play in cancer?
Failure of cancer cells to undergo apoptosis contributes to cancer
## Footnote
This may be due to altered signaling, mutations, or immune cell failure.
259
What factors may lead to failure of apoptosis in cancer cells?
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
## Footnote
The mitochondrial membrane is a crucial regulator of cell death and survival balance.
260
What is cellular senescence?
The process where cells stop dividing in response to DNA damage
## Footnote
Cancer cells can often bypass this signaling.
261
How does telomerase relate to cancer cell growth?
High levels of telomerase prevent telomere shortening and promote continual cell growth
## Footnote
This also prevents cellular senescence.
262
What is necessary for cancer cells to survive?
Development of new blood vessels (angiogenesis)
## Footnote
The molecular basis for the angiogenic switch is not fully understood.
263
What are the two potential mechanisms involved in the angiogenic switch?
Involves:
* Increased production of angiogenic factors
* Loss of angiogenic inhibitors
## Footnote
Anti-angiogenesis therapy is a key cancer treatment.
264
What is involved in the processes of invasion and metastasis in cancer?
Multiple genes and molecular pathways
## Footnote
Genetic programs present in stem cells during embryonic development may become operative in cancer stem cells.
265
What characteristic do cancer stem cells exhibit regarding cell growth?
Anchorage-independent cell growth
## Footnote
This allows them to detach, cross tissue boundaries, and colonize new tissues.
266
What are the three stages of cancer transformation?
1. Initiation
2. Promotion
3. Progression
267
What occurs during the initiation stage of cancer transformation?
Exposure of cells to a carcinogenic agent leading to irreversible alterations in the cellular genome
268
What types of agents can cause initiation in cancer transformation?
Physical, chemical, or biologic agents
269
How does repeated exposure to carcinogenic agents affect cells?
It may achieve the same effects as a single exposure of the same total amount
270
Which cells are most susceptible to mutagenic changes?
Cells actively synthesizing DNA
271
What is the main effect of the promotion stage in cancer transformation?
Abundant growth of cells triggered by growth factors or chemicals
272
Is the promotion stage reversible?
Yes, if the promoter substance is removed
273
Can initiated cells be promoted after a latency period?
Yes, initiated cells may be promoted even after long latency periods
274
What factors influence the latency period in cancer promotion?
Type of agent, dosage, and characteristics of the target cells
275
What characterizes the progression stage of cancer transformation?
Tumor cells become malignant with increased invasiveness and metastasis
276
What are the characteristics of malignant cells during progression?
Heightened invasiveness, ability to metastasize, unregulated growth, and increased genomic alterations
277
What are the main categories of risk factors linked to cancer?
Heredity, obesity, hormonal factors, immunologic mechanisms, environmental agents
## Footnote
Environmental agents include chemicals, radiation, and cancer-causing viruses.
278
What is the relationship between heredity and breast cancer?
Breast cancer is more frequent in women with a family history of the disease
## Footnote
This includes grandmothers, mothers, aunts, or sisters who have had breast cancer.
279
Which two tumor suppressor genes are linked to an increased risk of breast and ovarian cancer?
BRCA1 and BRCA2
## Footnote
Carriers of these mutations have significantly higher lifetime risks for breast and ovarian cancer.
280
What is the lifetime risk of developing breast cancer for BRCA mutation carriers by age 85?
80%
## Footnote
The lifetime risk for ovarian cancer is 40-60% with BRCA1 and 10-20% with BRCA2.
281
What type of inheritance is linked to other cancers besides breast and ovarian cancer?
Autosomal dominant inheritance
## Footnote
This typically involves a point mutation in a single allele of a tumor suppressor gene.
282
What must happen for cancer to develop in individuals with an inherited mutation?
The normal gene must be inactivated through a somatic mutation
## Footnote
This is often required for tumors to develop, such as in retinoblastoma and familial adenomatous polyposis.
283
What types of cancer have been linked to obesity?
Breast, endometrial, and prostate cancer
## Footnote
The relationship is multifactorial involving metabolic and immunologic mechanisms.
284
How does obesity contribute to cancer development?
Through insulin resistance, increased sex hormone levels, and chronic inflammation
## Footnote
These factors can stimulate cell proliferation and inhibit apoptosis.
285
What is the role of hormones in cancer development?
Hormones may promote cell division of malignant phenotypes
## Footnote
This association is particularly noted in breast, ovary, endometrium, and prostate cancers.
286
What is the relationship between immune mechanisms and cancer?
Impairment in immune surveillance is associated with cancer development
## Footnote
Immunotherapy aims to enhance immune responses to detect and destroy tumors.
287
What are tumor antigens?
Molecular determinants on tumor cells recognized by immune cells or antibodies
## Footnote
They enable the immune system to target and potentially eliminate cancer cells.
288
What types of T lymphocytes are involved in detecting and eliminating cancer cells?
CD4+ helper T cells and CD8+ cytotoxic T cells
## Footnote
CD4+ cells signal the presence of cancer cells, while CD8+ cells eliminate them.
289
True or False: People with immunodeficiency diseases have a higher rate of cancer.
True
## Footnote
This includes those on immunosuppressant drugs due to organ transplants.
290
Fill in the blank: The decline in the surveillance capacity of the immune system has been associated with _______.
cancer
## Footnote
This highlights the importance of immune mechanisms in cancer detection and treatment.
291
What is a carcinogen?
An agent capable of causing cancer.
292
What are the two types of chemical carcinogens?
* Direct-reacting agents
* Indirect-reacting agents (procarcinogens or initiators)
293
What do both direct and indirect carcinogens form that can bind to DNA, RNA, or proteins?
Highly reactive species (like free radicals).
294
What is the role of promoters in carcinogenicity?
They may enhance the carcinogenicity of some chemicals.
295
Name three lifestyle risk factors associated with chemical carcinogens.
* Smoking
* Dietary factors
* Alcohol consumption
296
What type of cancer is caused by cigarette smoke?
* Lung cancer
* Laryngeal cancer
* Mouth cancer
* Esophageal cancer
* Pancreatic cancer
* Liver cancer
* Kidney cancer
* Uterine cancer
* Bladder cancer
297
What percentage of all cancer deaths in the U.S. is attributed to tobacco use?
About 30%.
298
What is the classification of environmental tobacco smoke by the U.S. Environmental Protection Agency?
Group A carcinogen.
299
What are aflatoxins?
Natural dietary carcinogens occurring in plants.
300
What carcinogen is produced when foods are fried in reused fat?
Benzo[a]pyrene.
301
What are polycyclic aromatic hydrocarbons?
Potent carcinogens found in charcoal-broiled meats, smoked meats and fish, and tobacco smoke.
302
How are nitrosamines formed?
In foods that are smoked, salted, cured, or pickled using nitrites or nitrates.
303
What effect do antioxidants like vitamin C have on nitrosamines?
They may reduce the effects of nitrosamines.
304
What dietary factors are associated with colon cancer?
* High dietary fat
* Red meat intake
* Low dietary fiber intake
* Obesity
* Low physical activity
305
What is the most toxic metabolite of ethanol?
Acetaldehyde.
306
What mutations can acetaldehyde cause?
Point mutations in some cells.
307
How does alcohol consumption affect the carcinogenic effects of cigarette smoke?
It enhances them.
308
What is the relationship between dose and cancer risk?
The larger the dose or longer the duration of exposure, the greater the risk of cancer.
309
What can promote the effects of some chemical carcinogens?
Viruses or radiation exposure.
310
How long can it take for cancer to develop after exposure to carcinogenic agents?
Anywhere from 5 to 30 years.
311
What was diethylstilbestrol used for?
To prevent miscarriages.
312
What health issues were linked to in utero exposure to diethylstilbestrol?
* Vaginal adenosis
* Adenocarcinoma in young women
313
What are Polycyclic Hydrocarbons associated with?
Soots, tars, and oils; cigarette smoke
## Footnote
These substances are known human carcinogens.
314
Name three industrial agents that are considered carcinogenic.
* Aniline and azo dyes
* Arsenic compounds
* Asbestos
## Footnote
Other agents include B-naphthylamine, benzene, benzo[a]pyrene, carbon tetrachloride, insecticides, fungicides, nickel and chromium compounds, polychlorinated biphenyls, and vinyl chloride.
315
Fill in the blank: _______ is a known carcinogenic compound found in smoked foods.
Aflatoxin B
316
What dietary factors are associated with increased cancer risk?
* Smoked foods
* High fat/low fiber diet
* Alcohol
## Footnote
These factors can contribute to higher cancer risk in humans.
317
Which drugs are classified as anticancer agents that may also be carcinogenic?
* Alkylating agents
* Cyclophosphamide
* Chlorambucil
* Nitrosourea
## Footnote
These drugs, while used in cancer treatment, have carcinogenic potential.
318
True or False: Benzene is considered a carcinogenic industrial agent.
True
## Footnote
Benzene is listed among various industrial agents known for their carcinogenic properties.
319
What are some examples of food-related carcinogens?
* Nitrosamines
* Aflatoxin B
* Smoked foods
## Footnote
These substances are linked to dietary habits that may increase cancer risk.
320
Fill in the blank: _______ compounds are associated with cancer risk in industrial settings.
Nickel and chromium
321
What type of radiation is well documented in relation to cancer development?
Ionizing radiation
## Footnote
Particularly with the atomic bomb survivors
322
What types of cancer were diagnosed at high rates among atomic bomb survivors?
Malignant epitheliomas of the skin and leukemia
## Footnote
Death rate from leukemia climbed to 30 times the normal rate between 1950 to 1970
323
What factors influence the type of cancer that develops from ionizing radiation exposure?
Dose of radiation, gender, age at exposure
## Footnote
Younger exposure leads to earlier cancer development
324
What cancers showed increased rates due to ionizing radiation exposure?
Breast, lung, stomach, thyroid, salivary gland, gastrointestinal, lymphoid tissue cancer
## Footnote
Includes leukemia as well
325
What is the latency period for cancer development after exposure to ionizing radiation?
2-3 years for in utero exposure, 5-10 years after birth, 20 years for some solid tumors
## Footnote
Example: Children exposed in utero have increased leukemia risk
326
What type of radiation has been linked to skin cancer for over 100 years?
Ultraviolet radiation
## Footnote
Particularly from sunlight
327
Where does skin cancer most commonly develop due to UV exposure?
Areas frequently exposed to sunlight: head, neck, arms, hands, legs
## Footnote
The incidence is higher in people with light complexion
328
How does skin pigmentation affect the incidence of skin cancer?
People with less melanin have a higher incidence of skin cancer
## Footnote
Melanin helps filter out ultraviolet rays
329
Which regions have higher rates of skin cancer due to UV exposure?
Australia and the American Southwest
## Footnote
Related to intensity of exposure
330
What is the relationship between the intensity of UV exposure and skin cancer incidence?
Higher intensity of exposure correlates with higher incidence
## Footnote
Effects of UV radiation are additive
331
What type of sun exposure is more likely to cause melanoma?
Intense, episodic exposure during childhood
## Footnote
Compared to prolonged low-intensity exposure
332
What is an oncogenic virus?
Any virus that has been shown to cause cancer
333
What are the four DNA viruses linked to cancer in humans?
* Human papillomavirus (HPV)
* Epstein-Barr virus (EBV)
* Human herpesvirus-8 (HHV-8)
* Hepatitis B virus (HBV)
334
How many genetically different types does HPV consist of?
Over 100
335
Which HPV types are strongly associated with cervical cancer?
* Type 16
* Type 18
336
What percentage of oropharyngeal cancers are associated with high-risk HPV?
At least 20%
337
Cervical cancer can be viewed as a _______.
[sexually transmitted disease]
338
What virus primarily targets B cells and is linked to several human cancers?
Epstein-Barr virus (EBV)
339
What four human cancers are associated with EBV?
* Burkitt lymphoma
* Nasopharyngeal cancer
* B-cell lymphomas in immunosuppressed individuals
* Some cases of Hodgkin lymphoma
340
What condition may an infected individual experience due to EBV?
Infectious mononucleosis (mono)
341
What is HHV-8 associated with?
Kaposi sarcoma (KS)
342
What type of cells does Kaposi sarcoma develop from?
Endothelial cells
343
In what population does Kaposi sarcoma most frequently occur?
Immunosuppressed individuals
344
What is the causative agent of hepatitis B?
Hepatitis B virus (HBV)
345
What percentage of individuals infected with HBV progress to chronic liver damage?
15-25%
346
What is the most frequent malignancy related to HIV infection?
Kaposi sarcoma (KS)
347
What liver condition can develop due to HBV infection?
Hepatocellular carcinoma
348
What percentage of hepatocellular cancers worldwide are due to HBV or HCV infection?
70-85%
349
What is likely the cause of cancer development associated with HBV?
Prolonged HBV-induced liver damage and regeneration
350
2.5 Clinical Manifestations, Diagnostics, and Treatments
351
What is the effect of cancer on tissues?
Cancer disrupts the integrity of tissues, leading to bleeding, ulceration, and necrosis.
## Footnote
Bleeding can sometimes be the first sign of cancer, as seen in colorectal cancer.
352
What initial signs can indicate the presence of certain cancers related to fluid?
Unusual amounts of fluid in the pleural, pericardial, or peritoneal spaces may indicate cancer.
## Footnote
Lung, breast, and lymphomas often present with pleural effusions.
353
What is cancer anorexia-cachexia syndrome?
A syndrome associated with weight loss, muscle tissue wasting, weakness, anorexia, and anemia in cancer patients.
## Footnote
It occurs mainly with solid tumors, except in cases of breast cancer.
354
What are common symptoms associated with cancer-related fatigue?
Tiredness, weakness, and lack of energy.
## Footnote
Symptoms can persist for months post-treatment.
355
What causes cancer-related anemia?
Blood loss, hemolysis, or impaired red blood cell production.
## Footnote
It can also be due to the effects of cancer treatment.
356
What are paraneoplastic syndromes?
Symptoms produced in sites not directly affected by cancer, often due to hormones secreted by cancer cells.
## Footnote
They can occasionally be seen with lung, breast, and hematologic malignancies.
357
Name three common endocrine syndromes related to paraneoplastic syndromes.
* Syndrome of inappropriate ADH secretion
* Cushing syndrome due to ectopic ACTH production
* Hypercalcemia
358
True or False: Cancer treatment side effects can be as severe as the symptoms of the disease itself.
True
359
What are common clinical manifestations of cancer?
* Disruption of tissues
* Fluid accumulation
* Wasting syndrome
* Fatigue
* Anemia
* Paraneoplastic syndromes
360
Fill in the blank: The wasting syndrome associated with cancer is called _______.
cancer anorexia-cachexia syndrome
361
What is a common consequence of cancer-related anemia?
Decreased performance and quality of life.
## Footnote
It can also lead to increased mortality and blood transfusions.
362
What is the purpose of screening in cancer prevention?
Early detection of cancer
## Footnote
Screening is a secondary prevention strategy that improves outcomes by identifying cancers early.
363
Name three methods used for cancer screening.
* Observation
* Palpation
* Laboratory tests and procedures
## Footnote
Examples include skin observation, breast palpation, and tests like Pap smear and mammography.
364
What is the significance of detecting cancer early?
Better outcomes are achieved
## Footnote
The sooner cancer is detected, the more effective treatment can be.
365
What is the screening criteria for lung cancer?
20-pack per year smoker and age 50 or older
## Footnote
Annual low dose chest CT scan is recommended for this group.
366
Is there a screening test for pancreatic cancer?
No, it still does not exist
## Footnote
Not all forms of cancer have available screening tests.
367
List methods used to diagnose and stage cancer.
* Blood tests for tumor markers
* Cytologic studies
* Tissue biopsy
* Endoscopic examinations
* Ultrasonography
* X-ray studies
* MRI
* CT
* PET scans
## Footnote
These methods vary based on the location and type of suspected cancer.
368
How do tumor markers present themselves?
* Antigens expressed on the surface of tumor cells
* Substances released from normal cells in response to a tumor
## Footnote
Tumor markers include hormones and enzymes that indicate the presence of cancer.
369
What is the role of tumor markers in cancer management?
* Establishing prognosis
* Monitoring treatment
* Detecting recurrent disease
## Footnote
Tumor markers can help assess response to therapy and monitor for recurrence.
370
What is the most well-known tumor marker for prostate cancer?
Prostate specific antigen (PSA)
## Footnote
PSA levels can be screened via a blood test.
371
True or False: Most tumor markers are elevated in early stages of malignancy.
False
## Footnote
Most markers are not elevated in the early stages of cancer.
372
Describe histologic and cytologic studies.
Laboratory methodologies to examine tissues and cells
## Footnote
These studies include cytologic smears, tissue biopsies, and needle aspiration.
373
What is the purpose of the Papanicolaou (Pap) test?
Detect cancer cells
## Footnote
Commonly used for cervical cancer screening.
374
What is tissue biopsy?
Removal of a tissue specimen for microscopic study
## Footnote
Essential for diagnosing the correct cancer and histology.
375
What are the methods to obtain a biopsy?
* Needle
* Endoscopic methods
* Laparoscopic methods
* Excisional biopsy
* Fine-needle aspiration
## Footnote
Different methods are used based on the tumor site.
376
What is immunohistochemistry?
Technique using antibodies to identify specific cell products or surface markers
## Footnote
Important for accurately identifying cancer types and guiding treatment.
377
What does microarray technology analyze?
Expression levels of a large number of genes
## Footnote
It detects molecular changes in cancer cells to determine behavior patterns.
378
What are the two main strategies for classifying cancers?
* Grading
* Staging
## Footnote
Grading assesses cellular characteristics, while staging assesses the clinical spread of the disease.
379
What does tumor grading involve?
Microscopic examination of cancer cells to determine differentiation
## Footnote
Cancers are classified as grades I, II, III, or IV.
380
What is the TNM system used for?
Classifying cancer stages
## Footnote
Developed by the American Joint Committee on Cancer (AJCC), it uses Tumor, Nodes, and Metastasis components.
381
What does 'Tx' signify in the TNM Classification System?
Tumor cannot be adequately assessed
## Footnote
'Tx' indicates that the primary tumor's status cannot be determined.
382
What does 'T0' represent in the TNM Classification System?
No evidence of primary tumor
## Footnote
'T0' indicates that there is no detectable primary tumor.
383
What does 'Tis' indicate in the TNM Classification System?
Progressive increase in tumor size or involvement
## Footnote
'Tis' refers to a tumor that is in situ, meaning it has not invaded surrounding tissues.
384
What does 'Nx' signify in the context of lymph nodes in the TNM Classification System?
Regional lymph nodes cannot be assessed
## Footnote
'Nx' indicates that the status of regional lymph nodes is unknown.
385
What does 'N0' mean in the TNM Classification System?
No evidence of regional node metastasis
## Footnote
'N0' indicates that there are no cancerous cells in the nearby lymph nodes.
386
What does 'N1-3' denote in the TNM Classification System?
Increasing involvement of regional lymph nodes
## Footnote
'N1-3' refers to various levels of metastasis to regional lymph nodes, with higher numbers indicating greater involvement.
387
What does 'Mx' represent in the TNM Classification System?
Not assessed
## Footnote
'Mx' indicates that the presence of distant metastasis has not been evaluated.
388
What does 'M0' signify in the TNM Classification System?
No distant metastasis
## Footnote
'M0' indicates that there is no spread of cancer to distant sites.
389
What does 'M1' indicate in the TNM Classification System?
Distant metastasis present, specify sites
## Footnote
'M1' indicates that cancer has spread to distant sites, which need to be identified.
390
What does the 'T' in the TNM Classification System refer to?
The size and local spread of the primary tumor
## Footnote
'T' assesses the characteristics of the primary tumor.
391
What does the 'N' in the TNM Classification System indicate?
The involvement of the regional lymph nodes
## Footnote
'N' evaluates whether cancer has spread to nearby lymph nodes.
392
What does the 'M' in the TNM Classification System represent?
The extent of the metastatic involvement
## Footnote
'M' assesses whether cancer has spread to distant parts of the body.
393
What are the three categories of goals in cancer treatment methods?
Curative, control, and palliative
394
List the common methods used to achieve cancer treatment goals.
* Surgery
* Radiation therapy
* Chemotherapy
* Hormonal therapy
* Biotherapy
395
What factors influence the type of surgery performed for cancer treatment?
* Extent of disease
* Location
* Structures involved
* Tumor growth rate and invasiveness
* Surgical risk to the patient
* Quality of life post-surgery
396
What is the primary purpose of surgery in cancer treatment?
To remove cancer, diagnose, stage, and provide palliation
397
What is palliative surgery?
Surgery performed to relieve symptoms when a cure is not possible
398
True or False: Radiation therapy can only be used as a primary treatment method.
False
399
What are the primary effects of radiation therapy on cancer cells?
It destroys or damages cancer cells by creating free radicals and interrupting the cell cycle
400
What is the most common side effect of radiation therapy?
Skin irritation
401
How does chemotherapy work?
It uses drugs to prevent cell growth and replication by halting protein, DNA, and RNA synthesis
402
Chemotherapy drugs can be classified into which two major categories?
* Direct DNA-interacting agents
* Indirect DNA-interacting agents
403
What is an example of a cell-cycle specific chemotherapy drug?
Methotrexate
404
What are common side effects of chemotherapy?
* Neutropenia
* Anemia
* Thrombocytopenia
* Anorexia
* Nausea
* Vomiting
* Alopecia
405
What is the goal of hormonal therapy in cancer treatment?
To deprive cancer cells of hormonal signals that stimulate division
406
Which cancers are typically responsive to hormonal therapy?
* Breast
* Prostate
* Endometrium
407
What is biotherapy in cancer treatment?
It uses immunotherapy and biologic response modifiers to enhance the immune response to cancer
408
What are monoclonal antibodies (mAbs)?
Highly specific antibodies made from cloned cells
409
What is the role of rituximab in cancer treatment?
Targets CD20 antigen on B cells to treat non-Hodgkin lymphoma
410
Fill in the blank: Chemotherapy is a _______ treatment that uses drugs to reach the tumor site.
systemic
411
What is the function of anti-hormone drugs in hormonal therapy?
They bind to hormone receptors without stimulating them, blocking future signaling
412
True or False: Radiation therapy exclusively targets cancer cells.
False
413
What is the purpose of administering hematopoietic growth factors during chemotherapy?
To combat bone marrow suppression and restore blood cell levels
414
What is the primary role of hormonal therapy in prostate cancer treatment?
To suppress circulating hormone levels or alter hormone receptors
415
What are the primary types of drugs used in chemotherapy?
* Alkylating agents
* Antitumor antibiotics
* Topoisomerase inhibitors
* Antimetabolites
* Mitotic spindle inhibitors
